CN112967797A - Method for evaluating efficacy of smog surgery - Google Patents
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Abstract
A smog disease operation curative effect assessment method, combine 99 TCm-one and two half ethyl ester single photon emission computed tomography and computer tomography scan cerebral blood flow perfusion imaging technology, carry on three-dimensional ordered subset expectation maximization reconstruction to SPECTPEC workflow before and after the identical testee that collects separately, define and test Talairach boundary first, after finishing processing, presume the testee reference group, and set up the voxel data as being correlated, normalized to the maximum value of the whole brain; comparing the difference of SPECT brain imaging before and after the operation of the same subject, and evaluating the curative effect of the smog disease operation. Visually displaying the preoperative and postoperative visual perfusion results and quantitative perfusion ROI results of the same subject. The analysis may cover the entire cerebral cortex. The analysis method is visual, easy to learn and use, simple and convenient to operate, and the analysis result is more objective and real. The method can simultaneously carry out statistical analysis on quantitative data and qualitative data, is proved to be superior to visual evaluation by statistical basis, and ensures the reliability of a conclusion.
Description
Technical Field
The invention relates to an IPC classification G06F electric digital data processing or G06T image data processing or generating technology, which comprises a G06T5/00 image enhancement or restoration technology for establishing a similar graph from a bit image to a bit image, in particular to an evaluation method for the curative effect of smoke surgery.
Background
Smoke disease is a cerebrovascular disease with unknown etiology, characterized by chronic progressive stenosis or occlusion at the ends of bilateral internal carotid arteries, anterior cerebral arteries and the beginning of middle cerebral artery, and secondary formation of abnormal vascular network of skull base. This abnormal vascular network of the basis cranii is known as "smoke" because it appears as "smoke" in the cerebrovascular angiographic image.
The aerosolized vessels are dilated, fenestrated arteries that act as compensation for collateral circulation. The clinical manifestations of patients are multifarious, including cognitive dysfunction, epilepsy, involuntary movement or headache, with cerebral ischemia being the most common, and may be manifested as Transient Ischemic Attacks (TIA), Reversible Ischemic Neurological Dysfunction (RIND), or cerebral infarction, with TIA often induced by emotional stress, crying, strenuous exercise, or eating hot spicy food, etc. Spontaneous intracranial hemorrhage is often seen in adult patients, mainly because of rupture hemorrhage of foggy blood vessels or combined microaneurysms, and intracerebroventricular hemorrhage or cerebral parenchyma hemorrhage is the most common one to break into the ventricles, and basal ganglia or cerebral lobe hematoma is also seen, and simple subarachnoid hemorrhage is less frequent. Neurological dysfunction is associated with cerebral ischemia or intracranial hemorrhage.
Smog is high in east Asia countries, certain familial aggregation exists, genetic factors can participate in pathogenesis, women are frequently suffered, children and young and middle-aged people have two peak morbidity ages, cerebral ischemia and intracranial hemorrhage are two main hazards of the smog, the children and the adult patients are mainly cerebral ischemia, and the intracranial hemorrhage is frequently seen in the adult patients. In recent years, the incidence and prevalence of smog diseases in China have gradually increased, but some controversy still exists in diagnosis and treatment.
There has been interest in the treatment of smoke diseases.
Chinese patent application 201910592731.2, which is proposed by the first hospital affiliated to the university of Zhongshan, discloses preparation and application of a rnf213a gene complete knockout zebra fish mutant; designing a TALEN sequence aiming at the zebra fish rnf213a gene; constructing plasmids of the left arm and the right arm of the gene, and transcribing corresponding mRNA in vitro; mixing TALEN left and right arm mRNA and injecting into zebra fish embryo; breeding the injected embryo to F0 adult fish to mate with wild adult fish, breeding the embryo carrying rnf213a gene mutation to F1 adult fish; the F1 fish tail-cutting genotype identification finds that two heterozygote genotypes exist: +2bp and-7 bp; and (3) carrying out outcrossing on the heterozygote and the wild adult fish for 3 generations, purifying the genetic background, and then carrying out hybridization on the heterozygote of the same genotype to obtain two genotypes of the homozygote: +2bp and-7 bp. The phenotype observation of embryos obtained by hybridization of homozygotes and homozygotes shows that the smog phenotype and the cavernous hemangioma phenotype similar to that of a human exists. According to the invention, the rnf213a gene complete knockdown zebra fish strain can be quickly and efficiently established by a TALEN gene editing technology, and the drug screening work aiming at the smog disease or/and the spongiform hemangioma can be carried out by utilizing the model.
The document also discloses the research data of smoke diseases. RNF213 p.R4810K has obvious ethnic difference related to smog diseases, is mainly concentrated on Asians, and the mutation rate of the site of a Japanese smog patient is 90.1 percent, 78.9 percent in Korea and 23.1 percent in China; the normal people also have the variation of the site, 2.5 percent of Japanese, 2.7 percent of Korean and 0.9 percent of Chinese. Compared with Japan and Korea, China Han nationality smog disease patients have lower mutation rate of the mutation site. The incidence of smoke disease of caucasians is 1/10 of Japanese, and the caucasians do not find that RNF213 p.R4810K is obviously related to the smoke disease, which is probably one of the reasons for the low incidence of the smoke disease of the caucasians. In the research of RNF213 p.R4810K and patients with smog diseases of different systems in the same environment, p.R4810K is found to exist in 56% of patients with smog diseases of Asia systems, and p.R4810K point mutation does not exist in non-Asia patients with smog diseases of Asia systems. This suggests that RNF213 p.R4810K is involved in the pathogenesis of smog disease, and that there is a ethnic difference.
The work of evaluating the therapeutic effect of smoke diseases is being continuously developed, but no relevant patent documents are disclosed, and less documents are disclosed in the inquired disease therapeutic effect evaluation technology, such as:
chinese patent application 201911143440.1, proposed by the general hospital of the chinese people's liberation army, discloses a method and system for evaluating the three-dimensional spatial curative effect after liver tumor ablation, the method comprising: acquiring a medical image of a patient, and preprocessing the medical image; performing image segmentation and three-dimensional modeling on the medical image map to obtain a preoperative liver region, a preoperative liver tumor region, a postoperative liver region and an postoperative ablation region; performing global registration on the preoperative liver region and the postoperative liver region by using a CPD point set registration algorithm to obtain a transformation matrix, and then calculating a registration result tumor region of the preoperative liver tumor region corresponding to the postablation; extracting and locally registering common features, and then adjusting a tumor region of a registration result; and calculating the distance between the postoperative ablation region and the boundary of the registration result tumor region, and visually displaying the distance in a three-dimensional space. The invention can assist doctors in the curative effect evaluation after the ablation, and lays a foundation for the subsequent treatment scheme of patients.
The Chinese patent application 201811622007.1 filed by Beijing university of Richardman provides an assessment method and device for therapeutic effect of ablation surgery. The method for evaluating the treatment effect of the ablation operation comprises the following steps: respectively preprocessing a tumor region in the preoperative image and an ablation region in the postoperative image; carrying out image registration on a tumor region in the preprocessed preoperative image and an ablation region in the preprocessed postoperative image to obtain an elastic deformation field, carrying out vector field analysis on the elastic deformation field and determining a tumor shrinkage central point; and mapping the tumor region in the pre-processed preoperative image to the pre-processed postoperative image after image registration according to the tumor shrinkage central point to obtain an evaluation result of the treatment effect of the ablation operation. The method and the device for evaluating the treatment effect of the ablation operation provided by the embodiment of the invention can accurately reflect the shrinkage of the tumor in the operation, so that a more accurate evaluation result of the treatment effect of the ablation operation can be obtained.
Progress is needed in assessing the efficacy of smoke therapy, but these prior art documents do not provide a useful teaching of the present invention.
Disclosure of Invention
The invention aims to provide an evaluation method of smog surgery curative effect, which visually displays the visual perfusion result and quantitative perfusion ROI result before and after the same subject through SPECT cerebral development aberration difference.
The aim of the invention is achieved by the following technical measures: a smog disease operation curative effect assessment method, combine 99 TCm-one and two half ethyl ester single photon emission computed tomography and computer tomography scan cerebral blood flow perfusion imaging technology, carry on three-dimensional ordered subset expectation maximization reconstruction to SPECT Proc workflow separately preoperatively and postoperatively that gather the same experimenter, introduce into SPECT Proc workflow, define and test Talairach boundary first, after finishing processing, presume the examinee's reference group, and set up the voxel data as being correlated, normalized to the maximum value of the whole brain; comparing the difference of SPECT brain imaging before and after the operation of the same subject, and evaluating the curative effect of the smog disease operation.
In particular, the evaluation method further consists in:
1) the acquired preoperative and postoperative SPECT images of the same subject are respectively subjected to three-dimensional ordered subsets, namely 3D OSEM reconstruction, comprising 8 subsets and 12 iterations, and then imported into a neuroGam system SPECT Proc workflow.
2) Defining Talairach boundary line: the subject's preoperative SPECT data is set as the "baseline" data set and the subject's postoperative SPECT data is set as the "test" data set. Selecting 'benchmark' data from a pull-down menu at the upper right corner, and defining a Talairach boundary for the 'benchmark' data, wherein the definition method is as follows:
separating left and right hemispheres: the left and right hemispheres should be separated according to the gap between the hemispheres, and the separation line should be moved along the X-axis direction and should equally divide the brain stem and the hemispheric groove.
Separating the front part, the middle part, the back part, the top part and the bottom part of the brain: these partitions are based on the brain commissure lines. Vertical Anterior Commissure (AC) and Posterior Commissure (PC) lines are defined on the two images in the center of the screen, with a fixed distance of 24mm between the AC and PC lines, with the AC-PC line placed along the top of the brainstem.
-establishing a frame around the brain: the border of this box is defined by the lower limit of the temporal lobe, the upper limit of the cortex, the anterior limit of the frontal lobe, the posterior limit of the occipital lobe, the lateral limit of the cortical tissue.
Verifying the defined boundary line: the contour will also be updated in real time as each boundary line is adjusted. The 8 small images in the lower left portion of the screen are quality control images that show the Talairach calculated contour superimposed on the corresponding scaled perfusion image. The quality control QC images updated in real time are checked while adjusting the boundary line. The border lines are trimmed, if necessary, until the best QC image is obtained.
After setting is finished, selecting test data from a pull-down menu at the upper right corner, and defining a Talairach boundary for the test data by the same method;
3) after the treatment, the user enters a 'population comparison information' dialog box, the age, the sex, the injected medicament (ECD) and the selection of a reference group of the subject are input, and the voxel data are set to be related and normalized to the maximum value of the whole brain.
4) The difference in SPECT brain imaging before and after surgery was compared for the same subject. After the basic information setting is completed, the user enters a report interface to obtain the visual perfusion and quantitative perfusion ROI results of the normalized 'basic' data and the normalized 'test' data, and obtain the result of subtracting the normalized 'reference' data set from the normalized 'test' data set, wherein the result is defined as 'Delta data'. Selecting Delta data from a pull-down menu at the upper right corner to obtain a visual perfusion result and a quantitative perfusion ROI result of the Delta data, and visually displaying the difference of SPECT brain imaging before and after the same subject;
wherein; in the visual perfusion result, all image displays come from frontal, lateral and sagittal projections, showing the average plus surface activity sample values mapped on the 3D cortical surface; in the quantitative perfusion ROI results, different frontal, parietal, temporal, occipital, thalamic, basal ganglia and cerebellar lobes were selected as ROI, each ROI being expressed as a corresponding percentage of the entire volume; the system automatically quantifies any perfusion differences in severity and size of the damaged cortex, giving quantitative results including mean/max/min pixel values for each respective ROI, and selecting the mean pixel values for quantitative comparison.
Particularly, the curative effect of the smog disease operation is evaluated by means of a NeuroGam system and an SPSS system in combination with 99 TCm-double half ethyl ester single photon emission computed tomography and computed tomography cerebral blood perfusion imaging technology; comparing the visual assessment before and after the operation and the quantitative analysis of NeuroGam to find the difference of the number of the focus by using Mcnemar chi-square test; an SPSS system is adopted to complete all statistical analysis, and a pairing T test is applied to explore whether the difference between groups exists in the cerebral blood perfusion before and after the operation.
Particularly, taking the prefrontal lobe as an example, the number of frontal lobe lesions with decreased blood perfusion, which are found by visual assessment and NeuroGam quantitative analysis, is respectively input into an SPSS system, and a 2 × 2 list is drawn by taking a visual assessment group, a NeuroGam assessment group and frequency as a horizontal axis and 1 and 0 as vertical axes, assuming that a positive result is 1 and a negative result is 0; firstly, Data is weighted, Data in a toolbar above software is clicked, Weight cases are selected, Weight cases by in a pop-up window is clicked, a frequency variable is selected, and OK is clicked to finish weighting. Clicking 'Analyze' in a tool bar above the software, selecting 'Crosstabs' in 'Descriptive statics', selecting a visual evaluation group in a cross table window, selecting a NeuroGam evaluation group in a column, selecting a statistical method 'McNemar', and clicking 'Cells' to select the statistical content of a bigeminal table, wherein the statistical content comprises an observed value, an expected value, a row percentage, a column percentage and a population percentage; clicking "OK" after the selection is finished can obtain the observed value, the expected value, the row percentage, the column percentage, the total percentage and the P value of the inspection result. If the P value is < 0.05 then there is a statistical difference in the number of preoperative frontal lesions found by visual assessment and NeuroGam quantification. If the P value is greater than 0.05, the number of foci of the prefrontal lobe found by visual assessment and NeuroGam quantification is considered to be not statistically different. By analogy, the difference of the number of the lesion before and after the operation of each ROI, which is found by visual assessment and neuroGam, is gradually analyzed, so that whether the difference exists in the capacity of the two methods for assessing the curative effect of the smog disease operation is proved.
In particular, the paired T-test explores whether there is a difference in post-operative cerebral perfusion between the lateral and contralateral hemisphere. Similarly, taking frontal lobe as an example, the SPSS system is turned on, average pixel values of all subjects in the operative hemisphere and the contralateral hemisphere are imported, bilateral average pixel values of the same subject are assigned as a pair, and all the average pixel values are divided into an operative group and a control group; clicking 'Analyze' in the tool bar, selecting 'Paired Sample T Test' in 'company Means', and generating a pairing T Test window; simultaneously selecting the operation group and the control group, putting the operation group and the control group into paired variables, and clicking 'OK' to obtain a P value, an average value and a standard deviation of the operation group and the control group; if the P value is less than 0.05, the cerebral blood perfusion values of the frontal lobe of the operation group and the control group are considered to have statistical difference, and the cerebral blood perfusion values of the frontal lobe of the two groups can be compared according to the average value and the standard deviation; if the P value is more than 0.05, the cerebral blood flow perfusion values of the frontal lobe of the operation group and the control group are considered to have no statistical difference; paired T-tests of other ROIs were performed in the same manner.
Particularly, a T test is paired to investigate whether cerebral blood perfusion of cerebral hemispheres on the operation side and the non-operation side has difference before and after operation or not, Mcnemar chi-square test is used for comparing the difference of lesion numbers found by visual evaluation before and after operation and NeuroGam quantitative analysis, and if the P value is less than 0.05, the statistical difference is considered to exist; the ROIs selected were frontal, parietal, temporal, occipital, thalamus, basal ganglia and cerebellum, and the mean pixel values of the individual ROIs obtained by post-processing with NeuroGam software were used to represent the perfusion of blood flow to the individual brain regions.
The invention has the advantages and effects that: the analysis may cover the entire cerebral cortex. The analysis method is visual, easy to learn and use, simple and convenient to operate, and the analysis result is more objective and real. The method can simultaneously carry out statistical analysis on quantitative data and qualitative data, has high accuracy of analysis results, is proved to be superior to visual evaluation by statistical basis, and ensures the reliability of conclusion.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the embodiments of the present invention, and it is obvious that the described embodiments are some embodiments of the present invention, but not all embodiments. The embodiments of the present invention, and all other embodiments obtained by a person of ordinary skill in the art without any inventive step, are within the scope of the present invention.
In order to overcome the problems in the prior art, the invention provides a smog surgery curative effect evaluation method, which is characterized in that a 99 TCm-double half ethyl ester single photon emission computed tomography technology and a computed tomography brain blood perfusion imaging technology are combined, collected preoperative and postoperative SPECT images of the same subject are respectively subjected to three-dimensional ordered subset expectation maximization reconstruction and then led into a SPECT Proc workflow, a Talairach boundary is defined and tested, after the processing is finished, a subject reference group is set, and voxel data are set to be related and normalized to the maximum value of the whole brain; comparing the difference of SPECT brain imaging before and after the operation of the same subject, and evaluating the curative effect of the smog disease operation.
The evaluation method of the invention also comprises the following steps:
1) the acquired preoperative and postoperative SPECT images of the same subject are respectively subjected to three-dimensional ordered subsets, namely 3D OSEM reconstruction, comprising 8 subsets and 12 iterations, and then imported into a neuroGam system SPECT Proc workflow.
2) Defining Talairach boundary line: the subject's preoperative SPECT data is set as the "baseline" data set and the subject's postoperative SPECT data is set as the "test" data set. Selecting 'benchmark' data from a pull-down menu at the upper right corner, and defining a Talairach boundary for the 'benchmark' data, wherein the definition method is as follows:
separating left and right hemispheres: the left and right hemispheres should be separated according to the gap between the hemispheres, and the separation line should be moved along the X-axis direction and should equally divide the brain stem and the hemispheric groove.
Separating the front part, the middle part, the back part, the top part and the bottom part of the brain: these partitions are based on the brain commissure lines. Vertical Anterior Commissure (AC) and Posterior Commissure (PC) lines are defined on the two images in the center of the screen, with a fixed distance of 24mm between the AC and PC lines, with the AC-PC line placed along the top of the brainstem.
-establishing a frame around the brain: the border of this box is defined by the lower limit of the temporal lobe, the upper limit of the cortex, the anterior limit of the frontal lobe, the posterior limit of the occipital lobe, the lateral limit of the cortical tissue.
Verifying the defined boundary line: the contour will also be updated in real time as each boundary line is adjusted. The 8 small images in the lower left portion of the screen are quality control images that show the Talairach calculated contour superimposed on the corresponding scaled perfusion image. The quality control QC images updated in real time are checked while adjusting the boundary line. The border lines are trimmed, if necessary, until the best QC image is obtained.
After setting is finished, selecting test data from a pull-down menu at the upper right corner, and defining a Talairach boundary for the test data by the same method;
3) after the treatment, the user enters a 'population comparison information' dialog box, the age, the sex, the injected medicament (ECD) and the selection of a reference group of the subject are input, and the voxel data are set to be related and normalized to the maximum value of the whole brain.
4) The difference in SPECT brain imaging before and after surgery was compared for the same subject. After the basic information setting is completed, the user enters a report interface to obtain the visual perfusion and quantitative perfusion ROI results of the normalized 'basic' data and the normalized 'test' data, and obtain the result of subtracting the normalized 'reference' data set from the normalized 'test' data set, wherein the result is defined as 'Delta data'. Selecting Delta data from a pull-down menu at the upper right corner to obtain a visual perfusion result and a quantitative perfusion ROI result of the Delta data, and visually displaying the difference of SPECT brain imaging before and after the same subject. Wherein:
visualization of perfusion results: all images are shown from frontal, lateral and sagittal projections, showing the average plus surface activity samples mapped on the 3D cortical surface. The software uses three-dimensional images of cerebral blood flow labeled with different colors to display the perfusion of cerebral cortex and sub-cortical structures.
Quantifying perfusion ROI results: selecting different brain lobes, such as frontal, parietal, temporal, occipital, thalamus, basal ganglia and cerebellum, as regions of interest roi (regions of interest), each region of interest being expressed as a respective percentage of the entire volume; the system automatically quantifies any perfusion differences in severity and size of the damaged cortex, giving quantitative results including mean/max/min pixel values for each respective ROI, the mean pixel values being selected for quantitative comparison.
The present invention will be further described with reference to the following examples.
Example (b): evaluating the curative effect of the smoke disease operation by means of a NeuroGam system and an SPSS system by combining 99 TCm-double half ethyl ester single photon emission computed tomography and computed tomography cerebral blood perfusion imaging technology; comparing the visual assessment before and after the operation and the quantitative analysis of NeuroGam to find the difference of the number of the focus by using Mcnemar chi-square test; an SPSS system is adopted to complete all statistical analysis, and a pairing T test is applied to explore whether the difference between groups exists in the cerebral blood perfusion before and after the operation.
In the above, taking the preoperative frontal lobe as an example, the number of frontal lobe lesions with decreased blood perfusion, which are found by the visual assessment and the NeuroGam quantitative analysis, are respectively input into the SPSS system, assuming that the positive result is 1 and the negative result is 0, and a 2 × 2 list is drawn by taking the visual assessment group and the NeuroGam assessment group and the frequency as the horizontal axis and taking 1 and 0 as the vertical axis; firstly, Data is weighted, Data in a toolbar above software is clicked, Weight cases are selected, Weight cases by in a pop-up window is clicked, a frequency variable is selected, and OK is clicked to finish weighting. Clicking 'Analyze' in a tool bar above the software, selecting 'Crosstabs' in 'Descriptive statics', selecting a visual evaluation group in a cross table window, selecting a NeuroGam evaluation group in a column, selecting a statistical method 'McNemar', and clicking 'Cells' to select the statistical content of a bigeminal table, wherein the statistical content comprises an observed value, an expected value, a row percentage, a column percentage and a population percentage; clicking "OK" after the selection is completed can obtain the observed value, the expected value, the row percentage, the column percentage, the total percentage and the P value of the inspection result. If the P value is < 0.05, the number of prefrontal lesions found by visual assessment and NeuroGam quantification is considered to be statistically different. If the P value is greater than 0.05, the number of foci of the prefrontal lobe found by visual assessment and NeuroGam quantification is considered to be not statistically different. By analogy, the difference of the number of the lesion before and after the operation of each ROI, which is found by visual assessment and neuroGam, is gradually analyzed, so that whether the difference exists in the capacity of the two methods for assessing the curative effect of the smog disease operation is proved.
In the foregoing, paired T-test explores whether there is a difference in cerebral perfusion between the operative lateral hemisphere and the contralateral hemisphere after surgery. Similarly, taking frontal lobe as an example, the SPSS system is turned on, average pixel values of all subjects in the operative hemisphere and the contralateral hemisphere are imported, bilateral average pixel values of the same subject are assigned as a pair, and all the average pixel values are divided into an operative group and a control group; clicking 'Analyze' in a toolbar, selecting 'Paired Sample T Test' in 'company Means', and generating a pairing T Test window; simultaneously selecting the operation group and the control group, putting the operation group and the control group into paired variables, and clicking 'OK' to obtain a P value, and an average value and a standard deviation of the operation group and the control group; if the P value is less than 0.05, the cerebral blood perfusion values of the frontal lobe of the operation group and the control group are considered to have statistical difference, and the cerebral blood perfusion values of the frontal lobe of the two groups can be compared according to the average value and the standard deviation; if the P value is more than 0.05, the cerebral blood flow perfusion values of the frontal lobe of the operation group and the control group are considered to have no statistical difference; paired T-tests of other ROIs were performed in the same manner.
In the foregoing, a T-test is paired to investigate whether cerebral blood perfusion of cerebral hemispheres on the operative side and non-operative side is different before and after the operation, and Mcnemar chi-square test is used to compare the difference between the number of lesions found by visual assessment before and after the operation and quantitative analysis of NeuroGam, and if the P value is less than 0.05, it is considered that a statistical difference exists; the ROIs selected were frontal, parietal, temporal, occipital, thalamus, basal ganglia and cerebellum, and the mean pixel values of the individual ROIs obtained by post-processing with NeuroGam software were used to represent the perfusion of blood flow to the individual brain regions.
In the embodiment of the invention, the NeuroGam system can automatically analyze the SPECT cerebral blood flow perfusion image, a quantitative analysis method is adopted, the functional data obtained by SPECT/CT and a reference template (Talairach) are registered, the brain tissue image of the patient is quantitatively analyzed according to an artery ring, a Brodmann partition and the like, and the result obtained by SPECT is compared with the information of a normal or disease database. The software is applied to image post-processing to obtain images of visualized cerebral cortex and subcortical nuclei at different sections, three-dimensional images of the cerebral cortex and quantitative values of perfusion at different layers. And comparing the data of the same patient before and after the operation by using the data subtraction function, and visually displaying the increase or decrease of cerebral blood perfusion on the image to obtain the blood perfusion value of the corresponding cerebral area. Compared with visual evaluation, the neuroGam software is simple and convenient to operate, time-saving and labor-saving, and analysis can cover the whole cerebral cortex. Meanwhile, the accuracy of the result is guaranteed by the method based on voxel analysis, and the obtained result is more objective and real. The NeuroGam system can analyze brain function images based on voxels, and is widely applied to the research of various brain dysfunction diseases such as dementia, Parkinson's disease, pertinence, smog and the like. Compared with the similar software, the NeuroGam software has no technical limitation, has simple analysis method, can be used for clinical individual analysis and large sample research, is particularly suitable for clinical daily practice, can be used as a powerful tool for clinicians to analyze various abnormal brain functions, and still needs large sample, multi-center and prospective clinical research to verify the application value in the future.
In the embodiment of the invention, the version of the SPSS system is 16.0.1; the SPSS system, namely Statistical Product and Service Solutions, is short for short, for example, SPSS for Windows is a combined software package which integrates data entry, sorting and analysis functions. The user can select the module according to the actual need and the function of the computer to reduce the requirement on the capacity of the system hard disk, which is beneficial to the popularization and application of the software. The basic functions of the SPSS include data management, statistical analysis, graph analysis, output management, and the like. The SPSS statistical analysis process comprises several major classes such as descriptive statistics, mean comparison, general linear model, correlation analysis, regression analysis, logarithmic linear model, cluster analysis, data simplification, survival analysis, time sequence analysis, multiple responses and the like, wherein each class is divided into several statistical processes, such as multiple statistical processes of partial linear regression analysis, curve estimation, Logistic regression, Probit regression, weighted estimation, two-stage least square method, nonlinear regression and the like in the regression analysis, and each process allows a user to select different methods and parameters. The analysis result of SPSS for Windows is clear, intuitive, easy to learn and use, and can directly read EXCEL and DBF data files, and the SPSS for Windows is popularized to computers of various operating systems, and is called three major statistical software with the most influence on the world together with SAS and BMDP. There is a non-textual provision in the international academy, i.e., in international academy exchanges, it may not be necessary to describe the algorithm, regardless of the calculations and statistical analyses performed by the SPSS software. The SPSS system can simultaneously carry out statistical analysis on quantitative data and qualitative data, and provides statistical basis for proving that the value of neuroGam in the evaluation of the efficacy of the smog surgery is superior to that of visual evaluation.
The above-described embodiment of the apparatus is merely illustrative, wherein the NeuroGam system and the SPSS system are prior art, and some of the functional modules may be called according to actual needs, and the functional modules include operation methods belonging to the prior art, and some or all of the modules are selected and used to achieve the purpose of implementing some contents in the complete technical solution of the present embodiment. One of ordinary skill in the art can understand and implement it without inventive effort.
From the above description of the embodiments, those skilled in the art can clearly understand that the embodiments can be implemented by means of software and necessary general hardware device platform, and the technical solutions described above or portions contributing to the prior art can be embodied in the form of a software product, which can be stored in a computer-readable storage medium, such as ROM/RAM, magnetic disk, optical disk, etc., and includes several instructions for enabling a computer device (which may be a personal computer, a server, or a network device, etc.) to execute the methods of the embodiments or some portions of the embodiments.
Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may be modified, or some technical features may be equivalently replaced; and the modifications or the substitutions do not make the essence of the corresponding technical solutions depart from the spirit and scope of the technical solutions of the embodiments of the present invention.
Claims (6)
1. An assessment method for smoke surgery curative effect is characterized in that 99 TCm-bi-half ethyl ester single photon emission computed tomography and computed tomography brain blood flow perfusion imaging technology are combined, collected preoperative and postoperative SPECT images of the same subject are respectively subjected to three-dimensional ordered subset expectation maximization reconstruction and then led into a SPECT Proc workflow, a Talairach boundary is defined and tested, after the treatment is finished, a subject reference group is set, and voxel data are set to be related and normalized to the maximum value of the whole brain; comparing the difference of SPECT brain imaging before and after the operation of the same subject, and evaluating the curative effect of the smog disease operation.
2. The method of claim 1, wherein the method of assessing the efficacy of a smoke surgery further comprises:
1) respectively carrying out three-dimensional ordered subset expectation maximization, namely 3D OSEM reconstruction, including 8 subsets and 12 iterations on the acquired preoperative and postoperative SPECT images of the same subject, and then importing a neuroGam system SPECT Proc workflow;
2) defining Talairach boundary line: setting the SPECT data of the subject before operation as a reference data set, and setting the SPECT data of the subject after operation as a test data set; selecting 'benchmark' data from a pull-down menu at the upper right corner, and defining a Talairach boundary for the 'benchmark' data, wherein the definition method is as follows:
separating left and right hemispheres: the left hemisphere and the right hemisphere are separated according to the cerebral hemisphere gap, and a separation line is moved along the X-axis direction and is used for equally separating the brain stem and the cerebral hemisphere groove;
separating the front part, the middle part, the back part, the top part and the bottom part of the brain: these partitions are based on brain commissure lines; defining vertical Anterior Commissure (AC) and Posterior Commissure (PC) lines on two images in the center of the screen, with a fixed distance of 24mm between the AC and PC lines, placing the AC-PC line along the top of the brainstem;
-establishing a frame around the brain: the border of the frame is defined by the lower limit of temporal lobe, the upper limit of cortex, the front limit of frontal lobe, the rear limit of occipital lobe and the lateral limit of cortex tissue;
verifying the defined boundary line: the contour will also be updated in real time as each boundary line is adjusted. The 8 small images in the lower left portion of the screen are quality control images that show the Talairach calculated contour superimposed on the corresponding scaled perfusion image. Checking the quality control QC image updated in real time when adjusting the boundary line; if necessary, finely adjusting the boundary line until the optimal QC image is obtained;
after setting is finished, selecting test data from a pull-down menu at the upper right corner, and defining a Talairach boundary for the test data by the same method;
3) after the treatment is finished, entering a 'population comparison information' dialog box, inputting the age, the sex, the injection of a medicament (ECD) and the selection of a reference group of a subject, and setting voxel data as correlation and normalization to the maximum value of the whole brain;
4) comparing the difference in the SPECT brain images of the same subject before and after surgery; after the basic information is set, entering a report interface to obtain visual perfusion and quantitative perfusion ROI results of normalized 'basic' data and normalized 'test' data and obtain a result of subtracting the normalized 'reference' data set from the normalized 'test' data set, wherein the result is defined as 'Delta data'; selecting Delta data from a pull-down menu at the upper right corner to obtain a visual perfusion result and a quantitative perfusion ROI result of the Delta data, and visually displaying the difference of SPECT brain imaging before and after the same subject;
wherein; in the visual perfusion result, all image displays come from frontal, lateral and sagittal projections, showing the average plus surface activity sample values mapped on the 3D cortical surface; in the quantitative perfusion ROI results, different frontal, parietal, temporal, occipital, thalamic, basal ganglia and cerebellar lobes were selected as ROI, each ROI being expressed as a corresponding percentage of the entire volume; the system automatically quantifies any perfusion differences in severity and size of the damaged cortex, giving quantitative results including mean/max/min pixel values for each respective ROI, and selecting the mean pixel values for quantitative comparison.
3. The method of claim 1, wherein the efficacy of the smoke surgery is evaluated by a NeuroGam system and a SPSS system in combination with 99 TCm-double half-ethyl ester single photon emission computed tomography and computed tomography cerebral perfusion imaging; comparing the visual assessment before and after the operation and the quantitative analysis of NeuroGam to find the difference of the number of the focus by using Mcnemar chi-square test; an SPSS system is adopted to complete all statistical analysis, and a pairing T test is applied to explore whether the difference between groups exists in the cerebral blood perfusion before and after the operation.
4. The method of claim 3, wherein the number of frontal lobe lesions with decreased blood perfusion, as found by the visual assessment and the NeuroGam quantitative analysis, is inputted into the SPSS system, respectively, and a 2 x 2 tabulation is drawn with the horizontal axis of the visual assessment group and the NeuroGam assessment group and the frequency number and the vertical axis of 1 and 0 assuming that the positive result is 1 and the negative result is 0, taking the frontal lobe as an example before operation; firstly, weighting Data, clicking Data in a toolbar above software, selecting Weight cases, clicking Weight cases by in a pop-up window, selecting a frequency variable, and clicking OK to finish weighting; clicking 'Analyze' in a tool bar above the software, selecting 'Crosstabs' in 'Descriptive statics', selecting a visual evaluation group in a cross table window, selecting a NeuroGam evaluation group in a column, selecting a statistical method 'McNemar', and clicking 'Cells' to select the statistical content of a bigeminal table, wherein the statistical content comprises an observed value, an expected value, a row percentage, a column percentage and a population percentage; clicking 'OK' after the selection is finished to obtain an observed value, an expected value, a row percentage, a column percentage, a total percentage and a test result P value; if the P value is < 0.05, the number of prefrontal lesions found by visual assessment and NeuroGam quantification is considered to be statistically different. If the P value is more than 0.05, the number of the focus of the prefrontal lobe is considered to have no statistical difference by the visual evaluation and the NeuroGam quantitative analysis; by analogy, the difference of the number of the lesion before and after the operation of each ROI, which is found by visual assessment and neuroGam, is gradually analyzed, so that whether the difference exists in the capacity of the two methods for assessing the curative effect of the smog disease operation is proved.
5. The method of claim 3, wherein the paired T test explores the difference in cerebral perfusion between the operated lateral hemisphere and the contralateral hemisphere after surgery; similarly, taking frontal lobe as an example, the SPSS system is turned on, average pixel values of all subjects in the operative hemisphere and the contralateral hemisphere are imported, bilateral average pixel values of the same subject are assigned as a pair, and all the average pixel values are divided into an operative group and a control group; clicking 'Analyze' in a toolbar, selecting 'Paired Sample T Test' in 'company Means', and generating a pairing T Test window; simultaneously selecting the operation group and the control group, putting the operation group and the control group into paired variables, and clicking 'OK' to obtain a P value, an average value and a standard deviation of the operation group and the control group; if the P value is less than 0.05, the cerebral blood perfusion values of the frontal lobe of the operation group and the control group are considered to have statistical difference, and the cerebral blood perfusion values of the frontal lobe of the two groups can be compared according to the average value and the standard deviation; if the P value is more than 0.05, the cerebral blood flow perfusion values of the frontal lobe of the operation group and the control group are considered to have no statistical difference; paired T-tests of other ROIs were performed in the same manner.
6. The method of claim 3, wherein a T test is paired to detect differences in cerebral blood perfusion between the preoperative and postoperative cerebral hemispheres, and the Mcnemar chi-square test is used to compare the difference in lesion counts between the pre-and post-operative visual assessment and the quantitative NeuroGam analysis, and if the P value is less than 0.05, a statistical difference is deemed to exist; the ROIs selected were frontal, parietal, temporal, occipital, thalamus, basal ganglia and cerebellum, and the mean pixel values of the individual ROIs obtained by post-processing with NeuroGam software were used to represent the perfusion of blood flow to the individual brain regions.
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