Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/50—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
  • A61B6/51—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 dentistry
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
  • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/46—Arrangements for interfacing with the operator or the patient
  • A61B6/461—Displaying means of special interest
  • A61B6/466—Displaying means of special interest adapted to display 3D data
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/46—Arrangements for interfacing with the operator or the patient
  • A61B6/467—Arrangements for interfacing with the operator or the patient characterised by special input means
  • A61B6/469—Arrangements for interfacing with the operator or the patient characterised by special input means for selecting a region of interest [ROI]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/48—Diagnostic techniques
  • A61B6/488—Diagnostic techniques involving pre-scan acquisition
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/58—Testing, adjusting or calibrating thereof
  • A61B6/587—Alignment of source unit to detector unit
• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
  • G06T17/00—Three dimensional [3D] modelling, e.g. data description of 3D objects
  • G06T17/10—Constructive solid geometry [CSG] using solid primitives, e.g. cylinders, cubes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
  • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
  • A61B5/1077—Measuring of profiles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
  • A61B5/4504—Bones
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/50—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
  • A61B6/506—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 nerves
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
  • A61B6/54—Control of apparatus or devices for radiation diagnosis
  • A61B6/548—Remote control of the apparatus or devices

Definitions

• the invention relates to a method for producing a dental 3D X-ray image of an object and to an X-ray apparatus, wherein a volume can be created as a 3D X-ray image from a plurality of projection images during a rotation around the object.
• the problem is to select the location and / or the size of the volume so that the recorded volume matches the medically interesting area. This problem is the greater, the smaller the volume to be examined. Therefore, the operator various positioning aids are available, which are usually based on mechanical or optical methods, such as the display of positioning by a light visor on the patient's head.
• an X-ray apparatus is known in which an optical camera for an X-ray source Creation of an optical recording of the x-ray radiator illuminated patient's head is provided.
• an optical recording can be generated at the beginning or during the rotation of the X-ray source around the patient's head in order to simplify the assignment of the X-ray image to the visible surface of the recording object for diagnostic purposes.
• the method according to the invention for producing a 3D X-ray image of at least one partial region of an object formed by volume with an X-ray device comprising the positioning of the object relative to the device, wherein a plurality of X-ray projection images during an at least partial circulation of the system of X-ray and X-ray image detector At least part of the object can be displayed in a pictorial representation prior to the generation of the X-ray image of the volume, whereby the relative position of the pictorial representation to the current device and patient position is known.
• the recording volume that depends on the positioning of the object relative to the device and on the setting and / or control data is superimposed into the pictorial representation at least approximately in the correct position.
• the adjustment and / or control data for creating the 3D X-ray recording are redetermined or adjusted.
• the adjustment and / or control data determine, for example, the position of the axis of rotation of the rotating system of X-ray source and X-ray image detector, and optionally their change during circulation as well as other parameters.
• the at least approximately positionally correct insertion can be achieved, for example, by detecting the relative position by comparing the respective position data, ie the position data of the volume to be recorded and the position data of the pictorial representation, when the volume to be recorded is displayed corresponding alignment takes place to each other. It is sufficient that the volume to be recorded is displayed as an approximate area, for example, when the shooting angles are different in shooting.
• the volume shown at least schematically reproduces the position and the size of the subregion of the object embodied as a volume, it does not yet have the desired image content at this time, which is generated only in the subsequent circulation.
• the pictorial representation may be at least part of a surface and / or a contour of the object.
• An optical image that is to say a photograph with light in the visible range of the wave spectrum, but also a surface obtained by measurement, may be considered as a representation.
• a partial recording of the object is in particular a skull contour in question. It is also possible to calculate a three-dimensional contour from several optical recordings and to represent the volume in the three-dimensional contour.
• the pictorial representation may also be an existing 3D capture or a part thereof.
• a 3D recording in particular a 3D X-ray recording, but also a magnetic resonance imaging (MRI) into consideration.
• This existing 3D image can be individually patient-related have been created or stored as a standard recording callable stored.
• the use of an existing 3D image of the object to represent the position of the smaller volume within the object has the advantage that the user on the basis already generated information and structures, such as the course of nerve canals or tooth roots, a more accurate orientation and Selection of the size of the now to be recorded volume can meet.
• a plurality of images of the object can be created from different directions and displayed at the same time, wherein the position of the volume in each of these images is shown at least approximately in the correct position.
• a stored 3D image is simultaneously displayed, wherein the volume to be created both in the representation of the surface and / or contour of the object and in the stored 3D recording is displayed.
• the representation of the surface and / or the contour of the object and the existing SD recording can be aligned automatically with respect to their position relative to one another and / or input means can be provided for displaying the surface and / or the contour of the object and the existing image Manually align 3D image with respect to their position.
• the pictorial representation may select one of a plurality of predetermined typed anatomical structures or one of an existing one Have other representation of an anatomical structure generated anatomical structure.
• a particularly relevant anatomical structure is, in particular, an alveolar ridge, a temporomandibular joint and / or a wisdom tooth.
• Such anatomical structures can also be superimposed into another pictorial representation, such as an optical image.
• a particular advantage is achieved in that the position and / or the size of the volume before the creation of the SD X-ray exposure is variable, wherein the adjustment and / or control data, such as the positioning of the device and the trajectory to create the projection shots for the Generation of the volume is adapted to the changed position and / or size of the volume shown schematically.
• the schematic volume represented on a display can be displaced on the display by means of an input device, the position data and / or the size of the displayed volume being forwarded to the X-ray apparatus.
• the setting and / or control data for the creation of the recording can be set.
• a further subject of the invention relates to an X-ray device for producing dental 3D X-ray images, comprising a positioning device for positioning the patient in an X-ray device and a system comprising an X-ray emitter and an X-ray image detector as part of the X-ray device, which are movable in an orbit around the patient positioned in the positioning device.
• the volume shown schematically in the pictorial representation can be displaced on the display unit.
• Both the user interface of the x-ray device and a display unit independent of the x-ray device are considered as display means, which is only connected to the x-ray device by data technology and may have software for external control of the x-ray device.
• the existing pictorial representation may preferably be a patient-related or standardized 3D image of at least one anatomical structure and / or at least part of a surface and / or a contour of the object.
• the 3D image can be, for example, an optical image, an X-ray or MRI image.
• evaluation means for determining the setting and / or control data of the x-ray device can be provided from the position and / or size of the volume displayed in the pictorial representation.
• the device can be used for the production of the 3D X-ray recording on the means of Set input means changed selection range. This means that the adjustment and / or control data of the X-ray apparatus for establishing the 3D X-ray recording or the X-ray projection recordings required for it are determined by the position and the size of the schematically indicated volume. This may include the patient's position.
• an optical camera which is attached to the X-ray emitter or X-ray image detector or to the side of the X-ray emitter or the X-ray image detector can be arranged on the system of X-ray emitter and X-ray image detector, wherein two or more cameras can also be provided.
• the positional relationship between the image representation created with the camera and the volume to be recorded is known and a visual representation of the object to be recorded can be generated with the camera.
• FIG. 1 shows a dental X-ray device for creating 3D X-ray images in the jaw and head area
• FIG. 2 shows the X-ray device from FIG. 1 from above;
• FIG. Fig. 3 is a schematic representation of the arrangement of
• 4A, B show the display of the volume to be recorded in an optical recording
• 5 shows the display of the volume to be recorded in an optical recording as a contour
• 6 shows the display of the volume to be recorded in an optical recording with simultaneously displayed 3D X-ray recording
• FIG. 7 shows a pictorial representation of the volume in a contour with simultaneously displayed anatomical structure.
• the x-ray device 1 shows an X-ray device for creating 3D X-ray images in the jaw and head region, which comprises an X-ray device 1 and a display unit 2, wherein the display unit 2 can be part of a PC 3 which is connected to the X-ray device 1 may or is part of this.
• the x-ray device 1 has a system consisting of an x-ray emitter 4 and an x-ray image detector 6, the x-ray emitter 4 and the
• X-ray image detector 6 are connected to each other via a carrier 8 and wherein the carrier 8 can be pivoted about a rotation axis 10 about a patient's head 14 as an object to be examined.
• the axis of rotation 10 does not have to be stationary during the circulation, it can follow, for example, an elliptical movement.
• the carrier 8 is rotatably mounted on a along a column 16 guided adjustable slide 18 with a boom 20. Furthermore, a bite 22 for positioning the patient's head 14 can be provided on the height-adjustable carriage 18. The bite 22 may be provided on a boom 24 which is connected to the carriage 18. An operating surface 26 with a display unit 28 and with control buttons 30 can also be provided on the extension arm 24. To produce a pictorial representation of the object in the form of optical images, cameras are provided on the sensor 6 or laterally of the sensor 6, of which a camera 50 is shown. This will be described in more detail later in FIG.
• the captured with the camera 50 optical image 40 of the patient's head 14 is shown as a visual representation in the form of an optical side view - here in a recording situation of the camera 50 in one
• the image 40 of the patient's head which is shown on the display 2, has a region in which a volume 42 is displayed, which is to be generated with the X-ray device.
• This volume can be followed as a default setting of a standard position and adjusted, but it can also be preselected from several standard positions, which also in this case, a subsequent adjustment of the volume of the actually given by the respective patient situation is possible.
• the position of the volume 42 in the displayed image 40 of the head can be changed via the control buttons 30 or via an input means 44, such as a computer mouse, or a light pen or via a touch-sensitive screen, indicated by the arrows 46, 48. Furthermore, it is it is possible to change the size of the volume 42, for example via an input arrow 49 moved by the input means 44.
• the transmission of the position and size of the displayed volume 42 for determining the setting and / or control data of the x-ray device for producing the 3-D radiograph of the volume 42 can be done via evaluation means which are part of the PC 3. With the PC 3, the 3D x-ray recording of the volume 42 can also be generated from the different projection images.
• the receptacle 40 of the patient's head or a subarea thereof may also be an optical 3D image which has been formed from a plurality of optical images which have been created from different directions and is represented, for example, as a contour 40 (FIG. 5). Theoretically, however, already two projections from different directions are sufficient to unambiguously determine the position of a smaller volume 42. Instead of a 3D image, a lateral image of the patient's head and a frontal image can therefore be shown on which the respective position of the volume is indicated, see FIG. 4A, B.
• the receptacle 40 may also have been obtained from a measurement of the patient's head within the x-ray device, wherein measurement data are also initially created as individual recordings from a specific direction. Such scanning methods are known in the art. If necessary, these measurement data can be supplemented by further measurement recordings from different directions.
• the object may e.g. can be measured mechanically or optically, with some measuring points being sufficient to then calculate a contour from the measuring points schematically, see FIG. 5.
• FIG. 2 shows a schematic diagram for the production of optical recordings, starting from the patient's head 14 defined by means of the bite 22 via the delivery arm 24 and the slide 18 in the X-ray device as an object to be examined.
• the sides of the sensor 6 are provided with optical cameras 50, 52, which are projected from different directions onto the patient.
• tenkopf 14 are aligned. From these two images with known positional relationships to the object to be recorded, the patient's head 14 can be displayed simultaneously from two directions. If two shots are not sufficient, the sensor 6 can be rotated with the two cameras 50, 52 about the rotation axis 10, whereby further shots from different directions can be provided.
• an optical 3D measurement can also be carried out so that, instead of an optical recording, there is an optical 3D measurement data record of the patient's head.
• FIG. 3 shows two volumes Vl, V2, which are arranged at different positions and shown in frontal view.
• the position and size of the volume V1, V2 has an effect on the positioning of the patient 14 with respect to the device provided with radiator 4, 4 'and sensor 6, 6', on the position of the trajectory of the circulation of the radiator 4, 4 'and sensor 6, 6 'about the axis of rotation 10, 10', on the aperture setting for limiting the beam cone and optionally on other parameters.
• the boundaries 61, 62 for the volume V1 and boundaries 63, 64 for the volume V2 which are respectively covered on the patient's head 14 are shown in the optical recordings for the volume V2 shown in FIGS. 4A, 4B, for example. In this case, a conical beam can be taken into account, with a large and correct position display of the volume is desired.
• 4A is an optical receptacle 71 in a zx plane as a full front view of the patient's head 14
• FIG. 4B is an optical receptacle 72 in a zy plane as a side view of the patient's head 14.
• a change in the position of the boundaries 63, 64 for the volume V2 also changes the volume V2 and the device parameters required to create volume V2.
• the display of the volume 42 to be recorded in an optical receptacle 40 of the patient's head 14 is shown as a contour.
• the male volume 42 can be shown in perspective.
• a stored 3D image 73 is displayed in addition to the image representation of the image 71 of the surface of the object from FIG. 4A, wherein instead of the full image of the patient's head, the presentation of the lower facial region as a partial image may be sufficient.
• the receptacle 71 of the object and the 3D X-ray recording 73 can be aligned with respect to their position, wherein the volume Vl to be created is displayed both in the optical image 71 of the skull contour and in the 3D X-ray 73 and with respect to the position and Size is changeable.
• the spatial resolution of the volume V1 is higher after the production of the 3D X-ray recording of this volume 42 compared to the resolution of the stored 3D X-ray recording 73 and therefore permits a more accurate evaluation.
• the alveolar ridge arch 74 can either from a previous shot, about also a panoramic panoramic view of the patient are generated.
• a schematic representation of the anatomical structure is also possible, with the dentist himself assessing the shape of the jaw and optionally selecting a suitable one from various existing schemes. It is also possible to derive an expected alveolar ridge arc scheme from the head contour.
• the positioning can be made more reliable, since this structure is then also expected to be met.
• Limit values for the minimum coverage may be appropriate, at least 25% -50%, depending on the type of recording.
• An arrangement of the volume Vl 'outside the anatomical structure 74 would thus be excluded. This requirement could depend on the type of recording, that is to say on a preselection of the type of recording, for example tooth root, temporomandibular joint or the like
• the at least approximately positionally correct insertion of the volume to be recorded into a pictorial representation of the object requires a kind of position registration which determines the position of the pictorial representation with respect to the current devices and patient position.
• the data from the position of the patient fixation during the creation of the pictorial representation may have been recorded and stored, so that a comparison with the current position is possible.

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• 2008
  • 2008-07-29 DE DE102008035412A patent/DE102008035412A1/de not_active Withdrawn
• 2009
  • 2009-07-29 JP JP2011520497A patent/JP5555231B2/ja active Active
  • 2009-07-29 EP EP09781220.0A patent/EP2337498B1/de not_active Ceased
  • 2009-07-29 KR KR1020117004870A patent/KR101606165B1/ko not_active Expired - Fee Related
  • 2009-07-29 US US13/055,879 patent/US8750450B2/en active Active
  • 2009-07-29 WO PCT/EP2009/059781 patent/WO2010012754A1/de not_active Ceased

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