CN118476860A - Left auricle plugging simulation method, system and application - Google Patents
Left auricle plugging simulation method, system and application Download PDFInfo
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- 238000004873 anchoring Methods 0.000 claims description 26
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- 238000003384 imaging method Methods 0.000 abstract description 12
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- 238000013175 transesophageal echocardiography Methods 0.000 description 18
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- A—HUMAN NECESSITIES
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- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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Abstract
The invention relates to a left auricle plugging simulation method, a left auricle plugging simulation system and application, and belongs to the technical field of medical appliances. The invention respectively collects the image data of the two imaging methods through the combined application of the two imaging methods, designs software to realize fusion imaging, simultaneously displays the internal structure, the function and the external form of the left auricle and adjacency, then simulates to match the occluder, so that an operator can select an operation strategy by using the left auricle occlusion simulation device before operation, and selects the optimal and most suitable occluder device. The image fusion simulation system provided by the invention can realize the fusion of the transesophageal real-time four-dimensional echocardiogram and the CT multi-mode image of the left auricle, and can fuse the internal structure and the function of the left auricle, the external integral form and the adjacent left auricle, thereby providing a practical imaging method for improving the success rate of left auricle plugging operation and reducing complications.
Description
Technical Field
The invention relates to a left auricle plugging simulation method, a left auricle plugging simulation system and application, and belongs to the technical field of medical appliances.
Background
At present, in the left auricle plugging operation, the clinical application is mostly based on the guidance of a transesophageal echocardiography or CT single-mode imaging method, and the effect of observing the left auricle plugging is realized by combining operation center angiography.
However, with the wide development of left atrial appendage occlusion, particularly in extremely simple surgical modes, on the one hand, the residual split rate after left atrial appendage occlusion is high, which is still one of the important problems facing cardiovascular doctors, and the risk of thrombosis on the surface of the patient occluder with high residual split rate is increased, so that the residual cavity needs to be occluded again in addition to long-term anticoagulation treatment; on the other hand, because the anatomical form of the left auricle is various, the conventional method has limited evaluation on the anatomical form and adjacent form of the left auricle, and the diameter of an anchoring area, the depth of the left auricle and the like can be measured when left auricle radiography is carried out in the left auricle plugging operation, but the evaluation on the left auricle in the operation is limited, and the instant plugging strategy is relatively rapid and inaccurate. The situation can cause left auricle blocking failure or the situations of more residual shunt volume, displacement, even falling off of the blocking device and the like after blocking operation, and the like, and the operation doctor has difficulty in selecting the blocking device, so that the operation effect is influenced. Therefore, the technical problem of how to simulate the left atrial appendage occlusion effect before operation, reduce complications such as residual shunt after left atrial appendage occlusion operation and improve the success rate of operation is needed to be solved in the technical field.
Disclosure of Invention
The invention aims to solve the technical problems of simulating the left auricle plugging effect before operation, reducing complications such as residual shunt, displacement, even falling off and the like around a left auricle plugging device after the left auricle plugging operation and improving the success rate of the operation.
In order to achieve the purpose of solving the problems, the technical scheme adopted by the invention is to provide a method for predicting the left auricle plugging effect by fusing a transesophageal real-time four-dimensional echocardiogram and a CT multi-mode image, which comprises the following steps:
step 1: acquiring DICOM (DIGITAL IMAGING AND Communications IN MEDICINE, digital imaging and communication in medicine) format image data of a human heart left auricle transesophageal real-time four-dimensional echocardiogram and CT;
Step 2: threshold segmentation is carried out on CT images of the human heart; for a typical heart segmentation task, the input CT images are generated into right/left/right/left and basic vascular structures through a full convolutional neural network FCN (Fully-Convolutional Neural Networks); the FCN performs model training through a U-structure network and a supervised learning framework based on the disclosed full heart segmentation data set; extracting main directions by adopting all grid points in a heart structure; for a given DSCT (Dual Source CT) image Wherein C is the number of channels, D, H, W are the thickness, height and width of the input image, respectively.
Step 3: preprocessing and segmenting a real-time four-dimensional ultrasonic image of the left auricle of the human body through the esophagus based on an Expectation-Maximization (EM) algorithm; the segmentation process comprises the steps of firstly selecting a basic position through a four-cavity plane, carrying out local region expansion based on a Sobel operator, and introducing time sequence weight for similarity measurement between CT and TEE (transesophageal echocardiography, transesophageal echocardiography, TEE); given a sequence of RT4D-TEE ultrasound images, containing N E 3D-TEE images in total, the model will yield N E point set Y l for characterizing the four-lumen contours in the ultrasound images.
Step 4: based on the processed CT image and the ultrasonic image, performing initial coarse ultrasonic frame and CT horizon matching by an exhaustive discrete search method similar to the existing method; for each time point t, the cross section with the least mean square error will be transformed as a rigid to an optimal match;
step 5: carrying out spatial registration on the heart chamber, the CT three-dimensional model of the left auricle and the ultrasonic four-dimensional model of the left auricle to obtain a fusion model of a left auricle image based on an ultrasonic/CT image, and realizing the joint display of two image modes in a visual mode to obtain the fusion model of the left auricle image of the ultrasonic/CT image;
Step 6: based on the fusion model of the left auricle image, the left auricle plugging device is simulated to be placed into the left auricle fusion model for assisting a clinician in judging focus grades and guiding operation planning and postoperative effect evaluation.
Preferably, the spatial registration in the step 5 includes a registration algorithm, and the registration algorithm maps two heterogeneous image modes under the same coordinate space through feature transformation, and can have better robustness to local non-rigid deformation caused by motion.
Preferably, the inner surface of the left auricle displayed by the fusion model in the step 5 is provided with a positioning anchoring area, and the bottom is provided with a mark point of the depth of the left auricle; in the step 6, the left atrial appendage occlusion device is simulated to be placed in the left atrial appendage fusion model, and the left atrial appendage occlusion device is placed in the anchoring area.
The invention provides a left auricle plugging simulation system, which comprises:
the data acquisition module is used for acquiring DICOM format image data of real-time four-dimensional echocardiography and CT of the left auricle of the human heart;
The data processing module is used for processing CT images of the human heart and real-time four-dimensional ultrasonic images of the left auricle of the human body through the esophagus and modeling; carrying out spatial registration on the heart chamber, the CT three-dimensional model of the left auricle and the ultrasonic four-dimensional model of the left auricle to obtain a fusion model of the left auricle image based on ultrasonic/CT images;
the simulation operation module is used for simulating the placement of the left auricle plugging device into the left auricle fusion model;
the risk assessment module is used for assisting a clinician in distinguishing the focus and guiding operation planning and postoperative effect assessment; and selecting a proper left auricle plugging device and a proper operation scheme according to the simulation effect.
Preferably, the simulated operation module is provided with a matching device for simulating different types of left atrial appendage occlusion devices.
Preferably, the matching means is provided with formations for anchoring with the left atrial appendage anchoring region.
The invention provides a storage device which stores a plurality of instructions, wherein the instructions are suitable for executing the steps in the method for predicting the left auricle plugging effect through the fusion of the real-time four-dimensional echocardiogram and the CT multi-mode image.
The invention provides application of the left atrial appendage occlusion simulation system in a non-diagnostic method and a non-therapeutic method.
The invention provides application of the method for predicting the left auricle plugging effect by fusing the transesophageal real-time four-dimensional echocardiogram and the CT multi-mode image in a non-diagnosis method and a non-treatment method.
Compared with the prior art, the invention has the following beneficial effects:
The invention relates to a transesophageal real-time four-dimensional echocardiography and CT multi-mode image fusion system and a left auricle plugging simulation device. Through the combined application of the two imaging methods, DICOM image data of the two imaging methods are respectively acquired, fusion imaging is realized by design software, the internal structure and the function as well as the external morphology and the adjacent of the left auricle are simultaneously displayed, and then matching of the occluders is simulated, so that an operator can select an operation strategy by using the left auricle occlusion simulation device before operation, and the optimal and most suitable occluder device is selected. The left auricle multi-mode fusion-prediction system provided by the invention can realize the fusion of the transesophageal real-time four-dimensional echocardiogram and the CT multi-mode image of the left auricle, and the fusion of the internal structure and the function, the external integral form and the adjacent left auricle of the left auricle is carried out, so that a feasible imaging method is provided for improving the success rate of left auricle plugging operation and reducing complications.
The left auricle plugging simulation system provided by the invention can realize the matching of the left auricle plugging device and the left auricle, and helps a clinician to select the most suitable plugging device; the invention provides a feasible imaging method for improving the success rate of left auricle plugging operation and reducing complications for the feasibility, accuracy and generalizability of the conventional left auricle plugging device.
The invention is helpful for selecting the most suitable occluder device, and is helpful for judging whether the occluder device is suitable for occlusion or not and selecting an occluder for the left auricle with special shape; the invention is beneficial to designing the occluder device with special shape, guiding the design of the device and improving the device on the basis of the prior device, and lays a foundation for improving the left auricle occluder device.
Drawings
Fig. 1 is a diagram of an analysis process of complications such as occluder selection and residual shunt based on fusion images.
Fig. 2 is a schematic diagram of a left atrial appendage occlusion device for simulating left atrial appendage placement.
Fig. 3 is a schematic diagram II of a left atrial appendage occlusion device for simulating left atrial appendage placement.
Detailed Description
In order to make the invention more comprehensible, preferred embodiments accompanied with the accompanying drawings are described in detail as follows:
As shown in fig. 1-3, in order to reduce residual flow rate after left atrial appendage occlusion and improve operation success rate, the invention provides a method for predicting left atrial appendage occlusion effect by fusing a transesophageal real-time four-dimensional echocardiogram and a CT multi-modal image, which comprises the following steps:
Step 1: acquiring DICOM format image data of a human heart left auricle, a real-time four-dimensional echocardiogram and CT;
Step 2: threshold segmentation is carried out on CT images of the human heart; for a typical heart segmentation task, generating a right ventricle/left ventricle/right atrium/left atrium and a basic vascular structure from input CT images through a full convolution neural network FCN; the FCN performs model training through a U-structure network and a supervised learning framework based on the disclosed full heart segmentation data set; extracting main directions by adopting all grid points in a heart structure; for a given DSCT image Wherein C is the number of channels, D, H, W are the thickness, height and width of the input image, respectively.
Step 3: preprocessing and dividing a real-time four-dimensional ultrasonic image of the left auricle of the human body through the esophagus based on a maximization-expectation EM algorithm; the segmentation process comprises the steps of firstly selecting a basic position through a four-cavity plane, carrying out local region expansion based on a Sobel operator, and introducing time sequence weight for similarity measurement between CT and TEE; given a sequence of RT4D-TEE ultrasound images, containing N E 3D-TEE images in total, the model will yield N E point set Y l for characterizing the four-lumen contours in the ultrasound images.
Step 4: based on the processed CT image and the ultrasonic image, performing initial coarse ultrasonic frame and CT horizon matching by an exhaustive discrete search method similar to the existing method; for each time point t, the cross section with the least mean square error will be transformed as a rigid to an optimal match;
step 5: carrying out spatial registration on the heart chamber, the CT three-dimensional model of the left auricle and the ultrasonic four-dimensional model of the left auricle to obtain a fusion model of a left auricle image based on an ultrasonic/CT image, and realizing the joint display of two image modes in a visual mode to obtain the fusion model of the left auricle image of the ultrasonic/CT image;
Step 6: based on the fusion model of the left auricle image, the left auricle plugging device is simulated to be placed into the left auricle fusion model for assisting a clinician in judging focus grades and guiding operation planning and postoperative effect evaluation.
The spatial registration in the step 5 includes a registration algorithm, wherein the registration algorithm maps two heterogeneous image modes under the same coordinate space through feature transformation, and the registration algorithm has better robustness to local non-rigid deformation caused by motion.
The inner surface of the left auricle displayed by the fusion model in the step 5 is provided with a positioning anchoring area, and the bottom is provided with a mark point of the depth of the left auricle; in the step 6, the left atrial appendage occlusion device is simulated to be placed in the left atrial appendage fusion model, and the left atrial appendage occlusion device is placed in the anchoring area.
The invention provides a left auricle plugging simulation system for fusion of echocardiography and CT multi-mode images, which comprises the following components:
the data acquisition module is used for acquiring DICOM format image data of real-time four-dimensional echocardiography and CT of the left auricle of the human heart;
The data processing module is used for processing CT images of the human heart and real-time four-dimensional ultrasonic images of the left auricle of the human body through the esophagus and modeling; carrying out spatial registration on the heart chamber, the CT three-dimensional model of the left auricle and the ultrasonic four-dimensional model of the left auricle to obtain a fusion model of the left auricle image based on ultrasonic/CT images;
the simulation operation module is used for simulating the placement of the left auricle plugging device into the left auricle fusion model;
the risk assessment module is used for assisting a clinician in distinguishing the focus and guiding operation planning and postoperative effect assessment; and selecting a proper left auricle plugging device and a proper operation scheme according to the simulation effect.
The simulation operation module is provided with a matching device for simulating different types of left atrial appendage occlusion devices.
The matching device is provided with a structure for anchoring with the left auricle anchoring area.
The present invention provides a storage device storing a plurality of instructions adapted to perform the steps of a method of predicting left atrial appendage occlusion effect according to a transesophageal real-time four-dimensional echocardiography and CT multi-modal image fusion as described above.
The left auricle plugging simulation system for fusing the echocardiogram and the CT multi-mode image provided by the invention can realize the fusion of the transesophageal real-time four-dimensional echocardiogram and the CT multi-mode image of the left auricle, is applied to embedded equipment integrated with left auricle image modeling and the fusion system thereof,
The image fusion comprises the following steps: acquiring DICOM format image data of a human heart left auricle, a real-time four-dimensional echocardiogram and CT; threshold segmentation is carried out on CT images of the human heart; for a typical cardiac segmentation task, the fully convolutional neural network FCN generates input CT images into right/left/right/left (RV/LV/RA/LA) and basic vascular structures such as the Aorta (aortas) and the like. The FCN performs model training through the U-structured network and the supervised learning framework based on the disclosed full cardiac segmentation dataset. On this basis, all grid points in the heart structure are further used for main direction extraction. For a given DSCT imageWherein C is the number of channels, D, H, W are the thickness, height and width of the input image, respectively. The transesophageal real-time four-dimensional ultrasound image of the left atrial appendage of the human body is first preprocessed and segmented based on an Expectation-Maximization (EM) algorithm. The segmentation process firstly selects basic positions through four cavity planes, carries out local region expansion based on Sobel operators, and introduces time sequence weights for similarity measurement between CT and TEE (transesophageal echocardiography transesophageal echocardiography, TEE). Given a sequence of RT4D-TEE ultrasound images, containing N E 3D-TEE images in total, the model will yield N E point set Y l for characterizing the four-lumen contours in the ultrasound images.
The invention provides a transesophageal real-time four-dimensional echocardiography and CT multi-modal image fusion left auricle plugging simulation system, which comprises a transesophageal real-time four-dimensional echocardiography and CT multi-modal image fusion system and a matching device;
wherein, the image fusion system comprises a transesophageal echocardiogram and a CT image; the transesophageal echocardiography image includes two-dimensional and four-dimensional images; CT images, including two-dimensional and three-dimensional images; the matching device is used for simulating different types of left atrial appendage occluder devices; the matching device has anchoring areas of different occluder devices thereon.
The left auricle image modeling method of the left auricle plugging simulation system for the fusion of the echocardiography and the CT multi-mode image comprises the following steps:
1. ultrasonic image and CT data of the left auricle of the human body are acquired, and the medical detection instrument is used for acquiring ultrasonic image data and CT data of the left auricle DICOM format of the patient.
2. In the patient left atrial appendage ultrasound image, preprocessing and segmentation is first performed based on a maximization-expectation EM algorithm. The segmentation process firstly selects basic positions through four cavity planes, local region expansion is carried out based on Sobel operators, and time sequence weights are introduced for similarity measurement between CT and TEE.
3. In a CT image of a human heart, first, FCN is used to segment the basic structure of the heart. For a typical cardiac segmentation task, the FCN will input CT images to generate left and right ventricles/atria (RV/LV/RA/LA) and basic vascular structures (Aorta et al). The FCN performs model training through the U-structured network and the supervised learning framework based on the disclosed full cardiac segmentation dataset. On this basis, all grid points in the heart structure are further used for main direction extraction.
4. Based on the processed CT image and the ultrasound image, an initial coarse ultrasound frame is matched with the CT horizon by an exhaustive discrete search method similar to the prior method. For each time point t, the cross section with the least mean square error will be transformed as a rigid to the best match.
5. Spatially registering the heart chamber, the CT three-dimensional model of the left auricle and the ultrasonic four-dimensional model of the left auricle to obtain a fusion model of the left auricle image based on the ultrasonic-CT image, wherein the method comprises the following steps: a registration algorithm is designed, two heterogeneous image modes are mapped to the position under the same coordinate space through feature transformation, and the method has good robustness to local non-rigid deformation caused by movement. Finally, the combined display of the two image modes is realized in a visual mode, and a fusion model of the left auricle image of the ultrasonic-CT image is obtained and is used for clinical diagnosis.
6. Computer aided diagnosis framework research based on multi-modal feature fusion is conducted: after the multi-modal registration work is completed, a corresponding computer-aided diagnosis algorithm is designed based on the visualized image data, and is used for assisting a clinician in judging the focus level and guiding the operation planning and the postoperative effect evaluation.
The inner surface of the fusion model of the left auricle image is provided with a positioning anchoring area structure; the bottom of the fusion model of the left auricle image is provided with a mark point of left auricle depth; the left atrial appendage occlusion device is placed over the anchoring zone structure.
The inner surface of the fusion model of the left auricle image is provided with a positioning anchoring area structure in the direction extending to the inner position of the body of the movable part; the left auricle is plugged by placing the left auricle plugging device on the anchoring area structure.
The matching device is used for simulating different types of left atrial appendage occluder devices; the matching device is provided with different anchoring areas corresponding to different plugging device devices.
The fusion model of the left auricle image is positioned at the position of the left auricle inner opening and the gyrotron and is respectively provided with an anchoring area. The position of the anchoring area is an adjustable structure aiming at the left auricle with different forms. The position of the outer opening of the left auricle is positioned between the Hua method Lin Ji and the mitral valve annulus, the area of the connecting line between the connecting line and the anchoring area is provided with a coverage area, and the left auricle with different forms is an adjustable structure. The coverage area and the anchor area may be for different types of occluder devices.
The left auricle plugging simulation system provided by the invention can realize the matching of the left auricle plugging device and the left auricle, and is beneficial to selecting the most suitable plugging device; setting a matching device, wherein the matching device is provided with different anchoring areas corresponding to different plugging device devices; the position of the anchoring area in the fusion model of the left auricle image is an adjustable structure, and the fusion model is also provided with a coverage area, and the left auricle image is an adjustable structure aiming at different forms. The coverage area and the anchoring area can be aimed at occluder devices of different specifications and models.
While the invention has been described with respect to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims. Equivalent embodiments of the present invention will be apparent to those skilled in the art having the benefit of the teachings disclosed herein, when considered in the light of the foregoing disclosure, and without departing from the spirit and scope of the invention; meanwhile, any equivalent changes, modifications and evolution of the above embodiments according to the essential technology of the present invention still fall within the scope of the technical solution of the present invention.
Claims (10)
1. The left auricle plugging simulation method is characterized by comprising the steps of performing fusion modeling on a left auricle ultrasonic image and a human heart CT image to simulate a left auricle plugging effect; the method comprises the steps of processing four-dimensional echocardiography of left auricle of a human heart and DICOM format image data of CT of the human heart; modeling based on the processed CT image and the ultrasonic image, and performing spatial registration on a heart chamber, a CT three-dimensional model of the left auricle and an ultrasonic four-dimensional model of the left auricle to obtain a fusion model of the left auricle image based on the ultrasonic/CT image; based on a fusion model of the left auricle image, a plurality of left auricle plugging devices are simulated to be put into the left auricle fusion model; and selecting a proper left auricle plugging device according to the simulation effect.
2. The method according to claim 1, wherein the processing of the CT image of the human heart comprises thresholding the CT image of the human heart, and generating the input CT image into a right/left and basic vascular structures through a full convolutional neural network FCN for a typical heart segmentation task; the FCN performs model training through a U-structure network and a supervised learning framework based on the disclosed full heart segmentation data set; all grid points in the heart structure are used for main direction extraction.
3. The left atrial appendage occlusion simulation method of claim 1, wherein the processing of the human left atrial appendage four-dimensional ultrasound image comprises preprocessing and segmentation based on a maximization-expectation EM algorithm; the segmentation process comprises the steps of selecting basic positions through four cavity planes, carrying out local region expansion based on a Sobel operator, and introducing time sequence weights for similarity measurement between CT and TEE.
4. The left atrial appendage occlusion simulation method of claim 1, wherein the modeling comprises performing initial coarse ultrasound frame-to-CT horizon matching by an exhaustive discrete search method similar to existing methods based on processed CT images and ultrasound images; for each time point t, the cross section with the least mean square error will be transformed as a rigid to the best match.
5. The left atrial appendage occlusion simulation method of claim 1, wherein a positioning anchoring zone is provided on an inner surface of a left atrial appendage of the left atrial appendage fusion model; the simulation is that the left auricle plugging device is placed into the left auricle fusion model to simulate the placement of the left auricle plugging device in the anchoring area.
6. A left atrial appendage occlusion simulation system, comprising:
The data acquisition module is used for inputting the data of the left auricle four-dimensional echocardiogram of the human heart and the DICOM format image of the CT of the human heart;
The data processing module is used for processing the CT image and the left auricle four-dimensional ultrasonic image and modeling; carrying out spatial registration on the three-dimensional model of the heart chamber and the four-dimensional model of the left auricle to obtain a fusion model of the left auricle image based on the ultrasonic/CT image;
the simulation operation module is used for simulating the placement of the left auricle plugging device into the left auricle fusion model;
the risk assessment module is used for assisting a clinician in distinguishing the focus and guiding operation planning and postoperative effect assessment; and selecting a proper left auricle plugging device and a proper operation scheme according to the simulation effect.
7. The left atrial appendage occlusion simulation system of claim 6, wherein: the simulation operation module is internally provided with a matching device for simulating different types of left auricle plugging devices; the matching device is provided with an anchoring structure for anchoring with the left auricle anchoring area.
8. Use of a left atrial appendage occlusion simulation method of any one of claims 1 to 5 for the manufacture of a left atrial appendage occlusion device.
9. Use of a left atrial appendage occlusion simulation system of any of claims 6 to 7 for the manufacture of a left atrial appendage occlusion device.
10. Use of the method or system according to any one of claims 1 to 7 in non-diagnostic and non-therapeutic methods.
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