CN111743608B

CN111743608B - Device and system for CT guided puncture

Info

Publication number: CN111743608B
Application number: CN202010683572.XA
Authority: CN
Inventors: 徐晓磊
Original assignee: Sinovision Technology Beijing Co ltd
Current assignee: Sinovision Technology Beijing Co ltd
Priority date: 2020-07-15
Filing date: 2020-07-15
Publication date: 2021-07-02
Anticipated expiration: 2040-07-15
Also published as: CN111743608A

Abstract

The application discloses a method, a device and a system for CT guided puncture. The method of the application comprises the steps of receiving puncture needle inserting path information; taking the focus position as a scanning center, and controlling the motion of a CT scanning frame according to the information of the puncture needle insertion path, wherein the motion forms comprise movement and inclination; the puncture needle-inserting point and the puncture guide angle are marked by a laser lamp on the CT scanning frame. The application provides a new CT guided puncture mode to solve at least one of the defects of time consumption, complex operation, larger radiation dose of a patient, complex structure and the like in the existing CT guided puncture mode.

Description

Device and system for CT guided puncture

Technical Field

The application relates to the technical field of CT scanning, in particular to a method, a device and a system for CT guided puncture.

Background

CT guided needle technique has been widely used in clinical practice, including needle biopsy and needle ablation. The CT-guided puncture is generally based on the conventional CT, i.e. the CT scanning frame is fixed on the ground, and the patient is carried by the CT examination table to move up and down and back and forth. The biggest challenge of CT guided puncture is the precision control of puncture needle feeding point and puncture angle.

The traditional CT guided puncture mode is to position the patient at the center of the CT scanning frame. On the basis of the tomogram, the lesion position is determined. The puncture needle-inserting point is marked on the body of the patient by adopting a laser positioning lamp and an auxiliary grating which are inherent on the CT machine and controlling the in and out of the examining table. The puncture angle is established based on the lesion position and the puncture needle insertion point of the tomographic image, but in practice, there is no guidance of the puncture angle. The method has the remarkable defects that: firstly, the in-and-out and scanning confirmation of a CT scanning bed are controlled repeatedly, the efficiency is low, and the radiation dose is high; secondly, the needle insertion angle is not guided, the puncture precision is poor, and complications are easy to cause.

Therefore, various methods are proposed in the prior art, and attempts are made to solve the above defects, and the main solutions include three methods, namely laser guidance, electromagnetic guidance and fixed support guidance. When the laser guide mode is used for a multi-point puncture task, the position of the laser source needs to be frequently adjusted, so that time is consumed, and the efficiency is low; the electromagnetic guidance mode is that the relative position of the target area is transmitted to an electromagnetic navigation system through an electromagnetic induction sheet attached to the body surface of a patient, and the puncture path is planned and guided through the electromagnetic navigation system, so that the puncture path is not suitable for microwave ablation, cryoablation and other occasions, and has the problems of high price, complex operation and easy environmental influence; the fixed support has more complex guide mode and more components, and is mostly provided with a support, a fixed plate and the like for two grids or fixed on a larger puncture needle support of a CT examining table, and the puncture angle can not be determined.

In summary, the conventional CT guided puncture methods have some drawbacks, and therefore, it is necessary to provide a new CT guided puncture method to solve the above-mentioned drawbacks of the conventional methods.

Disclosure of Invention

The present application is directed to a method, an apparatus and a system for CT-guided puncture, which provides a new CT-guided puncture method to solve at least one of the above-mentioned drawbacks of the conventional methods.

To achieve the above object, according to a first aspect of the present application, a method of CT guided puncture is provided.

The method for CT guided puncture according to the application comprises the following steps:

receiving puncture needle insertion path information;

controlling the motion of a CT scanning frame by taking the focus position as a scanning center according to the information of the puncture needle insertion path;

the puncture needle-inserting point and the puncture guide angle are marked by a laser lamp on the CT scanning frame.

Optionally, the laser lamp includes the laser lamp of three direction, and three direction is X, Y, Z axle directions of original CT coordinate system respectively, laser lamp mark puncture needle point and puncture guide angle through on the CT scan frame include:

marking the intersection points of the laser lamps in the Z-axis direction and the X-axis direction on the body surface of the patient as puncture needle insertion points;

and marking the direction of the laser lamp passing through the Y-axis direction of the needle inlet point as a puncture guiding direction.

Optionally, before receiving the puncture needle path information, the method further includes:

after the position of the focus is determined in the first tomography, the coordinate of the position of the focus is received and adjusted to be the scanning center.

and determining a puncture needle inserting path based on the focus and surrounding tissue structure information acquired by the first tomography, wherein the puncture needle inserting path at least comprises a needle inserting point, a needle inserting angle and a needle inserting depth.

In order to achieve the above object, according to a second aspect of the present application, there is provided a CT-guided puncture device.

The device for CT guided puncture according to the application comprises:

the receiving unit is used for receiving information of a puncture needle inserting path;

the control unit is used for controlling the motion of the CT scanning frame by taking the focus position as a scanning center according to the information of the puncture needle inserting path;

and the marking unit is used for marking a puncture needle inserting point and a puncture guiding angle through a laser lamp on the CT scanning frame.

Optionally, the laser light includes laser lights in three directions, the three directions are respectively X, Y, Z axes directions of the original CT coordinate system, and the marking unit includes:

the first marking module is used for marking the intersection points of the laser lamps in the Z-axis direction and the X-axis direction on the body surface of the patient as puncture needle insertion points;

and the second marking module is used for marking the direction of the laser lamp passing through the Y-axis direction of the needle inlet point as a puncture guiding direction.

Optionally, the apparatus further comprises:

and the adjusting unit is used for receiving the coordinates of the focus position and adjusting the coordinates to be the scanning center after the focus position is determined in the first tomography before the information of the puncture needle inserting path is received.

Optionally, the apparatus further comprises:

the determination unit is used for determining a puncture needle inserting path based on the focus and surrounding tissue structure information acquired by the first tomography before receiving the puncture needle inserting path information, and the puncture needle inserting path at least comprises a needle inserting point, a needle inserting angle and a needle inserting depth.

In order to achieve the above object, according to a third aspect of the present application, there is provided a CT guided puncture system including an examination couch, a movable CT gantry, the system further including a control terminal:

the control terminal is configured to execute the CT-guided puncture method according to any one of the first aspect;

and the movable CT scanning frame is used for receiving the control information sent by the control terminal and moving according to the control information.

To achieve the above object, according to a fourth aspect of the present application, there is provided a non-transitory computer-readable storage medium, characterized in that the non-transitory computer-readable storage medium stores computer instructions that cause the computer to execute the method of CT-guided puncture of any one of the above first aspects.

In the method, the device and the system for CT guided puncture, the CT scanning frame is a movable CT scanning frame. When puncture guidance is performed, firstly, puncture needle insertion path information is received; then taking the focus position as a scanning center, and controlling the motion of a CT scanning frame according to the information of the puncture needle insertion path; and finally, marking a puncture needle inserting point and a puncture guide angle through a laser lamp on the CT scanning frame. It can be seen that, in the present application, the guidance of the puncture needle insertion point and the puncture needle insertion angle is performed in a laser guidance manner, which is different from the existing laser guidance manner in that the focus position is used as the scanning center, the motion of the CT scanning frame is controlled according to the puncture needle insertion path information, and then the puncture needle insertion point and the puncture guide angle are directly marked according to the laser lamp on the CT scanning frame. The position of the laser source does not need to be frequently adjusted, and the efficiency is improved to a certain extent.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this application, serve to provide a further understanding of the application and to enable other features, objects, and advantages of the application to be more apparent. The drawings and their description illustrate the embodiments of the invention and do not limit it. In the drawings:

FIG. 1 is a flow chart of a method of CT guided puncture according to one embodiment provided herein;

FIG. 2 is a schematic view of a CT gantry tilted with a lesion position as a scan center according to the present application;

FIG. 3 is a schematic view of the X, Y, Z axis orientation of an original CT coordinate system provided in accordance with the present application;

FIG. 4 is a schematic view of marking the needle insertion point and the needle guidance angle by a laser lamp on a CT gantry according to the present application;

FIG. 5 is a schematic view of a CT guided puncture provided in accordance with the present application;

FIG. 6 is a block diagram of the components of a CT guided puncture device provided in accordance with the present application;

fig. 7 is a block diagram of another CT guided puncture device provided in accordance with the present application.

Detailed Description

In order to make the technical solutions better understood by those skilled in the art, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only partial embodiments of the present application, but not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.

It should be noted that the terms "first," "second," and the like in the description and claims of this application and in the drawings described above are used for distinguishing between similar elements and not necessarily for describing a particular sequential or chronological order. It should be understood that the data so used may be interchanged under appropriate circumstances such that embodiments of the application described herein may be used. Furthermore, the terms "comprises," "comprising," and "having," and any variations thereof, are intended to cover a non-exclusive inclusion, such that a process, method, system, article, or apparatus that comprises a list of steps or elements is not necessarily limited to those steps or elements expressly listed, but may include other steps or elements not expressly listed or inherent to such process, method, article, or apparatus.

It should be noted that the embodiments and features of the embodiments in the present application may be combined with each other without conflict. The present application will be described in detail below with reference to the embodiments with reference to the attached drawings.

According to an embodiment of the present application, there is provided a CT-guided puncture method, as shown in fig. 1, including steps S101 to S103 as follows:

s101, receiving puncture needle inserting path information.

The puncture needle insertion path information can be determined according to the lesion and the surrounding tissue structure information. The puncture needle insertion path information includes information of a needle insertion point, a needle insertion angle, a needle insertion depth, and the like, and the specific determination method is not limited in this embodiment, and information of the needle insertion point, the needle insertion angle, the needle insertion depth, and the like may be planned for any determination method in the prior art, for example, image recognition based on a neural network, or a manual marking, and the like. The key of this embodiment is how to perform subsequent puncture guidance by using the puncture needle insertion path information, and how to acquire the puncture needle insertion path information is not limited, as long as the puncture needle insertion path information can be acquired.

And S102, controlling the motion of the CT scanning frame by taking the focus position as a scanning center according to the information of the puncture needle inserting path.

Before the step, a focus area needs to be determined firstly, the focus area can be determined through first CT tomography, a specific determination mode is not limited, and artificial intelligence algorithms (such as neural network classification algorithms and the like) can be used. In addition, after the lesion area is determined, the optimal level position needs to be determined by a doctor, and finally the position of the lesion corresponding to the optimal level position is determined, so that the coordinates of the lesion position can be acquired and then used as the scanning center. The coordinates of the lesion position, i.e., the coordinates of the lesion position, are converted to zero coordinates of a new coordinate system, i.e., the scanning center, using the lesion position as the scanning center. The coordinate system at the time of scanning in this step is not the original coordinate system at the time of CT tomographic scanning when lesion determination is performed, and adjustment of the coordinate system (adjustment of zero point coordinates) is necessary.

After the coordinate system is adjusted, the coordinates of the needle insertion point in the corresponding puncture needle insertion path information may also need to be adjusted correspondingly. The needle insertion angle and the needle insertion depth are not changed by adjusting the coordinate system, so that adjustment is not needed.

After adjustment, the focus position is taken as a scanning center, and the motion of the CT scanning frame is controlled according to the information of the puncture needle inserting path. The specific motion of the CT scanning frame comprises moving and inclining, the motion direction comprises front, back, left and right, and the scanning center is always kept unchanged during the motion. In addition, it should be noted that the CT gantry in the present application is a movable CT gantry, and the conventional movable CT examination table is changed in the present application, so that the patient can be better kept relatively still by moving the CT gantry, and the puncture surgery error caused by the position change is reduced. Specifically, as shown in fig. 2, a schematic diagram of the embodiment is provided, in which the position of the lesion is used as the scanning center and the CT gantry is tilted, and the center of the lesion in fig. 2 is the center of the position of the lesion or the scanning center in the embodiment.

And S103, marking a puncture needle inserting point and a puncture guiding angle through a laser lamp on the CT scanning frame.

There are three directional laser lights on the CT gantry, which are respectively X, Y, Z axial directions of the original CT coordinate system (as shown in fig. 3). The laser lamps in three directions are arranged in the rotating part of the scanning frame, and the rotation control of 0-360 degrees can be realized. The positioning logic follows the puncture path, including the needle entry point and the tilt angle. Compared with the traditional laser lamp which can only play a positioning role at a fixed position, the laser lamp is more flexible and has higher efficiency, and the laser lamp is also one embodiment of the invention point of the application. The laser lamp on the CT scanning frame marks the puncture needle inlet point and the puncture guide angle, and the method specifically comprises the following steps: as shown in fig. 4, after the CT scanning frame is tilted according to the puncture needle insertion path information, the CT scanning frame is kept still, and the intersection point of the laser lamps in the Z-axis direction and the X-axis direction on the body surface of the patient is marked as a puncture needle insertion point, and the specific body surface of the patient is the focus body surface position; the direction of the laser lamp passing through the Y-axis direction of the needle insertion point (vertical to the plane formed by the X and the Z) is marked as the puncture guiding direction. It should be noted that the puncture guiding laser lamp in fig. 4 is a laser lamp in the Y-axis direction.

From the above description, it can be seen that, in the method for CT guided puncture in the embodiment of the present application, the CT gantry is a movable CT gantry. When puncture guidance is performed, firstly, puncture needle insertion path information is received; then taking the focus position as a scanning center, and controlling the motion of a CT scanning frame according to the information of the puncture needle insertion path; and finally, marking a puncture needle inserting point and a puncture guide angle through a laser lamp on the CT scanning frame. It can be seen that, in the present application, the guidance of the puncture needle insertion point and the puncture needle insertion angle is performed in a laser guidance manner, which is different from the existing laser guidance manner in that the focus position is used as the scanning center, the motion of the CT scanning frame is controlled according to the puncture needle insertion path information, and then the puncture needle insertion point and the puncture guide angle are directly marked according to the laser lamp on the CT scanning frame. The position of the laser source does not need to be frequently adjusted, and the efficiency is improved to a certain extent.

Further, as a supplementary description of the above embodiment, another procedure of CT-guided puncture is provided, which is specifically as follows. Fig. 5 is a schematic view of CT-guided puncture provided in this embodiment.

1. ISO center (i.e. center of gantry circle) coordinates of original CT (x =0 y =0 z = 0)

2. Based on the original CT coordinate system, scanning to obtain the coordinates of the patient's lesion (X1, Y1, Z1)

3. Based on the acquired image of the original CT, a puncture path is planned, and the puncture path comprises a focus maximum layer, focus center measurement, a needle inserting point, a needle inserting angle, needle inserting depth and the like.

4. And determining the moving distance of the CT scanning frame in the Z direction (namely the foot-head position of the human body) according to the value of the difference in the Z direction (Z1-Z). Conventional CT is achieved by moving the patient (couch), and we design to keep the patient still, the moving CT gantry approach solves this problem.

5. According to the included angle between the puncture path and the Z direction, determining the inclination angle of the CT scanning frame from the original zero position to the Z direction; and determining the initial positioning angle of the CT scanning frame according to the included angle between the puncture path and the Y direction, namely rotating the internal laser positioning lamp to enable the Y direction laser lamp to coincide with the bed entering path.

Here, it relates both to the movement and tilting of the gantry and to the gantry internal rotation system (laser light control)

It should be noted that the steps illustrated in the flowcharts of the figures may be performed in a computer system such as a set of computer-executable instructions and that, although a logical order is illustrated in the flowcharts, in some cases, the steps illustrated or described may be performed in an order different than presented herein.

There is also provided, in accordance with an embodiment of the present application, apparatus for CT guided puncture for carrying out the method of fig. 1 described above, as shown in fig. 6, the apparatus including:

a receiving unit 21 for receiving information of a puncture needle insertion path;

the control unit 22 is used for controlling the motion of the CT scanning frame by taking the focus position as a scanning center according to the information of the puncture needle inserting path;

and the marking unit 23 is used for marking a puncture needle inserting point and a puncture guiding angle through a laser lamp on the CT scanning frame.

Specifically, the specific process of implementing the functions of each module in the apparatus in the embodiment of the present application may refer to the related description in the method embodiment, and is not described herein again.

From the above description, it can be seen that, in the apparatus for CT guided puncture in the embodiment of the present application, the CT gantry is a movable CT gantry. When puncture guidance is performed, firstly, puncture needle insertion path information is received; then taking the focus position as a scanning center, and controlling the motion of a CT scanning frame according to the information of the puncture needle insertion path; and finally, marking a puncture needle inserting point and a puncture guide angle through a laser lamp on the CT scanning frame. It can be seen that, in the present application, the guidance of the puncture needle insertion point and the puncture needle insertion angle is performed in a laser guidance manner, which is different from the existing laser guidance manner in that the focus position is used as the scanning center, the motion of the CT scanning frame is controlled according to the puncture needle insertion path information, and then the puncture needle insertion point and the puncture guide angle are directly marked according to the laser lamp on the CT scanning frame. The position of the laser source does not need to be frequently adjusted, and the efficiency is improved to a certain extent.

Further, as shown in fig. 7, the laser lamp includes three directions, which are X, Y, Z-axis directions of the original CT coordinate system, respectively, and the marking unit 23 includes:

the first marking module 231 is used for marking the intersection points of the laser lamps in the Z-axis direction and the X-axis direction on the body surface of the patient as puncture needle insertion points;

and a second marking module 232 for marking the direction of the laser light passing through the Y-axis direction of the needle insertion point as a puncture guiding direction.

Further, as shown in fig. 7, the apparatus further includes:

and an adjusting unit 24, configured to receive coordinates of a lesion position after determining the position of the lesion in the first tomography before receiving the information of the puncture needle insertion path, and adjust the coordinates to a scanning center.

Further, as shown in fig. 7, the apparatus further includes:

a determining unit 25, configured to determine a puncture needle insertion path based on the lesion and surrounding tissue structure information acquired by the first tomography before receiving the puncture needle insertion path information, where the puncture needle insertion path at least includes a needle insertion point, a needle insertion angle, and a needle insertion depth.

According to the embodiment of the present application, there is also provided a system for CT guided puncture, including an examining table and a movable CT scanning frame, wherein the system further includes a control terminal:

the control terminal is used for executing the method for CT guided puncture described in the figure 1;

From the above description, it can be seen that, in the system for CT guided puncture in the embodiment of the present application, the CT gantry is a movable CT gantry. When puncture guidance is performed, firstly, puncture needle insertion path information is received; then taking the focus position as a scanning center, and controlling the motion of a CT scanning frame according to the information of the puncture needle insertion path; and finally, marking a puncture needle inserting point and a puncture guide angle through a laser lamp on the CT scanning frame. It can be seen that, in the present application, the guidance of the puncture needle insertion point and the puncture needle insertion angle is performed in a laser guidance manner, which is different from the existing laser guidance manner in that the focus position is used as the scanning center, the motion of the CT scanning frame is controlled according to the puncture needle insertion path information, and then the puncture needle insertion point and the puncture guide angle are directly marked according to the laser lamp on the CT scanning frame. The position of the laser source does not need to be frequently adjusted, and the efficiency is improved to a certain extent.

There is also provided, in accordance with an embodiment of the present application, a non-transitory computer-readable storage medium storing computer instructions for causing a computer to perform any of the CT-guided puncture methods of fig. 1.

It will be apparent to those skilled in the art that the modules or steps of the present application described above may be implemented by a general purpose computing device, they may be centralized on a single computing device or distributed across a network of multiple computing devices, and they may alternatively be implemented by program code executable by a computing device, such that they may be stored in a storage device and executed by a computing device, or fabricated separately as individual integrated circuit modules, or fabricated as a single integrated circuit module from multiple modules or steps. Thus, the present application is not limited to any specific combination of hardware and software.

The above description is only a preferred embodiment of the present application and is not intended to limit the present application, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, improvement and the like made within the spirit and principle of the present application shall be included in the protection scope of the present application.

Claims

1. A CT-guided puncture apparatus, wherein the CT gantry is a movable CT gantry, the apparatus comprising:

the control unit is used for controlling the motion of the CT scanning frame according to the information of the puncture needle inserting path by taking the focus position as a scanning center, and the examining table is always kept still in the scanning process;

the marking unit is used for marking a puncture needle inserting point and a puncture guide angle through a laser lamp on the CT scanning frame;

the motion of the CT scanning frame comprises movement and inclination, the motion direction comprises front, back, left and right, and the scanning center is always kept unchanged during the motion;

the CT scanning frame is provided with laser lamps in three directions, the three directions are respectively the X-axis direction, the Y-axis direction and the Z-axis direction of an original CT coordinate system, and the laser lamps in the three directions are positioned in a rotating part of the scanning frame;

the marking unit includes:

the first marking module is used for keeping the CT scanning frame still after the CT scanning frame inclines according to the puncture needle inserting path information, and marking the intersection points of the laser lamps in the Z-axis direction and the X-axis direction on the body surface of the patient as puncture needle inserting points;

the second marking module is used for marking the direction of the laser lamp passing through the needle inlet point in the Y-axis direction as a puncture guiding direction, and the Y-axis direction is a direction vertical to a plane formed by the X-axis direction and the Z-axis direction;

the device further comprises:

2. The CT-guided puncture device according to claim 1, further comprising:

3. A system for CT guided puncture is characterized by comprising an examination bed and a movable CT scanning frame, and further comprising a control terminal:

the control terminal is used for executing a CT guided puncture method, and the method comprises the following steps:

the receiving unit receives information of a puncture needle inserting path;

the control unit takes the coordinate of the focus position determined by the CT tomography image as the scanning center, controls the motion of the CT scanning frame according to the puncture needle insertion path information, and keeps the examining table still all the time in the scanning process;

the marking unit marks a puncture needle inserting point and a puncture guide angle through a laser lamp on the CT scanning frame;

the laser lamp mark puncture needle inlet point and puncture guide angle on the CT scanning frame include:

when the CT scanning frame inclines according to the puncture needle insertion path information, keeping the CT scanning frame still, and marking the intersection points of the laser lamps in the Z-axis direction and the X-axis direction on the body surface of the patient as puncture needle insertion points; marking the direction of the laser lamp in the Y-axis direction passing through the needle inlet point as a puncture guiding direction, wherein the Y-axis direction is a direction vertical to a plane formed by the X-axis direction and the Z-axis direction;

before receiving the puncture needle path information, the method further comprises:

after the position of a focus is determined in the first tomography, receiving the coordinate of the position of the focus and adjusting the coordinate to be a scanning center;

4. The system of CT guided puncture according to claim 3, wherein prior to receiving puncture needle path information, the method further comprises:

5. A non-transitory computer readable storage medium storing computer instructions that cause a computer to perform a method of CT guided puncture, the method comprising:

the receiving unit receives information of a puncture needle inserting path;

the control unit takes the coordinate of the focus position determined by the CT tomography image as the scanning center, controls the motion of a CT scanning frame according to the puncture needle insertion path information, the CT scanning frame is a movable CT scanning frame, and the examining table is always kept still in the scanning process;

6. The non-transitory computer-readable storage medium of claim 5, wherein prior to receiving puncture needle path information, the method further comprises: