CN114788734A - Intraoperative three-dimensional navigation method and system based on double-C-arm imaging system - Google Patents
Intraoperative three-dimensional navigation method and system based on double-C-arm imaging system Download PDFInfo
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- CN114788734A CN114788734A CN202210716807.XA CN202210716807A CN114788734A CN 114788734 A CN114788734 A CN 114788734A CN 202210716807 A CN202210716807 A CN 202210716807A CN 114788734 A CN114788734 A CN 114788734A
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- 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
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- 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
Abstract
The invention discloses an intraoperative three-dimensional navigation method and system based on a double-C-arm imaging system, which relate to the technical field of image processing and comprise the following steps: acquiring a reference three-dimensional image before a target operation and entering an operation; the two-dimensional imaging of each C-arm imaging system in the operation is acquired in real time by keeping the relative positions of the double C-arm imaging systems and the real-time navigation area; respectively extracting a maximum density projection drawing at an angle matching position in the reference three-dimensional imaging based on the imaging angle of each two-dimensional imaging; acquiring the maximum density projection graphs of the double C-arm imaging systems after respective updating through fusion of two-dimensional imaging and corresponding maximum density projection; and acquiring intraoperative real-time three-dimensional imaging through fusion of the maximum density projection drawing updated by the double-C-arm imaging system and the reference three-dimensional imaging. The invention updates the preoperative three-dimensional imaging by the intraoperative two-dimensional imaging, and solves the problems of high irradiation dose and poor real-time performance of intraoperative three-dimensional image acquisition.
Description
Technical Field
The invention relates to the technical field of image processing, in particular to an intraoperative three-dimensional navigation method and system based on a double-C-arm imaging system.
Background
A C-arm X-ray machine (referred to as a C-arm for short) and a Digital Subtraction Angiography (DSA for short) based on the C-arm X-ray machine are core devices for supporting interventional diagnosis and treatment, and are widely applied to image navigation of interventional surgery, minimally invasive surgery and compound surgery. The three-dimensional C-shaped arm/DSA is based on the traditional two-dimensional C-shaped arm/DSA technology, a series of projection data in a certain angle range are collected around an imaging region, and a Cone-beam CT (Cone-beam CT, CBCT for short) three-dimensional image reconstruction algorithm and a related image post-processing algorithm are adopted, so that a rotatable three-dimensional image and a two-dimensional image of a cross section, a sagittal plane, a coronal plane or any other section can be rapidly generated in an operation, a 360-degree dead-angle-free observation angle is provided for an operator, the operation implementation condition is judged comprehensively and accurately, a guarantee is provided for the implementation of the operation, the operation success rate is improved, and the complication probability is reduced.
Three-dimensional C-arm/DSA surgical navigation has great advantages over two-dimensional C-arm/DSA, but it also faces two major principle limitations: 1. high imaging radiation dose: theoretically, three-dimensional C-arm/DSA requires hundreds or even hundreds of exposures to acquire projection data for three-dimensional imaging, with much higher radiation doses than for two-dimensional imaging; 2. the imaging real-time performance is poor: the three-dimensional C-arm/DSA needs to rotate to acquire a series of projection data within a certain angle range (180 degrees) for three-dimensional image reconstruction, and because of safety considerations, the rotation speed of the open C-arm is much slower than that of the closed traditional CT (usually less than 1/30 of the latter), which results in poor imaging real-time performance. Therefore, the prior art has not been able to apply three-dimensional C-arm/DSA to real-time intraoperative navigation for real-time and radiation dose considerations.
Disclosure of Invention
In order to reduce the irradiation dose of a three-dimensional C-arm/DSA and improve the real-time imaging performance of the three-dimensional C-arm/DSA during the intraoperative scanning task, the invention provides an intraoperative three-dimensional navigation method based on a double C-arm imaging system, which comprises the following steps:
s1: acquiring a reference three-dimensional image before a target operation and entering an operation;
s2: the method comprises the steps of obtaining two-dimensional imaging of each C-arm imaging system in the operation in real time by keeping the relative position of a double C-arm imaging system and a real-time navigation area;
s3: respectively extracting a maximum density projection drawing at an angle matching position in the reference three-dimensional imaging based on the imaging angle of each two-dimensional imaging;
s4: acquiring the maximum density projection graphs of the double C-arm imaging systems after respective updating through fusion of two-dimensional imaging and corresponding maximum density projection;
s5: and acquiring intraoperative real-time three-dimensional imaging through fusion of the maximum density projection drawing updated by the double-C-arm imaging system and the reference three-dimensional imaging.
Furthermore, the double-C-arm imaging system comprises a first C-arm imaging system and a second C-arm imaging system, and imaging surfaces of the first C-arm imaging system and the second C-arm imaging system are arranged in a non-parallel crossed manner.
Further, in the step S4, the maximum density projection graph is updated according to the following formula:
wherein 1 denotes a first C-arm imaging system, 2 denotes a second C-arm imaging system,for the updated maximum density projection view,for two-dimensional imaging to be acquired in real time,is the weight coefficient of the maximum density projection drawing,the rendering is the maximum density before updating.
Further, in the step S5, the fusion of the intraoperative real-time three-dimensional imaging is expressed as the following formula:
in the formula (I), the compound is shown in the specification,for real-time three-dimensional imaging after fusion operation,as the weight coefficient of the reference three-dimensional imaging,a baseline three-dimensional image is formed.
Furthermore, in the double-C-arm imaging system, each C-arm imaging system comprises an imaging combination consisting of an X-ray emission bulb and a flat panel detection system, and the imaging combination can move around a target in the C-arm imaging system to perform two-dimensional imaging acquisition.
Further, the step of S5 is followed by the step of:
s6: and judging whether a navigation ending signal is received or not, if so, ending the navigation, and if not, returning to the step S2.
The invention also provides an intraoperative three-dimensional navigation system based on the double-C-arm imaging system, which comprises the following components:
the reference acquisition module is used for acquiring reference three-dimensional imaging before a target operation;
the real-time imaging module is used for acquiring two-dimensional imaging of each C-arm imaging system in operation in real time by keeping the relative positions of the double C-arm imaging systems and the real-time navigation area;
the information extraction module is used for respectively extracting the maximum density projection drawing at the angle matching position in the reference three-dimensional imaging based on the imaging angle of each two-dimensional imaging;
the fusion updating module is used for acquiring the respectively updated maximum density projection graphs of the double-C arm imaging system through fusion of the two-dimensional imaging and the corresponding maximum density projection;
and the three-dimensional output module is used for acquiring intraoperative real-time three-dimensional imaging through fusion of the maximum density projection drawing updated by the double-C-arm imaging system and the reference three-dimensional imaging.
Furthermore, the double-C-arm imaging system comprises a first C-arm imaging system and a second C-arm imaging system, and imaging surfaces of the first C-arm imaging system and the second C-arm imaging system are arranged in a non-parallel crossed manner.
Further, in the fusion update module, the update of the maximum density projection graph is expressed as the following formula:
wherein 1 denotes a first C-arm imaging system, 2 denotes a second C-arm imaging system,for the updated maximum density projection view,for two-dimensional imaging to be acquired in real time,the weight coefficients for the maximum density projection graph,the rendering is the maximum density before updating.
Further, in the three-dimensional output module, the fusion of intraoperative real-time three-dimensional imaging is expressed as the following formula:
in the formula (I), the compound is shown in the specification,for real-time three-dimensional imaging after fusion operation,as the weight coefficient of the reference three-dimensional imaging,a baseline three-dimensional image is formed.
Compared with the prior art, the invention at least has the following beneficial effects:
(1) according to the intraoperative three-dimensional navigation method and system based on the double-C-arm imaging system, a mode that three-dimensional imaging is obtained preoperatively and the preoperative three-dimensional imaging is updated through two-way two-dimensional imaging acquired intraoperatively is adopted, so that the problems of high irradiation dose and poor real-time performance of intraoperative three-dimensional image acquisition are solved;
(2) in the double-C-arm imaging system, all the C-arm imaging systems are arranged in a non-parallel crossed manner, so that the three-dimensional imaging conversion can be realized by utilizing the cross of two non-parallel two-dimensional imaging, and the C-arm imaging systems are not required to scan in a surrounding manner to acquire the three-dimensional imaging;
(3) adopt the two C arm imaging system of non-stationary type, can carry out the formation of image angle according to actual operation demand and adjust, provide the formation of image show that more has the directive property when making things convenient for the doctor to carry out the operation.
Drawings
FIG. 1 is a step diagram of an intraoperative three-dimensional navigation method based on a dual C-arm imaging system;
FIG. 2 is a block diagram of an intraoperative three-dimensional navigation system based on a dual C-arm imaging system;
FIG. 3 is a schematic view of the arrangement orientation of the dual C-arm imaging system.
Description of reference numerals: 1-X-ray emission bulb tube and 2-flat panel detection system.
Detailed Description
The following are specific embodiments of the present invention and are further described with reference to the accompanying drawings, but the present invention is not limited to these embodiments.
Example one
Aiming at the problems of the existing three-dimensional C-arm/DSA in the support interventional operation, as shown in figure 1, the invention provides an intraoperative three-dimensional navigation method based on a double C-arm imaging system, which comprises the following steps:
s1: acquiring a reference three-dimensional image before a target operation and entering an operation;
s2: the two-dimensional imaging of each C-arm imaging system in the operation is acquired in real time by keeping the relative positions of the double C-arm imaging systems and the real-time navigation area;
s3: respectively extracting a maximum density projection drawing at an angle matching position in the reference three-dimensional imaging based on the imaging angle of each two-dimensional imaging;
s4: acquiring the updated maximum density projection images of the double-C-arm imaging system through fusion of two-dimensional imaging and the corresponding maximum density projection;
s5: acquiring intraoperative real-time three-dimensional imaging through fusion of the maximum density projection image updated by the double-C-arm imaging system and the reference three-dimensional imaging;
s6: and judging whether a navigation ending signal is received or not, if so, ending the navigation, and if not, returning to the step S2.
First, the problems of excessive irradiation dose and poor real-time performance when the conventional three-dimensional C-arm/DSA is applied to intraoperative navigation are analyzed. This is because the C-arm cannot directly acquire a three-dimensional image, and each time the X-ray emission bulb 1 is exposed, only one two-dimensional image in the current exposure view angle direction can be acquired. Two-dimensional imaging of the operation target in different exposure visual angle directions can be obtained along with exposure scanning around the target in a C-arm imaging system by an imaging combination formed by the X-ray emission bulb tube 1 and the flat panel detection system 2, and when the collected two-dimensional imaging is enough, the current integral three-dimensional imaging of the operation target can be obtained through a three-dimensional image reconstruction algorithm. As can be seen, the formation of a three-dimensional image requires a C-arm imaging system to scan at an angle around the surgical target before it can be obtained. Also, the state of the target cannot be changed during scanning, otherwise there may be a deviation in the acquired three-dimensional images, which makes the scanning period of one three-dimensional image still need to be sufficiently short. However, with the dual-C-arm imaging system, although two-dimensional imaging within half of the scanning angle can be acquired by the two C-arm imaging systems, the scanning time is only reduced by half, and the irradiation dose is not reduced.
In the support interventional operation, real-time three-dimensional imaging is not only needed to ensure that the operation progress is kept up with, but also the most direct method for reducing the irradiation dose is to reduce the exposure times of the X-ray emission bulb tube 1 in order to avoid the damage of the high irradiation dose to the patient and the doctor, and a single two-dimensional imaging can be obtained only by exposing once. From this point of view, the present invention proposes the idea of updating the fiducial (preoperative) three-dimensional imaging in real time by acquiring two-dimensional imaging during the procedure. The aim of acquiring intraoperative real-time three-dimensional imaging is achieved by updating reference three-dimensional imaging through two-dimensional imaging. In the method provided by the invention, firstly, the reference three-dimensional imaging before the operation of the operation target needs to be obtained, because the invention adopts the double-C-arm imaging system, the reference three-dimensional imaging can be obtained through the single-C-arm imaging system alone or the double-C-arm imaging system in a linkage manner.
After obtaining the reference three-dimensional image, how to update the reference three-dimensional image by the real-time two-dimensional image needs to be considered. Since real-time two-dimensional imaging is only one plane, a single plane image is obviously not available for updating of three-dimensional imaging. Therefore, the invention obtains two non-parallel and mutually crossed two-dimensional images by means of a double C-arm imaging system (as shown in figure 3, comprising a first C-arm imaging system and a second C-arm imaging system which are arranged in a non-parallel way and comprise two pairs of X-ray emission bulbs 1 and a flat panel detection system 2), and two-dimensional information is raised to three-dimensional information through the crossing of the two-dimensional images, and the crossing area is a real-time navigation area which needs to be followed in the operation. Therefore, the dual C-arm imaging system needs to maintain the relative position as the real-time navigation area moves, in addition to acquiring the two-dimensional imaging of the real-time navigation area.
Further, in order to blend the real-time two-dimensional imaging into the reference three-dimensional imaging, the maximum density projection image at the angle matching position in the reference three-dimensional imaging is respectively extracted according to the imaging angle of the two-dimensional imaging acquired by each C-arm imaging system (the maximum density projection image is the two-dimensional imaging, namely the extracted maximum density projection image and the corresponding two-dimensional imaging are positioned on the same section of the operation target). Firstly, through the fusion between the two-dimensional imaging and the two-dimensional imaging, the updating of the maximum density projection graph on the two crossed planes under the corresponding angle is obtained, and the updating can be specifically expressed as the following formula:
wherein 1 denotes a first C-arm imaging system, 2 denotes a second C-arm imaging system,for the updated maximum density projection view,for two-dimensional imaging to be acquired in real time,is the weight coefficient of the maximum density projection drawing,the maximum density projection graph before updating.
Then, the maximum density projection diagrams updated by the double-C-arm imaging system are fused into the reference three-dimensional imaging, so that intraoperative real-time three-dimensional imaging can be obtained, and the formula can be specifically expressed as follows:
in the formula (I), the compound is shown in the specification,for real-time three-dimensional imaging after fusion operation,as the weight coefficient of the reference three-dimensional imaging,a baseline three-dimensional image is formed.
It can be seen from the above that, as the updating of the reference three-dimensional imaging is performed by adopting the bidirectional two-dimensional imaging fusion mode, a single updating only needs to expose the X-ray emission bulb tube 1 in each C-arm imaging system once, so compared with the updating of intraoperative three-dimensional imaging performed by a surrounding scanning type of a double C-arm imaging system, the exposure times are greatly reduced, meanwhile, the two-dimensional imaging acquisition time is also greatly reduced, therefore, the irradiation dose can be greatly reduced, and meanwhile, the real-time performance is also greatly improved.
It should be noted that, in order to better meet the requirements of different operations in the operation on the operation space and/or the three-dimensional imaging view angle of the doctor, the imaging combination consisting of the X-ray emission bulb 1 and the flat panel detection system 2 can be moved around the target in the C-arm imaging system to perform two-dimensional imaging acquisition, and meanwhile, the included angle between the first C-arm imaging system and the second C-arm imaging system can also be changed according to the actual requirements. Therefore, the invention can provide directional imaging display while facilitating the operation of doctors.
According to actual requirements, the navigation chart can be displayed by single screen alternation or multiple screens simultaneously according to user settings、、. Furthermore, three-dimensional maps can be mappedAnd further carrying out image processing to obtain a two-dimensional image of a cross section, a sagittal plane, a coronal plane or any other tangent plane, and carrying out real-time navigation.
The above two C-arm imaging system cross two-dimensional imaging acquisition, two-dimensional and two-dimensional imaging fusion, and two-dimensional and three-dimensional imaging fusion are continuously performed in the operation process until the operation navigation is finished.
Example two
In order to better understand the technical point of the present invention, the present embodiment illustrates the present invention by the form of a system structure, as shown in fig. 2, an intraoperative three-dimensional navigation system based on a dual C-arm imaging system, comprising:
the reference acquisition module is used for acquiring reference three-dimensional imaging before a target operation;
the real-time imaging module is used for acquiring two-dimensional imaging of each C-arm imaging system in the operation in real time by keeping the relative position of the double C-arm imaging system and the real-time navigation area;
the information extraction module is used for respectively extracting the maximum density projection drawing at the angle matching position in the reference three-dimensional imaging based on the imaging angle of each two-dimensional imaging;
the fusion updating module is used for acquiring the respectively updated maximum density projection graphs of the double-C arm imaging system through fusion of the two-dimensional imaging and the corresponding maximum density projection;
and the three-dimensional output module is used for acquiring intraoperative real-time three-dimensional imaging through fusion of the maximum density projection drawing updated by the double-C-arm imaging system and the reference three-dimensional imaging.
Furthermore, the double-C-arm imaging system comprises a first C-arm imaging system and a second C-arm imaging system, and imaging surfaces of the first C-arm imaging system and the second C-arm imaging system are arranged in a non-parallel crossed mode.
Further, in the fusion update module, the update of the maximum density projection graph is expressed as the following formula:
wherein 1 denotes a first C-arm imaging system, 2 denotes a second C-arm imaging system,to the updated maximum density projection map,for two-dimensional imaging to be acquired in real time,is at mostThe weight coefficients of the density projection graph,the rendering is the maximum density before updating.
Further, in the three-dimensional output module, the fusion of intraoperative real-time three-dimensional imaging is expressed as the following formula:
in the formula (I), the compound is shown in the specification,for post-fusion intraoperative real-time three-dimensional imaging,as the weight coefficient of the reference three-dimensional imaging,a baseline three-dimensional image is formed.
In summary, the intraoperative three-dimensional navigation method and system based on the double-C-arm imaging system provided by the invention adopt a mode of acquiring three-dimensional imaging before an operation and updating the three-dimensional imaging through two-way two-dimensional imaging acquired in the operation, so that the problems of high irradiation dose and poor real-time performance of intraoperative three-dimensional image acquisition are solved.
In the double-C-arm imaging system, all the C-arm imaging systems are arranged in a non-parallel crossed manner, so that the three-dimensional imaging conversion can be realized by utilizing the crossed of two non-parallel two-dimensional imaging systems, and the surrounding scanning of the C-arm imaging systems is not needed for obtaining the three-dimensional imaging. Adopt two C arm imaging system of non-stationary type, can carry out the formation of image angle according to actual operation demand and adjust, provide the formation of image show that more has the directive property when making things convenient for the doctor to carry out the operation.
It should be noted that all the directional indicators (such as up, down, left, right, front, and rear … …) in the embodiment of the present invention are only used to explain the relative position relationship between the components, the movement situation, etc. in a specific posture (as shown in the drawing), and if the specific posture is changed, the directional indicator is changed accordingly.
Furthermore, descriptions of the present invention as related to "first," "second," "a," etc. are for descriptive purposes only and are not to be construed as indicating or implying relative importance or to imply that the number of technical features indicated is indicative. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one of the feature. In the description of the present invention, "a plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.
In the present invention, unless otherwise expressly stated or limited, the terms "connected," "secured," and the like are to be construed broadly, and for example, "secured" may be a fixed connection, a removable connection, or an integral part; can be mechanically or electrically connected; they may be directly connected or indirectly connected through intervening media, or they may be interconnected within two elements or in a relationship where two elements interact with each other unless otherwise specifically limited. The specific meanings of the above terms in the present invention can be understood according to specific situations by those of ordinary skill in the art.
In addition, the technical solutions in the embodiments of the present invention may be combined with each other, but it must be based on the realization of the technical solutions by those skilled in the art, and when the technical solutions are contradictory to each other or cannot be realized, such a combination of the technical solutions should not be considered to exist, and is not within the protection scope of the present invention.
Claims (10)
1. An intraoperative three-dimensional navigation method based on a double C-arm imaging system is characterized by comprising the following steps:
s1: acquiring a reference three-dimensional image before a target operation and entering an operation;
s2: the method comprises the steps of obtaining two-dimensional imaging of each C-arm imaging system in the operation in real time by keeping the relative position of a double C-arm imaging system and a real-time navigation area;
s3: respectively extracting a maximum density projection drawing at an angle matching position in the reference three-dimensional imaging based on the imaging angle of each two-dimensional imaging;
s4: acquiring the updated maximum density projection images of the double-C-arm imaging system through fusion of two-dimensional imaging and the corresponding maximum density projection;
s5: and acquiring intraoperative real-time three-dimensional imaging through fusion of the maximum density projection image updated by the double-C-arm imaging system and the reference three-dimensional imaging.
2. The intra-operative three-dimensional navigation method based on the double-C-arm imaging system as claimed in claim 1, wherein the double-C-arm imaging system comprises a first C-arm imaging system and a second C-arm imaging system, and the imaging surfaces of the first C-arm imaging system and the second C-arm imaging system are arranged in a non-parallel and crossed manner.
3. The method as claimed in claim 2, wherein in the step S4, the maximum intensity projection map is updated according to the following formula:
wherein 1 denotes a first C-arm imaging system, 2 denotes a second C-arm imaging system,to the updated maximum density projection map,for two-dimensional imaging to be acquired in real time,is the weight coefficient of the maximum density projection drawing,the maximum density projection graph before updating.
4. The method for intraoperative three-dimensional navigation based on the double C-arm imaging system as claimed in claim 3, wherein in the step S5, the fusion of intraoperative real-time three-dimensional imaging is expressed as the following formula:
5. The method as claimed in claim 1, wherein each of the two C-arm imaging systems comprises an imaging assembly of an X-ray emission bulb and a flat panel detection system, and the imaging assembly can move around the target in the C-arm imaging system for two-dimensional imaging acquisition.
6. The method for intraoperative three-dimensional navigation based on a double C-arm imaging system as claimed in claim 1, wherein the step S5 is further followed by the steps of:
s6: and judging whether a navigation ending signal is received or not, if so, ending the navigation, and if not, returning to the step S2.
7. An intraoperative three-dimensional navigation system based on a dual C-arm imaging system, comprising:
the reference acquisition module is used for acquiring reference three-dimensional imaging before a target operation;
the real-time imaging module is used for acquiring two-dimensional imaging of each C-arm imaging system in the operation in real time by keeping the relative position of the double C-arm imaging system and the real-time navigation area;
the information extraction module is used for respectively extracting the maximum density projection drawing at the angle matching position in the reference three-dimensional imaging based on the imaging angle of each two-dimensional imaging;
the fusion updating module is used for acquiring the respectively updated maximum density projection graphs of the double-C arm imaging system through fusion of the two-dimensional imaging and the corresponding maximum density projection;
and the three-dimensional output module is used for acquiring intraoperative real-time three-dimensional imaging through fusion of the maximum density projection drawing and the reference three-dimensional imaging which are respectively updated by the double-C-arm imaging system.
8. The intraoperative three-dimensional navigation system based on the double C-arm imaging system as claimed in claim 7, wherein the double C-arm imaging system comprises a first C-arm imaging system and a second C-arm imaging system, and imaging surfaces of the first C-arm imaging system and the second C-arm imaging system are arranged in a non-parallel crossed mode.
9. The intraoperative three-dimensional navigation system based on a double-C-arm imaging system as claimed in claim 8, wherein in the fusion updating module, the updating of the maximum density projection graph is represented as the following formula:
wherein 1 denotes a first C-arm imaging system, 2 denotes a second C-arm imaging system,to the updated maximum density projection map,for two-dimensional imaging to be acquired in real time,is the weight coefficient of the maximum density projection drawing,the maximum density projection graph before updating.
10. The intraoperative three-dimensional navigation system based on the double-C-arm imaging system as claimed in claim 9, wherein in the three-dimensional output module, the fusion of intraoperative real-time three-dimensional imaging is represented by the following formula:
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