KR102240501B1 - Intravesical pressure diagnosis method-based on urography image data - Google Patents

Abstract

The present invention relates to a method for diagnosing intravesical pressure based on urography image data, comprising: injecting a contrast agent into the urethra and bladder through the urethra, and obtaining X-ray image data while urinating after a certain period of time after the injection; Acquiring urethral data related to a urethral image through geometric information of a urethral boundary surface from the acquired image data; Acquiring 3D modeling data of the urethra using coordinate points of the urethra data; And measuring a pressure value with respect to the length of the urethra through flow analysis of the 3D modeling data and diagnosing the internal bladder pressure based on the measurement result.

Description

Intravesical pressure diagnosis method-based on urography image data

The present invention relates to a method for diagnosing intra-bladder pressure based on urography image data, and more particularly, to increase test reliability when examining the degree of stricture of the urethra and to prevent excessive dilatation of the urethra to minimize pain of the patient. The present invention relates to a method for diagnosing intravesical pressure based on urography image data.

Urinary tract stricture due to an enlarged prostate is a common disease with about half of older men. This urinary tract stricture causes discomfort during the urination of the patient, causing great discomfort in daily life.

In the case of urinary tract stricture due to prostatic hyperplasia, the degree of stenosis should be determined through various tests or related surgery should be determined. Methods for examining urinary tract stricture include retrograde urography and urodynamic study (UDS).

Retrograde urography is a test that visualizes the urethra (urinary tract) by injecting a contrast agent solution at the tip of the urethra.Because a high-viscosity contrast agent solution is injected retrogressively from the tip of the urethra without a catheter, the urethra around the constriction area is excessively expanded and the patient It has a problem that causes pain and bleeding.

In the urodynamic test, a catheter is inserted from the urinary tract to the bladder, then a urine solution mixed with water and salt is injected into the catheter, and the pressure inside the bladder is measured using a pressure sensor at the end of the catheter during urination. In the case of the urodynamic test, the bladder pressure may be overestimated due to the catheter inserted into the urinary tract when measuring the pressure during urination, so the measurement reliability is low, and pain is caused to the patient.

As a prior art, there is Korean Patent Registration No. 10-1389243 "Non-invasive ultrasonic bladder pressure measurement system and method thereof".

The present invention was conceived to solve the above problems, and an object of the present invention is to enable highly reliable bladder pressure measurement when examining the degree of urethral stenosis, to minimize pain resulting from the examination, and to minimize pain during urography. The purpose of this study is to provide a method for diagnosing intravesical pressure based on urinary tract image data that can maximize measurement accuracy by preventing distortion of the image on the urinary tract.

The problem of the present invention is not limited to those mentioned above, and other problems that are not mentioned will be clearly understood by those skilled in the art from the following description.

In order to achieve the above object, the method for diagnosing intravesical pressure based on image data of urography according to the present invention includes injecting a contrast agent into the urethra and bladder through the urethra, and obtaining X-ray image data while urinating after a certain period of time after the injection. The step of doing; Acquiring urethral data related to a urethral image through geometric information of a urethral boundary surface from the acquired image data; Acquiring 3D modeling data of the urethra using coordinate points of the urethra data; And measuring a pressure value with respect to the length of the urethra through flow analysis of the 3D modeling data and diagnosing the internal bladder pressure based on the measurement result.

In the present invention, it is preferable to project the X-ray at a certain angle with respect to the plane of the urethra in the front and rear direction of the body so that interference with the pelvic bone can be prevented during X-ray projection.

The urethra data obtained in the urethral data acquisition step may be secondary data obtained by correcting the primary data acquired through the urethral boundary surface geometry information in consideration of a projection angle of the urethra of the X-ray.

In the step of acquiring 3D modeling data, it is preferable to generate a circular cross section for each coordinate using coordinate points and midpoint of the urethra data, and acquire 3D modeling data of the urethra based on the generated cross section.

In the method for diagnosing intravesical pressure based on urinary tract image data according to the present invention having the configuration as described above, in the step of acquiring X-ray image data, the steps of acquiring image data for the urethra and bladder, and acquiring urethral data In the step of acquiring urethral data about the urethra image through geometric information of the urethra boundary surface, 3D modeling data of the urethra using the coordinate points of the urethra data in the step of acquiring 3D modeling data, and 3D in the step of diagnosing bladder pressure By measuring the pressure value for the length of the urethra through flow analysis of modeling data and diagnosing the intra-bladder pressure based on the measurement result, it is possible to measure the bladder pressure with high reliability when examining the degree of urethral stricture, and the patient's pain following the examination. It has the effect of maximizing measurement accuracy by minimizing and preventing distortion of the image on the urinary tract during urography.

The effects of the present invention are not limited to those mentioned above, and other effects not mentioned will be clearly understood by those skilled in the art from the following description.

1 is a flow chart illustrating a method for diagnosing intravesical pressure based on urography image data according to an embodiment of the present invention.
2 is a diagram for explaining a step of acquiring X-ray image data employed in an embodiment of the present invention.
3 and 4 are diagrams for explaining a step of acquiring urethra data employed in an embodiment of the present invention.
5 to 7 are diagrams for explaining a step of acquiring 3D modeling data of a urethra employed in an embodiment of the present invention.
8 to 11 are diagrams for explaining the steps of diagnosing the bladder pressure employed in an embodiment of the present invention.
12 is a view for explaining a change in pressure and velocity with respect to the center line of the urethra according to the diameter of the constriction portion.

Hereinafter, a method for diagnosing intravesical pressure based on urography image data according to an embodiment of the present invention will be described in detail with reference to the accompanying drawings.

1 is a flow chart for explaining a method for diagnosing intravesical pressure based on urography image data according to an embodiment of the present invention, and FIG. 2 is a flowchart illustrating a step of acquiring X-ray image data employed in an embodiment of the present invention. 3 and 4 are diagrams for explaining the steps of acquiring urethra data employed in an embodiment of the present invention, and FIGS. 5 to 7 are 3D modeling of the urethra employed in an embodiment of the present invention Data It is a diagram for explaining the step of acquiring, and FIGS. 8 to 11 are diagrams for explaining the step of diagnosing the intravesical pressure of the bladder employed in an embodiment of the present invention.

As shown in these figures, a method for diagnosing intravesical pressure based on urinary tract image data according to an embodiment of the present invention includes obtaining X-ray image data (S100) and obtaining urethral data (S200). , Acquiring 3D modeling data of the urethra (S300), and diagnosing the bladder pressure (S400).

In the step of acquiring the X-ray image data (S100), a contrast agent is injected into the urethra and the bladder through the urethra, and when urination is performed after a certain period of time after the injection, X-ray image data of the urethra and the bladder is acquired. (See Fig. 2).

In the step of acquiring the X-ray image data (S100), the X-ray image data can be acquired by projecting an X-ray at an angle of 45 degrees to the urethral surface mainly distributed in the front and rear directions of the body. do. It is obvious to those skilled in the art that the X-ray image data can be acquired by an image acquisition unit such as a known X-ray device.

In the step of acquiring the X-ray image data (S100), a contrast agent is injected (retrograde) and X-ray image data is acquired during urination (progressive) different from the method of acquiring X-ray image data. At the injection part of the urethra, it is possible to prevent the urethra from distorting the diameter of the urethra due to excessive expansion.

In the step of acquiring the urethra data (S200), urethra data related to the urethra image is acquired from the acquired X-ray image data through geometric information on the urethra boundary surface. In the step of acquiring the urethra data (S200), the urethra is visualized through contrast adjustment from the X-ray image data, and the urethra length is determined in consideration of the X-ray projection angle after extracting the urethral boundary geometric information (see FIG. 3). By correcting (refer to FIG. 4), it is possible to maximize measurement accuracy by preventing image distortion on the urethra.

Here, the method of extracting the urethral boundary geometric information can be implemented using software developed and provided in the past (eg, Web plot digitizer) or software developed to perform the step of acquiring the urethra data (S200). Do. As described above, it is obvious to those skilled in the art that the urethra data can be acquired by a data acquisition unit such as well-known Web plot digitizer software.

In the step of acquiring the urethra data (S200), correcting the urethra length in consideration of the X-ray projection angle is performed by applying a weight to the urethral boundary surface geometry information.

In other words, it can be assumed that the urethra in the form of a curve is located in one plane in the normal case. The vertical axis (the length direction of a person) and the horizontal axis are designated as y-axis and x-axis, respectively. If the x-ray is taken perpendicular to the x-y axis, an angiography 2D image can express the urethral curve without significant distortion. However, in order to acquire X-ray image data of the urethra, an X-ray should be scanned diagonally at a certain angle to avoid interference with pelvic bones.

In this case, the X-ray is still perpendicular to the y-axis, but has an angle less than 90 degrees from the x-axis. At this time, the angle deviated from the vertical is called θ. The x-coordinate of the boundary surface of the urethra extracted from the X-ray is converted by applying a weight of x1/cos(θ) as shown in FIG. 4 to estimate the actual diameter and length of the urethra. On the other hand, if there is an angle deviating from 90 degrees for the y-axis, correction can be performed in the same way.

In the step of acquiring 3D modeling data of the urethra (S300), 3D modeling data of the urethra is acquired by using coordinate points of the corrected urethra data. In the step of acquiring 3D modeling data of the urethra (S300), a cross section of the urethra is formed through points and midpoints (see FIG. 5) of coordinates corrected in the step of acquiring the urethra data (S200) (see FIG. 6). And, by using the LOFT function, 3D geometry is created (see Fig. 7).

In the step of diagnosing the bladder pressure (S400), the pressure value for the length of the urethra is measured through flow analysis of the 3D modeling data, and the bladder pressure can be diagnosed based on the measurement result. In the step of diagnosing the bladder pressure (S400), for flow analysis, existing software (eg, Ansys Fluent) or dedicated software for performing step S400 may be used. As described above, it is obvious to those skilled in the art that the bladder internal pressure can be diagnosed using a diagnostic unit such as the widely known Ansys Fluent flow analysis software.

In the step of diagnosing the bladder internal pressure (S400), when there is flow rate information through a uroflowmeter, etc., the bladder pressure (internal pressure) is estimated by applying it as an inlet boundary condition (see FIG. 9 ). ). On the other hand, in the step of diagnosing the bladder pressure (S400), when there is no flow rate information, a normal bladder pressure is estimated for a model (see FIG. 8) in which the stricture is virtually removed from the 3D model of the urethra.

In the step of diagnosing the bladder pressure (S400), the effect of the stenosis on the bladder pressure is analyzed through comparison of the bladder pressure according to the presence or absence of stenosis in the urethra, and the Navier-stroke equation, which is a motion equation for a viscous fluid. -stokes equation) to analyze fluid velocity and bladder pressure (internal pressure).

In the step of diagnosing the bladder pressure (S400), as the velocity of the fluid according to the urethral constriction increases through the Navier-stroke equation, the intra-bladder pressure decreases, and as the urethral constriction does not occur, the lower the fluid velocity, the lower the bladder intra-pressure pressure. It leads to an analysis result that increases.

In the present embodiment including the steps as described above, image data for the urethra and bladder is acquired in the step of acquiring X-ray image data (S100), and the urethral boundary surface geometric information is obtained in the step of acquiring urethral data (S200). In the step of acquiring urethral data related to the urethra image and acquiring 3D modeling data (S300), 3D modeling data of the urethra is obtained using coordinate points of the urethra data, and 3D in the step (S400) of diagnosing bladder pressure. By measuring the pressure value for the length of the urethra through flow analysis of modeling data and diagnosing the intra-bladder pressure based on the measurement result, it is possible to measure the bladder pressure with high reliability when examining the degree of urethral stricture, and the patient's pain following the examination. It has the effect of maximizing measurement accuracy by minimizing and preventing distortion of the image on the urinary tract during urography.

On the other hand, in the step of acquiring X-ray image data (S100) in this embodiment, the X-ray is constant with respect to the plane in the front and rear direction of the body of the urethra so that interference with the pelvic bone can be prevented during X-ray projection. By projecting at an angle, the accuracy of X-ray image data for the urethra and bladder is improved.

In addition, the urethra data obtained in the urethral data acquisition step (S200) is secondary data obtained by correcting the primary data obtained through the urethral boundary surface geometry information in consideration of the projection angle of the urethra of the X-ray. Therefore, the step of acquiring 3D modeling data of the urethra (S300) is performed by using the child marks of the secondary data. Modeling.

In the present embodiment, in the 3D modeling data acquisition step (S300), the coordinate points and the midpoint of the urethra data are called from the drawing (see Fig. 5), and a circular cross section of the urethra is generated for each coordinate (see Fig. 6), It is possible to acquire 3D modeling data (see Fig. 7) of the urethra based on the created cross section.

On the other hand, the step of diagnosing bladder pressure (S400) is to be able to obtain data on the pressure drop along the center line of the urethra as shown in FIGS. 10 and 11 to diagnose an enlarged prostate. Has the effect of doing.

In other words, looking at the pressure drop of the bladder along the centerline, the pressure in the bladder decreases significantly in the urethral stricture part (the part where the area of the urethra cross-section perpendicular to the centerline is small) due to prostate enlargement after the bladder. , It can be seen that the pressure is recovered in the area where the urethra is not constricted (the area with a large area of the urethra cross-section perpendicular to the center line).

As shown in FIG. 11, it can be seen that the velocity of urine during urination increases in the urethral stricture and decreases in the urethral stricture. In addition to the overall pressure drop, information on the pressure drop according to the constriction when the fluid moves through the urethra makes it possible to diagnose an enlarged prostate.

The pressure and velocity changes (bladder pressure and fluid velocity varying along the center line) of the urethra center line according to the diameter of the constriction that can be measured in the step of diagnosing the bladder pressure (S400) will be further described.

12 is a view for explaining a change in pressure and velocity with respect to the center line of the urethra according to the diameter of the constriction portion.

Referring to FIG. 12, based on a specific model of a patient with urethral stenosis, a simulation was performed while increasing the diameter of the constriction by 10%, 20%, 50%, and 100%.As a result, the pressure in the bladder according to the increase in the diameter It can be seen that is gradually decreasing. In addition, it can be seen that the pressure drop, which decreases as it passes through the constriction, changes significantly. As in the present invention, it is possible to more accurately diagnose the stricture of the urethra through the pressure drop and velocity distribution measured while passing through the constriction.

The step of diagnosing the bladder internal pressure employed in the present embodiment may further include a pressure measurement determination step S410. In the pressure measurement determination step (S410), it is possible to determine whether to perform surgery for removing the urethral stricture based on the reference values for the pressure before the stricture area and the pressure after the stricture area of the urethra.

In the pressure measurement determination step (S410), the ratio of the pressure after the constriction and the pressure before the constriction in the urethral model of the patient with urethral stricture is calculated, and if a value less than the reference value for the ratio is derived from the patient, the patient Allow them to determine that surgery is necessary (see Table 1).

case
Pressure before the stenosis
(cmH2O)
Pressure after constriction
(cmH2O)

( % )

( % )

Model of the patient's urethra

57.08
30.06
0.54
Constricted 10% increase in diameter

49.08
32.25
0.65
Constricted 20% increase in diameter

48.62
36.04
0.74
Constricted 50% increase in diameter

38.13
33.08
0.86
Constricted 100% increase in diameter

34.93

33.35

0.95

Here, as shown in Table 1, the ratio can be obtained by dividing the pressure after the constriction by the pressure before the constriction, and the reference numerical value for the ratio means 0.54 or less (0.54 or less and 0.1 or more). As the diameter of the urethral constriction is increased by 10%, 20%, 50%, and 100%, this ratio has values of 0.65, 0.74, 0.86, and 0.95 and increases gradually.

This means that in the patient's model, as the diameter of the constriction is increased, the pressure drop when passing through the constriction of which the diameter is increased is reduced. Therefore, the smaller the value is, the greater the pressure drop. If this value is less than 0.54 based on the above data, it can be determined that surgery is necessary.

In the above description, the pre-constriction pressure refers to the pressure of the urethra along the length of the urethra before constriction is established. In addition, the pressure after the stricture refers to the pressure in the urethra where there is no stricture after passing through the stricture.

This embodiment can be programmed and stored in a removable memory storage device or a CD-ROM, and executed by a computer. These embodiments and the accompanying drawings in the present specification are merely illustrative of some of the technical matters included in the present invention, and those skilled in the art can easily infer within the scope of the technical idea included in the specification and drawings of the present invention. It will be apparent that all possible modifications and specific embodiments are included in the scope of the present invention.

S100: Acquiring X-ray image data
S200: Step of acquiring urethral data
S300: Acquiring 3D modeling data of the urethra
S400: Diagnosing intra-bladder pressure

Claims (5)

Injecting a contrast agent into the urethra and the bladder through the urethra by the image acquisition unit, and obtaining X-ray image data while urinating after a certain period of time after the injection;
Obtaining, by a data acquisition unit, urethra data relating to a urethra image through geometric information on a urethra boundary surface from the acquired image data, and obtaining 3D modeling data of the urethra by using coordinate points of the urethra data; And
Measuring a pressure value for the length of the urethra through the flow analysis of the 3D modeling data, and diagnosing the intra-bladder pressure based on the measurement result; Diagnostic method.
The method of claim 1,
A method for diagnosing intravesical pressure based on urography image data, characterized in that the X-ray is projected at an angle with respect to the plane of the urethra in the front and rear direction of the body so that interference with the pelvic bone can be prevented during X-ray projection.
The method of claim 2,
The urethra data obtained in the urethral data acquisition step is secondary data obtained by correcting the primary data acquired through the urethral boundary surface geometry information in consideration of the projection angle of the urethra of the X-ray. A method for diagnosing intravesical pressure based on image data.
The method of claim 1,
In the step of obtaining 3D modeling data, a circular cross section for each coordinate is generated by using coordinate points and midpoint of the urethra data, and 3D modeling data of the urethra is acquired based on the generated cross section. A method for diagnosing intravesical pressure based on data.
The method of claim 1,
The step of diagnosing bladder pressure may further include a pressure measurement determination step of determining whether to perform surgery for removing the urethral stricture based on reference values for the pressure before the stricture area and the pressure after the stricture area of the urethra; A method for diagnosing intravesical pressure based on urography image data.

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