CN117815545A

CN117815545A - Operation planning method for combining single needle channel and double targets with deep brain electrical stimulation

Info

Publication number: CN117815545A
Application number: CN202311718680.6A
Authority: CN
Inventors: 毛之奇; 刘斌; 惠瑞; 樊令仲; 高超宏
Original assignee: First Medical Center of PLA General Hospital
Current assignee: First Medical Center of PLA General Hospital
Priority date: 2023-12-14
Filing date: 2023-12-14
Publication date: 2024-04-05

Abstract

The embodiment of the specification discloses a surgical planning method for combining single needle tract and double targets with deep brain electrical stimulation, which comprises the following steps: acquiring MRI image data of a candidate patient; determining a first target and a second target based on the MRI image data of the candidate patient, wherein the first target is a VIM target, and the second target is an STN target; and determining a surgery planning track based on the first target spot and the second target spot, wherein the surgery planning track is used for realizing simultaneous puncture of the first target spot and the second target spot.

Description

Operation planning method for combining single needle channel and double targets with deep brain electrical stimulation

Technical Field

The invention relates to the field of medicine, in particular to a single-needle-tract double-target-point combined deep brain electrical stimulation operation planning method.

Background

Parkinson's disease is a disease caused by neurotransmitters lacking dopamine in the brain, and the lack of dopamine can change the discharge frequency and discharge mode of neurons, and is accompanied by synchronous discharge phenomenon of beta frequency band (12-35 Hz) of neurons in the basal nuclei of the brain. The synchronous discharge of the pathological states can severely affect the ability of the thalamus to respond to external stimuli, such that parkinsonian patients can be characterized by four motor symptoms of tremor, bradykinesia, rigidity, postural gait instability, of which about 75% of parkinsonian patients can be characterized as tremor symptoms. If the tremor symptoms are apparent in the patient and the other parkinsonian symptoms are mild, the patient is classified as tremor is major parkinsonian (TD-PD). This subpopulation is believed to have different pathophysiology, mainly manifested as: the rate and severity of progression did not match other motor symptoms and loss of dopaminergic neurons in the substantia nigra compacta was not apparent. Thus, TD-PD patients tend to respond unsatisfactorily to dopaminergic drugs, ultimately resorting to DBS (deep brain stimulation) treatment.

Hypothalamic nucleus (STN) and globus pallidus medial (GPi) are the two major DBS targets for treatment of TD-PD patients. STN-DBS correlated with 70% -75% tremor improvement in PD patients during the 1 year follow-up, and this benefit remained stable for 5 years. GPi-DBS was not significantly different from STN-DBS in terms of tremor improvement. However, about 10% of TD-PD patients still respond poorly to STN or GPi stimulation, and this failure rate may increase to 33% when the patients are evaluated under drug administration conditions. That is, the benefit of DBS is compromised in the presence of drug refractory tremors. In addition, a retrospective study centered on PD tremor found that 33.3% (STN-DBS) and 60% (GPi-DBS) patients failed to decrease resting tremor scores by 2 points at 12 months post-surgery. These findings suggest that STN or GPi stimulation alone may be insufficient to control tremors of TD-PD, particularly for drug resistant TD-PD.

Thalamoventral intermediate nucleus (VIM) is a classical target for treating tremors by DBS, is a preferred target for essential tremors, and is also effective for PD tremors and dystonia tremors. However, VIM-DBS has poor effects on other motor symptoms of Parkinson's disease relative to STN or GPi stimulation. Based on the above presumption, if STN and VIM nuclei are used simultaneously, not only is the intractable tremor of the patient treated, but also symptoms such as rigidity and bradykinesia of the patient are considered. Some studies use two sets of DBS electrodes to stimulate both STN (or GPi) and VIM, indeed demonstrating that stimulation of both nuclei simultaneously can well control tremor as a symptom of parkinson's disease. However, this solution requires the implantation of two sets of DBS electrodes in the patient, which not only doubles the risk of bleeding and infection, but also greatly increases the economic cost of the patient.

Based on the above, a new surgical planning method for combining single-needle-tract double-target point with deep brain electrical stimulation is needed.

Disclosure of Invention

The embodiment of the specification provides a surgical planning method for combining single needle tract double targets with deep brain electrical stimulation, which is used for solving the following technical problems: in the existing operation scheme, STN and VIM nuclei are simultaneously taken into consideration, and two sets of DBS electrodes are required to be implanted in a patient, so that the risk of bleeding and infection is doubled, and the economic cost of the patient is greatly increased.

In order to solve the above technical problems, the embodiments of the present specification are implemented as follows:

the embodiment of the specification provides a surgical planning method for combining single needle tract and double targets with deep brain electrical stimulation, which comprises the following steps:

acquiring MRI image data of a candidate patient;

determining a first target and a second target based on the MRI image data of the candidate patient, wherein the first target is a VIM target, and the second target is an STN target;

and determining a surgery planning track based on the first target spot and the second target spot, wherein the surgery planning track is used for realizing simultaneous puncture of the first target spot and the second target spot.

Further, the method further comprises:

based on the operation planning track, a pair of DBS electrodes is adopted to realize simultaneous puncture of the first target spot and the second target spot.

Further, the DBS electrode is an electrode with a pair of contacts spaced at a distance of 1.5 mm.

Further, two ventral contacts of the DBS electrode are embedded in the second target spot, and a dorsal contact of the DBS electrode is embedded in the first target spot.

Further, the determining a first target and a second target based on the MRI image data of the candidate patient specifically includes:

determining the boundary of the second target point based on the MRI image data of the candidate patient, and taking the back outer part in the boundary of the second target point as the second target point;

probability fiber bundle tracking is carried out on MRI image data of the candidate patient, based on tracking results of cone bundle fibers, inner side hill fibers and dentate nucleus thalamus bundle fibers, the dentate red nucleus thalamus bundle is moved along the included angle between the cone bundle fibers and the inner side hill fibers, and the position 3mm away from the cone bundle fibers and the inner side hill fibers is selected when the first target point is positioned

Further, the determining a surgical planning trajectory based on the first target and the second target specifically includes:

and drawing a track once according to a preset drawing rule based on the first target spot and the second target spot, wherein the preset drawing rule needs to avoid central anterior, cerebral sulcus and cortical vessels as the operation planning track.

Further, the method for implementing the simultaneous puncture of the first target and the second target by using a pair of DBS electrodes based on the operation planning track specifically includes:

determining frame coordinates based on the CT scan image data of the candidate patient and the MRI image data of the candidate patient;

based on the frame coordinates, performing secondary positioning on the first target spot and the second target spot by adopting microelectrode recording;

based on the first target spot and the second target spot of the secondary positioning, a pair of DBS electrodes are adopted along the operation planning track, so that the first target spot and the second target spot can be punctured simultaneously.

Further, the method for implementing the simultaneous puncture of the first target and the second target by using a pair of DBS electrodes based on the operation planning track includes:

based on the operation planning track, after macro stimulation is carried out by adopting a microelectrode outer sleeve, a pair of DBS electrodes are used for implanting the first target spot and the second target spot, so that simultaneous puncture of the first target spot and the second target spot is realized.

Further, the surgical planning method is a frontal surgical planning method.

Further, the method further comprises:

and registering and normalizing the DBS electrode, positioning the DBS electrode position and displaying the DBS electrode.

According to the operation planning method for single-needle-tract double-target combined deep brain electrical stimulation, MRI image data of a candidate patient are obtained; determining a first target and a second target based on the MRI image data of the candidate patient, wherein the first target is a VIM target, and the second target is an STN target; based on the first target and the second target, determining a surgery planning track, wherein the surgery planning track is used for realizing simultaneous puncture of the first target and the second target, and the surgery planning method can realize simultaneous stimulation of the two targets through a pair of DBS electrodes, so that all movement symptoms of tremors, rigidity and bradykinesia of a patient suffering from Parkinson's disease are considered, and the surgery risk and economic burden of the patient are not increased.

Drawings

In order to more clearly illustrate the embodiments of the present description or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described below, it being obvious that the drawings in the following description are only some of the embodiments described in the present description, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.

Fig. 1 is a schematic flow chart of a procedure planning method for single-needle-tract double-target combined deep brain electrical stimulation according to an embodiment of the present disclosure;

FIG. 2 is a schematic diagram of a puncturing pattern according to an embodiment of the present disclosure;

FIG. 3 is a flow chart of yet another method for planning a single-needle dual-target combined deep brain electrical stimulation according to an embodiment of the present disclosure;

FIG. 4 is a flow chart of yet another method for planning a single-needle dual-target combined deep brain electrical stimulation according to an embodiment of the present disclosure;

fig. 5 is a schematic diagram of a surgical planning apparatus for single-needle-tract dual-target combined deep brain electrical stimulation according to an embodiment of the present disclosure.

Detailed Description

In order to make the technical solutions in the present specification or the prior art better understood, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only some embodiments of the present application, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, shall fall within the scope of the present application.

Fig. 1 is a schematic flow chart of a procedure planning method for single-needle-tract double-target combined deep brain electrical stimulation according to an embodiment of the present disclosure. From the program perspective, the execution subject of the flow may be a program installed on an application server or an application terminal. It is understood that the method may be performed by any apparatus, device, platform, cluster of devices having computing, processing capabilities. As shown in fig. 1, the surgical planning method includes:

step S101: MRI image data of a candidate patient is acquired.

In the present embodiment, candidate patients are determined based on a reasonable patient selection, comprehensive preoperative evaluation, and MRI image data of the candidate patients are acquired.

In the present embodiment, the candidate patient is a patient who satisfies a preset screening criteria, and is available for the surgical planning method. Specifically, the preset screening criteria include: the diagnosis is the primary parkinsonism; severe tremors affect quality of life; the course of the disease is more than or equal to 3 years; hoehn-Yahr stage is not less than 2.5; there was no other history of stereotactic surgery. It should be noted that if the patient is primary tremor complicated or atypical parkinsonism, the patient is not a candidate. If the patient satisfies the requirements of the candidate patient, but when the surgical planning trajectory is determined later, because of the individual difference of the candidate patient, a suitable primary path for connecting the first target and the second target cannot be designed, the patient cannot be used as the candidate patient. For satisfying the candidate patient screening condition, but because of the individual difference, the suitable surgical planning track of the primary path connecting the first target and the second target cannot be designed, and the candidate patient should be excluded at a later stage.

In the embodiment of the present disclosure, MRI image data of a candidate patient specifically includes: 3D-T1 images, flair images, and diffusion weighted images. The 3D-T1 image is used for displaying the skeleton structure and the anatomical form of the tissue; the Flair image is a liquid inversion recovery decay sequence; diffusion weighted images, DWIs, are capable of providing information of brain physiological states.

Step S103: and determining a first target and a second target based on the MRI image data of the candidate patient, wherein the first target is a VIM target, and the second target is an STN target.

In an embodiment of the present disclosure, the determining a first target and a second target based on MRI image data of the candidate patient specifically includes:

the MRI image data of the candidate patient is subjected to probabilistic fiber bundle tracking, and based on tracking results of cone bundle fibers, inner side hill fibers and dentate nucleus thalamus bundle fibers, the dentate nucleus erythrothalamus bundle is moved along an included angle between the cone bundle fibers and the inner side hill fibers, and when the first target point is located, a position which is 3mm away from the cone bundle fibers and the inner side hill fibers is selected, and it is required to particularly explain that when the first target point is located, stimulation is prevented from diffusing to the cone bundle and the inner side hill fibers, and side reactions of motion and paresthesia are caused.

In the present embodiment, as previously described, the MRI image data of the candidate patient includes a 3D-T1 image, a Flair image, and a diffusion weighted image. When probability fiber bundle tracking is carried out based on the MRI image data of the candidate patient, the MRI image data is first registered, the registration method is completed by adopting an automatic method, and the specific image registration method does not limit the application.

The VIM target, thalamoventral middle nucleus, STN is a lens-shaped, slightly inclined nucleus located in the region of the metaencephalon-midbrain junction, and the average volume of human STN is 3mm by 5mm by 12mm. Studies have shown that STN plays an important role in the mediation of motor, cognitive and emotional behavior as one of the components of the basal ganglia, being the ligament integrating motor, cognitive and emotional, and that the integration of information in the motor, union and border areas by STN is achieved by two different cortical-basal ganglia projection systems, namely cortical-striatal projection (indirect pathway) and cortical-thalamo subtalar nuclear projection (direct pathway). The VIM target is the most common target for treating tremors, and the disfiguring mechanism is to reduce the hyperexcitation of nuclear masses and the excessive output of the nuclear masses, and the tremor channel is blocked by radio-frequency thermosetting disfiguring tremor cells, so that the purpose of eliminating tremor symptoms is achieved. Because the VIM target is a non-visual target, the positioning of the VIM target is critical to the surgical planning method.

STN target, i.e. hypothalamic nucleus, can reliably improve dopaminergic drug responsive symptoms such as tremors, rigidity and bradykinesia, relieve fluctuation and dyskinesia, reduce dopaminergic drug requirements, and improve overall quality of life, and therefore, the target has an important role in surgical planning methods.

Step S105: and determining a surgery planning track based on the first target spot and the second target spot, wherein the surgery planning track is used for realizing simultaneous puncture of the first target spot and the second target spot.

In an embodiment of the present disclosure, the determining a planned surgical trajectory based on the first target and the second target specifically includes:

In this embodiment of the present disclosure, the preset drawing rule at least includes: the method can realize one-time track drawing, and can fulfill the aim of simultaneously stimulating the first target and the second target by a pair of DPS electrodes.

Based on the operation planning method, the puncture mode needs to be considered when puncture is performed. Fig. 2 is a schematic diagram of a puncturing pattern according to an embodiment of the present disclosure, wherein fig. 2A is a frontal puncturing pattern and fig. 2B is a top puncturing pattern. Vop is posterior ventral nucleus, voa is anterior ventral nucleus, vc is caudal nucleus, laser is Lateral, superior is Superior, inferior, and Medial is internal.

In an embodiment of the present disclosure, the surgical planning method is a nominal surgical planning method.

By the method, a surgical planning scheme capable of simultaneously stimulating two target targets by a pair of DBS electrodes can be obtained.

In an embodiment of the present specification, the method further comprises:

It should be noted that, when the DBS electrode is used to achieve simultaneous penetration of the first target and the second target along the planned surgical trajectory, the planned surgical trajectory may be adjusted in response to the stimulation of the candidate patient.

Fig. 3 is a schematic flow chart of another method for planning a single-needle-tract dual-target combined deep brain electrical stimulation according to an embodiment of the present disclosure. As shown in fig. 3, the operation planning method includes:

step S301: acquiring MRI image data of a candidate patient;

step S303: determining a first target and a second target based on the MRI image data of the candidate patient, wherein the first target is a VIM target, and the second target is an STN target;

step S305: determining a surgery planning track based on the first target spot and the second target spot, wherein the surgery planning track is used for realizing simultaneous puncture of the first target spot and the second target spot;

step S307: based on the operation planning track, a pair of DBS electrodes is adopted to realize simultaneous puncture of the first target spot and the second target spot.

In the present embodiment, the DBS electrode is a pair of electrodes with a contact spacing of 1.5 mm.

In the present embodiments, two ventral contacts of the DBS electrode are embedded in the second target, and a dorsal contact of the DBS electrode is embedded in the first target.

In this embodiment of the present disclosure, the performing, based on the planned surgical trajectory, simultaneous penetration of the first target and the second target using a pair of DBS electrodes specifically includes:

In an embodiment of the present disclosure, the performing, based on the planned surgical trajectory, simultaneous penetration of the first target and the second target using a pair of DBS electrodes includes:

After the DBS electrode is implanted in the target area, the position of the post-operative electrode needs to be confirmed for the convenience of later observation and operation.

In an embodiment of the present specification, the method further comprises:

In a specific embodiment, the positioning of the DBS electrode may be performed using a CT scan method. Specifically, the CT image data of the postoperative CT scanning is registered and normalized with the MRI image data before the operation, so that the reconstruction of the DBS electrode is realized, and the position of the DBS electrode is positioned and displayed.

Fig. 4 is a schematic flow chart of another method for planning a single-needle-tract dual-target combined deep brain electrical stimulation according to an embodiment of the present disclosure. As shown in fig. 4, the operation planning method includes:

step S401: acquiring MRI image data of a candidate patient;

step S403: determining a first target and a second target based on the MRI image data of the candidate patient, wherein the first target is a VIM target, and the second target is an STN target;

step S405: determining a surgery planning track based on the first target spot and the second target spot, wherein the surgery planning track is used for realizing simultaneous puncture of the first target spot and the second target spot;

step S407: based on the operation planning track, a pair of DBS electrodes are adopted to realize simultaneous puncture of the first target spot and the second target spot;

step S409: and registering and normalizing the DBS electrode, positioning the DBS electrode position and displaying the DBS electrode.

It should be specifically noted that, in the surgical planning method provided in the embodiments of the present disclosure, after the surgery is performed, the startup and program control may be performed at predetermined time intervals, specifically, the predetermined time intervals may be 1 month, and the implanted DBS electrode may be activated and operated by the DBS control program. At activation, first in unipolar mode, the pulse width and frequency are maintained at 60us and 130Hz, respectively, while the voltage is increased from 1V to 4V in steps of 0.5V. During activation, the extent of relief of tremors and other motor symptoms is observed. If the monopolar mode is capable of achieving a satisfactory control result, the monopolar mode is used. If the monopolar mode does not achieve satisfactory control results, a bipolar, bipolar or tripolar mode may be used. When the candidate patient is stimulated, the stimulation setting can be adjusted at any time according to the response of the candidate patient.

The embodiment of the specification provides a surgical planning method for single-needle-tract double-target combined deep brain electrical stimulation, and correspondingly, the specification also provides a surgical planning device for single-needle-tract double-target combined deep brain electrical stimulation, as shown in fig. 5. Fig. 5 is a schematic diagram of a surgical planning apparatus for single-needle-tract dual-target combined deep brain electrical stimulation according to an embodiment of the present disclosure, where the surgical planning apparatus includes:

an acquisition module 501 for acquiring MRI image data of a candidate patient;

a target determination module 503, configured to determine a first target and a second target based on MRI image data of the candidate patient, where the first target is a VIM target, and the second target is an STN target;

the operation planning module 505 determines an operation planning track based on the first target and the second target, where the operation planning track is used to achieve simultaneous puncture of the first target and the second target.

The embodiment of the specification also provides an electronic device, including:

at least one processor; the method comprises the steps of,

a memory communicatively coupled to the at least one processor; wherein,

the memory stores instructions executable by the at least one processor to enable the at least one processor to:

acquiring MRI image data of a candidate patient;

The foregoing describes specific embodiments of the present disclosure. Other embodiments are within the scope of the following claims. In some cases, the actions or steps recited in the claims can be performed in a different order than in the embodiments and still achieve desirable results. In addition, the processes depicted in the accompanying figures do not necessarily require the particular order shown, or sequential order, to achieve desirable results. In some embodiments, multitasking and parallel processing are also possible or may be advantageous.

In this specification, each embodiment is described in a progressive manner, and identical and similar parts of each embodiment are all referred to each other, and each embodiment mainly describes differences from other embodiments. In particular, for apparatus, electronic devices, non-volatile computer storage medium embodiments, since they are substantially similar to method embodiments, the description is relatively simple, as relevant to the description of the method embodiments.

The apparatus, the electronic device, the nonvolatile computer storage medium and the method provided in the embodiments of the present disclosure correspond to each other, and therefore, the apparatus, the electronic device, the nonvolatile computer storage medium also have similar beneficial technical effects as those of the corresponding method, and since the beneficial technical effects of the method have been described in detail above, the beneficial technical effects of the corresponding apparatus, the electronic device, the nonvolatile computer storage medium are not described here again.

In the 90 s of the 20 th century, improvements to one technology could clearly be distinguished as improvements in hardware (e.g., improvements to circuit structures such as diodes, transistors, switches, etc.) or software (improvements to the process flow). However, with the development of technology, many improvements of the current method flows can be regarded as direct improvements of hardware circuit structures. Designers almost always obtain corresponding hardware circuit structures by programming improved method flows into hardware circuits. Therefore, an improvement of a method flow cannot be said to be realized by a hardware entity module. For example, a programmable logic device (Programmable Logic Device, PLD) (e.g., field programmable gate array (Field Programmable Gate Array, FPGA)) is an integrated circuit whose logic function is determined by the programming of the device by a user. A designer programs to "integrate" a digital system onto a PLD without requiring the chip manufacturer to design and fabricate application-specific integrated circuit chips. Moreover, nowadays, instead of manually manufacturing integrated circuit chips, such programming is mostly implemented by using "logic compiler" software, which is similar to the software compiler used in program development and writing, and the original code before the compiling is also written in a specific programming language, which is called hardware description language (Hardware Description Language, HDL), but not just one of the hdds, but a plurality of kinds, such as ABEL (Advanced Boolean Expression Language), AHDL (Altera Hardware Description Language), confluence, CUPL (Cornell University Programming Language), HDCal, JHDL (Java Hardware Description Language), lava, lola, myHDL, PALASM, RHDL (Ruby Hardware Description Language), etc., VHDL (Very-High-Speed Integrated Circuit Hardware Description Language) and Verilog are currently most commonly used. It will also be apparent to those skilled in the art that a hardware circuit implementing the logic method flow can be readily obtained by merely slightly programming the method flow into an integrated circuit using several of the hardware description languages described above.

The controller may be implemented in any suitable manner, for example, the controller may take the form of, for example, a microprocessor or processor and a computer readable medium storing computer readable program code (e.g., software or firmware) executable by the (micro) processor, logic gates, switches, application specific integrated circuits (Application Specific Integrated Circuit, ASIC), programmable logic controllers, and embedded microcontrollers, examples of which include, but are not limited to, the following microcontrollers: ARC 625D, atmel AT91SAM, microchip PIC18F26K20, and Silicone Labs C8051F320, the memory controller may also be implemented as part of the control logic of the memory. Those skilled in the art will also appreciate that, in addition to implementing the controller in a pure computer readable program code, it is well possible to implement the same functionality by logically programming the method steps such that the controller is in the form of logic gates, switches, application specific integrated circuits, programmable logic controllers, embedded microcontrollers, etc. Such a controller may thus be regarded as a kind of hardware component, and means for performing various functions included therein may also be regarded as structures within the hardware component. Or even means for achieving the various functions may be regarded as either software modules implementing the methods or structures within hardware components.

The system, apparatus, module or unit set forth in the above embodiments may be implemented in particular by a computer chip or entity, or by a product having a certain function. One typical implementation is a computer. In particular, the computer may be, for example, a personal computer, a laptop computer, a cellular telephone, a camera phone, a smart phone, a personal digital assistant, a media player, a navigation device, an email device, a game console, a tablet computer, a wearable device, or a combination of any of these devices.

For convenience of description, the above devices are described as being functionally divided into various units, respectively. Of course, the functionality of the units may be implemented in one or more software and/or hardware when implementing one or more embodiments of the present description.

It will be appreciated by those skilled in the art that the present description may be provided as a method, system, or computer program product. Accordingly, the present specification embodiments may take the form of an entirely hardware embodiment, an entirely software embodiment or an embodiment combining software and hardware aspects. Furthermore, the present description embodiments may take the form of a computer program product on one or more computer-usable storage media (including, but not limited to, disk storage, CD-ROM, optical storage, etc.) having computer-usable program code embodied therein.

The present description is described with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems) and computer program products according to embodiments of the specification. It will be understood that each flow and/or block of the flowchart illustrations and/or block diagrams, and combinations of flows and/or blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, embedded processor, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.

These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including instruction means which implement the function specified in the flowchart flow or flows and/or block diagram block or blocks.

These computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide steps for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.

In one typical configuration, a computing device includes one or more processors (CPUs), input/output interfaces, network interfaces, and memory.

The memory may include volatile memory in a computer-readable medium, random Access Memory (RAM) and/or nonvolatile memory, such as Read Only Memory (ROM) or flash memory (flash RAM). Memory is an example of computer-readable media.

Computer readable media, including both non-transitory and non-transitory, removable and non-removable media, may implement information storage by any method or technology. The information may be computer readable instructions, data structures, modules of a program, or other data. Examples of storage media for a computer include, but are not limited to, phase change memory (PRAM), static Random Access Memory (SRAM), dynamic Random Access Memory (DRAM), other types of Random Access Memory (RAM), read Only Memory (ROM), electrically Erasable Programmable Read Only Memory (EEPROM), flash memory or other memory technology, compact disc read only memory (CD-ROM), digital Versatile Disks (DVD) or other optical storage, magnetic cassettes, magnetic tape disk storage or other magnetic storage devices, or any other non-transmission medium, which can be used to store information that can be accessed by a computing device. Computer-readable media, as defined herein, does not include transitory computer-readable media (transmission media), such as modulated data signals and carrier waves.

It should also be noted that the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising one … …" does not exclude the presence of other like elements in a process, method, article or apparatus that comprises the element.

The description may be described in the general context of computer-executable instructions, such as program modules, being executed by a computer. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types. The specification may also be practiced in distributed computing environments where tasks are performed by remote processing devices that are linked through a communications network. In a distributed computing environment, program modules may be located in both local and remote computer storage media including memory storage devices.

In this specification, each embodiment is described in a progressive manner, and identical and similar parts of each embodiment are all referred to each other, and each embodiment mainly describes differences from other embodiments. In particular, for system embodiments, since they are substantially similar to method embodiments, the description is relatively simple, as relevant to see a section of the description of method embodiments.

The foregoing is merely exemplary embodiments of the present disclosure and is not intended to limit the present disclosure. Various modifications and changes may be made to the present application by those skilled in the art. Any modifications, equivalent substitutions, improvements, etc. which are within the spirit and principles of the present application are intended to be included within the scope of the claims of the present application.

Claims

1. A surgical planning method for combining single needle tract and double targets with deep brain electrical stimulation, which is characterized by comprising the following steps:

acquiring MRI image data of a candidate patient;

2. The surgical planning method of claim 1, wherein the method further comprises:

3. The surgical planning method of claim 2 wherein the DBS electrode is a pair of electrodes with contact spacing of 1.5 mm.

4. The surgical planning method of claim 2 wherein two ventral contacts of the DBS electrode are embedded in the second target and a dorsal contact of the DBS electrode is embedded in the first target.

5. The surgical planning method of claim 1, wherein determining a first target and a second target based on MRI image data of the candidate patient, comprises:

and carrying out probabilistic fiber bundle tracking on the MRI image data of the candidate patient, and based on tracking results of cone bundle fibers, inner side hill fibers and dentate nucleus thalamus bundle fibers, enabling the dentate red nucleus thalamus bundle to run along an included angle between the cone bundle fibers and the inner side hill fibers, and selecting a position 3mm away from the cone bundle fibers and the inner side hill fibers when positioning the first target point.

6. The surgical planning method of claim 1, wherein determining a surgical planning trajectory based on the first target and the second target comprises:

7. The surgical planning method according to claim 2, wherein the simultaneous penetration of the first target and the second target is achieved by using a pair of DBS electrodes based on the surgical planning trajectory, specifically comprising:

8. The surgical planning method of claim 2 wherein said employing a pair of DBS electrodes based on said surgical planning trajectory to achieve simultaneous penetration of said first target and said second target comprises:

9. The surgical planning method of claim 1 wherein the surgical planning method is a nominal surgical planning method.

10. The surgical planning method of claim 2, wherein the method further comprises: