CN116999129A - Positioning navigation system and method for neurosurgery puncture operation - Google Patents
Positioning navigation system and method for neurosurgery puncture operation Download PDFInfo
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- CN116999129A CN116999129A CN202310973504.0A CN202310973504A CN116999129A CN 116999129 A CN116999129 A CN 116999129A CN 202310973504 A CN202310973504 A CN 202310973504A CN 116999129 A CN116999129 A CN 116999129A
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Classifications
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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
- A61B17/3403—Needle locating or guiding means
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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
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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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
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
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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
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
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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
- A61B2034/2051—Electromagnetic tracking systems
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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
- A61B2034/2055—Optical tracking systems
Abstract
The invention discloses a positioning navigation system and a positioning navigation method for neurosurgery puncture operation, wherein the system comprises a nuclear magnetic resonance scanning unit, an optical positioning unit, a puncture unit and a navigation system terminal; the puncture unit comprises a mechanical arm and a puncture needle; the optical positioning unit comprises an optical positioning instrument and a positioning navigation bracket, wherein the positioning navigation bracket is fixed at the tail ends of the cranium of a patient and the mechanical arm, and a plurality of optical marking balls are fixed on the positioning navigation bracket; the optical positioning instrument is used for collecting optical image information of the optical marking ball; the nuclear magnetic resonance scanning unit comprises a nuclear magnetic resonance scanner, a Z frame and a plurality of titanium nails, wherein the titanium nails are fixed on the skull of a patient, and the Z frame is positioned at the tail end of the mechanical arm; the nuclear magnetic resonance scanner is used for collecting scanning image information of the cranium, the titanium nails, the Z frame and the puncture needle of the patient; the navigation system terminal is connected with the nuclear magnetic resonance scanning unit, the optical positioning unit and the puncture unit. The invention can realize brain tissue offset compensation in operation and ensure the safety of puncture paths.
Description
Technical Field
The invention mainly relates to the technical field of operation positioning navigation, in particular to a positioning navigation system and a positioning navigation method for neurosurgery puncture operation.
Background
Diseases such as Parkinson's disease, brain tumor, cerebral apoplexy and the like are one of the most serious diseases affecting national health. Neurosurgical puncture is the most prominent method of treating these brain neurological disorders. The main process is to pierce the puncture needle into the cranium of the patient to clear the focus. However, due to the complex intracranial nerve function area and vascular distribution, improper puncture path selection or target positioning deviation may cause serious sequelae and even endanger the life of the patient, so that a surgical navigation system is needed to navigate the whole intracranial puncture process so as to ensure that the puncture needle can safely and accurately reach the focus target of the patient.
The existing operation navigation system mostly uses an optical positioning technology or an electromagnetic navigation technology to track the position coordinates of the operation instrument in an operation space in real time during operation, and displays the position coordinates of the operation instrument on a display screen in a virtual three-dimensional image model mode, so that a doctor can observe the relative spatial position of the operation instrument in the cranium of a patient in real time, and the smooth operation of puncture operation is ensured. In order to convert the position coordinates of the surgical instrument to a three-dimensional image model of the surgical area for display, a plurality of titanium nails are required to be punched on the skull, and the registration of a coordinate system is convenient, so that the space conversion relation between the surgical space and the three-dimensional image is determined. However, the existing operation navigation system does not consider the brain tissue drifting phenomenon possibly happening in the operation, and the operation navigation is carried out only according to the three-dimensional model reconstructed before the operation and the puncture path planned in advance, so that the problems of inaccurate focus target positioning, unsafe puncture path and the like often occur. In addition, the operation navigation system is blind puncture in the puncture process, can not monitor the intracranial actual condition in the puncture process in real time, and can not timely respond and properly treat accidents possibly happening at any time in the operation process.
Disclosure of Invention
The technical problem to be solved by the invention is as follows: aiming at the technical problems existing in the prior art, the invention provides a positioning navigation system and a positioning navigation method for neurosurgery puncture operation, which are used for realizing brain tissue offset compensation and guaranteeing the safety of a puncture path in operation.
In order to solve the technical problems, the technical scheme provided by the invention is as follows:
a positioning navigation system for neurosurgery puncture operation comprises a nuclear magnetic resonance scanning unit, an optical positioning unit, a puncture unit and a navigation system terminal;
the puncture unit comprises a mechanical arm and a puncture needle, and the puncture needle is positioned at the movable end of the mechanical arm;
the optical positioning unit comprises an optical positioning instrument and two positioning navigation brackets, wherein the two positioning navigation brackets are rigidly fixed at the tail ends of the skull and the mechanical arm of the patient, and a plurality of optical marking balls are fixed on the positioning navigation brackets; the optical positioning instrument is used for collecting optical image information of the optical marking ball so as to optically track the position of the skull of the patient and the tail end of the mechanical arm;
the nuclear magnetic resonance scanning unit comprises a nuclear magnetic resonance scanner, a Z frame and a plurality of titanium nails, wherein the titanium nails are fixed on the skull of a patient, and the Z frame is positioned at the tail end of the mechanical arm; the nuclear magnetic resonance scanner is used for collecting scanning image information of cranium, titanium nails, Z frames and puncture needles of a patient;
the navigation system terminal is respectively connected with the nuclear magnetic resonance scanning unit, the optical positioning unit and the puncture unit and is used for carrying out three-dimensional reconstruction and segmentation on the cranium of a patient according to the three-dimensional scanning image information of the cranium of the patient and titanium nails on the surface of the cranium before operation to obtain a cranium three-dimensional model; according to the scanned image information and the optical image information of the titanium nails on the surface of the skull, determining the space conversion relation between a scanned image coordinate system acquired before the operation and an optical navigation coordinate system, and completing the initial pose calibration of the mechanical arm;
in operation, according to the scanning image information of the Z frame, the two-dimensional slice scanning plane of the nuclear magnetic resonance scanner is adjusted, and the craniocerebral three-dimensional model is spatially registered with the two-dimensional slice scanning plane in operation; and determining the relative spatial position relation between a focus target point and the puncture needle according to the registered two-dimensional image information containing the puncture needle and the cranium of the patient, and evaluating and re-planning the safety of the puncture path of the puncture needle.
As a further improvement of the above technical scheme:
the optical positioning instrument comprises a near infrared light source and two near infrared cameras; the near infrared light source is used for emitting near infrared light to irradiate an object to be measured, the infrared light is reflected from the optical marking ball to the near infrared camera on the optical positioning unit, and three-dimensional coordinates of the optical marking ball are obtained through triangulation according to the intersection point of the light rays.
Four optical marking balls are fixed on the positioning navigation support, and an infrared light reflecting coating is arranged on the surface of each optical marking ball.
The Z frame comprises a concave main body structure, a cylindrical tunnel is arranged inside the main body structure and communicated with the corner, and the tunnel of each surface is Z-shaped.
The main structure of the Z frame is made of acrylic plastic, and the inside of the tunnel is filled with resin visible under a nuclear magnetic resonance scanner.
The puncture needle comprises an outer sleeve and an inner needle, the outer sleeve is sleeved outside the inner needle, the outer sleeve is made of pure tantalum, and the inner needle is made of titanium alloy.
The navigation system terminal comprises an information acquisition module, an image processing module and a processing calculation module; the input end of the information acquisition module is connected with the nuclear magnetic resonance scanning unit and the optical positioning unit, and the output end of the information acquisition module is connected with the image processing module and the processing calculation module.
And the input end of the information acquisition module is connected with the nuclear magnetic resonance scanning unit and the optical positioning unit through a USB interface.
The invention also discloses a positioning navigation method based on the positioning navigation system for neurosurgery puncture operation, which comprises the following steps:
before an operation, performing three-dimensional reconstruction and segmentation on the cranium of a patient according to the cranium of the patient and the three-dimensional scanning image of the titanium nails on the surface of the cranium to obtain a cranium three-dimensional model; according to the image information and the optical image information of the titanium nails on the surface of the skull, determining the space conversion relation between an image coordinate system acquired before the operation and an optical navigation coordinate system, and completing the initial pose calibration of the mechanical arm;
in operation, according to the scanning image information of the Z frame, a two-dimensional slice scanning plane of a nuclear magnetic resonance scanner is adjusted, and a pre-operation cranium three-dimensional model is spatially registered with the intra-operation two-dimensional slice scanning plane; according to the registered two-dimensional image information containing the puncture needle and the cranium of the patient, determining the relative spatial position relation between the focus target point and the puncture needle, and evaluating and re-planning the safety of the puncture path of the puncture needle.
As a further improvement of the above technical scheme:
taking the pre-operation cranium three-dimensional model as a moving image, taking the intra-operation two-dimensional slice scanning plane as a reference image, and performing spatial registration on the pre-operation cranium three-dimensional model and the intra-operation two-dimensional slice scanning plane by using an Elastix tool.
Compared with the prior art, the invention has the advantages that:
before a puncture needle enters the cranium, an optical positioning unit is adopted to perform initial calibration of a mechanical arm and tracking of the puncture needle; after the puncture needle enters the cranium, registering the real-time two-dimensional nuclear magnetic image in operation with the cranium three-dimensional model before operation by adopting a nuclear magnetic image positioning mode of a nuclear magnetic resonance scanning unit, thereby realizing compensation of brain offset and ensuring the safety of a puncture path in operation; and simultaneously, repositioning focus targets, rescheduling puncture paths and finely positioning puncture needle points are realized by using the registered two-dimensional images.
The invention can effectively monitor and compensate the brain tissue drift problem caused by various possible reasons such as cranium pressure change, puncture needle extrusion and the like in the operation, realize the accurate positioning of the puncture needle and focus target spot in the operation, and improve the accuracy and safety of operation navigation. Because the system adopts two modes of optical positioning and nuclear magnetic image positioning, the possible shielding problem of the pure optical navigation system can be effectively solved, thereby effectively improving the accuracy and stability of the puncture operation process and being more suitable for the specific application scene of the neurosurgery puncture operation.
Drawings
FIG. 1 is a flow chart of a positioning navigation method according to an embodiment of the present invention.
FIG. 2 is a diagram of an embodiment of a positioning navigation system according to the present invention in a specific application.
Fig. 3 is a schematic structural diagram of a mechanical arm end structure in an embodiment of the invention.
Fig. 4 is a schematic structural view of a Z-frame according to an embodiment of the present invention.
Fig. 5 is a schematic structural diagram of a positioning navigation bracket in an embodiment of the present invention.
Fig. 6 is a schematic structural diagram of an optical positioning unit according to an embodiment of the present invention.
FIG. 7 is a topology diagram of a positioning navigation system in an embodiment of the invention.
Legend description: 1. a nuclear magnetic resonance scanning unit; 101. a nuclear magnetic resonance scanner; 102. a Z frame; 103. titanium nails; 2. an optical positioning unit; 201. an optical positioner; 2011. a near infrared light source; 2012. a near infrared camera; 202. positioning a navigation bracket; 2021. an optical marking ball; 3. a puncture unit; 301. a mechanical arm; 302. a puncture needle; 4. a navigation system terminal; 401. an information acquisition module; 402. an image processing module; 403. a processing calculation module; 5. a display.
Detailed Description
The invention is further described below with reference to the drawings and specific examples.
As shown in fig. 2, the positioning and navigation system for neurosurgical puncture operation according to the embodiment of the present invention includes a nuclear magnetic resonance scanning unit 1, an optical positioning unit 2, a puncture unit 3, and a navigation system terminal 4;
the puncture unit 3 comprises a multi-degree-of-freedom mechanical arm 301 and a puncture needle 302, and the puncture needle 302 is positioned at the movable end of the multi-degree-of-freedom mechanical arm 301; wherein the multi-degree-of-freedom mechanical arm 301 is fixed on a patient's patient bed and is used for automatically executing a puncturing operation; wherein the puncture needle 302 is used to perform a puncturing operation;
the optical positioning unit 2 comprises an optical positioning instrument 201 and two positioning navigation brackets 202, wherein the two positioning navigation brackets 202 are rigidly fixed at the tail ends of the skull and the mechanical arm 301 of the patient, and a plurality of optical marking balls 2021 are fixed on the positioning navigation brackets 202; the optical positioner 201 is used for acquiring optical image information of the optical marker ball 2021 so as to optically track the position of the skull of the patient and the tail end of the mechanical arm 301;
the nuclear magnetic resonance scanning unit 1 comprises a nuclear magnetic resonance scanner 101, a Z frame 102 and a plurality of titanium nails 103, wherein the plurality of titanium nails 103 are fixed on the skull of a patient, and the Z frame 102 is positioned at the tail end of a mechanical arm 301; the nuclear magnetic resonance scanner 101 is used for collecting scanning image information of the cranium of a patient, the titanium nails 103, the Z frame 102 and the puncture needle 302;
the navigation system terminal 4 is respectively connected with the nuclear magnetic resonance scanning unit 1, the optical positioning unit 2 and the puncture unit 3 and is used for carrying out three-dimensional reconstruction and segmentation on the cranium of a patient according to the three-dimensional scanning image information of the cranium of the patient and the titanium nails 103 on the surface of the cranium before operation to obtain a cranium three-dimensional model; according to the scanned image information and the optical image information of the titanium nails 103 on the surface of the skull, determining the space conversion relation between a scanned image coordinate system acquired before the operation and an optical navigation coordinate system, and completing the calibration of the mechanical arm 301;
and in operation, according to the scanned image information of the Z frame 102, adjusting the two-dimensional slice scanning plane of the nuclear magnetic resonance scanner 101, and performing spatial registration on the craniocerebral three-dimensional model and the intra-operation two-dimensional slice scanning plane; according to the registered two-dimensional image information containing the puncture needle 302 and the cranium of the patient, the relative spatial position relation between the focus target point and the puncture needle 302 is determined, and the safety of the puncture path of the puncture needle 302 is evaluated and re-planned.
Before a puncture needle 302 enters the cranium, an optical positioning unit 2 is adopted to perform initial calibration of a mechanical arm 301 and tracking of the puncture needle 302; after the puncture needle 302 enters the cranium, registering the real-time two-dimensional nuclear magnetic image in operation with the cranium three-dimensional model before operation by adopting a nuclear magnetic image positioning mode of the nuclear magnetic resonance scanning unit 1, thereby realizing the compensation of brain tissue offset and ensuring the safety of a puncture path in operation; and simultaneously, repositioning focus targets, rescheduling puncture paths and finely positioning puncture needle points are realized by using the registered two-dimensional images.
The invention can effectively monitor and compensate the problem of brain tissue drift caused by various possible reasons such as cranium pressure change, extrusion of the puncture needle 302 and the like in operation, realize accurate intraoperative positioning of the puncture needle 302 and focus targets, and improve the accuracy and safety of operation navigation. Because the system adopts two modes of optical positioning and nuclear magnetic image positioning, the possible shielding problem of the pure optical navigation system can be effectively solved, thereby effectively improving the accuracy and stability of the puncture operation process and being more suitable for the specific application scene of the neurosurgery puncture operation.
In one embodiment, as shown in fig. 6, the optical positioner 201 includes a near infrared light source 2011 and two near infrared cameras 2012; the near-infrared light source 2011 is used for emitting near-infrared light to irradiate an object to be measured, the infrared light is reflected from the optical marking ball 2021 back to the near-infrared camera 2012 on the optical positioning unit 2, and three-dimensional coordinates of the optical marking ball 2021 are obtained by performing triangulation according to the intersection point of the light rays. As shown in fig. 5, four optical marking balls 2021 are fixed on the positioning navigation bracket 202, and an infrared light reflection coating is provided on the surface of each optical marking ball 2021, so as to ensure that infrared light can be reflected. Wherein the main structure of the positioning navigation bracket 202 is made of titanium alloy. Of course, in other embodiments, three, five or more optical marker balls 2021 may be provided, and the specific number may be determined according to the actual situation.
In one embodiment, as shown in FIG. 3, the Z-frame 102 is secured to the end of a robotic arm 301 and is directly coupled to a lancet 302. As shown in fig. 4, the Z-frame 102 includes a concave body structure, in which cylindrical tunnels are provided and communicate at corners, and the tunnels of each face are in a Z-shaped distribution. The frame is entirely composed of acrylic plastic except for the tunnel, which is filled with (polyetheretherketone) resin visible under the nuclear magnetic resonance scanner 101. The Z frame 102 is used as a reference coordinate system in surgery, and the registration of the coordinate system of the surgical instrument (puncture needle 302) and the image coordinate system is indirectly realized through the registration of the Z frame 102 coordinate system and the image coordinate system, so as to adjust the imaging plane of the nmr scanner 101, and realize the positioning of the puncture needle 302 in the scanned image.
In one embodiment, the needle 302 includes an outer sleeve and an inner needle, the outer sleeve being disposed over the inner needle, the outer sleeve being of pure tantalum material, and the inner needle being of titanium alloy material. The titanium nail 103 can be clearly imaged under the nuclear magnetic resonance scanner 101 and the CT scanner and is used for being implanted into the skull of a patient and serving as a marker to realize registration between an optical coordinate system and a three-dimensional image coordinate system. The mechanical arm 301 is made of a material compatible with nuclear magnetism, such as titanium alloy, so as to ensure that the mechanical arm can work normally under the nuclear magnetic resonance scanner 101.
In a specific embodiment, as shown in fig. 7, the navigation system terminal 4 includes an information acquisition module 401, an image processing module 402, and a processing calculation module 403; the input end of the information acquisition module 401 is connected with the nuclear magnetic resonance scanning unit 1 and the optical positioning unit 2 through a USB interface, and the output end of the information acquisition module 401 is connected with the image processing module 402 and the processing calculation module 403.
After the information acquisition module 401 acquires the optical positioning information and the scanned image information, the optical positioning information is sent to the processing calculation module 403, the scanned image information is sent to the image processing module 402, and the processed image information is sent to the processing calculation module 403. The method comprises the following steps:
the information acquisition module 401 is used for acquiring optical positioning information and CT and nuclear magnetic image information before and during operation. It should be understood that the information acquisition module 401 may be a communication module having a plurality of communication interfaces through which it is communicatively connected to the nuclear magnetic resonance scanner 101, the optical positioning unit 2 so as to acquire optical positioning information and scanned image information, the image acquisition interface may be a USB interface or the like.
An image processing module 402, configured to build a three-dimensional image model according to preoperative CT and MR image information; for processing the acquired scanned image information and optical image information of the titanium pin 103; calculating the imaging plane direction of the nuclear magnetic scanner according to the nuclear magnetic image of the Z frame 102; carrying out space registration on the preoperative three-dimensional model and the intraoperative two-dimensional nuclear magnetic image; the puncture needle 302 is segmented and positioned according to the registered two-dimensional nuclear magnetic images.
The processing calculation module 403 is configured to perform further calculation according to the calculation result of the image processing module 402, specifically: completing initial calibration of a preoperative system; adjusting an imaging plane of the nuclear magnetic resonance apparatus to be parallel to a plane where the puncture needle 302 is located, so as to ensure that the puncture needle 302 can be completely imaged in a single-frame two-dimensional nuclear magnetic image slice; re-determining the focus target position; the safety of the puncture path is assessed and re-planned.
The pre-operation initial system calibration process specifically adopts the existing image positioning technology to determine the model positioning information of the titanium nail 103 in the three-dimensional image model, namely the position coordinates in the image space. The position coordinates of the titanium nails 103 in the operation space, namely the space position coordinates of each titanium nail 103 under the coordinate system of the optical positioning system, are also determined according to the optical positioning information. The processing calculation module 403 calculates a transformation matrix between the optical space coordinate system and the image space coordinate system according to the image space position coordinates and the optical space position coordinates of the plurality of titanium nails 103 by adopting an existing transformation matrix algorithm.
The information acquisition module 401 is provided with two USB interfaces, and the information acquisition module 401 is connected with the optical positioning unit 2 and the nmr scanner 101 through the USB interfaces, so as to acquire scanned image information.
The embodiment of the invention also discloses a positioning navigation method based on the positioning navigation system for neurosurgery puncture operation, which comprises the following steps:
before an operation, performing three-dimensional reconstruction and segmentation on the cranium of a patient according to the cranium of the patient and the three-dimensional scanning image of the titanium nails 103 on the surface of the cranium to obtain a cranium three-dimensional model; according to the image information and the optical image information of the titanium nails 103 on the surface of the skull, determining the space conversion relation between the image coordinate system acquired before the operation and the optical navigation coordinate system, and completing the initial calibration of the mechanical arm 301;
in operation, according to the scanning image information of the Z frame 102, the two-dimensional slice scanning plane of the nuclear magnetic resonance scanner 101 is adjusted, and the pre-operation cranium brain three-dimensional model is spatially registered with the intra-operation two-dimensional slice scanning plane; according to the two-dimensional image information which contains the puncture needle 302 and the cranium of the patient after registration, the relative spatial position relation between the focus target point and the puncture needle 302 is determined, and the safety of the puncture path of the puncture needle 302 is evaluated and re-planned.
The method in which the transformation matrix between the optical space coordinate system and the image coordinate system is calculated may use an ICP registration algorithm.
The registration method of the preoperative three-dimensional model and the intraoperative two-dimensional nuclear magnetic resonance image can directly take the preoperative three-dimensional model as a moving image, the intraoperative two-dimensional nuclear magnetic resonance image as a reference image, and an Elastix tool is used for registration.
The Mask-RCNN deep learning network may be used for the segmentation and positioning method of the puncture needle 302 tip based on the registered two-dimensional nmr image.
In order to better understand the above technical solutions, the following details of the above technical solutions will be described with reference to the accompanying drawings and specific embodiments, as shown in fig. 1:
1. pre-operative patient craniocerebral three-dimensional reconstruction and surgical path planning: the positioning navigation stent 202 is required to be rigidly connected to the skull of the patient before surgery and at least three titanium nails 103 are implanted on the skull. Preoperative scanning of the patient's cranium is performed using a CT scanner and a nuclear magnetic resonance scanner 101, and acquired CT and MR images including the titanium pin 103 and the patient's cranium are transmitted to the navigation system terminal 4. Based on the acquired CT and MR images, high-precision three-dimensional segmentation and reconstruction of important brain tissues, nerves, blood vessels and lesions are carried out, the planning of an operation path is carried out according to the high-precision craniocerebral three-dimensional model obtained by reconstruction, and the three-dimensional space coordinates of each titanium nail 103 under an image coordinate system are determined.
2. Pre-operative system initial calibration: the puncture needles 302 sequentially click all the titanium nails 103 on the surface of the skull, record the optical image information of the optical marking ball 2021200 at the tail end of the mechanical arm 301, and determine the three-dimensional coordinates of each titanium nail 103 under the optical navigation coordinate system. And combining the three-dimensional coordinates of the titanium nails 103 in the image space coordinate system, calculating the conversion relation between the image space coordinate system and the optical navigation system coordinate system, and completing the initial calibration of the system. According to the puncture path planned before the operation, the tail end of the mechanical arm 301 is automatically adjusted to move to a pre-punching position, and the craniocerebral opening is completed by using an ultrasonic bone knife. After the perforation is completed, the ultrasonic osteotome is replaced by the puncture needle 302, the operation bed is moved by the slide rail, and the head of the patient and the mechanical arm 301 are moved into the nuclear magnetic resonance scanner 101 to prepare for the puncture operation.
3. Intraoperative nuclear magnetic imaging plane adjustment: according to the image of the Z frame 102 acquired by the nmr scanner 101, the scan plane of the nmr scanner 101 is adjusted in real time to be parallel to the plane of the puncture needle 302, so as to ensure that the puncture needle 302 can be completely imaged in a single frame of two-dimensional nuclear magnetic image slice.
4. Safety assessment and re-planning of puncture paths: the two-dimensional image slice scanned by the nuclear magnetic resonance scanner 101 in real time during operation is registered with the preoperative high-precision three-dimensional model, so that the position coordinate information of important brain tissues, nerves, blood vessels and focuses is rapidly obtained in the two-dimensional scanning image, and the safety evaluation and re-planning of the puncture path planned before operation are performed.
5. Positioning and navigation of the puncture needle 302: segmentation and positioning of the puncture needle 302 are performed based on the two-dimensional slice images scanned by the nuclear magnetic resonance scanner 101, so that navigation and positioning of the puncture needle 302 in the operation process are realized.
The above is only a preferred embodiment of the present invention, and the protection scope of the present invention is not limited to the above examples, and all technical solutions belonging to the concept of the present invention belong to the protection scope of the present invention. It should be noted that modifications and adaptations to the invention without departing from the principles thereof are intended to be within the scope of the invention as set forth in the following claims.
Claims (10)
1. A positioning navigation system for neurosurgical puncture operation, which is characterized by comprising a nuclear magnetic resonance scanning unit (1), an optical positioning unit (2), a puncture unit (3) and a navigation system terminal (4);
the puncture unit (3) comprises a mechanical arm (301) and a puncture needle (302), wherein the puncture needle (302) is positioned at the movable end of the mechanical arm (301);
the optical positioning unit (2) comprises an optical positioning instrument (201) and two positioning navigation brackets (202), wherein the two positioning navigation brackets (202) are rigidly fixed at the tail ends of the skull and the mechanical arm (301) of a patient, and a plurality of optical marking balls (2021) are fixed on the positioning navigation brackets (202); the optical positioning instrument (201) is used for collecting optical image information of the optical marking ball (2021) so as to optically track the position of the skull of the patient and the tail end of the mechanical arm (301);
the nuclear magnetic resonance scanning unit (1) comprises a nuclear magnetic resonance scanner (101), a Z frame (102) and a plurality of titanium nails (103), wherein the titanium nails (103) are fixed on the skull of a patient, and the Z frame (102) is positioned at the tail end of the mechanical arm (301); the nuclear magnetic resonance scanner (101) is used for collecting scanning image information of the cranium, the titanium nails (103), the Z frame (102) and the puncture needle (302) of a patient;
the navigation system terminal (4) is respectively connected with the nuclear magnetic resonance scanning unit (1), the optical positioning unit (2) and the puncture unit (3) and is used for carrying out three-dimensional reconstruction and segmentation on the cranium of a patient according to the cranium of the patient and the three-dimensional scanning image information of the titanium nails (103) on the surface of the cranium before an operation to obtain a cranium three-dimensional model; according to the scanned image information and the optical image information of the titanium nails (103) on the surface of the skull, determining the space conversion relation between a scanned image coordinate system acquired before the operation and an optical navigation coordinate system, and completing the initial pose calibration of the mechanical arm (301);
during operation, according to the scanning image information of the Z frame (102), adjusting a two-dimensional slice scanning plane of the nuclear magnetic resonance scanner (101), and performing spatial registration on the craniocerebral three-dimensional model and the intra-operation two-dimensional slice scanning plane; and determining the relative spatial position relation between a focus target point and the puncture needle (302) according to the registered two-dimensional image information containing the puncture needle (302) and the cranium of the patient, and evaluating and re-planning the safety of the puncture path of the puncture needle (302).
2. The positioning navigation system for neurosurgical puncture surgery according to claim 1, wherein the optical positioner (201) comprises a near infrared light source (2011) and two near infrared cameras (2012); the near infrared light source (2011) is used for emitting near infrared light to irradiate an object to be measured, the infrared light is reflected from the optical marking ball (2021) to the near infrared camera (2012) on the optical positioning unit (2), and three-dimensional coordinates of the optical marking ball (2021) are obtained by performing triangulation according to the intersection point of the light rays.
3. The positioning and navigation system for neurosurgical puncture operation according to claim 2, wherein four optical marking balls (2021) are fixed on the positioning and navigation bracket (202), and an infrared light reflecting coating is provided on the surface of each optical marking ball (2021).
4. A positioning and navigation system for neurosurgical puncture operations according to claim 1 or 2 or 3, characterized in that the Z-frame (102) comprises a concave body structure, inside which cylindrical tunnels are provided and which communicate at the corners, the tunnels of each face being in a Z-shaped distribution.
5. The positioning and navigation system for neurosurgical puncture operation according to claim 4, wherein the main structure of the Z frame (102) is made of acrylic plastic, and the tunnel interior is filled with resin visible under the nuclear magnetic resonance scanner (101).
6. A positioning and navigation system for neurosurgical puncture according to claim 1, 2 or 3, wherein the puncture needle (302) comprises an outer sleeve and an inner needle, the outer sleeve being arranged outside the inner needle, the outer sleeve being of pure tantalum material, the inner needle being of titanium alloy material.
7. A positioning navigation system for neurosurgical puncture surgery according to claim 1 or 2 or 3, characterized in that the navigation system terminal (4) comprises an information acquisition module (401), an image processing module (402) and a processing calculation module (403); the input end of the information acquisition module (401) is connected with the nuclear magnetic resonance scanning unit (1) and the optical positioning unit (2), and the output end of the information acquisition module (401) is connected with the image processing module (402) and the processing calculation module (403).
8. Positioning and navigation system for neurosurgical puncture according to claim 7, characterized in that the input of the information acquisition module (401) is connected to the nuclear magnetic resonance scanning unit (1) and the optical positioning unit (2) via a USB interface.
9. A positioning navigation method based on the positioning navigation system for neurosurgical puncture operation according to any one of claims 1-8, characterized by comprising the steps of:
before an operation, performing three-dimensional reconstruction and segmentation on the cranium of a patient according to the cranium of the patient and a three-dimensional scanning image of a titanium nail (103) on the surface of the cranium to obtain a cranium three-dimensional model; according to the image information and the optical image information of the titanium nails (103) on the surface of the skull, determining the space conversion relation between an image coordinate system acquired before the operation and an optical navigation coordinate system, and completing the initial pose calibration of the mechanical arm (301);
in operation, according to the scanning image information of the Z frame (102), adjusting a two-dimensional slice scanning plane of the nuclear magnetic resonance scanner (101), and carrying out spatial registration on a pre-operation cranium three-dimensional model and the intra-operation two-dimensional slice scanning plane; according to the two-dimensional image information which contains the puncture needle (302) and the cranium of the patient after registration, determining the relative spatial position relation between a focus target point and the puncture needle (302), and evaluating and re-planning the safety of the puncture path of the puncture needle (302).
10. The positioning navigation method of claim 9, wherein the pre-operative three-dimensional model of the cranium is used as a moving image and the intra-operative two-dimensional slice scan plane is used as a reference image, and the pre-operative three-dimensional model of the cranium is spatially registered with the intra-operative two-dimensional slice scan plane using an Elastix tool.
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| CN117224233A (en) * | 2023-11-09 | 2023-12-15 | 杭州微引科技有限公司 | Integrated perspective CT and interventional operation robot system and use method thereof |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN117224233A (en) * | 2023-11-09 | 2023-12-15 | 杭州微引科技有限公司 | Integrated perspective CT and interventional operation robot system and use method thereof |
| CN117224233B (en) * | 2023-11-09 | 2024-02-20 | 杭州微引科技有限公司 | Integrated perspective CT and interventional operation robot system and use method thereof |
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