TW202019350A - Method for identifying and locating nerves - Google Patents

Abstract

The present invention relates a method for identifying and locating at least one nerve in a determined operation area. In the method, an image detector is utilized to scan the determined operation area according to a nerve direction forecast from a nerve identifying program, capture multiple 2D cross-sectional images of the determined operation area in different parts, and determine whether the 2D cross-sectional images belong to a target nerve by the nerve identifying program. If the 2D cross-sectional images are identified as the target nerve by the nerve identifying program, the nerve identifying program constructs a 3D nerve image from the 2D cross-sectional images by 3D image reconstruction.

Description

Nerve identification and positioning method

The invention relates to a nerve identification and positioning method, in particular to a nerve identification and positioning method for reconstructing a three-dimensional nerve image.

In the surgical operation, it is necessary to confirm various nerve directions to avoid accidental injury or compression of the nerve. Taking an orthopedic trauma surgery as an example, when performing minimally invasive surgery, a bone plate needs to be implanted in a limb through all mouths In order to fix the broken bone, however, the nerve must be avoided during the implantation of the bone plate to prevent the bone plate from compressing the nerve, resulting in postoperative pain or paralysis.

Because the nerve direction of each person is different, in order to avoid nerves and blood vessels during surgery, doctors can only predict the nerve direction based on anatomical knowledge and surgical experience. Therefore, there is a risk of bone plate compression nerves in each operation.

The main purpose of the present invention is to confirm the nerve direction of the position to be operated in advance before the operation to avoid damage to the nerve during the operation (such as the nerve being compressed by the bone plate).

A nerve identification and positioning method of the present invention includes providing an image display device, an image display device having a nerve identification program and a nerve identification module; providing a detection device, a detection device having a detection machine and an image detector, The image detector is installed on the inspection machine; and a scan identification procedure is performed. The scan identification procedure includes: a first step, scanning a standby with the image detector The surgical site to confirm an initial position of a nerve to be located; in a second step, the image detector captures a plurality of two-dimensional cross-sectional images of the initial position of the nerve to be located, and the nerve identification program uses the nerve identification The module recognizes the two-dimensional cross-sectional images and provides the detection machine with a predicted nerve direction; in a third step, the detection machine drives the image detector to move to the standby according to the predicted nerve direction An area of the surgical site, and acquiring a plurality of two-dimensional cross-sectional images of the area; and a fourth step, the neural recognition program recognizes whether the two-dimensional cross-sectional images of the area are the pending by the neural recognition module Nerve, when the nerve recognition program recognizes that the two-dimensional images are the nerve to be located, the detection machine then drives the image detector to scan the nerve to be located in the next area of the operation site according to the predicted nerve direction , And capture a plurality of two-dimensional cross-sectional images of the area and identify whether the two-dimensional cross-sectional images of the area are the nerve to be located, and if the two-dimensional cross-sectional images are the nerve to be located, repeat the process The fourth step is until the image detector scans to the last area.

In the present invention, the two-dimensional cross-sectional images of the nerve to be located are acquired by the image display device, the detection device, and the scan identification program, and according to the predicted nerve direction, and the two The three-dimensional cross-sectional image is constructed as a three-dimensional image, so that the doctor can confirm the nerve position before the operation, so as to reduce the risk of bone plate compression on the nerve.

Before the orthopedic surgeon performs minimally invasive surgery, it is necessary to pay attention to the following main nerves, such as radial nerve (radial nerve, its cross-sectional area is about 4mm), median nerve (median nerve, its cross-sectional area is about 4mm), axillary nerve (axillary nerve, its Cross-sectional area of about 3.6mm), ulnar nerve (ulnar nerve, the cross-sectional area of about 3mm), etc., in this embodiment, to identify and locate a radial nerve as an example, but not limited to this, please refer to Figure 1, in a limb A radial nerve is wound around a bone of the upper extremity. When a radius or bone of the upper limb is broken, a bone plate (not shown) must be used to fix the broken bone. However, due to the radial nerve of each person It is assumed that the bone positions of the upper limbs are not the same, thus increasing the risk of surgery.

In order to reduce the risk of surgery, please refer to FIG. 2, the present invention adopts a neural identification and positioning method 100, which includes: "providing an image display device" 110, "providing a detection device" 120, and "performing a Scan identification process" 130.

Please refer to FIG. 3, in the “providing an image display device” 110, an image display device 110a includes a display 110b and a neural recognition program and a neural recognition module in a computer 110c. The neural recognition module It is an identification module composed of at least one nerve section.

Please refer to Figures 1, 3, 4 and 5, in the "providing an image display device" 110, a detection device 120a has a detection machine 120b and an image detector 120c, the image detector 120c is provided in the detection The machine 120b. In this embodiment, the inspection machine 120b has a first rail 120d, a second rail 120e, a rotating plate 120f, a carrier 120g, a base 120h, and an accommodating space 120i The accommodating space 120i is used for accommodating a site to be operated 200. In this embodiment, the site to be operated 200 is an arm, but not limited to this, the first rail member 120d is disposed on the base 120h, The second rail member 120e is movably coupled to the first rail member 120d, and the second rail member 120e surrounds the accommodating space 120i, the rotating plate 120f is movably coupled to the second rail member 120e, and the carrier 120g Combined with the rotating plate 120f and swinging with the rotating plate 120f, the carrier 120g has a perforation 120j and a transmission rod 120k, the transmission rod 120k is movably penetrated through the perforation 120j, and the image detector 120c is combined with the transmission Rod 120k, and the image detector 120c is selectively directed toward or away from the site 200 to be operated by the driving rod 120k, the image detector 120c is electrically connected to the computer 110c to transmit image signals, and the image detector 120c is selected Since an ultrasonic detector.

Please refer to FIGS. 4 and 5. Preferably, the testing machine 120b further includes a screw 120m, a first motor 120n, a second motor 120p, a third motor 120q, and at least one encoder 120r. The first The motor 120n is used to drive the screw 120m to rotate, the second rail member 120e is engaged with the screw 120m, and the first motor 120n is used to drive the screw 120m to rotate to drive the second rail member engaged with the screw 120m 120e moves laterally along the first rail member 120d, the second motor 120p is used to drive the rotating plate 120f to swing, so that the image detector 120c can move around the site to be operated 200, and the second motor 120p drives the rotation The way in which the plate 120f swings is selected from gear and rack transmission, transmission wheel and belt transmission, etc. The third motor 120q is used to drive the transmission rod 120k, so that the image detector 120c can be selectively moved toward or away from the standby In the surgical site 200, the manner in which the third motor 120q drives the transmission rod 120k to move is selected from gear and rack transmission, transmission wheel and belt transmission, and the like.

Please refer to Figs. 4 and 5, the encoder 120r is used to record the transmission data (such as the number of forward or reverse rotations, etc.) of the first motor 120n, the second motor 120p and the third motor 120q, the encoder 120r may be integrated into the first motor 120n, the second motor 120p, and the third motor 120q.

Please refer to FIGS. 1, 4, 5 and 6, in the scan identification process 130, first, the operation site 200 is placed in the accommodating space 120i, and then, a first step 131 is performed on the first In step 131, the image detector 120c is used to scan the site to be operated 200 to confirm an initial position 210a of a nerve 210 to be located. Please refer to FIGS. 1, 3 and 4 to contact the site to be operated with the image detector 120c 200, and a cross-sectional image of the nerve to be located in the site to be operated 200 is displayed on the display 110b. In this embodiment, the nerve to be located 210 is used as the illustration of the radial nerve winding, but not limited to this And set an image capture frequency parameter and a plurality of scanning area parameters for the image detector 120c, wherein the image capture frequency parameter is the number of two-dimensional cross-sectional images captured by the image detector 120c in a time, for example Capture 300 two-dimensional cross-sectional images in 1 second. The scanning area parameters are the number of times the inspection machine 120b drives the image detector 120c to move sequentially in one direction on the surface of the site to be operated 200. Please refer to page 3. As shown in the figure, preferably, the image detector 120c transmits a scanned image of the site to be operated 200 to the display 110b for confirmation.

Please refer to FIGS. 1, 4, 5, and 6, after the first step 131, a second step 132 is performed. In the second step 132, according to the image capture frequency parameter, the image detector 120c captures A plurality of two-dimensional cross-sectional images P (see FIG. 7) of the initial position 210a of the nerve 210 to be located, the two-dimensional cross-sectional images P include a section of the nerve 210 to be located, in this embodiment, the The image detector 120c surrounds the to-be-operated site 200 and contacts the to-be-operated site 200 by the second rail member 120e to capture the two-dimensional cross-sectional images P, and the image detector 120c combines the two-dimensional cross-sectional images P is transmitted to and stored in the computer 110c of the image display device 110a. The neural recognition program recognizes the two-dimensional cross-sectional images P through the neural recognition module, and provides the detection machine 120b with a predicted nerve direction. In addition, When fetching the two-dimensional cross-sectional images P, the encoder 120r transmits the transmission data of the first motor 120n, the second motor 120p, and the third motor 120q to the computer 110c for conversion of an arithmetic program into each The respective shooting coordinates of the two-dimensional cross-sectional image P, and record the respective shooting coordinates corresponding to the two-dimensional cross-sectional images P. In the present embodiment, each of the shooting coordinates is the image detector 120c through the first A displacement coordinate when the rail member 120d, the second rail member 120e, and the transmission rod 120k move to a position.

Please refer to Figures 4, 5, 6 and 7, after the second step 132, a third step 133 is performed. In the third step 133, based on the predicted nerve direction and the scan area parameters, the detection machine 120b drives the image detector 120c to an area 200a of the site to be operated 200. In this embodiment, the first motor 120n drives the screw 120n to rotate to drive the second rail member 120e and the rotating plate 120f, the transmission rod 120k and the image detector 120c move to the area 200a. Similarly, the image detector 120c surrounds the site to be operated 200 by the second rail member 120e and contacts the site to be operated 200, and according to The image capture frequency parameter captures a plurality of two-dimensional cross-sectional images P of the area 200a (see FIG. 7), the encoder 120r combines the first motor 120n, the second motor 120p, and the third motor 120q The transmission data of is transmitted to the computer 110c, and the shooting coordinates of the two-dimensional cross-sectional image P in the area 200a are recorded. In this embodiment, the shooting coordinates are the image detector 120c through the first track A displacement coordinate of the member 120d, the second rail member 120e, the rotating plate 120f and the transmission rod 120k when moving to the area 200a.

Please refer to FIG. 6, after the third step 133, a fourth step 134 is performed, in which the neural recognition program recognizes the image in the third step 133 by the neural recognition module Whether the two-dimensional cross-sectional images P of the detector 120c moving to the area 200a to be operated on is the nerve 210 to be located, when the nerve recognition program recognizes that the two-dimensional images are the nerve 210 to be located, it is preferable Ground, the computer 110c sends out a prompt signal, the prompt signal can be selected from the optical signal, audio signal, and then, the detection machine 120b then drives the image detector 120c at the site 200 to be operated according to the predicted nerve direction The next region 200a scans the nerve 210 to be located, and acquires a plurality of two-dimensional cross-sectional images of the region 200a and the shooting coordinates of the two-dimensional cross-sectional images P recorded in the region 200a, and recognizes the region 200a Whether the two-dimensional cross-sectional images are the nerve 210 to be located, and if the two-dimensional cross-sectional images P are the nerve 210 to be located, repeat the fourth step until the image detector 120c scans to the last one Area 200a. Conversely, in the fourth step, when the neural recognition program recognizes that the two-dimensional images P are not the nerve to be located, the neural recognition program provides the detection machine 120b with another predicted nerve direction, and then performs the first Three steps and the fourth step until the image detector scans to the last area.

Please refer to FIGS. 7 and 8, the scan identification process 130 further includes a fifth step 135. After the fourth step 134, the fifth step 135 is performed. In the fifth step 135, a three-dimensional image reconstruction technique is used Constructing the two-dimensional cross-sectional images captured in the third step and the fourth step into a three-dimensional image P1, the three-dimensional image includes a three-dimensional neural image, preferably, the three-dimensional image includes a warning area, The warning area is located outside the three-dimensional nerve image.

Please refer to FIG. 8 and FIG. 9, the scan identification program 130 further includes a sixth step 136, after the fifth step 135, the sixth step 136 is performed, and in the sixth step 136, the three-dimensional neural image is reconstructed to In a to-be-operated site image P2 (see FIG. 9), the to-be-operated site image P2 is a broken bone 220 image of the to-be-operated site 200, so as to refer to the three-dimensional image during the operation , To avoid damage to nerves during surgery (such as nerve compression by bone plate).

In the present invention, by capturing the two-dimensional cross-sectional images of the nerve to be located, and using the three-dimensional image reconstruction technology to construct the two-dimensional cross-sectional images into the three-dimensional image, the doctor can confirm the nerve position before the operation to effectively Reduce the risk of nerve damage.

The scope of protection of the present invention shall be deemed as defined by the scope of the attached patent application. Any changes and modifications made by those who are familiar with this skill without departing from the spirit and scope of the present invention shall fall within the scope of protection of the present invention. .

100: nerve identification and positioning method 110: provide an image display device 110a: image display device 110b: display 110c: computer 120: provide a detection device 120a: detection device 120b: detection machine 120c: image detector 120d: first track piece 120e: second rail 120f: rotating plate 120g: carrier 120h: base 120i: accommodating space 120j: perforation 120k: transmission rod 120m: screw 120n: first motor 120p: second motor 120q: third motor 120r: Encoder 130: performing a scan identification procedure 131: first step 132: second step 133: third step 134: fourth step 135: fifth step 136: sixth step 200: site to be operated 210: nerve to be positioned 220 : Broken bone P: 2D cross-sectional image P1: 3D image P2: Image of the site to be operated

Figure 1: Schematic diagram of a radial nerve in a limb wound around a bone of an upper limb. Figure 2: Flow chart of the nerve identification and positioning method of the present invention. Figure 3: A schematic diagram of the image display device of the present invention. Figure 4: A perspective view of the detection device of the present invention. Figure 5: Another perspective view of the detection device of the present invention. Figure 6: Flow chart of the scan identification process of the present invention. Figure 7: A schematic diagram of a two-dimensional cross-sectional image of the present invention. Figure 8: A schematic diagram of the three-dimensional image of the present invention. Figure 9: A schematic diagram of an image reconstructed from a three-dimensional neural image of the present invention to a site to be operated.

100: nerve identification and positioning method

110: Provide an image display device

120: Provide a detection device

130: Perform a scan identification process

Claims (18)

A nerve identification and positioning method includes: providing an image display device with an nerve identification program and a nerve identification module; providing a detection device with a detection machine and an image detector. The image detector is installed on the detection machine; and a scan identification procedure is performed, the scan identification procedure includes: a first step, the image detector is used to scan a site to be operated to confirm an initial position of a nerve to be located; In a second step, the image detector captures a plurality of two-dimensional cross-sectional images of the initial position of the nerve to be located, the nerve recognition program recognizes the two-dimensional cross-sectional images by the nerve recognition module, and provides the detection A machine predicts the nerve direction; a third step, the detection machine drives the image detector to move to an area of the site to be operated according to the predicted nerve direction, and acquires a plurality of two-dimensional cross-sectional images of the area; and In a fourth step, the nerve recognition program recognizes whether the two-dimensional cross-sectional images of the area are the nerve to be located by the nerve recognition module, when the nerve recognition program recognizes the two-dimensional images to be the nerve to be located , The detection machine then drives the image detector to scan the nerve to be located in the next area of the site to be operated according to the predicted nerve direction, and acquires a plurality of two-dimensional cross-sectional images of the area and recognizes the area Whether the two-dimensional cross-sectional images are the nerve to be located, if the two-dimensional cross-sectional images are the nerve to be located, the fourth step is repeated until the image detector scans to the last area. The nerve identification and positioning method as described in item 1 of the patent application scope, wherein when the image detector contacts the site to be operated, a cross-sectional image of the nerve in the site to be operated is displayed on a display. The nerve recognition localization method as described in item 1 of the patent application scope, wherein in the fourth step, when the nerve recognition program recognizes that the two-dimensional images are not the nerve to be located, the nerve recognition program provides the detection machine The other predicts the nerve direction, and then performs the third step and the fourth step until the image detector scans to the last area. The nerve identification and positioning method as described in item 1 of the patent scope, wherein when the nerve identification program identifies the two-dimensional cross-sectional images as the nerve to be located, a prompt signal is sent out, and the prompt signal can be selected from optical signals , Sound signal. The neural recognition localization method as described in item 1 of the patent application scope, wherein the scan recognition process further includes a fifth step, which uses the three-dimensional image reconstruction technology to extract the third step and the fourth step The two-dimensional cross-sectional image is constructed as a three-dimensional image, and the three-dimensional image includes a three-dimensional neural image. The nerve identification and positioning method as described in item 5 of the patent application scope, wherein the three-dimensional image includes a warning area, and the warning area is located outside the three-dimensional nerve image. The nerve identification localization method as described in item 1 of the patent application scope, wherein the scan identification process further includes a sixth step, which reconstructs the three-dimensional image formed in the fifth step to a pending operation of the site to be operated Part image. The nerve identification localization method as described in item 1 of the patent application scope, wherein the two-dimensional cross-sectional images include a cross-section of the nerve to be localized. The nerve identification and positioning method as described in item 1 of the patent application scope, wherein when capturing the two-dimensional cross-sectional images, a shooting coordinate of each of the two-dimensional cross-sectional images is simultaneously recorded. The nerve identification and positioning method as described in item 9 of the patent application scope, wherein the detection machine has a first rail member, a second rail member, a rotating plate and a carrier, and the second rail member is movably combined with The first track member, the rotating plate is movably coupled to the second track member, the carrier is coupled to the rotating plate and swings with the rotating plate, the carrier has a perforation and a transmission rod, the transmission rod is movably Passing through the perforation, the image detector is combined with the transmission rod, and the shooting coordinates are a displacement coordinate of the image detector moving to a position by the second rail member, the rotating plate, and the transmission rod. The nerve identification and positioning method as described in item 10 of the patent application scope, wherein the detection machine has a base and an accommodating space, the accommodating space is used for accommodating the site to be operated, and the first rail member is disposed at The base, the second track member surrounds the accommodating space, and the image detector is selectively directed toward or away from the site to be operated by the transmission rod. The nerve identification and positioning method as described in item 11 of the patent application scope, wherein the testing machine has a screw and a first motor, the first motor is used to drive the screw to rotate, and the second track member is engaged with the screw , The first motor drives the screw to rotate to drive the second rail member to move laterally along the first rail member. The nerve identification and positioning method as described in item 12 of the patent application scope, wherein the measuring machine has a second motor, the second motor is used to drive the rotating plate to swing, so that the image detector can be around the operation site mobile. The nerve identification and positioning method as described in item 13 of the patent application scope, wherein the measuring machine has a third motor, the third motor is used to drive the transmission rod, so that the image detector can selectively move towards or away from the The area to be operated. The nerve identification and positioning method as described in item 14 of the patent application scope, wherein the detection machine has at least one encoder, the encoder is used to record the transmission data of the first motor, the second motor and the third motor to For an arithmetic program to convert into the shooting coordinates. The nerve identification localization method as described in item 1 of the patent application scope, wherein in the first step, an image acquisition frequency parameter and a plurality of scanning area parameters are set for the image detector. The nerve identification and positioning method as described in item 16 of the patent application scope, wherein in the second step, the image detector captures the two-dimensional of the initial position of the nerve to be positioned according to the image capture frequency parameter Cross-sectional image. The nerve identification and positioning method as described in item 16 of the patent application scope, wherein in the third step, the detection machine drives the image detector to move to the site to be operated according to the predicted nerve direction and the scan area parameters In this area, the image detector captures the two-dimensional cross-sectional images of the area according to the image capture frequency parameter.

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