CN112603535A - Real-time stereo display system for craniocerebral intervention operation - Google Patents

Real-time stereo display system for craniocerebral intervention operation Download PDF

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CN112603535A
CN112603535A CN202011597977.8A CN202011597977A CN112603535A CN 112603535 A CN112603535 A CN 112603535A CN 202011597977 A CN202011597977 A CN 202011597977A CN 112603535 A CN112603535 A CN 112603535A
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许侃
庞晓丽
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First Hospital Jinlin University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361Image-producing devices, e.g. surgical cameras
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107Visualisation of planned trajectories or target regions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/108Computer aided selection or customisation of medical implants or cutting guides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2065Tracking using image or pattern recognition

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Abstract

The invention discloses a real-time three-dimensional display system for a craniocerebral interventional operation, which relates to the field of medical image processing and clinical medicine and solves the problems that in the current craniocerebral interventional operation process, the position and the trend of a guide wire in a blood vessel of a patient are observed from two angles through a front side X-ray film and the observed position deviation exists. The system can register and fuse the three-dimensional structure of the cerebral vessel of the patient and the real-time three-dimensional position of the guide wire, thereby displaying the position of the guide wire in the three-dimensional structure of the cerebral vessel in real time, greatly improving the space three-dimensional display effect of the guide wire, and being particularly beneficial to a doctor to quickly and accurately judge the position relationship between the guide wire and the vessel. The system can realize the display of the three-dimensional structure of the cerebral vessels and the real-time tracking of the three-dimensional position of the guide wire, thereby solving the problem that the three-dimensional position of the guide wire can not be accurately judged under a two-dimensional image.

Description

Real-time stereo display system for craniocerebral intervention operation
Technical Field
The invention relates to the field of medical image processing and clinical medicine, in particular to a real-time three-dimensional display system for craniocerebral interventional operation.
Background
Cerebrovascular disease is a high-grade disease, and has the characteristics of high disability rate and high death rate. At present, the examination of cerebrovascular diseases mainly relies on a digital subtraction technique, which can perform transmission imaging on human tissues and remove unnecessary unrelated tissues to leave only tissues such as blood vessels, and is called angiography. Angiography is completed by digital subtraction equipment in an X-ray two-dimensional environment, and a doctor cannot obtain sensory information such as size, distance and the like of a real scene due to the fact that a two-dimensional image lacks corresponding depth information.
Three-dimensional display technology has advanced dramatically in recent years and is widely applied to many fields. At home and abroad, teams begin to make preliminary attempts in the medical field, the development of diagnosis and treatment technology and medical education is greatly promoted, and the concept of the current precise medicine is not matched.
However, the existing three-dimensional display device is not matched with the existing information acquisition device such as a digital subtraction device, and the information of the digital subtraction device cannot be directly displayed on the three-dimensional display device, so that further image processing, information extraction and fusion, three-dimensional encoding of images and the like are required, and finally, the images can be displayed on the three-dimensional display device.
Disclosure of Invention
The invention provides a real-time three-dimensional display system for a craniocerebral interventional operation, aiming at solving the problems that the position and the trend of a guide wire in a blood vessel of a patient are observed from two angles through a front side view X-ray film in the current craniocerebral interventional operation process, the observed position deviation exists and the like.
The real-time stereo display system for craniocerebral intervention operation comprises a DSA image acquisition system, a two-dimensional guide wire extraction system, a three-dimensional guide wire calculation system and a stereo display system;
the DSA image acquisition system acquires a three-dimensional image of the cerebral vessel in advance and transmits the three-dimensional image to the three-dimensional guide wire calculation system and the three-dimensional display system; collecting guide wire front-view images and side-view images in real time, and transmitting the guide wire front-view images and the side-view images to a two-dimensional guide wire extraction system and a three-dimensional guide wire calculation system;
the two-dimensional guide wire extraction system receives a front-view image and a side-view image provided by the DSA image acquisition system, extracts two-dimensional positions of the guide wire from the front-view image and the side-view image respectively, and transmits the two-dimensional positions to the three-dimensional guide wire calculation system;
the three-dimensional guide wire calculation system firstly receives a cerebral blood vessel three-dimensional image of the DSA image acquisition system, displays the cerebral blood vessel three-dimensional image in a three-dimensional coordinate system, and manually selects a metal mark point in the three-dimensional coordinate system;
then, displaying the front-view image and the side-view image of the DSA image acquisition system in the three-dimensional coordinate system, respectively selecting metal mark points in the front-view image and the side-view image, and carrying out two-dimensional and three-dimensional combined calibration to obtain the position relationship of the cerebrovascular three-dimensional image and the front-view image and the side-view image in the space;
the three-dimensional guide wire computing system receives the two-dimensional guide wire coordinate data transmitted by the two-dimensional guide wire extracting system in real time after being calibrated through two-dimensional and three-dimensional combination, is used for computing the three-dimensional curve coordinate of the guide wire and transmits the data of the three-dimensional curve coordinate to the three-dimensional display system;
and the stereo display system displays the cerebrovascular three-dimensional image fused with the DSA image acquisition system and the three-dimensional guide wire space curve of the three-dimensional guide wire calculation system in the same coordinate system and performs polarization three-dimensional display.
The invention has the beneficial effects that: the real-time three-dimensional display system for the craniocerebral interventional operation fuses and codes various collected information so as to carry out three-dimensional display. The system can register and fuse the three-dimensional structure of the cerebral vessel of the patient and the real-time three-dimensional position of the guide wire, thereby displaying the position of the guide wire in the three-dimensional structure of the cerebral vessel in real time, greatly improving the space three-dimensional display effect of the guide wire, and being particularly beneficial to a doctor to quickly and accurately judge the position relationship between the guide wire and the vessel.
The invention relates to a real-time three-dimensional display system for craniocerebral interventional operation, which can display the three-dimensional position of a catheter in a three-dimensional structure of a cerebral vessel in real time. The system can realize the display of a three-dimensional structure of the cerebral vessels and the real-time tracking of the three-dimensional position of the guide wire, thereby solving the problem that the three-dimensional position of the guide wire can not be accurately judged under a two-dimensional image.
The stereo display system is beneficial to dynamically observing the stereo structure of cerebral artery and the real-time three-dimensional position of the guide wire in the cerebral vessel in real time, and solves the problems that the three-dimensional position of the guide wire and the three-dimensional trend of the cerebral vessel cannot be accurately judged under a two-dimensional image and the like.
Drawings
FIG. 1 is a block diagram of the overall data flow and system architecture of a real-time stereoscopic display system for craniocerebral interventional procedures according to the present invention;
FIG. 2 is a flow chart of a three-dimensional guidewire computing system according to the present invention;
Detailed Description
In the first embodiment, the embodiment is described with reference to fig. 1 to 2, and the real-time stereo display system for craniocerebral intervention operation displays the true three-dimensional data of the guide wire and the blood vessel by using stereo vision display equipment, so that a doctor can observe the relative position relationship between the guide wire and the blood vessel in real time only by wearing stereo display glasses, and can better judge the trend of the guide wire in the blood vessel. The three-dimensional guide wire three-dimensional display system comprises a DSA image acquisition system, a two-dimensional guide wire extraction system and a three-dimensional guide wire calculation system.
The DSA image acquisition system acquires a three-dimensional image of the cerebral vessel in advance and transmits the three-dimensional image to the three-dimensional guide wire calculation system and the three-dimensional display system;
the DSA image acquisition system also needs to acquire a guide wire front-view image and a side-view image in real time and transmit the guide wire front-view image and the side-view image to a two-dimensional guide wire extraction system and a three-dimensional guide wire calculation system;
since we subsequently perform two-dimensional and three-dimensional joint calibration, the patient has to place a certain number of metal marker points at different positions of the head before operation. The number of the mark points is not less than 3, the material is lead or iron and other metals which are not easy to penetrate by X-rays, and the mark points are randomly placed on the head of the patient. Therefore, in the three-dimensional image of the cerebral vessels and the front side view image of the guide wire, the metal marking points can be obviously seen, and the subsequent point selection of a doctor is facilitated;
the two-dimensional guide wire extraction system receives a front side view image provided by the DSA image acquisition system, extracts a two-dimensional position (a two-dimensional curve formed by closely-connected pixel points) of the guide wire from the front side view image, and transmits the two-dimensional position to the three-dimensional guide wire calculation system;
the three-dimensional guide wire computing system is the most central component of the invention. Firstly, receiving a cerebral blood vessel three-dimensional image of a DSA image acquisition system (wherein metal mark points can be obviously seen), displaying the cerebral blood vessel three-dimensional image in a three-dimensional coordinate system, and manually clicking the metal mark points.
Then, the front side view image of the DSA image acquisition system is also displayed in the coordinate system, and the physician selects the metal marker points in the front side view image respectively, so that a one-to-one correspondence relationship is established between the metal marker points in the three-dimensional image of the cerebral vessels and the metal marker points in the front side view image, and subsequent calibration is facilitated. Note that the clicking process is only performed after the cerebrovascular three-dimensional image and the first front-side view image are received, and the mark point does not need to be clicked again in the subsequent real-time stereo display process;
after the metal mark points are respectively and correspondingly selected from the three-dimensional image of the cerebral vessel and the front side-view two-dimensional image, the two-dimensional and three-dimensional combined calibration is carried out. The core purpose is to calculate the three-dimensional space position of the X-ray emission source of the front side view image. Once this position is available, the three-dimensional position of the guide wire can be calculated in real time based on several key parameters provided in the front side view data (medical image data in Dicom format). These key parameters include: the length of each pixel in the X and y directions in the data in the actual physical space (imagepixelspating), the distance between the X-ray emission source and the X-ray receiver (discrete source detector), the angle between the line between the X-ray emission source and the center of the X-ray receiver and the body of the patient (positionerprimary angle);
in order to calculate the three-dimensional spatial position (set as S, a three-dimensional coordinate) of the X-ray emission source in the front side view image, a numerical optimization approach is adopted. First, given an initial estimate of S, a ray is introduced from this initial value to the three-dimensional coordinates of each metal marker point (selected from the three-dimensional image of the cerebral blood vessel), and the intersection of these rays with the front side view image is the projection of the three-dimensional metal marker point in the front side view under the current S value configuration. Since the current S value is not accurate, the coordinates of the metal mark points calculated by projection are also inaccurate, which usually have a large difference from the metal mark points already selected in the front-side view image. For this purpose, the sum of squares of distances between these metal mark points calculated by projection and the real metal mark points is taken as an objective function F, the S value is taken as an optimization variable, and a numerical optimization algorithm is used to maximize the reduction F value (ideally, the F value is 0). And when the optimization process is finished, the obtained S value is the real position of the X-ray source in the three-dimensional coordinate system. The optimization algorithm uses the slslsrp algorithm.
And the three-dimensional guide wire computing system receives the two-dimensional guide wire coordinate data transmitted by the two-dimensional guide wire extracting system in real time after acquiring the real three-dimensional space position of the X-ray emission source in the front side view through two-dimensional and three-dimensional combined calibration. The data is a two-dimensional curve composed of a series of pixel coordinates, meaning the pixels of the guidewire in the front side view image. And then, the front side view image is placed in a correct three-dimensional space through the S value calculated in the calibration process, and at the moment, the two-dimensional guide wire data have the coordinates of a third dimension and become a projection curve of the real guide wire in the front side view image. Connecting the S and guide wire projection curves in a front side view configuration, respectively, two spatial polygons (P1, P2) are obtained, the geometrical meaning of which is the line between the X-ray emission source and the guide wire. A key fact is noted: in both front and side views, the common part of these connecting lines must be exactly the three-dimensional position of the guide wire in space, so that only the intersection operation of P1 and P2 is needed, and the resulting three-dimensional space curve is exactly the position of the guide wire in three-dimensional space. Then, the data of the three-dimensional curve is transmitted to a stereo display system;
the three-dimensional display system fuses the cerebral blood vessel three-dimensional image from the DSA acquisition system and the three-dimensional guide wire space curve from the three-dimensional guide wire calculation system, displays the two images in the same coordinate system and carries out three-dimensional display. By wearing the three-dimensional glasses, the outstanding three-dimensional effect can be seen just like watching a three-dimensional movie.
The stereoscopic display system described in this embodiment is a display system that allows the three-dimensional positions of the three-dimensional cerebral vessels and the guide wires to be simultaneously visible, and may be a three-dimensional display device of any form. Such as: polarized 3D displays, 3D glasses, immersive 3D viewfinders, and the like.
It should be understood that the above examples are only for clarity of illustration and are not intended to limit the embodiments. Other variations and modifications will be apparent to persons skilled in the art in light of the above description. And are neither required nor exhaustive of all embodiments. And obvious variations or modifications therefrom are within the scope of the invention.

Claims (4)

1. The real-time stereo display system for craniocerebral intervention operation comprises a DSA image acquisition system, a two-dimensional guide wire extraction system, a three-dimensional guide wire calculation system and a stereo display system; the method is characterized in that:
the DSA image acquisition system acquires a three-dimensional image of the cerebral vessel in advance and transmits the three-dimensional image to the three-dimensional guide wire calculation system and the three-dimensional display system; collecting guide wire front-view images and side-view images in real time, and transmitting the guide wire front-view images and the side-view images to a two-dimensional guide wire extraction system and a three-dimensional guide wire calculation system;
the two-dimensional guide wire extraction system receives a front-view image and a side-view image provided by the DSA image acquisition system, extracts two-dimensional positions of the guide wire from the front-view image and the side-view image respectively, and transmits the two-dimensional positions to the three-dimensional guide wire calculation system;
the three-dimensional guide wire calculation system firstly receives a cerebral blood vessel three-dimensional image of the DSA image acquisition system, displays the cerebral blood vessel three-dimensional image in a three-dimensional coordinate system, and manually selects a metal mark point in the three-dimensional coordinate system;
then, displaying the front-view image and the side-view image of the DSA image acquisition system in the three-dimensional coordinate system, respectively selecting metal mark points in the front-view image and the side-view image, and carrying out two-dimensional and three-dimensional combined calibration to obtain the position relationship of the cerebrovascular three-dimensional image and the front-view image and the side-view image in the space;
the three-dimensional guide wire computing system receives the two-dimensional guide wire coordinate data transmitted by the two-dimensional guide wire extracting system in real time after being calibrated through two-dimensional and three-dimensional combination, is used for computing the three-dimensional curve coordinate of the guide wire and transmits the data of the three-dimensional curve coordinate to the three-dimensional display system;
and the stereo display system displays the cerebrovascular three-dimensional image fused with the DSA image acquisition system and the three-dimensional guide wire space curve of the three-dimensional guide wire calculation system in the same coordinate system and performs polarization three-dimensional display.
2. A craniocerebral interventional procedure real-time stereoscopic display system according to claim 1, characterized in that: the specific process of carrying out two-dimensional and three-dimensional combined calibration comprises the following steps:
calculating the three-dimensional space position of the X-ray emission source S of the front-view image and the side-view image: setting an estimated value of S for both front-view and side-view images, introducing a ray to the three-dimensional coordinate of each metal mark point through the estimated value, and finally obtaining the intersection point of the ray and the front-view and side-view images, namely the calculated value of the metal mark point;
taking the sum of squares of the distances between the calculated values of the metal mark points and the real metal mark points as an objective function F, taking the initial estimated value of S as an optimization variable, adopting a numerical optimization algorithm to maximally reduce the value of F, obtaining the value of S after the optimization process is finished, namely the real position of the X-ray source in a three-dimensional coordinate system, and calculating the three-dimensional position of the guide wire in real time according to the real position.
3. A craniocerebral interventional procedure real-time stereoscopic display system according to claim 1, characterized in that: the manual clicking selects the metal mark points in the three-dimensional coordinate system, and the number of the metal mark points is more than or equal to 3.
4. A craniocerebral interventional procedure real-time stereoscopic display system according to claim 1, characterized in that: the stereoscopic display system is a polarized 3D display, 3D glasses, or an immersive 3D viewfinder.
CN202011597977.8A 2020-12-29 2020-12-29 Real-time stereo display system for craniocerebral intervention operation Pending CN112603535A (en)

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Application publication date: 20210406