US20110015530A1 - Living body tissue three-dimensional model and production method therefor - Google Patents

Living body tissue three-dimensional model and production method therefor Download PDF

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Publication number
US20110015530A1
US20110015530A1 US12/891,318 US89131810A US2011015530A1 US 20110015530 A1 US20110015530 A1 US 20110015530A1 US 89131810 A US89131810 A US 89131810A US 2011015530 A1 US2011015530 A1 US 2011015530A1
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lumen
dimensional model
living body
body tissue
dimensional
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Hiroshi Misawa
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Terumo Corp
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Terumo Corp
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Publication of US20110015530A1 publication Critical patent/US20110015530A1/en
Priority to US14/736,952 priority Critical patent/US10029418B2/en
Priority to US16/015,995 priority patent/US10926472B2/en
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    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
    • B29C64/30—Auxiliary operations or equipment
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    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0073—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by tomography, i.e. reconstruction of 3D images from 2D projections
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B6/03—Computed tomography [CT]
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    • A61B6/504—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of blood vessels, e.g. by angiography
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
    • B29C64/10—Processes of additive manufacturing
    • B29C64/106—Processes of additive manufacturing using only liquids or viscous materials, e.g. depositing a continuous bead of viscous material
    • B29C64/124—Processes of additive manufacturing using only liquids or viscous materials, e.g. depositing a continuous bead of viscous material using layers of liquid which are selectively solidified
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
    • B29C64/10—Processes of additive manufacturing
    • B29C64/106—Processes of additive manufacturing using only liquids or viscous materials, e.g. depositing a continuous bead of viscous material
    • B29C64/124—Processes of additive manufacturing using only liquids or viscous materials, e.g. depositing a continuous bead of viscous material using layers of liquid which are selectively solidified
    • B29C64/129—Processes of additive manufacturing using only liquids or viscous materials, e.g. depositing a continuous bead of viscous material using layers of liquid which are selectively solidified characterised by the energy source therefor, e.g. by global irradiation combined with a mask
    • B29C64/135—Processes of additive manufacturing using only liquids or viscous materials, e.g. depositing a continuous bead of viscous material using layers of liquid which are selectively solidified characterised by the energy source therefor, e.g. by global irradiation combined with a mask the energy source being concentrated, e.g. scanning lasers or focused light sources
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
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    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
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    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
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    • G09B23/303—Anatomical models specially adapted to simulate circulation of bodily fluids
    • A—HUMAN NECESSITIES
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    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00707—Dummies, phantoms; Devices simulating patient or parts of patient
    • A61B2017/00716—Dummies, phantoms; Devices simulating patient or parts of patient simulating physical properties
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    • B29L—INDEXING SCHEME ASSOCIATED WITH SUBCLASS B29C, RELATING TO PARTICULAR ARTICLES
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    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29L—INDEXING SCHEME ASSOCIATED WITH SUBCLASS B29C, RELATING TO PARTICULAR ARTICLES
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    • B29L2031/753—Medical equipment; Accessories therefor
    • B29L2031/7532—Artificial members, protheses
    • B—PERFORMING OPERATIONS; TRANSPORTING
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    • B29L—INDEXING SCHEME ASSOCIATED WITH SUBCLASS B29C, RELATING TO PARTICULAR ARTICLES
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    • B29L2031/753—Medical equipment; Accessories therefor
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    • G06T2207/10072—Tomographic images
    • G06T2207/10081—Computed x-ray tomography [CT]

Definitions

  • the present invention generally pertains to a living body tissue three-dimensional model and method for producing such a three-dimensional model. More specifically, the invention here relates to a living body tissue three-dimensional model and method for producing such a three-dimensional model having particularly useful application to reconstruct living body tissue having a lesion region inside a human body.
  • Patent Documents 1 to 4 disclose examples.
  • diagnosis and treatment of a lesion region also can be carried out by passing an operation instrument such as a catheter into the bore or lumen.
  • diagnosis and treatment of a lesion region also can be carried out by passing an operation instrument such as a catheter into the bore or lumen.
  • a living body tissue having a tube-like lumen such as a blood vessel
  • this would be effective to confirm a function of a living body tissue.
  • Living body tissue having a tube-like lumen such as a blood vessel, where the pressure of fluid, for example, blood, which passes in a lumen varies, a living body tissue expands and contracts. If the pressure in the lumen becomes excessively high as a result of insertion of a manipulation instrument into a lumen or expansion or the like of a manipulation instrument in a lumen, it is possible that a lesion region of the living body tissue may experience or undergo an improper movement causing, for example, a rupture.
  • identifying movement of a living body tissue reconstructed by a reconstruction structure model is not provided in the past, and the existing techniques are thus still insufficient as a living body tissue model.
  • a method of hardening light-curing resin using light generated from three-dimensional data is used as a method of reconstructing a living body tissue based on three-dimensional data in the past, since the living body tissue three-dimensional model is reconstructed by hardening active energy-curing resin, it has rigidity higher than that of a living body tissue and therefore is lacking in flexibility. Therefore, the living body tissue three-dimensional model does not reconstruct the flexibility of living body tissue, and enhancement of a function as an operation maneuver simulator such as to confirm compatibility with a stent or stent graft is desirable or demanded.
  • the disclosure here contemplates a living body tissue three-dimensional model and production method which make it possible to appropriately reconstruct a lumen portion including a lesion region, make it possible to confirm fluid flow in a lumen in a living body tissue which has the lumen, by visual inspection, or make it possible to grasp, when pressure in a lumen varies, a variation of a region of a living body tissue which occurs in response to the variation of the pressure or else make it possible to produce a living body tissue three-dimensional model so as to have flexibility using hardened resin of active energy-curing resin.
  • a living body tissue three-dimensional model includes a three-dimensional model of a lumen wall portion of a lumen portion of an actual living body so the three-dimensional model is a three-dimensional model of the lumen portion of the actual living body.
  • the three-dimensional model is configured to possess or reconstruct the thickness of the lumen wall portion of the lumen portion including a reconstructed lesion region of the actual living body
  • the living body tissue three-dimensional model may be configured such that a living body lumen model produced based on tomographic image data of a living body has a projecting plate (thin plate) extending from a lumen wall toward a lumen.
  • the living body tissue three-dimensional model can also be configured such that pressure in a lumen surrounded by a lumen wall in a living body model produced based on tomographic image data of a living body is measured through displacement in response to a variation of the pressure in the lumen.
  • the measurement can occur with a measuring structure provided on the lumen wall.
  • the living body tissue three-dimensional model can additionally be configured such that a living body model produced by hardening liquid-state active energy-curing resin based on tomographic image data of a living body has a liquid-state compartment in which the active energy-curing resin remains unhardened and is surrounded by the hardened resin.
  • the thickness of the lumen wall portion including the lesion region of the actual living body is reconstructed and so the state of the lesion region in the lumen can be visually inspected clearly.
  • the diagnosis in the lumen can be carried out more easily.
  • the plate projecting from the lumen wall toward the lumen allows the flowing manner of fluid which flows in the lumen to be confirmed by visually inspecting movement of the plate which moves so as to correspond to the flowing manner of the fluid.
  • the lumen wall surrounding the lumen is produced based on tomographic image data of a living body, and the measuring structure is formed on the lumen wall such that pressure in the lumen is measured through displacement which occurs with the measuring structure. This thus allows motion which occurs with the lumen wall by a variation of the pressure in the lumen to be measured with relative certainty.
  • the living body model of the actual living body tissue is produced by carrying out a hardening process of active energy-curing resin, it is possible to provide the unhardened liquid-state compartment enclosed in the hardened resin, and so a living body image main model of a soft touch can be obtained.
  • FIG. 1 is a block diagram of a living body tissue three-dimensional model production system according to an embodiment disclosed here.
  • FIG. 2 is a flow chart illustrating a portion of the shaping data production processing procedure performed by the image data processing apparatus in FIG. 1 .
  • FIG. 3 is a flow chart illustrating a portion of the shaping data production processing procedure performed by the image data processing apparatus in FIG. 1 .
  • FIGS. 4A-4C are cross-sectional views showing front vertical sectional data D 21 , side vertical sectional data D 31 and horizontal sectional data D 11 respectively regarding upper stage tomographic data.
  • FIGS. 5A-5C are cross-sectional views showing intermediate shaping image data of the upper stage tomographic data in FIG. 4 .
  • FIGS. 6A-6C are cross-sectional views showing front vertical sectional data, side vertical sectional data and middle stage tomographic data of middle stage tomographic respectively.
  • FIGS. 7A-7C are cross-sectional views showing intermediate shaping image data in FIG. 6 .
  • FIGS. 8A-8C are cross-sectional views showing front vertical sectional data, side vertical section data and horizontal sectional data of lower stage tomographic data respectively.
  • FIGS. 9A-9C are cross-sectional views showing intermediate shaping image data in FIG. 8 .
  • FIG. 10 is a schematic view illustrating a process where a thrombus exists in an aortic aneurysm.
  • FIG. 11 is a side elevational view showing a produced three-dimensional model.
  • FIG. 12 is a schematic view illustrating a process of image data where an aorta dissociation is found.
  • FIG. 13 is a schematic view illustrating a process of image data where bifurcation of a blood vessel is found.
  • FIG. 14 is a schematic view illustrating an image process where a blood vessel which should not originally exist is found.
  • FIG. 15 is a side elevational view illustrating a three-dimensional model which is configured so that an operation instrument can be inserted.
  • FIG. 16 is a side elevational view showing an insertion port in FIG. 15 .
  • FIG. 17 is sectional views showing a configuration of a connection end portion in FIG. 15 .
  • FIG. 18 is a partial sectional view showing a three-dimensional model wherein a flow indicating element projects from a lumen wall.
  • FIG. 19 is a schematic view illustrating a case wherein a flow indicating element is applied where a thrombus exists in an aortic aneurysm.
  • FIG. 20 is a perspective view showing a motion detection section provided on a three-dimensional model.
  • FIG. 21 is a perspective view showing the motion detection section as viewed from a different direction from that in FIG. 20 .
  • FIG. 22 is schematic views illustrating motion detection operation by a motion detecting protrusion.
  • FIG. 23 is schematic views illustrating motion detection operation by a distortion detection element.
  • FIG. 24 is schematic views illustrating motion detection operation by a pressure sensing mechanism.
  • FIG. 25 is schematic views illustrating a formation process of a liquid-state compartment.
  • FIG. 26 is a side elevational view showing an embodiment applied to a three-dimensional model of an aorta wherein a thrombus exists in an aortic aneurysm.
  • FIG. 27 is a sectional view showing a horizontal sectional structure in FIG. 26 .
  • FIG. 1 illustrates a living body tissue three-dimensional model production system 1 .
  • the living body tissue three-dimensional model production system includes a three-dimensional data acquisition apparatus 2 which acquires from a subject a three-dimensional tomographic data S 1 of a region including a living body tissue whose living body tissue three-dimensional model is to be produced. The acquired data is transferred to an image data processing apparatus 3 of the living body tissue three-dimensional model production system.
  • the three-dimensional data acquisition apparatus 2 is in the form of an X-ray CT apparatus, and acquires the three-dimensional tomographic data S 1 including 100 to 300 tomographic images (300 tomographic images in this example), obtained by slicing, with a slice width of 1 mm, a lesion region of an aorta which is a living body tissue, and then supplies the three-dimensional tomographic data S 1 to the image data processing apparatus 3 .
  • the image data processing apparatus 3 extracts image data of a living body tissue region (in the case of the embodiment, a lesion region of an aorta) to be shaped as a living body tissue three-dimensional model from the image data for each slice of the three-dimensional tomographic data S 1 and carries out an interpolation editing process for the extracted image data as the occasion demands.
  • a living body tissue region in the case of the embodiment, a lesion region of an aorta
  • the image data processing apparatus 3 produces and supplies tomographic shaping data S 2 including planar point data of multi layers to a three-dimensional model production apparatus 4 of the living body tissue three-dimensional model production system.
  • the three-dimensional model production apparatus 4 is comprised of an optical shaping apparatus, and irradiates ultraviolet laser light on a liquid surface of liquid-state light-curing resin at a position of the point data for each slice of the tomographic shaping data S 2 to harden the resin slices in a predetermined thickness for each slice and laminates the hardened light-curing resin for each slice of the tomographic shaping data S 2 to form a three-dimensional model 5 wherein the hardened slices are connected three-dimensionally.
  • an optical shaping apparatus of a lamination pitch 0.05 [mm], CMET Inc., RM-3000, can be applied.
  • This optical shaping apparatus repetitively carries out lamination operation for selectively irradiating ultraviolet laser light controlled by a computer so that a desired pattern is obtained on a liquid surface of liquid-state light-curing resin placed in a container to harden the fluid light-curing resin in a predetermined thickness and supplying liquid-state resin per one slice onto the hardened slice and then irradiating ultraviolet laser light to harden the liquid-state resin similarly as described above so that a continued hardened slice is obtained.
  • a urethane acrylate-based light-curing resin composition such as disclosed in Japanese Patent Laid-Open No. Hei 9-169827 can be employed, and a silicon-based light-curing resin composition such as disclosed in Japanese Patent Laid-Open No. 2006-2087 can be applied.
  • the above-described resin composition whose ductility is relatively high while having a relatively low Young's modulus is low or like resin composition is preferable.
  • the image data processing apparatus 3 carries out an image process for the three-dimensional tomographic data S 1 supplied from the three-dimensional data acquisition apparatus 2 in accordance with a shaping data production processing procedure RT 0 illustrated in FIGS. 2 and 3 .
  • the three-dimensional tomographic data S 1 include, as shown as a representative example by tomographic data at an upper stage portion, a middle stage portion and a lower stage portion in FIGS. 4 , 6 and 8 , horizontal sectional data D 11 , D 12 and D 13 , front vertical sectional data D 21 , D 22 and D 23 and side vertical sectional data D 31 , D 32 , and D 33 , by which a living body tissue of an image point at a three-dimensional position inside the body is represented by the brightness of luminance (accordingly, by the density of an image).
  • the horizontal sectional data D 11 , D 12 and D 13 shown in FIG. 4(C) , FIG. 6(C) and FIG. 8(C) represent tomographic data at a height of a horizontal sectional line L 1 shown in the front vertical sectional data D 21 , D 22 and D 23 and the side vertical sectional data D 31 , D 32 and D 33 in FIG. 4(A) , FIG. 6(A) and FIG. 8(A) , and FIG. 4(B) , FIG. 6(B) and FIG. 8(B) , respectively.
  • the front vertical sectional data D 21 , D 22 and D 23 and the side vertical sectional data D 31 , D 32 and D 33 in FIG. 4(A) , FIG. 6(A) and FIG. 8(A) , and FIG. 4(B) , FIG. 6(B) and FIG. 8(B) represent vertical sectional data obtained at a position in a leftward and rightward direction of the human body and a position in a forward and rearward direction of the human body in accordance with a side vertical sectional line L 3 and a front vertical sectional line L 2 as shown in FIG. 4(C) , FIG. 6(C) and FIG. 8(C) , respectively.
  • the user of the image data processing apparatus 3 can select tomographic image data including a region of a living body tissue to be obtained as the tomographic shaping data S 2 from within the tomographic data supplied as the three-dimensional tomographic data S 1 to cause a display unit of the image data processing apparatus 3 to display the selected data, and can carry out editing operation (image process such as deletion, addition, changing or the like of image data regarding the region of the living body tissue in the image region designated as a target) for the displayed image data.
  • editing operation image process such as deletion, addition, changing or the like of image data regarding the region of the living body tissue in the image region designated as a target
  • the image data processing apparatus 3 starts the shaping data production processing procedure RT 0 shown in FIG. 2 and selects, first at step SP 1 , a tomographic image including a living body tissue such as a blood vessel, an organ or the like which is a shaping target (that is, a target) whose living body tissue three-dimensional model is to be formed in response to the designation operation by the user from within the three-dimensional tomographic data S 1 and then causes the display unit to display the selected image on the display unit. Thereafter, at step SP 2 , the image data processing apparatus 3 causes the user to confirm whether or not the shaping target is correctly identified.
  • a tomographic image including a living body tissue such as a blood vessel, an organ or the like which is a shaping target (that is, a target) whose living body tissue three-dimensional model is to be formed in response to the designation operation by the user from within the three-dimensional tomographic data S 1 and then causes the display unit to display the selected image on the display unit.
  • the image data processing apparatus 3 causes the user to confirm
  • the user would move the horizontal sectional line L 1 , front vertical sectional line L 2 and side vertical sectional line L 3 to search for a range of the tomographic image including the shaping target (for example, an aorta) inside the human body to identify a processing target region TG.
  • the shaping target for example, an aorta
  • the image data processing apparatus 3 advances the processing to step SP 3 in response to the designation operation by the user, and extracts those image data having a luminance the same as that of the shaping target from the three-dimensional tomographic data in the processing target region TG including the shaping target (that is, the target) and then causes the extracted data to be displayed on the display unit.
  • the processing target region TG is set in regard to a heightwise range in the upward and downward direction including the target, a widthwise range in the leftward and rightward direction and a depthwise range in the forward and rearward direction, and one slice of the tomographic data which includes the processing target region TG, for example, the upper stage tomographic data shown in FIG. 4 , is displayed on the display unit.
  • the aorta designated as the target is a tube-formed living body tissue having a bore in which blood is filled, and, when the three-dimensional tomographic data S 1 is acquired for a check of the lesion region by the three-dimensional data acquisition apparatus 2 , image pickup is carried out using contrast medium. Therefore, the three-dimensional tomographic data S 1 are fetched as such image data that the bore of the blood vessel has relatively light luminance by the image data processing apparatus 3 .
  • a lumen wall portion of the blood vessel in the processing target region TG is displayed as image data in which the lumen wall portion and the other tissue on the outer side (outwardly) of the lumen wall portion are not clearly distinguished from each other.
  • the image data processing apparatus 3 extracts a boundary between the lumen wall portion of the blood vessel and the tissue on the outer side of the shaping target in accordance with the operation by the user.
  • the extraction operation is carried out while the position or the shape of the shaping object (that is, the aorta) inside the body of a healthy person is being assumed or information based on examples of dissection of patients having the same affection is being taken into consideration based on anatomical information.
  • an image data portion of a density the same as that of a lumen wall portion of a blood vessel is a blood vessel and is cut away from an image of the external tissue to carry out an extraction operation of the blood vessel along an outer wall of the shaping object.
  • horizontal sectional data above and below the horizontal sectional data D 11 are referred to so that image data which conform to a flow of a plurality of tomographic images (flow from an upper position to a lower position or flow from a lower position to an upper position) are determined as image data of the shaping object and are cut away from the external tissue.
  • an outer shape of the shaping object including the lesion region is different from that of an organ of an anatomically healthy person.
  • the outer shape of the lesion region is for example, extraordinary swollen or extraordinary thin. Therefore, extraction of a boundary between the object image and the other organ including the difference is carried out.
  • the image data processing apparatus 3 carries out, at the next step SPS, a process of erasing the portion other than the shaping object from the processing target region TG.
  • the image data processing apparatus 3 can obtain intermediate shaping image data OB 1 having an outer shape on one section of the living body tissue three-dimensional model to be shaped from the horizontal sectional data D 11 as illustrated in FIG. 5(C) and accumulates the intermediate shaping image data OB 1 into the internal memory.
  • the image data processing apparatus 3 returns the processing to step SP 3 through step SP 6 described above so that it repetitively carries out processing of the process loop involving steps SP 3 -SP 4 -SP 5 -SP 6 -SP 3 similarly for the tomographic data of a different tomogram from among the tomographic data of 300 tomograms.
  • the extraction process of the shaping object is successively carried out for all tomographic data.
  • the image data processing apparatus 3 obtains an affirmative result at step SP 6 and advances to the processing to step SP 7 .
  • the processing at step SP 7 involves using the intermediate shaping image data (OB 1 to OB 3 ) accumulated in the memory of the image data processing apparatus 3 by the processing at steps SP 3 -SP 4 -SP 5 -SP 6 -SP 3 to cause the data to be displayed as a three-dimensional image on the display unit.
  • the image data processing apparatus 3 causes the user, at step SP 8 , to make a decision regarding whether or not the shaping object has successfully been extracted correctly. If it is decided that the extraction from the tomographic data is not correct, then the processing returns to step SP 3 described above to carry out the extraction process of the shaping object again.
  • the image data processing apparatus 3 causes, at next step SP 9 , the user to make a decision regarding whether or not the erasure process has successfully been carried out correctly. If a negative result is obtained, the processing returns to step SP 5 described above, and the image data processing apparatus 3 carries out, at step SP 5 described above, the erasure process of the tomographic data which is estimated not to have correctly undergone the erasure process.
  • step SP 9 the image data processing apparatus 3 advances the processing to step SP 10 , at which it removes noise by a smoothing process to smooth the surface. Thereafter, at step SP 11 , the image data processing apparatus 3 causes the user to make a decision regarding whether or not all data necessary for clinical processing are prepared. If it is confirmed that all data are prepared, then the image data processing apparatus 3 returns the processing to step SP 10 described above to carry out the smoothing process again.
  • step SP 11 If an affirmative result is obtained at step SP 11 , this signifies there is no clinical problem and the image data processing apparatus 3 then decides at step SP 12 whether or not the shaping object is a blood vessel.
  • the image data processing apparatus 3 advances the processing to step SP 13 , at which it immediately carries out a production process of tomographic shaping data S 2 to be passed to the three-dimensional model production apparatus 4 .
  • step SP 12 if an affirmative result is obtained at step SP 12 , this signifies that the three-dimensional images which have been processed till then require a bore, and then the image data processing apparatus 3 causes, at step SP 16 , the user to make a decision regarding whether or not a blood vessel wall is extracted. If an affirmative result is obtained here, this signifies that a blood vessel is shaped already as the shaping object. At this time, the image data processing apparatus 3 advances the processing to step SP 13 , at which it carries out a production process of tomographic shaping data S 2 having a bore.
  • the shaping object is a blood vessel which does not have a lesion region
  • the three-dimensional tomographic data S 1 obtained from the three-dimensional data acquisition apparatus 2 is a result of image pickup using a contrast medium
  • a lumen wall portion of a blood vessel surrounds the periphery with an anatomically fixed wall thickness, and therefore, an affirmative result is obtained at step SP 16 .
  • step SP 16 if a negative result is obtained at step SP 16 described above, this signifies that the three-dimensional image produced by the processing till then is not completed as a blood vessel as yet.
  • the image data processing apparatus 3 causes the processing to proceed to step SP 17 , at which it causes the user to write image data of a lumen wall of a predetermined wall thickness regarding the three-dimensional image produced till then and then displays the three-dimensional image.
  • the wall thickness of the blood vessel wall is determined in accordance with conditions of the blood vessel region of the shaping object based on the fact that anatomically a thick blood vessel has a great wall thickness while a thin blood vessel has a small wall thickness.
  • step SP 18 the image data processing apparatus 3 advances the processing to step SP 18 , at which it causes the user to make a decision regarding whether or not the blood vessel has some collapse or dissociation.
  • the image data processing apparatus 3 corrects the fault at step SP 19 and then returns the processing to step SP 18 described above. Consequently, the image data processing apparatus 3 repeats the correction process until after the three-dimensional image of the blood vessel becomes free from any fault.
  • the image data processing apparatus 3 ends the production process of the tomographic shaping data S 2 based on the three-dimensional tomographic data Si from the three-dimensional data acquisition apparatus 2 at step SP 13 and then sends the tomographic shaping data S 2 to the three-dimensional model production apparatus 4 , which is an optical shaping apparatus, at step SP 14 so that a shaping process is carried out. Consequently, the shaping data production processing procedure RT 0 ends at step SP 15 .
  • the image data processing apparatus 3 extracts, at step SP 4 of the shaping data production processing procedure RT 0 , a boundary between a shaping object and the other tissue. Consequently, as three-dimensional tomographic data 15 of the aorta 11 at the height levels V 1 , V 2 , V 3 and V 4 , outer surfaces 11 A 1 , 11 A 2 , 11 A 3 and 11 A 4 which are extraordinarily swollen at the portion of the aortic aneurysm 12 are extracted.
  • the image data processing apparatus 3 causes the user to place wall thicknesses of predetermined lumen walls 11 B 1 , 11 B 2 , 11 B 3 and 11 B 4 into the inner side of the outer surfaces 11 A 1 , 11 A 2 , 11 A 3 and 11 A 4 of the aorta 11 and then displays a three-dimensional image of the aorta 11 on the display unit.
  • the wall thicknesses of the lumen walls 11 B 1 , 11 B 2 , 11 B 3 and 11 B 4 are selectively set to comparatively great thicknesses because the aorta 11 is a thick blood vessel.
  • blood flow portions 11 C 1 , 11 C 2 , 11 C 3 and 11 C 4 of the bore at the lumen walls 11 B 1 , 11 B 2 , 11 B 3 and 11 B 4 include a contrast medium therein, they are filled with image data brighter than those of the lumen walls 11 B 1 , 11 B 2 , 11 B 3 and 11 B 4 .
  • the image data processing apparatus 3 when an image process is carried out selecting an aorta as a shaping object, the image data processing apparatus 3 produces a decision result at step SP 18 that the blood vessel has dissociation.
  • the three-dimensional model 5 obtained from the three-dimensional model production apparatus 4 reconstructs the aorta 11 (which has an internal structure wherein the thrombus 13 exists in the inside of the aortic aneurysm 12 ) having the aortic aneurysm 12 as shown in FIG. 11 .
  • step SP 17 when lumen walls 21 C 1 , 21 C 2 , 21 C 3 , 21 C 4 and 21 C 5 of the aorta 11 are inputted at step SP 17 described hereinabove, if double blood vessel walls 21 B 2 , 21 B 3 , 21 B 4 and 21 B 5 exist in the tomographic data at the height levels V 12 , V 13 , V 14 and V 15 , then the image data processing apparatus 3 decides at step SP 18 that the blood vessel has collapse or dissociation. Therefore, at step SP 19 , a correction process of the fault is carried out.
  • the blood flow portions 21 D 2 , 21 D 3 , 21 D 4 and 21 D 5 exist between the double blood vessel walls 21 B 2 , 21 B 3 , 21 B 4 and 21 B 5 and the lumen walls 21 C 2 , 21 C 3 , 21 C 4 and 21 C 5 , and according to circumstances, the double blood vessel walls 21 B 2 , 21 B 3 , 21 B 4 and 21 B 5 may partly be cut such that they look in such manner as to hang down like a flap the double blood vessel wall 21 B 4 .
  • a three-dimensional model can be produced by reconstructing without being lost blood vessel information which the three-dimensional tomographic data 25 have.
  • boundaries 31 A 2 , 31 A 3 and 31 A 4 of a small elliptical shape corresponding to a brachiocephalic artery 32 , a left common carotid artery 33 and a left subclavian artery 34 are extracted and boundaries 31 A 5 and 31 A 6 corresponding to two branches are extracted at the height level V 23 on the lower side of the boundary 31 A 1 .
  • the shaping data production processing procedure RT 0 can be simplified by the omission of the processing step.
  • an image data process is illustrated where, in the case wherein a region in which an aorta 42 extends from the heart 41 is determined as a shaping object, lumen walls 43 A, 43 B and 43 C are obtained as three-dimensional tomographic data 43 on height levels V 31 , V 32 and V 33 of the portion of the aorta 42 and a tomographic image 43 D is obtained on a height level V 34 of the heart 41 and three-dimensional tomographic data S 1 including a shaping object which includes a bypass blood vessel 44 which should not anatomically exist are supplied.
  • the image data processing apparatus 3 can extract boundaries 45 A, 45 B and 45 C on the height levels V 31 , V 32 and V 33 by extracting the boundary between the shaping object and the other tissue at step SP 4 of the shaping data production processing procedure RT 0 .
  • the image data processing apparatus 3 extracts a boundary 45 D on the height level V 34 between the heart 41 as the shaping object and the other tissue at step SP 4 of the shaping data production processing procedure RT 0 similarly.
  • the tomographic data on the height level V 32 includes a connecting blood vessel portion 47 in regard to a connecting portion between the aorta 42 and the bypass blood vessel 44 .
  • Another connecting blood vessel portion 48 is included in a portion at which the bypass blood vessel 44 is connected to the heart 41 on the height level V 34 .
  • the three-dimensional tomographic data 43 include a bypass blood vessel portion 49 in the neighborhood of the lumen wall 43 C of the aorta on the height level V 33 .
  • the connecting blood vessel portions 47 and 48 regarding the bypass blood vessel 44 and the bypass blood vessel portion 49 can be decided as blood vessels because, although it cannot be anatomically forecast, that the blood flows 50 B and 50 C as well as 50 D exist in the blood vessel portions is displayed as an image of the contrast medium.
  • the image data processing apparatus 3 decides from the specificity of the tomographic data that the bypass blood vessel 44 exists, and carries out an image process of the bypass blood vessel 44 .
  • the three-dimensional model 5 shown in FIG. 11 is obtained from the tomographic shaping data S 2 produced by the image data processing apparatus 3 using the three-dimensional model production apparatus 4 and reconstructs not only the external shape of the same but also the structure of a bore.
  • three-dimensional tomographic data S 1 of a femoral artery 5 Y positioned far away from the aorta 11 are obtained from the three-dimensional data acquisition apparatus 2 to produce tomographic shaping data S 2 using the shaping data production processing procedure RT 0 illustrated in FIGS. 2 and 3 .
  • the tomographic shaping data S 2 are processed by the three-dimensional model production apparatus 4 to reconstruct a femoral artery 5 Y as a three-dimensional model 5 X.
  • the three-dimensional model 5 X is prepared as a part connecting to a part of the three-dimensional model 5 separately from the three-dimensional model 5 which includes the aortic aneurysm 12 .
  • the image data processing apparatus 3 carries out a processing operation so that an insertion port member 5 Y 1 which reconstructs an insertion port is provided on the three-dimensional model 5 X in a corresponding relationship to the position of a femoral region at which the insertion port is provided in order to clinically insert a catheter into a femoral artery to feed into the aortic aneurysm.
  • the insertion port member 5 Y 1 which is used clinically has a configuration shown in FIG. 16 .
  • the insertion port member 5 Y 1 has an insertion port body 5 Y 2 having a generally cylindrical shape, and a communicating opening 5 Y 4 communicating with a bore of the femoral artery is cut away at a side portion of an attaching side end portion 5 Y 3 to the femoral artery. Consequently, the insertion port member 5 Y 1 is attached obliquely to the communicating opening 5 Y 4 such that it extends along the femoral artery.
  • a catheter is inserted into an opening of a circular sectional shape of a catheter insertion side end portion 5 Y 5 , and a distal end of the catheter is inserted into the femoral artery through the communicating opening 5 Y 4 .
  • the three-dimensional model 5 X is produced by adding tomographic data of the insertion port member 5 Y 1 to tomographic data produced by the image data processing apparatus 3 executing the shaping data production processing procedure RT 0 of FIGS. 2 and 3 with regard to the three-dimensional tomographic data S 1 obtained from the femoral region by the three-dimensional data acquisition apparatus 2 .
  • a fitting portion 5 A 1 configured as a cylindrical recessed portion is formed, and a circumferential line portion of the connecting end portion 5 A is cut in a thick portion of a lumen wall 5 A 2 .
  • a projection 5 X 2 configured as a cylindrical projection is formed on the connecting end portion 5 X 1 of the three-dimensional model 5 X, and a circumferential portion of the projection 5 X 2 is configured such that an outer circumferential portion of a thick portion of a lumen wall 5 X 3 is cut away.
  • a bore 5 A 3 of the connecting end portion 5 A of the three-dimensional model 5 and a bore 5 X 4 of a connecting end portion 5 X 1 of the three-dimensional model 5 X have inner diameters equal to each other.
  • the projection 5 X 2 is configured such that it can be fitted in the fitting portion 5 A 1 without play, and when a catheter as a surgical instrument inserted in the bore 5 X 4 of the three-dimensional model 5 X passes the boundary of the fitting portion 5 A 1 from the projection 5 X 2 , since no offset exists at the boundary, the distal end of the catheter can move from the bore 5 X 4 of the connecting end portion 5 X 1 to the bore 5 A 3 of the connecting end portion 5 A.
  • a three-dimensional model having a bore structure the same as a clinical bore structure from the aortic aneurysm 12 to the insertion port member 5 Y 1 of the femoral artery 5 Y positioned in a spaced relationship from the aortic aneurysm 12 is reconstructed by connecting the three-dimensional models 5 and 5 X which are different parts from each other.
  • the catheter insertion technique from the insertion port member 5 Y 1 can be attempted prior to carrying out the same in actual clinic use.
  • a three-dimensional model which reconstructs a living body tissue having a bore such as a blood vessel can be obtained utilizing the fact that the three-dimensional tomographic data S 1 obtained from the three-dimensional data acquisition apparatus 2 includes image information of a three-dimensional position in the human body.
  • a three-dimensional model as a tool with which a state of a tissue in the body including a lesion region or a prior surgical operation mark can be forecast sufficiently can be obtained appropriately.
  • Such flow indicating elements 51 as shown in FIG. 18 are added to a living body tissue having a tube-like lumen, for example, a blood vessel, in the tomographic shaping data S 2 produced by the image data processing apparatus 3 in such a manner as described hereinabove with reference to FIGS. 10 to 14 .
  • the flow indicating elements 51 are implanted at suitable intervals for visual observation on a lumen inner face 53 of a lumen wall 52 such that they project into the bore space.
  • the flow indicating elements 51 are small pieces (cantilever pieces) each in the form of a thin plate and have a flexible thin leg portion 51 A and a flow abutting portion 51 B of a greater width formed at an end portion of the leg portion 51 A.
  • the flow indicating element 51 changes its state in response to a manner in which the fluid flowing in the lumen 54 surrounded by the tube-shaped lumen wall 52 flows, by visually inspecting the variation of the flow indicating elements 51 , the flowing manner of the fluid can be discriminated.
  • this flow indicating element 51 is applied to a case in which a thrombus exists in an aortic aneurysm described hereinabove, for example, with reference to FIG. 10 , then a flowing manner of the blood in the aortic aneurysm 12 in which the thrombus 13 exists can be confirmed from a flowing manner of the fluid which can be visually inspected from the flow indicating elements 51 of the lumen walls 11 B 1 and 11 B 4 in which no thrombus exists and a flowing manner of the fluid which can be discriminated by visually inspecting the flow indicating elements 51 of the lumen walls 11 B 2 and 11 B 3 in which the thrombus 13 exists as shown in FIG. 19 .
  • the tomographic shaping data S 2 including three-dimensional tomographic data where the flow indicating elements 51 are projected on the lumen wall 52 are produced as a three-dimensional model 5 by being supplied from the image data processing apparatus 3 to the three-dimensional model production apparatus 4 , when the flow indicating elements 51 are produced from the three-dimensional tomographic data, it is effective to apply an active energy effectiveness resin as disclosed in Japanese Patent Laid-Open No. 2006-2087.
  • the flow indicating elements 51 are shaped such that a flow abutting portion 51 B of a greater width is formed at an end portion (free end portion) of a leg portion 51 A, the shape of the flow indicating element 51 is not limited to this, but flow indicators of various shapes can be applied. What is important is that small pieces in the form of a thin plate project into the lumen 54 of the lumen wall 52 and are yielded by a flow of fluid a.
  • the image data processing apparatus 3 can obtain a three-dimensional model 5 by carrying out an image process of the three-dimensional tomographic data S 1 acquired from the three-dimensional data acquisition apparatus 2 to produce tomographic shaping data S 2 regarding a living body tissue to be targeted and then supplying the tomographic shaping data S 2 to the three-dimensional model production apparatus 4 .
  • a motion detection section 62 having a plurality of motion detecting protrusions 61 arrayed thereon is provided on an outer surface of the lumen wall 60 of the three-dimensional model 5 .
  • the motion detection section 62 comprising the plurality of motion detecting protrusions 61 constitutes one embodiment of means for detecting movement (displacement) of the lumen wall to allow measurement of pressure in the lumen surrounded by the lumen wall (means for measuring pressure).
  • a plurality of motion detecting protrusions 61 having a cylindrical shape project from the lumen wall 60 of the aorta 11 and are arrayed such that they have a mutual distance W 1 therebetween on an imaginary array line L 11 as shown in FIGS. 22(A) and 22(B) .
  • the mutual distance W 1 between the motion detecting protrusions 61 which configure the motion detection section 62 increases to W 1 X because the outer surface 60 A of the lumen wall 60 moves in a direction in which the distance between the motion detecting protrusions 61 increases as the lumen wall 60 is swollen in FIG. 22(C) ) from the FIG. 22(B) state before the pressure is applied.
  • the variation of the distance between the motion detecting protrusions 61 corresponds to the degree of swelling of the lumen wall 60 and accordingly to the magnitude of the internal pressure P 1 .
  • the user can find a variation of the swelling manner of the lumen wall 60 and accordingly a variation of the magnitude of the internal pressure P 1 .
  • FIG. 23 shows a motion detection section 66 which can detect distortion applied to the lumen wall 60 as an electric signal by distortion detection elements 65 .
  • the motion detection section 66 comprising the distortion detection elements 65 constitutes another embodiment of means for detecting movement (displacement) of the lumen wall to allow measurement of pressure in the lumen surrounded by the lumen wall (means for measuring pressure).
  • a plurality of distortion detecting holes 60 B are perforated on an imaginary array line L 12 on the outer surface 60 A of the lumen wall 60 , and the distortion detection elements 65 are force fitted in the distortion detecting holes 60 B as shown in FIG. 23(C) thereby to configure the motion detection section 66 .
  • FIG. 24 shows a motion detection section 69 which detects a variation of the pressure in the lumen wall 60 through a pressure sensing mechanism 70 provided on the lumen wall 60 .
  • the motion detection section 69 constitutes another embodiment of means for detecting movement (displacement) of the lumen wall to allow measurement of pressure in the lumen surrounded by the lumen wall (means for measuring pressure).
  • the lumen wall 60 forms unhardened portions 60 E in which the light curing resin remains in the form of liquid without being light-cured in a hardened portion 60 D in which the light curing resin is light-cured as shown in FIG. 24(B) . That is, following the energy curing, portions of the liquid-state energy-curing resin do not cure and do not harden, and those portions form the unhardened (liquid-state) portions 60 E of the lumen wall 60 .
  • the hardened portion 60 D has a configuration wherein a plurality of unhardened portions 60 E having a rectangular shape in horizontal section and having a small thickness in vertical section are arrayed on an imaginary array line L 13 .
  • flexible portions 60 C are formed in which the unhardened portions 60 E are sandwiched by thin hardened plate portions 60 F and 60 G on the upper side and lower side positions.
  • the lumen wall 60 has rigidity as an original light curing resin
  • the unhardened portions 60 E which are intervals of the unhardened liquid-state light curing resin are supported by the thin hardened plate portions 60 F and 60 G. Therefore, this configuration portion forms a pressure sensing mechanism 70 which reacts with a variation of the pressure in the lumen.
  • This pressure sensing mechanism 70 reacts in such a manner that, if the pressure in the lumen surrounded by the lumen wall 60 becomes high, then the hardened plate portions 60 F and 60 G are displaced so as to move to the outer side together with the unhardened portions 60 E.
  • a displacement detection section 71 which utilizes such displacement operation of the pressure sensing mechanism 70 as just described so that detection light emitted from a light emitting element 71 A is reflected by the surface of the outer side hardened plate portion 60 F and received by a light receiving element 71 B to detect the displacement operation of the pressure sensing mechanism 70 .
  • a displacement detection section 72 is provided such that, when the pressure sensing mechanism 70 carries out displacement movement by the pressure in the lumen in a state in which a contact element 72 C provided at an end of a pressure sensing plate 72 B projecting from a detector body 72 A contacts the hardened plate portion 60 F on the outer side, the pressure sensing plate 72 B is pushed up by the displacement movement thereby to output a detection output corresponding to the pushup amount from the detector body 72 A.
  • the pressure sensing mechanism 70 which carries out displacement operation to the outer side in response to the pressure in the lumen surrounded by the lumen wall 60 is configured by providing the unhardened portions 60 E which are liquid-state intervals in which the resin is not light-hardened in the lumen wall 60 , the motion detection section 69 by which it is possible to obtain the shift amount of the pressure sensing mechanism 70 , and accordingly a displacement detection output corresponding to the pressure in the lumen, can be effected.
  • the lumen wall 60 having high rigidity is configured as the three-dimensional model 5 , a detection output corresponding to the variation of the pressure in the inside of the lumen can be obtained, effective information to investigate the movement of the lumen wall can be obtained with regard to a living body tissue including a lesion region which can be detected by reconstructing the living body tissue.
  • the three-dimensional model production apparatus 4 carries out a process to form, while liquid-state compartments 81 are left in the inside of a living body tissue region 80 which does not make a bore from within a living body tissue to be targeted, solid-state curing resin 82 in the other region.
  • a configuration is adopted such that the liquid-state compartments 81 in the form of a disk are arrayed on an imaginary array line L 14 of the living body tissue region 80 and, in the liquid-state compartments 81 , the liquid resin material is left without carrying out a hardening process of the liquid-state active energy curing resin thereby to enclose the liquid-state compartments 81 in the solid-state curing resin 82 .
  • such a three-dimensional model 5 that a thrombus 13 exists in an aortic aneurysm 12 as a lesion region of an aorta 11 is formed as a three-dimensional model 5 configured such that, as the portions of the lumen wall 83 ( 11 B 1 to 11 B 4 of FIG. 10 ) or the thrombus 13 , the liquid-state compartments 81 are enclosed in the solid-state curing resin 82 .
  • a soft living body tissue is produced by the configuration wherein the liquid-state compartments 81 are enclosed in the solid-state curing resin 82 which forms the lumen wall 83 .
  • the liquid-state compartments 81 in which the resin remains in the form of liquid without being light-cured are enclosed in the solid-state curing resin 82 in a light-cured state. Therefore, the outer surface of the lumen wall 83 of the three-dimensional model 5 presents a soft touch as the liquid-state compartments 81 are enclosed.
  • the three-dimensional model 5 has flexibility proximate to that of a living body tissue inside the body, even if the three-dimensional model 5 is used as an operation technique simulator of compatibility confirmation with a stent graft or a stent and so forth, detailed survey of the three-dimensional model 5 can be carried out without causing the user to feel an uncomfortable feeling.
  • the three-dimensional model and associated method disclosed here can be utilized to reconstruct a living body tissue inside the body having a lesion region.
  • the detailed description above describes embodiments of the three-dimensional model and associated method for producing such three-dimensional model.
  • the invention is not limited, however, to the precise embodiment and variations described and illustrated above. Various changes, modifications and equivalents could be effected by one skilled in the art without departing from the spirit and scope of the invention as defined in the appended claims. It is expressly intended that all such changes, modifications and equivalents which fall within the scope of the claims are embraced by the claims.

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US10029418B2 (en) 2018-07-24
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