KR20200102138A - Neuronavigation with electrophysiological stimulation device - Google Patents

Abstract

The present invention relates to a neuronavigation device including an electrophysiological stimulator. According to the present invention, the neuronavigation device including an electrophysiological stimulator comprises: an electrophysiological neural stimulation unit; a probe location detection unit; a neural monitoring unit; a microcomputer electrically connected to the electrophysiological neural stimulation unit, the probe location detection unit, and the neural monitoring unit; and a display unit. According to the present invention, brain surgery can now be performed rapidly and safely.

Description

Neuronavigation with electrophysiological stimulation device {Neuronavigation with electrophysiological stimulation device}

The present invention relates to a nerve navigation device, and more particularly, by stimulating the brain or a cranial nerve with an electrophysiological stimulation device that checks brain or cranial nerve function, and detecting the degree of response corresponding thereto, The present invention relates to a nerve navigation device including an electrophysiological stimulation device that displays a three-dimensional nerve image by mapping a functional cerebral nerve image by reconstructing the position in a three-dimensional space through a nerve navigation device.

In general, in the field of neurosurgery, neuronavigation is used to accurately identify the location of structures during brain surgery, while electrophysiological monitoring devices evaluate the function of the brain in brain tumor or epilepsy surgery, etc. It is used as a method for preservation.

For example, in order to safely remove a tumor near the motor center, the boundary of the tumor is checked through a nerve navigation device, and the brain is stimulated through an electrophysiological monitoring device to check whether the motor center is correct.

Looking at the dual nerve navigation system, in recent years, an image-based neuronavigation software was used to confirm which part of the MRI the actual visible location corresponds to, while performing surgery.

The above-described image-based neuronavigation uses devices such as infrared markers and stereo cameras to identify a corresponding part from the patient's head.

As for the prior art, Korean Patent Publication No. 10-2018-0091860 (2018.08.16) may be referred to. (The Korean Intellectual Property Office requires at least one prior art to be described in the specification.)

On the other hand, the cranial nerve monitoring device is used for, for example, applying electrical stimulation to an exercise center or a cranial nerve, and detecting an electrical signal from a face, arm, leg, etc. to check whether the stimulated part is the exercise center or the corresponding cranial nerve.

However, in order to mark the area after applying the stimulation, conventionally, the stimulated area is memorized by the public eye, or the stimulated area is directly marked by placing a small sticker or piece of paper on the stimulated area, or on a standardized brain map. I used a method that roughly marks the location on.

The problem with this method is laborious, a piece of paper that is placed on it obscures the field of view, and if the blood is washed off with water, it is washed off, and the feedback on the stimulus is not immediate, so it should be marked on a different area than the irritated area. There was a possibility to be.

In addition, there was a problem in that relatively very thin nerves could not be marked in the first place.

The present invention stimulates the cranial nerve with an electrophysiological stimulation means to check the damage of the cranial nerve function, detects the reactive and non-reactive cranial nerves corresponding thereto, and maps the three-dimensional cranial nerve image according to the reactive and non-reactive cranial nerves. It is an object of the present invention to provide a neuronavigation device including an electrophysiological stimulation device that enables fast, accurate and safe brain surgery, since it is possible to check the structure of the cranial nerve and whether the brain function is lost with a single device.

The neural navigation device including the electrophysiological stimulation device according to the present invention includes a probe that contacts a measurement site, and emits an electrical stimulation signal through the probe to apply stimulation to the brain or cranial nerves in a local area. Part, a probe position detection unit for detecting the position of the probe on the measurement site, the probe is electrically connected to a detector, and a nerve monitoring unit for detecting an electrical response signal of the brain or cranial nerve according to the electrical stimulation signal by the detector, the nerve stimulation The unit, the probe position detection unit, and the nerve monitoring unit are electrically connected, based on the position of the probe detected by the probe position detection unit and the corresponding electrical response signal detected by the nerve monitoring unit, Among the nerves, reactive cranial nerves that respond to electrical signals and non-reactive cranial nerves that do not respond to electrical signals are distinguished, a three-dimensional coordinate system is calculated for the responsive cranial nerves and non-reactive cranial nerves, and the response calculated on the collected brain image A microcomputer that maps a three-dimensional cranial nerve image by substituting a three-dimensional coordinate system of a cranial nerve and a non-reactive cranial nerve, and a display unit that is electrically connected to the micom and displays a three-dimensionally mapped cranial nerve image on a screen. .

At this time, the probe according to the present invention is used as a position indicator of a neural navigation device and plays a role of emitting an electrical signal, a switch that turns on/off (OFF) the electrical signal emission, and the intensity of the electrical signal. It may include a volume to adjust to increase or decrease.

In addition, the probe according to the present invention may display a line or point on three-dimensional coordinates, separate from the cranial nerve.

Further, one side of the probe according to the present invention may be provided with a detector for receiving an electrical response signal of the brain or cranial nerve.

In addition, the neural navigation device including the electrophysiological stimulation device according to the present invention may further include a storage unit for storing the corresponding 3D cranial nerve image mapped by the microcomputer as a file of a corresponding format.

In addition, the display unit according to the present invention may display a brain shape image, a reactive cranial nerve, and a non-reactive cranial nerve in different colors, and the brightness or saturation of the display color may be changed according to the response sensitivity of the reactive cranial nerve.

The effects that appear to be understood in the neuronavigation apparatus including the electrophysiological stimulation apparatus according to the present invention are as follows.

By stimulating the cranial nerve with an electrophysiological stimulation means for checking the damage of the cranial nerve function, detecting the reactive and non-reactive cranial nerves corresponding thereto, and mapping and displaying a three-dimensional cranial nerve image according to the reactive and non-reactive cranial nerves, With one device, it is possible to check the structure of the cranial nerve and whether the brain function is lost, enabling fast, accurate and safe brain surgery.

1 is a block diagram showing the configuration of a nerve navigation device including an electrophysiological stimulation device according to an embodiment of the present invention.
2 is an exemplary diagram illustrating a three-dimensional cranial nerve image mapped by a nerve navigation device including an electrophysiological stimulation device according to an embodiment of the present invention.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. Prior to this, terms or words used in the specification and claims should not be construed as being limited to their usual or dictionary meanings, and the inventors appropriately explain the concept of terms in order to explain their own invention in the best way. Based on the principle that it can be defined, it should be interpreted as a meaning and concept consistent with the technical idea of the present invention.

Therefore, the embodiments described in the present specification and the configurations shown in the drawings are only the most preferred embodiments of the present invention, and do not represent all of the technical spirit of the present invention, so at the time of the present application, they are equivalent to It should be understood that there may be variations.

The present invention stimulates the cranial nerve with an electrophysiological stimulation means to check the damage of the cranial nerve function, detects the reactive and non-reactive cranial nerves corresponding thereto, and maps the three-dimensional cranial nerve image according to the reactive and non-reactive cranial nerves. By displaying, it is possible to check the structure of the cranial nerve and whether the brain function is lost with one device, and it relates to a nerve navigation device including an electrophysiological stimulation device that enables fast, accurate and safe brain surgery. A detailed look is as follows.

A nerve navigation apparatus including an electrophysiological stimulation device according to an embodiment of the present invention includes an electrophysiological nerve stimulation unit 100, a nerve monitoring unit 200, a microcomputer 300, and a display unit 400 First of all, the electrophysiological nerve stimulation unit 100 includes a probe 110 whose tip is interviewed on the head of the person measuring, and radiates an electrical stimulation signal through the probe 110 to generate a local cranial nerve. Stimulates

At this time, the electrophysiological nerve stimulation unit 100 includes a stimulation signal generation unit 120 that outputs an electrical stimulation signal to the probe 110, and the stimulation signal generation unit 120 is a control signal according to user manipulation. Is output to the probe 110.

The probe 110 generates and emits an electrical stimulation signal in the form of voltage, current, or pulse based on the signal output from the stimulation signal generation unit 120. At this time, the probe 110 turns on the electrical signal emission. )/Off (OFF) a switch 111 and a volume 112 that adjusts to increase or decrease the intensity of the electrical signal, so that the divergence and intensity of the electrical stimulation signal can be selectively adjusted.

In addition, the threshold value can be adjusted in a similar way, and this threshold value serves as a criterion for determining a positive or negative response according to the electrical stimulation.

At this time, it is preferable that the probe 110 further includes a marking means 113 for artificially displaying a line or point on a three-dimensional coordinate.

Therefore, the user can selectively manipulate the switch 111, the volume 112, and the marking means 113 provided in the probe 110 to turn on or off the emission of electrical stimulation signals during cranial nerve detection, and increase the intensity of stimulation. It can be raised or lowered, and if necessary, it can be artificially marked with lines or dots on the 3D cranial nerve image.

Here, in an embodiment of the present invention, the probe 110 is described based on a single configuration, but the present invention is not limited thereto, and a plurality of the probes 110 are provided, and the probe 110 is used to emit electrical stimulation signals using a triangular method. Alternatively, an electrical response signal may be received.

In addition, the probe position detection unit 600 detects the position of the probe 110 flowing on the measurement site. To detect the position of the probe 110, various methods may be applied. The position of the probe 110 may be detected by RGB processing of an image captured by photographing a head.

At this time, the probe 110 may have a background (measurement part) and a mark that clearly shows a difference in brightness, saturation, color, etc., and a background in which brightness, saturation, color contrast, etc. of the photographed images clearly differ. The position of the probe 110 on the corresponding measurement area is recognized and detected in contrast between the and the mark.

Here, the probe position detection unit 600 uses a camera as a means for detecting the position of the probe 110, and the camera continuously and repeatedly photographs the measurement area (head), and the background (measurement area) among the captured images After analyzing the image in which the brightness, saturation, and color are contrasting, it is checked whether the analyzed image corresponds to the mark value of the probe 110, and if it is matched, a 3D coordinate system for the mark image contrasting with the background is calculated. , By reflecting the mapping time, the position of the probe 110 on the corresponding measurement site is detected.

At this time, since it is desirable to keep the head of the measuring person, which is the background, in a fixed position as the reference when shooting, the virtual reference area line is the camera so that the head of the measuring person can be placed in the reference area. It may be formed in the viewfinder of, and before the measurement through the viewfinder, the head of the corresponding measurer may be positioned within the reference area line.

And it can be fixed with a restraint tool or the like to prevent the person's head from flowing during the measurement.

Therefore, the probe position detection unit 600 photographs the entire measurement area together with the probe 110 located on the measurement area, and then determines the difference between the measurement area and the brightness, saturation, color, etc. in the captured image. After recognizing the visible probe 110, the position of the probe 110 is detected using a three-dimensional coordinate system.

In addition, the detection signal for the position of the probe 110 detected by the probe position detection unit 600 is transmitted to the microcomputer 300, and the three-dimensional coordinate system of the reactive and non-reactive cranial nerves is substituted by the microcomputer 300 When mapping to a dimensional cranial nerve image, a 3D coordinate system for the position of the probe 110 detected in the head and brain shape images is applied and expressed on the mapped image.

Here, a plurality of cameras of the probe position detecting unit 600 may be provided, and the position of the probe 110 may be detected using images captured by a plurality of cameras.

In addition, the neural monitoring unit 200 is electrically connected to a detector 210 coupled to one side of the probe 110, and receives and detects an electrical response signal corresponding to an electrical signal by the detector 210.

At this time, the neural monitoring unit 200 includes a signal detection unit 220, the signal detection unit 220 receives the electrical response signal received from the detector 210, classifies it by signal band, and classifies it by signal band. Among the electrical response signals, distorted response signals are corrected and output.

The electrical response signals output from the signal detection unit 220 are input to the amplifying unit 230, which amplifies the electrical response signals into an amplified signal having a preset electrical gain and outputs the amplified electrical response signals.

In this case, the amplification unit 230 may include an operational amplifier having an electrical gain value within a range of 1 to 10 or an amplifier including a transistor.

The electrical response signals output from the amplification unit 230 are input to the analog-to-digital conversion unit 240, which converts the amplified signal output from the amplification unit 230 into a digital signal and outputs it. do.

The analog-to-digital converter 240 inputs electrical response signals converted into digital signals to the micom 300, and the micom 300 is based on the electrical response signals collected by the nerve monitoring unit 200. Responsive cranial nerves that responded to signals and non-reactive cranial nerves that did not respond to electrical signals are classified, and a three-dimensional coordinate system for reactive cranial nerves and non-reactive cranial nerves is calculated based on a preset center of the brain, and the collected brain shape The three-dimensional coordinate system of the reactive and non-reactive cranial nerves calculated in the image is substituted and mapped to a three-dimensional cranial nerve image.

At this time, the micom 300 models the brain shape image in 3D based on the brain shape image previously collected through MRI, CT, ultrasound scanner, and camera, and the 3D of reactive and non-reactive cranial nerves to the modeled brain shape image. Substitute the coordinate system.

Here, when an operator included therein calculates a three-dimensional coordinate system for reactive and non-reactive neurons, the microcomputer 300 may calculate the central part of the brain through a reference coordinate system using a preset reference point.

In addition, the display unit 400 is electrically connected to the microcomputer 300 and displays a cranial nerve image mapped in three dimensions by the microcomputer on a screen.

At this time, it is preferable that the display unit 100 displays a brain shape image and a reactive cranial nerve and a non-reactive cranial nerve in different colors, and the responsive cranial nerve is preferably displayed with the brightness or saturation of the display color changed according to the reaction sensitivity. .

In addition, by adjusting the threshold value as a reference, the overall brightness and saturation can be changed to change the degree of display on the screen.

For example, when the probe 110 of the nerve stimulation unit 100 is brought into contact with the corresponding head, when the stimulation emitted from the probe 110 is applied, the region to which the stimulation is applied is displayed as a three-dimensional brain nerve image on the display unit.

At this time, if the response to the stimulus is positive (+) in the 3D cranial nerve image, the cranial nerve is displayed in red, if it is negative (-), the cranial nerve is displayed in blue, and the cranial nerve displayed in red depends on the intensity of the response to the stimulus. The brightness or saturation of the display color may be changed and displayed. How much brightness and saturation are displayed can be changed by adjusting the threshold value.

In addition, the neural navigation device including the electrophysiological stimulation device according to an embodiment of the present invention further includes a storage unit 500 for storing the 3D cranial nerve image mapped by the micom 300 as a file of a corresponding format. Can include.

The storage unit 500 stores the cranial nerve image of the stimulus on the display unit 400 at the same time as it is displayed, and stores a three-dimensional cranial nerve image for each time period or in response to an electrical stimulus so that it can be viewed later.

Through this process, it is possible to digitize and record a record of the stimulated part of the cranial nerve.

The present invention has been described with reference to the embodiments shown in the drawings, but these are merely exemplary, and those of ordinary skill in the art will appreciate that various modifications and equivalent other embodiments are possible therefrom. Therefore, the true technical protection scope of the present invention should be determined by the technical spirit of the appended claims.

100: electrophysiological nerve stimulation section
110: probe
111: switch
112: volume
113: marking means
120: stimulation signal generation unit
200: nerve monitoring unit
210: detector
220: signal detection unit
230: amplification unit
240: analog to digital conversion unit
300: micom
400: display
500: storage
600: probe position detection unit

Claims (7)

An electrophysiological nerve stimulation unit that includes a probe in contact with the measurement site, and applies stimulation to the brain or cranial nerves in a local area by emitting an electrical stimulation signal through the probe;
A probe position detection unit for detecting a position of a probe on the measurement site;
The probe is electrically connected to the detector, and the detector detects an electrical response signal of the brain or cranial nerve according to the electrical stimulation signal;
It is electrically connected to the nerve stimulation unit, the probe position detection unit, and the nerve monitoring unit, and based on the position of the probe detected by the probe position detection unit and the corresponding electrical response signal detected by the nerve monitoring unit, the probe is located Reactive cranial nerves that respond to electrical signals and non-reactive cranial nerves that do not respond to electrical signals are classified among the nerves in the brain region, calculated through a three-dimensional coordinate system for the reactive and non-reactive cranial nerves, and collected brain shape images A microcomputer for mapping into a three-dimensional cranial nerve image by substituting the three-dimensional coordinate system of the responsive and non-reactive cranial nerves calculated in; And
A nerve navigation apparatus including an electrophysiological stimulation device comprising a; a display unit electrically connected to the micom and displaying a three-dimensionally mapped cranial nerve image by the micom.
The method according to claim 1,
The probe is
It is used as a position indicator of a nerve navigation device and at the same time plays a role of emitting electrical signals.
A switch for turning on/off (OFF) electric signal divergence;
A nerve navigation device including an electrophysiological stimulation device comprising a; volume for adjusting to increase or decrease the intensity of an electrical signal.
The method according to claim 2,
The probe is
Apart from the cranial nerve, a nerve navigation device including an electrophysiological stimulation device that displays lines or points on three-dimensional coordinates.
The method according to claim 1,
A nerve navigation device including an electrophysiological stimulation device having a detector for receiving an electrical response signal from a brain or a cranial nerve at one side of the probe.
The method according to claim 1,
A storage unit for storing the 3D cranial nerve image mapped by the microcomputer as a file of a corresponding format type; a nerve navigation apparatus further comprising an electrophysiological stimulation device.
The method according to claim 1,
The display unit
A neuronavigation apparatus including an electrophysiological stimulation device, characterized in that the brain shape image and the reactive and non-reactive cranial nerves are displayed in different colors.
The method of claim 6,
The display unit
A nerve navigation device including an electrophysiological stimulation device, characterized in that the brightness or saturation of the display color is changed and displayed according to the reaction sensitivity of the reactive brain nerve.

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