CN113520543B - Intracranial puncture method, intracranial puncture device, intracranial puncture system, and storage medium - Google Patents

Intracranial puncture method, intracranial puncture device, intracranial puncture system, and storage medium Download PDF

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CN113520543B
CN113520543B CN202110729676.4A CN202110729676A CN113520543B CN 113520543 B CN113520543 B CN 113520543B CN 202110729676 A CN202110729676 A CN 202110729676A CN 113520543 B CN113520543 B CN 113520543B
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puncture
intracranial
head
path
information
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CN113520543A (en
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王琳
邵天琪
王烨
姜鹏
杜世伟
李光林
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Shenzhen Institute of Advanced Technology of CAS
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Shenzhen Institute of Advanced Technology of CAS
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Priority to LU500668A priority patent/LU500668B1/en
Publication of CN113520543A publication Critical patent/CN113520543A/en
Priority to PCT/CN2021/137596 priority patent/WO2023273189A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, 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
    • A61B90/10—Instruments, 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 for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/11—Instruments, 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 for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2048—Tracking techniques using an accelerometer or inertia sensor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2065—Tracking using image or pattern recognition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2072—Reference field transducer attached to an instrument or patient

Abstract

The application discloses an intracranial puncture method, an intracranial puncture device, an intracranial puncture system and a storage medium, wherein the method comprises the following steps: acquiring head posture information, a head scanning image and puncture needle posture information; determining puncture path attitude information by using the head attitude information and the head scanning image, wherein a reference plane of a ground coordinate of the head attitude information and a cross section of the head scanning image are on the same horizontal plane; and displaying the puncture path and the puncture needle in real time based on the puncture path attitude information and the puncture needle attitude information. By the mode, the skull does not need to be fixed, and navigation optimization can be performed on intracranial puncture, so that accurate puncture path attitude information and puncture needle attitude information are provided.

Description

Intracranial puncture method, intracranial puncture device, intracranial puncture system, and storage medium
Technical Field
The present application relates to the field of intracranial puncture technologies, and in particular, to an intracranial puncture method, an intracranial puncture device, an intracranial puncture system, and a storage medium.
Background
Cerebral hemorrhage (Intracerebral hemorrhage ICH) is a disease with high mortality and morbidity. At present, the treatment means for removing the intracranial hematoma mainly comprise conservative treatment, a craniotomy hematoma removal operation, a ossicle window hematoma removal operation and a minimally invasive puncture drainage technology (MIPD) of the intracranial hematoma.
Existing navigation systems include optical surgical navigation systems, electromagnetic surgical navigation systems, mechanical surgical navigation systems, and the like. However, most navigation systems have the limitations of complex operation, high requirements for use environment, high manufacturing cost, and the like.
At present, intracranial puncture hematoma drainage is a minimally invasive operation for avoiding craniotomy, and cerebral hemorrhage can be well treated. However, in the conventional intracranial hematoma puncture surgery, in order to improve the accuracy, a doctor needs to combine a plurality of key factors and fix the skull of a patient, and then precisely insert a surgical needle according to a guide puncture path. However, the patient often cannot maintain a posture for a long time, so that the navigation route is misaligned, which results in inaccurate insertion in the puncture operation.
Disclosure of Invention
A first aspect of embodiments of the present application provides an intracranial puncture method comprising: acquiring head posture information, a head scanning image and puncture needle posture information; determining puncture path attitude information by using the head attitude information and the head scanning image, wherein a reference plane of a ground coordinate of the head attitude information and a cross section of the head scanning image are on the same horizontal plane; and displaying the puncture path and the puncture needle in real time based on the puncture path attitude information and the puncture needle attitude information.
A second aspect of embodiments of the present application provides an intracranial puncture device comprising: the device comprises a processor and a memory, wherein the memory stores a computer program, and the processor is used for executing the computer program to realize the method provided by the first aspect of the embodiment of the application.
A third aspect of embodiments of the present application provides an intracranial puncture system comprising: a first sensor configured to be fixed to the head for acquiring head pose information; a scanning device for acquiring a head scan image; the second sensor is configured to be fixed on the puncture needle and used for acquiring pose information of the puncture needle; the intracranial puncture device is connected with the first sensor, the scanning device and the second sensor and used for executing the method provided by the first aspect of the embodiment of the application.
A fourth aspect of embodiments of the present application provides a computer-readable storage medium, in which a computer program is stored, and the computer program, when executed by a processor, implements the method provided by the first aspect of embodiments of the present application.
The beneficial effect of this application is: different from the situation of the prior art, the navigation method for the intracranial puncture is designed to ensure that the connection between the head posture and the head scanning image is closely related by designing the reference plane of the ground coordinate of the head posture information and the cross section of the head scanning image to be always on the same horizontal plane, the skull of a patient does not need to be fixed, and the navigation optimization can be carried out on the intracranial puncture, so that accurate puncture path posture information and puncture needle posture information are provided, and the puncture path and the puncture needle are displayed in real time.
Drawings
In order to more clearly illustrate the technical solutions in the embodiments of the present application, the drawings needed to be used in the description of the embodiments are briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present application, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.
FIG. 1 is a system framework diagram of the intracranial puncture method of the present application;
FIG. 2 is a schematic flow chart of a first embodiment of an intracranial puncture method of the present application;
FIG. 3 is a flowchart illustrating an embodiment of step S12 in FIG. 2;
FIG. 4 is a flowchart illustrating an embodiment of step S21 of FIG. 3;
FIG. 5 is a flowchart illustrating an embodiment of step S22 of FIG. 3;
FIG. 6 is a schematic diagram of a first fixed inertial measurement unit worn by a patient according to the present application;
FIG. 7 is a schematic structural diagram illustrating a configuration of calculating an included angle between a puncture path and a reference plane by using predetermined software according to the present application;
FIG. 8 is a schematic diagram illustrating a calculation manner of three-axis Euler angles of an intracranial puncture path in a ground coordinate according to the present application;
FIG. 9 is a flowchart illustrating an embodiment of step S23 of FIG. 3;
FIG. 10 is a schematic illustration of the subject puncture needle device with a second inertial measurement unit;
FIG. 11 is a schematic block diagram of an embodiment of an intracranial puncture apparatus according to the present application;
FIG. 12 is a schematic block diagram of one embodiment of a computer-readable storage medium of the present application;
Detailed Description
In the following description, for purposes of explanation and not limitation, specific details are set forth, such as particular system structures, techniques, etc. in order to provide a thorough understanding of the embodiments of the present application. It will be apparent, however, to one skilled in the art that the present application may be practiced in other embodiments that depart from these specific details. In other instances, detailed descriptions of well-known systems, devices, circuits, and methods are omitted so as not to obscure the description of the present application with unnecessary detail.
It will be understood that the terms "comprises" and/or "comprising," when used in this specification and the appended claims, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof.
It is also to be understood that the terminology used in the description of the present application herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. As used in the specification of the present application and the appended claims, the singular forms "a," "an," and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise.
It should be further understood that the term "and/or" as used in this specification and the appended claims refers to and includes any and all possible combinations of one or more of the associated listed items.
As used in this specification and the appended claims, the term "if" may be interpreted contextually as "when", "upon" or "in response to a determination" or "in response to a detection". Similarly, the phrase "if it is determined" or "if a [ described condition or event ] is detected" may be interpreted contextually to mean "upon determining" or "in response to determining" or "upon detecting [ described condition or event ]" or "in response to detecting [ described condition or event ]".
For explaining the technical solution of the present application, the following description is made by using specific embodiments to describe a first aspect of the present application to provide an intracranial puncture method, and for better explaining the intracranial puncture method proposed in the present application, please refer to fig. 1, where fig. 1 is a system frame diagram of the intracranial puncture method of the present application, and the system at least includes: the device comprises an acquisition module 1, a resolving module 2, a Personal Computer (PC) terminal 3 and a display module 4.
Three data acquisition modules: the wearable Inertial Measurement Unit (IMU) 10, the Computed Tomography (CT) image acquisition module 20, and the IMU measurement module 30 on the surgical needle are collectively referred to as data acquisition modules, hereinafter referred to as acquisition modules 1.
The data processing module based on the PC terminal 3: for receiving and processing head gestures through a bluetooth serial port, as shown in fig. 1, intracranial data obtained and associated with the head wearable IMU10, such as a CT image acquisition module 20, may be obtained through CT scanning. The real-time pose (angle in the earth coordinate) of the intracranial puncture path is derived by fusing the two data sources, and may be referred to as a "processing module" hereinafter, such as the resolving module 2 in the figure.
A data visualization module: the real-time posture (angle under the ground coordinate) of the intracranial puncture path and the real-time posture (angle under the ground coordinate) of the surgical probe are visualized in real time so as to be provided for doctors to assist the operation of the surgical operation, and the display module 4 can be called as the display module for short.
And a resolving module 2: processing the CT scanning image data of the pre-acquisition module b through image processing software, designing a target point according to the position of an intracranial hematoma block of a patient, designing a range of a transcranial puncture path, and obtaining the values of yaw, roll and pitch of the puncture path relative to the CT scanning cross section. And combining data of an IMU inertial sensing unit of the front-collecting module a and CT scanning images of the front-collecting module b to process transcranial puncture path data, and calculating according to the position relation to obtain attitude information of the intracranial puncture path fed back by the IMU inertial sensing unit.
The display module 4: the display module can also be arranged in the PC end 3 and is used for receiving the posture data of the intracranial puncture path input by the data module and the needle head posture information input by the acquisition module 1 and synchronously outputting the posture data of the intracranial puncture path and the needle head posture information so as to guide a doctor to adjust the surgical probe to be in accordance with the posture of the puncture path and complete the puncture action.
Aiming at a system frame diagram of an intracranial puncture method, in order to provide an accurate puncture angle for an operator, the application provides the intracranial puncture method so as to provide a navigation method aiming at intracranial hematoma. Referring to fig. 2, fig. 2 is a schematic flow chart of a first embodiment of an intracranial puncture method according to the present application, which specifically includes the following steps:
s11: acquiring head posture information, a head scanning image and puncture needle posture information;
generally, the system of the intracranial puncture method of the present application is provided with an acquisition module 1 for acquiring head posture information, a head scan image and puncture needle posture information, as shown in fig. 1, the acquisition module 1 at least includes a first acquisition module (e.g. an anterior acquisition module a), a second acquisition module (e.g. an anterior acquisition module b) and a third acquisition module (e.g. an anterior acquisition module c).
The first acquisition module is used for acquiring head posture information, the second acquisition module is used for acquiring a head scanning image, and the third acquisition module is used for acquiring puncture needle posture information. Of course, the head posture information, the head scan image and the puncture needle posture information may also be obtained by calling the calculation module 2 in a database pre-stored in the PC terminal 3, and in addition, those skilled in the art may also obtain the information by other ways, which is not limited herein.
In conjunction with fig. 1, acquiring the head posture information, the head scan image, and the puncture needle posture information may specifically include:
based on the information acquired by the first sensor, a first position relation is established, an accelerometer 12, a gyroscope 11 and a magnetometer 13 of the first sensor are fused through a first preset algorithm (such as a Madgwick algorithm), and the attitude angle of the first sensor is calculated to obtain head attitude information.
A front mining module a: the patient's skull is equipped with a wearable IMU10 such that the IMU10 on the wearable equipment establishes a positive positional relationship with the patient's skull. The IMU10 includes a gyroscope 11, an accelerometer 12 and a magnetometer 13, fused by the Madgwick algorithm, to provide euler angles in three axes. The wearable equipment is a two degree of freedom adjustment device intended to calibrate the head-mounted IMU10 over a patient's cranial CT scan cross-section.
Specifically, the gyroscope 11 and the accelerometer 12 of the first sensor do not directly provide attitude angles, the accelerometer 12 provides accelerations in three axis directions, the gyroscope 11 provides angular velocities in three axis directions, the magnetometer 13 provides magnetic forces in three axes, the attitude angles are three respective (the accelerometer 12, the gyroscope 11, and the magnetometer 13) obtained through formula calculation, which formula is specifically adopted is described in detail later, and then the madgwick algorithm further fuses and reduces noise to obtain stable and accurate three-axis attitude angles.
Importing the scanned image into preset software to obtain a head scanned image, wherein the preset software can be 3DSlicer, and specifically, a CT image (DICOM file) can be imported into the 3DSlicer software for acquisition; and a front mining module b: the image equipment is used for carrying out CT slice scanning on the skull of a cerebral hemorrhage patient to obtain the image data of the skull of the patient.
And establishing a second position relation based on the information acquired by the second sensor, and calculating the attitude angle of the second sensor by fusing the accelerometer 31, the gyroscope 32 and the magnetometer 33 of the second sensor through a second preset algorithm (such as a Madgwick algorithm) so as to obtain the attitude information of the puncture needle.
A front mining module c: the IMU inertial sensing unit 30 is equipped on the puncture needle guide for doctor operation and is responsible for detecting and recording the attitude information of the needle. The IMU measurement module 30 also includes a gyroscope 31, an accelerometer 32, and a magnetometer 33, fused by the Madgwick algorithm, to provide euler angles in three axes.
S12: determining puncture path attitude information by using the head attitude information and the head scanning image;
based on the acquisition module 1, it can be known that the system needs at least two inertial sensing units (IMU), the first IMU (denoted as IMUa) is installed on the head-worn device, and the position relation is established with the head of the patient, so that the real-time posture change of the intracranial puncture path of the patient is fed back through the related calculation, and the real-time head posture information is acquired.
In order to control cost, simple operation and real-time positioning and enable the head of a patient to move, the reference plane of the ground coordinate for setting the head posture information and the cross section of the head scanning image are on the same horizontal plane, therefore, a doctor can rapidly determine the posture information of the puncture path by using the head posture information and the head scanning image without angle calibration when the head of the patient moves, namely, without spending time to perform angle conversion, thus the navigation optimization of the puncture path is promoted, and accurate posture information of the puncture path is provided.
S13: and displaying the puncture path and the puncture needle in real time based on the puncture path attitude information and the puncture needle attitude information.
Generally, in a conventional intracranial hematoma high-precision puncture surgery, a doctor needs to determine a puncture path including a puncture point, a target point, a puncture angle (yaw, pitch, roll angle relative to a CT reference plane), and a depth through a CT image, and then precisely insert a surgical needle according to a guide puncture path.
Therefore, it is particularly important to display the puncture path and the puncture needle in real time based on the puncture path posture information and the puncture needle posture information. Specifically, the puncture path and the puncture needle can be displayed in real time through software of an upper computer.
Therefore, according to the navigation method for the intracranial puncture at present, the relation between the head posture and the head scanning image is closely related by designing that the reference plane of the ground coordinate of the head posture information and the cross section of the head scanning image are always on the same horizontal plane, the skull of a patient does not need to be fixed, and the navigation optimization can be carried out on the intracranial puncture, so that accurate puncture path posture information and puncture needle posture information are provided, the puncture path and the puncture needle are displayed in real time, and the operation error of a doctor is reduced.
Further, the head pose information and the head scan image are used to determine the pose information of the puncture path, please refer to fig. 3, fig. 3 is a flowchart illustrating an embodiment of step S12 in fig. 2, and the method specifically includes the following steps:
s21: processing the head scanning image to obtain a puncture path and an Euler angle of the puncture path corresponding to the cross section of the head scanning image;
the skull is medically divided into three basic planes, sagittal, coronal and transverse. CT scanning is scanning a cross section of the skull. The CT image (DICOM file) is imported into 3DSlicer software, and a CT image doctor obtains a processing experience value input by the doctor in the 3DSlicer software according to experience, and then the head scanning image is processed, and a transcranial puncture path and an Euler angle of the puncture path corresponding to the cross section of the head scanning image are designed.
Specifically, how to calculate the euler angle of the puncture path corresponding to the cross section of the head scanning image is described in detail when an exemplary diagram of the included angle between the puncture path and the reference surface is calculated by 3d scanner software.
S22: determining a theoretical axis angle of the puncture path in a ground coordinate according to the puncture path, the Euler angle and the cross section of the head scanning image;
since the puncture path is actually a path in the range of the puncture path, there are actually many puncture paths, and one of the puncture paths is taken for representative illustration, so as to improve the realizability of the puncture method for realizing the puncture method.
The euler angle is actually the angle of rotation of the object about three coordinate axes (x, y, z axes) of the coordinate system. Generally, the euler angle can be divided into two cases: 1, static state: i.e. rotation about three axes of the world coordinate system, is called static since the coordinate axes remain stationary during rotation of the object. 2, dynamic: namely, the rotation around three axes of the object coordinate system, and the coordinate axes rotate along with the object in the rotation process of the object, so the rotation is called dynamic. The magnitude of the rotation angle can be generally expressed by yaw (yaw with y-axis), pitch (pitch with x-axis), roll (roll with z-axis) angle values.
As can be seen from step S12 in fig. 2, the three-axis angle of the surgical needle is designed to be the same as the three-axis angle of the puncture path during calibration, so that the theoretical axis angle of the puncture path in the ground coordinate can be determined from the puncture path, the euler angle, and the cross section of the head scan image.
S23: and determining the puncture path attitude information by using the head attitude information and the theoretical axis angle.
The head posture information is displayed in real time, and a doctor can observe the real-time display state of hematoma in real time and feed back the real-time posture change of the intracranial puncture path of the patient through related calculation.
During the calibration process, the three-axis angles of the surgical needle are actually equal to the three-axis angles of the puncture path, so that the calculated theoretical axis angles are actually used for determining the angle inserted in the surgical operation, and the puncture path posture information can be determined because the puncture path is determined.
Further, processing the head scan image to obtain the puncture path, please refer to fig. 4, where fig. 4 is a flowchart illustrating an embodiment of step S21 in fig. 3, and the method specifically includes the following steps:
s31: processing the head scanning image through image processing software to obtain the position of the intracranial hematoma block;
intracranial hematoma (Intracranial hematomas) is formed when blood is collected in the brain or between the brain and the skull after blood vessels in the brain or between the brain tissue and the skull are ruptured due to trauma or the like, and the brain tissue is compressed.
The size of the intracranial hematoma directly determines which operation measure is adopted, for example, if the hematoma amount is not more than 30ml, the medicine for detumescence, dehydration, hemostasis and cranial nerve nutrition can be applied through conservative treatment. If the hematoma amount is larger and exceeds 30ml, the cerebral hernia can occur due to the compression of brain tissues and brainstem, the hematoma needs to be removed through operation, and the treatment can be carried out according to the method after the operation.
Therefore, after the head scanning image is obtained, the scanning image of the head can be processed by the image processing software, and in particular, the detailed information such as the position, the size and the shape of the intracranial hematoma can be determined according to the basic principle of three-dimensional stereotactic.
S32: designing a target point and a craniofacial puncture point according to the position of the intracranial hematoma block;
through the confirmation of detailed information such as the position, the size, the shape and the like of the intracranial hematoma, the volume of the hematoma amount can be calculated through a preset formula, wherein the preset formula can adopt a microtia formula.
The target point design and the cranium surface puncture point design are carried out according to the position of an intracranial hematoma block, specifically, a hematoma puncture plane is determined at first, and the layer which is the maximum layer of the hematoma and the layer which is the center of the hematoma is selected as the puncture layer in principle.
And moreover, a target point is determined, for spherical or elliptical hematoma, the target point is selected at the central position of a hematoma puncture plane, and when the hematoma is large, the target point can be used as the puncture target point at a position slightly deviated from the central position by 0.5-1.0 cm as appropriate, so that the hematoma removal is facilitated. For example, when the amount of bleeding exceeds 80ml, two puncture target points can be selected as intracranial hematoma, double-needle puncture is adopted, the front and back positions of a hematoma puncture plane are selected, and the distance between two puncture needles on an upper puncture plane and a lower puncture plane can be selected according to the condition, wherein the distance between the two puncture needles is usually more than 2 cm.
Then, determining the puncture point of the cranial surface, namely avoiding the main trunk of the cutaneous-temporal superficial artery and venous sinus, wherein the puncture point, the collateral vessels and important brain functional regions such as motion regions and the like can not be selected within 2cm above and below the lateral sinus such as the left and right side opening of the sagittal sinus and the transverse sinus; secondly, on the hematoma puncture plane, the head surface puncture point is closest to the outer edge of the intracranial hematoma; thirdly, the epidural and subdural hematoma puncture points should be selected at the central position where the wide diameter of the hematoma is the thickest. Certainly, the target point and the cranium surface puncture point are designed, and other modes can be provided according to different hematoma numbers, sizes and the like, for example, the puncture point is usually determined according to the experience of a doctor, for example, the puncture point is one third of the hematoma and is less than 10cm away from the vertex of the head, and the puncture point is specifically selected according to the needs, and the design is not limited here.
S33: and determining a puncture path by using the target point and the craniofacial puncture point.
The straight line distance between the target point and the cranium surface puncture point can be determined by utilizing the target point and the cranium surface puncture point, but other tissues are arranged between the target point and the cranium surface puncture point, so that the puncture path is selected to avoid the positions of the frontal sinus and the middle line and the position 2cm before the tubular peak, and the puncture path is preferably matched with the long axis of hematoma.
Furthermore, a theoretical axis angle of the puncture path in the ground coordinate is determined according to the puncture path, the euler angle and the cross section of the head scan image, please refer to fig. 5-8, fig. 5 is a schematic flow chart of an embodiment of step S22 in fig. 3; FIG. 6 is a schematic diagram of a first fixed inertial measurement unit worn by a patient according to the present application; FIG. 7 is a schematic structural diagram illustrating a configuration of calculating an included angle between a puncture path and a reference plane by using preset software; FIG. 8 is a schematic diagram illustrating a calculation manner of three-axis Euler angles of an intracranial puncture path in a ground coordinate according to the present application; the method specifically comprises the following steps:
s41: establishing a ground coordinate by taking the target point as a coordinate origin, wherein a reference surface of the ground coordinate and the cross section of the head scanning image are on the same horizontal plane;
in order to facilitate the insertion of the angle of the puncture needle, a ground coordinate taking the target point as a coordinate origin is established, so that the conversion and calculation of the angle of the three-axis Euler angle of the intracranial puncture path in the ground coordinate can be facilitated.
Generally, in order to obtain an accurate target point of the position of the intracranial hematoma and an accurate cranium surface puncture point, the skull of the patient must be fixed to ensure the correct puncture path, as shown in fig. 6, the IMU10 is worn on the head of the patient, and the reference plane of the ground coordinate is a plane formed by two points determined by two ears of the patient and a point above the nose, wherein the plane is a reference plane.
In order to make the head of a patient more comfortable, the reference surface S2 of the designed ground coordinate and the cross section S1 of the head scanning image are on the same horizontal plane, so that the relation between the head posture and the head scanning image is closely related, the skull of the patient does not need to be fixed, the intracranial puncture can be navigated and optimized, and accurate puncture path posture information is provided.
Further, the head pose information and the theoretical axis angle are used to determine the puncture path pose information, please refer to fig. 9, fig. 9 is a flowchart illustrating an embodiment of step S23 in fig. 3, and the method specifically includes the following steps:
s51: reconstructing a three-dimensional model of the skull by using the head posture information and preset software;
because the first IMU (denoted as IMUa) is mounted on the head-worn device, head pose information can be acquired, and a three-dimensional model of the skull can be reconstructed through preset software.
Specifically, for example, the operation is performed under MATLAB R2016a version, the operation result includes a CT image of the skull, and the operation result may display a stereo image and three views of the skull, although those skilled in the art may also use 3d scanner software to reconstruct the CT image of the skull and display the stereo image and three views of the skull, where the operation is selected according to the requirements, and is not limited specifically.
S52: displaying the skull in real time according to the three-dimensional model;
the first IMU (denoted as IMUa) is installed on the head-worn device and aims to establish a position relation with the head of a patient, so that the real-time posture change of the intracranial puncture path of the patient is fed back through correlation calculation, and the skull can be displayed in real time through a three-dimensional model.
S53: and determining puncture path attitude information through the craniocerebral surface puncture point and the theoretical axis angle.
A second IMU (denoted IMUb) is mounted on the needle apparatus and is responsible for detecting and registering the three-axis attitude changes of the needle. To calculate the euler angle variation during IMU rotation, we define the three-axis rotation matrix of IMU as equations (1), (2) and (3):
Figure BDA0003139611550000111
Figure BDA0003139611550000112
Figure BDA0003139611550000113
wherein θ is a roll angle roll, which is an x-axis rotation angle around the IMU;
Figure BDA0003139611550000114
is the pitch angle pitch, i.e. the y-axis rotation angle around the IMU; ψ is the heading angle yaw, i.e., the angle of rotation about the z-axis of the IMU. The IMU has a posture angle theta at the (n + 1) th moment>
Figure BDA0003139611550000115
ψ means that the IMU coordinate system rotates around a rotation angle of Y through an initial position at time n through a rotation angle of ψ around Z>
Figure BDA0003139611550000116
The final posture is obtained by rotating the angle theta around the X.
The three rotation matrices of the above equations (1), (2) and (3) are multiplied by each other in the order of z-y-x rotation to obtain a rotation Matrix C, also called Direction Cosine Matrix (DCM), which can represent one euler rotation. We define this as rotation from the reference frame (m-frame) to its own coordinate system (b-frame) by
Figure BDA0003139611550000117
To represent
Figure BDA0003139611550000121
The accelerometer measuring the acceleration of the element itself, by
Figure BDA0003139611550000122
And expressing that the accelerometer resolving attitude angle is expressed as formula (5) in the IMU rotation process: />
Figure BDA0003139611550000123
As can be obtained by solving equation (5),
Figure BDA0003139611550000124
for gyroscopes (gyroscopic)
Figure BDA0003139611550000125
The three-axis attitude angle at the n +1 th moment is shown as follows: theta + delta theta, based on the presence of a trigger signal>
Figure BDA0003139611550000126
ψ + Δ ψ, wherein the change in the attitude angle Δ θ, < >>
Figure BDA0003139611550000127
Δ ψ can be integrated by angular velocity with time period, i.e.
Figure BDA0003139611550000128
The gyroscope resolving attitude angle is expressed as formula (7):
Figure BDA0003139611550000129
the inversion torque matrix can be obtained:
Figure BDA0003139611550000131
magnetometer (magnetometer) used under its own coordinate system (system b)
Figure BDA0003139611550000132
Expressed by M in a magnetic geographic coordinate system (M system) m And (4) showing. Converting from a b system to an m system coordinate system, wherein the relation is as follows:
Figure BDA0003139611550000133
wherein
Figure BDA0003139611550000134
Is a direction cosine matrix converted from b to m systems: />
Figure BDA0003139611550000135
When b is coincident with m,
Figure BDA0003139611550000136
substituting the roll angle (roll) and pitch angle (pitch) determined by the accelerometer into the direction cosine matrix can determine:
Figure BDA0003139611550000137
the yaw angle of the magnetometer is obtained as:
Figure BDA0003139611550000138
s42: acquiring a first axis angle of a first sensor;
by using the 3D scanner software shown in FIG. 7, in one embodiment, the calculation results of the included angles of the puncture path with respect to the three reference surfaces are 23.6, 14.3 and 62.0 respectively, and the distance from the puncture point of the skull to the target point of hematoma is measured to be 42.4mm.
Wherein, the horizontal line of the lower half in fig. 8 is a plane as a cross section, the vertical line of the lower half in fig. 8 is another plane as a sagittal plane, and the included angle between the puncture path and the two planes is the angle information that we need to obtain, i.e. the first peripheral angle.
In particular, as can be seen in fig. 8, the head-mounted IMUa has coordinates where x a Is the x-axis angle, y, of IMUa a Is the y-axis angle of IMUa, where x a And y a As the first axis angle of the first sensor.
S43: and calculating a theoretical second axis angle and a theoretical third axis angle of the puncture path corresponding to the craniofacial puncture point based on the first axis angle according to the puncture path, the Euler angle and the reference plane.
As can be seen from fig. 8, the straight-line distance between the target point O and the craniocerebral puncture point a is OA, and the theoretical second axis angle and the theoretical third axis angle of the puncture path corresponding to the craniocerebral puncture point, that is, the insertion angle of the puncture needle, are calculated based on the first axis angle according to the puncture path, the euler angle of the target point O and the reference plane S2, as shown in expression (14) and expression (15).
x b ＝x a -(90°-θ) (14)
Figure BDA0003139611550000141
The z-axis angle of the puncture point is not calculated, but the x-axis angle = x of the needle is ensured in the calibration process of the subsequent operation puncture b Y-axis angle = y b Z-axis angle = z a The triaxial angle of the needle at this time = the triaxial angle of the puncture path. Therefore, the method and the device have the following beneficial effects that:
1. surgical puncture is performed by matching the puncture of the puncture needle with the euler angle of the intracranial puncture path under the ground coordinate.
2. The method establishes a determined relation by applying the IMU and the scanning cross section of the skull CT, thereby realizing the real-time coordinate Euler angle of the intracranial puncture path indirectly measured by the IMU. The method is a data fusion method of CT image information and IMU posture information.
3. Provides a new navigation method for assisting intracranial hematoma puncture surgery.
An embodiment of the present application further provides an intracranial puncture system, please refer to fig. 10, fig. 10 is a schematic diagram of a puncture needle device of the present application carrying a second inertial measurement unit, and the intracranial puncture system includes:
a first sensor configured to be fixed to the head for acquiring head pose information;
a scanning device for acquiring a head scan image;
the second sensor is configured to be fixed on the puncture needle and used for acquiring the pose information of the puncture needle;
the intracranial puncture device is connected with the first sensor, the scanning device and the second sensor and used for executing the method provided by the first aspect of the embodiment of the application.
Aiming at a navigation system urgently needed by an intracranial hematoma puncture drainage operation, the intracranial hematoma positioning and puncture path navigation method fusing a wearable IMU inertial sensing element (such as a first sensor) of a head and CT image data is disclosed. Compared with the existing optical navigation system, mechanical navigation system and electromagnetic navigation system, the system can provide more accurate intracranial puncture path navigation, has the advantages of more convenient operation and lower price, and more efficiently and quickly assists doctors to complete intracranial hematoma puncture drainage surgery.
Under this application hematoma puncture system, developed the collaborative precision experiment of two IMUs. The experimental method is that two IMUs applied to the system are calibrated in the same horizontal plane and then are placed on two sides of the same horizontal wood board. And then, the wood board is taken up every ten minutes to move, the posture data of the two IMUs are recorded, and five movement actions are carried out in total and recorded as five groups of experiments. The three-axis angle error between the two IMUs is then statistically analyzed. The purpose of the experiment is to verify whether two IMUs applied to a navigation system can synchronously provide sufficiently accurate attitude information in real time within a certain operation time. The experimental result proves that the average error of the three-axis angles of the two IMUs under the synergistic effect is within 1 degree.
The second experiment is a simulation experiment of the operation under the navigation of the method, and the error between the puncture path and the intracranial puncture path after the simulation operation is completed is measured. The experimental result meets the medical error requirement.
The operation is simpler under the condition of ensuring the precision, the limiting conditions are fewer, the cost is greatly reduced, and the clinical use efficiency is greatly improved. Compared with the recently researched navigation system based on the IMU, the novel method realizes real-time navigation of the puncture path by the IMU.
Further, referring to fig. 11, fig. 11 is a schematic block diagram of an embodiment of an intracranial puncture apparatus according to the present application. The embodiment of the present application further provides an intracranial puncture apparatus 5, which includes a processor 51 and a memory 52, wherein the memory 52 stores a computer program 521, and the processor 51 is configured to execute the processing method of the computer program 521 according to the first aspect of the embodiment of the present application, and is not described herein again.
Referring to fig. 12, fig. 12 is a schematic block diagram of an embodiment of a computer-readable storage medium of the present application. If implemented in the form of software functional units and sold or used as a stand-alone product, may be stored in the computer-readable storage medium 60. Based on such understanding, the technical solution of the present application may be substantially implemented or contributed to by the prior art, or all or part of the technical solution may be embodied in a software product, which is stored in a storage device and includes instructions (computer program 61) for causing a computer device (which may be a personal computer, a server, or a network device) or a processor (processor) to execute all or part of the steps of the method according to the embodiments of the present application. The aforementioned storage device includes: various media such as a usb disk, a portable hard disk, a Read-Only Memory (ROM), a Random Access Memory (RAM), a magnetic disk or an optical disk, and electronic devices such as a computer, a mobile phone, a notebook computer, a tablet computer, and a camera having the storage medium.
The description of the implementation process of the computer program in the computer readable storage medium can refer to the above-mentioned embodiment of the processing method of the intracranial puncture device 5, and will not be described herein again.
The above description is only a part of the embodiments of the present application, and not intended to limit the scope of the present application, and all equivalent devices or equivalent processes performed by the content of the present application and the attached drawings, or directly or indirectly applied to other related technical fields, are also included in the scope of the present application.

Claims (7)

1. An intracranial puncture system, comprising:
a first sensor configured to be fixed to the head for acquiring head pose information;
a scanning device for acquiring a head scan image;
the second sensor is configured to be fixed on the puncture needle and used for acquiring pose information of the puncture needle;
the intracranial puncture device is connected with the first sensor, the scanning equipment and the second sensor and is used for executing an intracranial puncture method;
the intracranial puncture device is used for acquiring head posture information, a head scanning image and puncture needle posture information;
the intracranial puncture device determines puncture path attitude information by utilizing the head attitude information and the head scanning image, wherein a reference plane of a ground coordinate of the head attitude information and a cross section of the head scanning image are on the same horizontal plane;
the intracranial puncture device displays the puncture path and the puncture needle in real time based on the puncture path attitude information and the puncture needle attitude information.
2. The intracranial puncture system according to claim 1,
the intracranial puncture device utilizes the head posture information and the head scanning image to determine puncture path posture information, and comprises:
the intracranial puncture device processes the head scanning image to obtain a puncture path and an Euler angle of the cross section of the head scanning image corresponding to the puncture path;
the intracranial puncture device determines a theoretical shaft angle of the puncture path in a ground coordinate according to the puncture path, the Euler angle and the cross section of the head scanning image;
the intracranial puncture device determines puncture path attitude information by utilizing the head attitude information and the theoretical shaft angle.
3. The intracranial puncture system as recited in claim 2,
the intracranial puncture device processes the head scanning image to obtain a puncture path, and the method comprises the following steps:
the intracranial puncture device processes the head scanning image through image processing software to obtain the position of an intracranial hematoma block;
the intracranial puncture device designs a target point and a cranium surface puncture point according to the position of the intracranial hematoma block;
the intracranial puncture device determines the puncture path by utilizing the target point and the craniocerebral puncture point.
4. The intracranial puncture system as recited in claim 3,
the intracranial puncture device determines a theoretical shaft angle of the puncture path in a ground coordinate according to the puncture path, the Euler angle and a cross section of the head scanning image, and comprises:
the intracranial puncture device establishes a ground coordinate by taking the target point as an origin of coordinates, and a reference surface of the ground coordinate and the cross section of the head scanning image are on the same horizontal plane;
the intracranial puncture device acquires a first axial angle of a first sensor;
and the intracranial puncture device calculates a theoretical second axis angle and a theoretical third axis angle of the puncture path corresponding to the cranium surface puncture point based on the first axis angle according to the puncture path, the Euler angle and the reference plane.
5. The intracranial puncture system as recited in claim 3,
the intracranial puncture device utilizes the head posture information and the theoretical shaft angle to determine puncture path posture information, and comprises:
the intracranial puncture device reconstructs a three-dimensional model of the skull by using the head posture information and adopting preset software;
the intracranial puncture device displays the skull in real time according to the three-dimensional model;
the intracranial puncture device determines puncture path posture information through the cranium surface puncture point of the skull and the theoretical shaft angle.
6. The intracranial puncture system according to claim 1,
the intracranial puncture device acquires head posture information, a head scanning image and puncture needle posture information, and comprises:
the intracranial puncture device establishes a first position relation based on information collected by a first sensor, fuses an accelerometer, a gyroscope and a magnetometer of the first sensor through a first preset algorithm, and calculates an attitude angle of the first sensor to obtain the head attitude information;
the intracranial puncture device leads the scanned image into preset software to obtain the head scanned image;
the intracranial puncture device establishes a second position relation based on information acquired by a second sensor, fuses an accelerometer, a gyroscope and a magnetometer of the second sensor through a second preset algorithm, and calculates an attitude angle of the second sensor to obtain puncture needle attitude information.
7. The intracranial puncture system according to claim 1,
intracranial piercing depth is based on puncture route gesture information with puncture needle gesture information shows puncture route and puncture needle in real time, includes:
the intracranial puncture device displays the puncture path and the puncture needle in real time through upper computer software based on the puncture path attitude information and the puncture needle attitude information.
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Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105054999A (en) * 2015-08-18 2015-11-18 浙江工业大学 Improved encephalic puncture guiding method and device

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2008061858A (en) * 2006-09-08 2008-03-21 Toshiba Corp Puncture treatment navigation apparatus
CN103040525B (en) * 2012-12-27 2016-08-03 深圳先进技术研究院 A kind of multimode medical image operation piloting method and system
CN103417201B (en) * 2013-08-06 2015-12-02 中国科学院深圳先进技术研究院 A kind of sports auxiliary training system and its implementation gathering human body attitude
CN103800051B (en) * 2014-02-17 2015-09-16 浙江工业大学 A kind of intracranial puncture assists guidance system
JP6629031B2 (en) * 2015-10-05 2020-01-15 キヤノンメディカルシステムズ株式会社 Ultrasound diagnostic device and medical image diagnostic device
US20210307838A1 (en) * 2017-12-29 2021-10-07 Weipeng (Suzhou) Co., Ltd. Surgical navigation method and system
JP2022509316A (en) * 2018-12-03 2022-01-20 ３メンシオ メディカル イメージング ビー ヴイ Methods, devices and systems for planning intracavitary probe procedures
CN113520543B (en) * 2021-06-29 2023-04-07 深圳先进技术研究院 Intracranial puncture method, intracranial puncture device, intracranial puncture system, and storage medium

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105054999A (en) * 2015-08-18 2015-11-18 浙江工业大学 Improved encephalic puncture guiding method and device

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