WO2020107165A1 - Auxiliary lung diagnosis method and device - Google Patents
Auxiliary lung diagnosis method and device Download PDFInfo
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- WO2020107165A1 WO2020107165A1 PCT/CN2018/117472 CN2018117472W WO2020107165A1 WO 2020107165 A1 WO2020107165 A1 WO 2020107165A1 CN 2018117472 W CN2018117472 W CN 2018117472W WO 2020107165 A1 WO2020107165 A1 WO 2020107165A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
Definitions
- the present disclosure relates to the field of medical technology, and in particular, to a lung assisted diagnosis method and device.
- Computer tomography computed tomography, CT
- TTNA transthoracic wall biopsy
- TTNA guided by electromagnetic navigation is commonly used. Compared with relying solely on CT positioning, accurate preoperative positioning and intraoperative real-time navigation can shorten the puncture time, reduce the radiation dose and needle adjustment times received by patients, and reduce the occurrence of complications. .
- the electromagnetic navigation bronchoscopy system (ie ENB system) is a new diagnostic method for lung lesions.
- ENB system transbronchial lung biopsy biopsy
- TBLB transbronchial lung biopsy biopsy
- the embodiments of the present disclosure provide a method and device for assisting diagnosis of lungs, to solve the technical problem that the current electromagnetic navigation bronchoscopy technology cannot immediately convert TBLB to TTNA during biopsy of lung lesions.
- a lung assisted diagnosis method including:
- the puncture needle When the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed.
- the method before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, the method further includes:
- the target puncture point is marked on the skin of the subject.
- the step of acquiring the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image includes:
- the step of acquiring a lesion image using a peripheral ultrasound probe according to the registration matrix includes:
- the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe;
- the step of withdrawing the puncture needle and performing needle biopsy after the puncture needle reaches a predetermined position includes:
- the puncture needle When the puncture needle reaches the predetermined position, if the sheath in the bronchoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and the needle Aspiration biopsy;
- the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
- the step of withdrawing the puncture needle and performing needle biopsy further includes:
- the puncture needle When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;
- the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved.
- Aspiration biopsy
- a lung biopsy device including:
- the registration matrix acquisition module is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image
- a lesion image acquisition module configured to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix
- On-site cytology evaluation module used to perform bronchoscopy and parallel on-site cytology evaluation when the lesion image is acquired;
- the first biopsy module is used for bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;
- the first information import module is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system
- the first adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle
- the puncture module is used to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path and the breathing time of the subject to be detected is consistent with the CT time;
- the second biopsy module is used to withdraw the puncture needle after the puncture needle reaches a predetermined position and perform a needle biopsy.
- the above device further includes:
- the second information import module is used to import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;
- the primary puncture point alignment module is used to align the needle of the puncture needle with the primary puncture point on the subject;
- the second adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle aimed at the examinee according to the position and direction indicator of the puncture needle displayed on the CT image;
- the target puncture point determination module is used to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.
- the registration matrix acquisition module includes:
- a second registration matrix acquisition sub-module which is used to acquire the main bronchus by using a positioning wire for point cloud registration if the pre-operative CT image has no markers;
- the registration matrix acquisition submodule is used to record the registration matrix of the electromagnetic navigation bronchoscope.
- the lesion image acquisition module includes:
- the second lesion image acquisition submodule uses peripheral ultrasound probes to acquire lesion images.
- the second biopsy module is used to: when the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, then the electromagnet When the navigation of the navigation system ends, the puncture needle is withdrawn and a needle biopsy is performed;
- the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
- the second biopsy module is also used to:
- the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved.
- Aspiration biopsy
- the method and device for assisted diagnosis of the lungs combine transthoracic lung biopsy with transthoracic electromagnetic navigation system puncture navigation, and use electromagnetic navigation bronchoscopy preoperative planning and intraoperative navigation information to guide transthoracic wall biopsy , So that there is no need for CT equipment for intraoperative information collection and registration registration, which can guide doctors to perform electromagnetic navigation-guided transthoracic biopsy immediately when TBLB is not in place or when electromagnetic navigation bronchoscopy biopsy is not ideal. , Minimize patient diagnosis transfer time and puncture risk, without the need for CT equipment assistance and guidance during operation, transthoracic puncture biopsy without registration and registration during the operation, directly use electromagnetic navigation bronchoscope registration information.
- FIG. 1 is one of the flowcharts of a lung assisted diagnosis method provided by an embodiment of the present disclosure
- FIG. 2 is a second flowchart of a method for assisting diagnosis of lungs provided by an embodiment of the present disclosure
- FIG. 3 is a third flowchart of a method for assisting diagnosis of lungs provided by an embodiment of the present disclosure
- FIG. 4 is a fourth flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure.
- FIG. 6 is one of the structural diagrams of a lung biopsy device provided by an embodiment of the present disclosure.
- FIG. 1 is a flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure. As shown in FIG. 1, an embodiment of the present disclosure provides a lung assisted diagnosis method, including the following steps:
- Step 101 Acquire the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image.
- preoperative CT planning such as planning the path of the electromagnetic navigation bronchoscopy system (ENB-TBLB) and the puncture needle path of the transthoracic electromagnetic navigation system (EMN-TTNA), and planning and marking the patient's skin Puncture point on the target.
- ENB-TBLB electromagnetic navigation bronchoscopy system
- EN-TTNA transthoracic electromagnetic navigation system
- the electromagnetic navigation bronchoscope device is in place, and the positioning wire is inserted into the working channel of the bronchoscope together with the guide sheath.
- the registration matrix is obtained according to the preoperative CT image.
- Step 102 Navigate according to the registration matrix, and use peripheral ultrasound probes to obtain lesion images.
- the positioning wire carries the sheath to navigate to the vicinity of the lesion, the positioning wire is withdrawn, a peripheral ultrasound probe is inserted for confirmation, and the lesion image is acquired through the peripheral ultrasound probe.
- Step 103 Under the condition that the image of the lesion is acquired, perform a bronchoscopy test and perform on-site cytological assessment.
- the peripheral ultrasound probe does not display the lesion image, that is, if the lesion image is not acquired, the sheath and bronchoscope are withdrawn, and step 105 is executed.
- Step 104 If the on-site cytology is negative, perform bronchoalveolar lavage and bronchoscopy biopsy. Preferably, if the on-site cytology is positive, a bronchoscopy biopsy is performed and the operation is ended.
- Step 105 Import the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system
- Step 106 According to the puncture path and the registration registration information, aim the puncture at the target puncture point on the prospective examinee.
- the target puncture point is preset.
- Step 107 Adjust the spatial angle of the puncture needle. According to the position and direction indicator of the puncture needle displayed on the CT image before surgery, adjust the spatial angle of the puncture needle aligned with the body of the patient to be detected.
- Step 108 Obtain the breathing curve of the person to be detected.
- a body position sensor is provided on the person to be detected, and the breathing curve of the person to be detected can be obtained through the body position sensor.
- Step 109 When the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time, the puncture operation is started. That is, the electromagnetic navigation puncture needle is used to guide the intraoperative puncture, and the respiratory gating technique is used to guide the intraoperative puncture time, which can effectively ensure the puncture effect.
- Step 110 After the puncture needle reaches a predetermined position, withdraw the puncture needle and perform needle biopsy.
- the lung assisted diagnosis method in this embodiment obtains the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image; according to the registration matrix, the peripheral ultrasound probe is used to obtain the lesion image; when the lesion image is obtained Next, perform a bronchoscopy test and perform on-site cytology assessment; if the on-site cytology is negative, perform bronchoalveolar lavage and transbronchoscope biopsy; import the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system
- the puncture path and registration registration information aim the puncture at the target puncture point on the subject to be tested; adjust the spatial angle of the puncture needle; obtain the breathing curve of the subject to be tested; when the puncture path of the puncture needle and the introduced puncture path
- the puncture operation starts; when the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed.
- transbronchial lung biopsy combined with transthoracic electromagnetic navigation system puncture navigation, using electromagnetic navigation bronchoscopy preoperative planning and intraoperative navigation information to guide transthoracic wall biopsy, without CT equipment for intraoperative information collection and registration Registration
- Transthoracic needle biopsy does not require registration and registration during the operation, and directly uses electromagnetic navigation bronchoscope registration information.
- step 105 before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, the method further includes:
- Step 112 Import the puncture needle calibration database to the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture on the tail of the puncture needle;
- Step 113 Align the needle of the puncture needle to the primary puncture point on the subject to be tested;
- Step 114 Adjust the spatial angle of the puncture needle aligned with the person to be detected according to the position and direction indicator of the puncture needle displayed on the CT image;
- Step 115 When the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject, mark the target puncture point on the skin of the subject.
- the spatial angle of the puncture needle aimed at the subject to be inspected is adjusted according to the position and direction indicator of the puncture needle displayed on the CT image.
- step 101 includes:
- Step 1011 if there are markers in the preoperative CT image, use the markers for point registration registration; otherwise, use positioning wires to collect the main bronchus for point cloud registration registration;
- Step 1012 Record the registration matrix of the electromagnetic navigation bronchoscope.
- step 102 includes:
- Step 1021 According to the registration matrix, the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe.
- Step 1022 Use a peripheral ultrasound probe to acquire the lesion image.
- the focus image is obtained according to the registration matrix, and the position of the focus can be obtained, so as to perform on-site cytological evaluation of the position.
- step 110 includes:
- Step 1102 if the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and a needle biopsy is performed.
- the electromagnetic navigation-guided transthoracic puncture biopsy is performed immediately to minimize the patient's transit time and puncture risk.
- step 110 further includes: after the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or airway optical coherence from the sheath through the chest wall Small imaging probe;
- the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved.
- Aspiration biopsy
- the peripheral ultrasound probe or the airway optical coherent imaging small probe is used to confirm the image of the lesion, and X-ray assistance is not required at all, which can reduce the damage of the X-ray to the patient's body.
- FIG. 4 is a structural diagram of a lung biopsy device according to an embodiment of the present disclosure. As shown in FIG. 4, an embodiment of the present disclosure provides a lung biopsy device 200, including:
- the registration matrix obtaining module 201 is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;
- the lesion image acquisition module 202 is used to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix;
- the on-site cytology evaluation module 203 is used to perform a bronchoscopy test and parallel on-site cytology evaluation when the lesion image is acquired;
- the first biopsy module 204 is used to perform bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;
- the first information import module 205 is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system;
- the target puncture point alignment module 206 is used to target the puncture to the target puncture point on the subject to be detected according to the puncture path and the registered registration information;
- the puncture module 209 is configured to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time;
- the second biopsy module 210 is configured to withdraw the puncture needle and perform a needle biopsy after the puncture needle reaches a predetermined position.
- the lung biopsy device 200 further includes:
- the second information import module 211 is used to import a puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;
- the primary puncture point alignment module 212 is used to align the needle of the puncture needle with the primary puncture point on the subject to be tested;
- the puncture needle second adjustment module 213 is used to adjust the spatial angle of the puncture needle aligned with the subject according to the position and direction indicator of the puncture needle displayed on the CT image;
- the target puncture point determination module 214 is configured to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.
- the registration matrix acquisition module 201 includes:
- the first registration matrix acquisition sub-module 2011 is used to register the points using the markers if the pre-operative CT image has markers;
- the second registration matrix acquisition sub-module 2012 is used to acquire the main bronchus using the positioning wire for point cloud registration if the preoperative CT image has no markers;
- the registration matrix acquisition submodule 2013 is used to record the registration matrix of the electromagnetic navigation bronchoscope.
- the lesion image acquisition module 202 includes:
- the first lesion image acquisition sub-module 2021 is used for navigating the positioning wire and carrying the sheath to the lesion according to the registration matrix, withdrawing the positioning wire, and inserting a peripheral ultrasound probe;
- the second lesion image acquisition submodule 2022 uses peripheral ultrasound probes to acquire the lesion image.
- the second biopsy module is used to: when the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, then the electromagnet When the navigation of the navigation system ends, the puncture needle is withdrawn and a needle biopsy is performed;
- the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
- the second biopsy module is also used to:
- the puncture needle When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;
- the lung biopsy device 200 is a passage established from a lung parenchyma puncture to a lung lesion.
- the lung biopsy device 200 can also be used in interventional treatment, such as radiofrequency ablation, freezing, and other interventional treatment methods.
- the lung biopsy device in the above embodiment can implement any of the implementation methods in the method embodiments shown in FIGS. The corresponding content will not be repeated here.
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Abstract
The present disclosure provides an auxiliary lung diagnosis method and device. The method comprises: obtaining a registration matrix of an electromagnetic navigation bronchoscope according to a preoperative CT image; obtaining a lesion image using a peripheral ultrasound probe; in the case that the lesion image is obtained, performing on-site cytological evaluation; importing a puncture path and registration information to a transthoracic electromagnetic navigation system; directing a puncture needle at a target puncture point on a person to be tested; adjusting the spatial angle of the puncture needle; obtaining a respiration curve of said person; and after the puncture needle reaches a predetermined position, performing needle aspiration biopsy. Thus, transthoracic needle aspiration biopsy guided by electromagnetic navigation is performed, thereby reducing the diagnosis transit time and puncture risk of a patient to the maximum extent.
Description
本公开涉及医疗技术领域,尤其涉及一种肺部辅助诊断方法及装置。The present disclosure relates to the field of medical technology, and in particular, to a lung assisted diagnosis method and device.
计算机体层摄影(computed tomography,简称CT)引导下的经胸壁穿刺活检(TTNA)是诊断肺部病变的有效手段,但由于该技术不能实时引导,导致对部分小病灶难以准确定位进行诊断,且需反复穿刺肺部,而反复穿刺肺部会造成气胸、出血等并发症。Computer tomography (computed tomography, CT) guided transthoracic wall biopsy (TTNA) is an effective method for diagnosing lung lesions, but due to the fact that the technology cannot be guided in real time, it is difficult to accurately diagnose some small lesions Need to puncture the lungs repeatedly, and repeated puncture of the lungs will cause pneumothorax, bleeding and other complications.
目前,常用的是电磁导航引导下的TTNA,与单纯依靠CT定位比较,通过术前准确定位和术中实时导航,可以缩短穿刺时间,减少患者接受的辐射剂量和调针次数,减少并发症发生。At present, TTNA guided by electromagnetic navigation is commonly used. Compared with relying solely on CT positioning, accurate preoperative positioning and intraoperative real-time navigation can shorten the puncture time, reduce the radiation dose and needle adjustment times received by patients, and reduce the occurrence of complications. .
然而,传统的电磁导航仍然需要CT设备辅助。其原因是:导航系统的注册模块需要识别CT三维重建的标记点,因此穿刺前需要患者贴着标记物进行CT扫描。电磁导航支气管镜系统(即ENB系统)是一项新的肺部病变诊断手段,通过电磁导航引导能够经支气管(自然腔道)对肺部病变进行活检,即行经支气管镜肺活检术(transbronchial lung biopsy,简称TBLB),一般ENB系统无法到位的情况下,若将TBLB立即转为TTNA,可继续对肺部病变进行活检。但是TBLB操作一般在气管镜室,而TTNA操作一般在CT室。因此,现有的电磁导航系统无法满足这一情况。However, the traditional electromagnetic navigation still needs the assistance of CT equipment. The reason is that the registration module of the navigation system needs to identify the marked points of the CT three-dimensional reconstruction, so the patient needs to carry out a CT scan with the markers before puncture. The electromagnetic navigation bronchoscopy system (ie ENB system) is a new diagnostic method for lung lesions. Through electromagnetic navigation guidance, the lung lesions can be biopsied through the bronchus (natural cavity), that is, transbronchial lung biopsy biopsy (TBLB for short), when the ENB system is not in place, if TBLB is immediately converted to TTNA, biopsy of lung lesions can be continued. But TBLB operation is generally in the bronchoscope room, while TTNA operation is generally in the CT room. Therefore, the existing electromagnetic navigation system cannot satisfy this situation.
发明内容Summary of the invention
本公开实施例提供了一种肺部辅助诊断方法及装置,以解决现有电磁导航支气管镜技术在对肺部病变进行活检时,无法实现将TBLB立即转为TTNA的技术问题。The embodiments of the present disclosure provide a method and device for assisting diagnosis of lungs, to solve the technical problem that the current electromagnetic navigation bronchoscopy technology cannot immediately convert TBLB to TTNA during biopsy of lung lesions.
为了达到上述目的,本公开提供一种肺部辅助诊断方法,包括:In order to achieve the above object, the present disclosure provides a lung assisted diagnosis method, including:
根据术前CT图像获取电磁导航支气管镜的配准矩阵;Obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;
根据所述配准矩阵,利用外周超声探头获取病灶影像;According to the registration matrix, use peripheral ultrasound probes to obtain lesion images;
在获取到所述病灶影像的情况下,行经支气管镜刷检,并行现场细胞学评估;In the case of acquiring the image of the lesion, perform a bronchoscopy brush test and perform on-site cytological assessment;
若现场细胞学呈阴性,行支气管肺泡灌洗和经支气管镜活检;If the on-site cytology is negative, perform bronchoalveolar lavage and bronchoscopy biopsy;
向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息;Import pre-acquired puncture path and registration information to the transthoracic electromagnetic navigation system;
根据穿刺路径和注册配准信息,将穿刺针对准待检测者身上的目标穿刺点;According to the puncture path and registration registration information, aim the puncture at the target puncture point on the prospective examinee;
调整穿刺针的空间角度;Adjust the spatial angle of the puncture needle;
获取待检测者的呼吸曲线;Obtain the breathing curve of the person to be tested;
当所述穿刺针的穿刺路径与导入的穿刺路径重合,且所述待检测者的呼吸时刻与CT时刻一致时,开始穿刺操作;When the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time, the puncture operation is started;
当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检。When the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed.
优选的,在所述向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息的步骤之前,还包括:Preferably, before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, the method further includes:
向经胸壁电磁导航系统导入穿刺针校准数据库,输入穿刺针型号,将电磁导航卡具安装在穿刺针尾部;Import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture on the tail of the puncture needle;
将穿刺针的针头对准待检测者身上的初选穿刺点;Align the needle of the puncture needle to the primary puncture point on the subject;
根据CT图像上显示的穿刺针位置和方向指示器调整对准待检测者的穿刺针的空间角度;According to the position and direction indicator of the puncture needle displayed on the CT image, adjust the spatial angle of the puncture needle aimed at the examinee;
当CT图像上显示的穿刺针的穿刺路径与对准待检测者的穿刺针的穿刺路径重合时,在待检测者的皮肤上标记目标穿刺点。When the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject, the target puncture point is marked on the skin of the subject.
优选的,所述根据术前CT图像获取电磁导航支气管镜的配准矩阵的步骤,包括:Preferably, the step of acquiring the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image includes:
若所述术前CT图像有标记物,则使用标记物进行点配准注册;If there are markers in the pre-operative CT image, use the markers for point registration registration;
若所述术前CT图像没有标记物,则使用定位导线采集主支气管进行点云配准注册;If there is no marker in the preoperative CT image, use the positioning wire to collect the main bronchus for registration of point cloud registration;
记录电磁导航支气管镜的配准矩阵。Record the registration matrix of the electromagnetic navigation bronchoscope.
优选的,所述根据所述配准矩阵,利用外周超声探头获取病灶影像的步 骤,包括:Preferably, the step of acquiring a lesion image using a peripheral ultrasound probe according to the registration matrix includes:
根据所述配准矩阵,定位导线携带鞘管导航至病灶处,撤出定位导线,插入外周超声探头;According to the registration matrix, the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe;
利用外周超声探头获取病灶影像。Use peripheral ultrasound probes to obtain lesion images.
优选的,所述当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检的步骤,包括:Preferably, the step of withdrawing the puncture needle and performing needle biopsy after the puncture needle reaches a predetermined position includes:
当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,且通过X线透视能看到穿刺针,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检;When the puncture needle reaches the predetermined position, if the sheath in the bronchoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and the needle Aspiration biopsy;
若气管镜内的鞘管和外周超声探头未撤回,且通过外周超声探头能看到穿刺针时,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检。If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
优选的,所述当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检的步骤,还包括:Preferably, after the puncture needle reaches a predetermined position, the step of withdrawing the puncture needle and performing needle biopsy further includes:
当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,撤回穿刺针,从经胸壁的鞘管插入外周超声探头或者气道光学相干成像小探头;When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;
若通过所述外周超声探头或者所述气道光学相干成像小探头获得病灶影像,则经胸壁电磁导航系统的导航结束,撤回所述外周超声探头或者所述气道光学相干成像小探头,行针吸活检;If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;
若通过所述气道光学相干成像小探头未获得病灶影像,将穿刺针的针头对准患者身上标记的穿刺点。If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient.
本公开另一方面提供一种肺部活检装置,包括:Another aspect of the present disclosure provides a lung biopsy device, including:
配准矩阵获取模块,用于根据术前CT图像获取电磁导航支气管镜的配准矩阵;The registration matrix acquisition module is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;
病灶影像获取模块,用于根据所述配准矩阵,利用外周超声探头获取病灶影像;A lesion image acquisition module, configured to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix;
现场细胞学评估模块,用于在获取到所述病灶影像的情况下,行经支气管镜刷检,并行现场细胞学评估;On-site cytology evaluation module, used to perform bronchoscopy and parallel on-site cytology evaluation when the lesion image is acquired;
第一活检模块,用于若现场细胞学呈阴性,行支气管肺泡灌洗和经支气 管镜活检;The first biopsy module is used for bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;
第一信息导入模块,用于向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息;The first information import module is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system;
目标穿刺点对准模块,用于根据穿刺路径和注册配准信息,将穿刺针对准待检测者身上的目标穿刺点;Target puncture point alignment module, which is used to target the puncture point to the target puncture point on the subject to be detected according to the puncture path and registered registration information;
穿刺针第一调整模块,用于调整穿刺针的空间角度;The first adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle;
呼吸曲线获取模块,用于获取待检测者的呼吸曲线;The breathing curve acquisition module is used to acquire the breathing curve of the person to be detected;
穿刺模块,用于当所述穿刺针的穿刺路径与导入的穿刺路径重合,且所述待检测者的呼吸时刻与CT时刻一致时,开始穿刺操作;The puncture module is used to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path and the breathing time of the subject to be detected is consistent with the CT time;
第二活检模块,用于当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检。The second biopsy module is used to withdraw the puncture needle after the puncture needle reaches a predetermined position and perform a needle biopsy.
优选的,上述装置还包括:Preferably, the above device further includes:
第二信息导入模块,用于向经胸壁电磁导航系统导入穿刺针校准数据库,输入穿刺针型号,将电磁导航卡具安装在穿刺针尾部;The second information import module is used to import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;
初选穿刺点对准模块,用于将穿刺针的针头对准待检测者身上的初选穿刺点;The primary puncture point alignment module is used to align the needle of the puncture needle with the primary puncture point on the subject;
穿刺针第二调整模块,用于根据CT图像上显示的穿刺针位置和方向指示器调整对准待检测者的穿刺针的空间角度;The second adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle aimed at the examinee according to the position and direction indicator of the puncture needle displayed on the CT image;
目标穿刺点确定模块,用于当CT图像上显示的穿刺针的穿刺路径与对准待检测者的穿刺针的穿刺路径重合时,在待检测者的皮肤上标记目标穿刺点。The target puncture point determination module is used to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.
优选的,所述配准矩阵获取模块,包括:Preferably, the registration matrix acquisition module includes:
第一配准矩阵获取子模块,用于若所述术前CT图像有标记物,则使用标记物进行点配准注册;A first registration matrix acquisition sub-module, which is used for registration of point registration using the marker if the pre-operative CT image has a marker;
第二配准矩阵获取子模块,用于若所述术前CT图像没有标记物,则使用定位导线采集主支气管进行点云配准注册;A second registration matrix acquisition sub-module, which is used to acquire the main bronchus by using a positioning wire for point cloud registration if the pre-operative CT image has no markers;
配准矩阵获取子模块,用于记录电磁导航支气管镜的配准矩阵。The registration matrix acquisition submodule is used to record the registration matrix of the electromagnetic navigation bronchoscope.
优选的,所述病灶影像获取模块包括:Preferably, the lesion image acquisition module includes:
第一病灶影像获取子模块,用于根据所述配准矩阵,定位导线携带鞘管 导航至病灶处,撤出定位导线,插入外周超声探头;The first lesion image acquisition sub-module is used for navigating the positioning wire carrying the sheath to the lesion according to the registration matrix, withdrawing the positioning wire, and inserting a peripheral ultrasound probe;
第二病灶影像获取子模块,利用外周超声探头获取病灶影像。The second lesion image acquisition submodule uses peripheral ultrasound probes to acquire lesion images.
优选的,所述第二活检模块用于,当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,且通过X线透视能看到穿刺针,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检;Preferably, the second biopsy module is used to: when the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, then the electromagnet When the navigation of the navigation system ends, the puncture needle is withdrawn and a needle biopsy is performed;
若气管镜内的鞘管和外周超声探头未撤回,且通过外周超声探头能看到穿刺针时,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检。If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
优选的,所述第二活检模块还用于:Preferably, the second biopsy module is also used to:
当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,撤回穿刺针,从经胸壁的鞘管插入外周超声探头或者气道光学相干成像小探头;When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;
若通过所述外周超声探头或者所述气道光学相干成像小探头获得病灶影像,则经胸壁电磁导航系统的导航结束,撤回所述外周超声探头或者所述气道光学相干成像小探头,行针吸活检;If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;
若通过所述气道光学相干成像小探头未获得病灶影像,将穿刺针的针头对准患者身上标记的穿刺点。本公开实施例提供的肺部辅助诊断方法及装置,在经支气管肺活检中结合经胸壁电磁导航系统的穿刺导航,使用电磁导航支气管镜的术前规划和术中导航信息来指导经胸壁穿刺活检,这样就无需CT设备进行术中的信息采集和注册配准,可引导医生在TBLB无法到位的情况下或者在电磁导航支气管镜活检不理想的情况下,立即进行电磁导航引导的经胸壁穿刺活检,最大限度的减少患者诊断中转时间和穿刺风险,术中无需CT设备辅助和引导,经胸壁穿刺活检在术中无需注册和配准,直接使用电磁导航支气管镜的配准信息。If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient. The method and device for assisted diagnosis of the lungs provided by the embodiments of the present disclosure combine transthoracic lung biopsy with transthoracic electromagnetic navigation system puncture navigation, and use electromagnetic navigation bronchoscopy preoperative planning and intraoperative navigation information to guide transthoracic wall biopsy , So that there is no need for CT equipment for intraoperative information collection and registration registration, which can guide doctors to perform electromagnetic navigation-guided transthoracic biopsy immediately when TBLB is not in place or when electromagnetic navigation bronchoscopy biopsy is not ideal. , Minimize patient diagnosis transfer time and puncture risk, without the need for CT equipment assistance and guidance during operation, transthoracic puncture biopsy without registration and registration during the operation, directly use electromagnetic navigation bronchoscope registration information.
图1是本公开实施例提供的一种肺部辅助诊断方法的流程图之一;FIG. 1 is one of the flowcharts of a lung assisted diagnosis method provided by an embodiment of the present disclosure;
图2是本公开实施例提供的一种肺部辅助诊断方法的流程图之二;2 is a second flowchart of a method for assisting diagnosis of lungs provided by an embodiment of the present disclosure;
图3是本公开实施例提供的一种肺部辅助诊断方法的流程图之三;3 is a third flowchart of a method for assisting diagnosis of lungs provided by an embodiment of the present disclosure;
图4是本公开实施例提供的一种肺部辅助诊断方法的流程图之四;4 is a fourth flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure;
图5是本公开实施例提供的一种肺部辅助诊断方法的流程图之五;FIG. 5 is a fifth flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure;
图6是本公开实施例提供的一种肺部活检装置的结构图之一。6 is one of the structural diagrams of a lung biopsy device provided by an embodiment of the present disclosure.
为使本公开要解决的技术问题、技术方案和优点更加清楚,下面将结合附图及具体实施例进行详细描述。To make the technical problems, technical solutions, and advantages to be solved by the present disclosure clearer, the following will describe in detail with reference to the accompanying drawings and specific embodiments.
请参见图1,图1是本公开实施例提供的一种肺部辅助诊断方法的流程图,如图1所示,本公开实施例提供一种肺部辅助诊断方法,包括以下步骤:Please refer to FIG. 1. FIG. 1 is a flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure. As shown in FIG. 1, an embodiment of the present disclosure provides a lung assisted diagnosis method, including the following steps:
步骤101、根据术前CT图像获取电磁导航支气管镜的配准矩阵。Step 101: Acquire the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image.
在本步骤之前,首先需要进行术前CT规划,例如规划电磁导航支气管镜系统(ENB-TBLB)路径,和经胸壁电磁导航系统(EMN-TTNA)的穿刺进针路径,并规划和标记患者皮肤上的目标穿刺点。然后电磁导航支气管镜设备就位,定位导线连同导向鞘插入气管镜工作通道。上述步骤完成之后,根据术前CT图像来获取配准矩阵。Before this step, it is necessary to perform preoperative CT planning, such as planning the path of the electromagnetic navigation bronchoscopy system (ENB-TBLB) and the puncture needle path of the transthoracic electromagnetic navigation system (EMN-TTNA), and planning and marking the patient's skin Puncture point on the target. Then the electromagnetic navigation bronchoscope device is in place, and the positioning wire is inserted into the working channel of the bronchoscope together with the guide sheath. After the above steps are completed, the registration matrix is obtained according to the preoperative CT image.
步骤102、根据所述配准矩阵进行导航,利用外周超声探头获取病灶影像。具体为,定位导线携带鞘管导航至病灶附近,撤出定位导线,插入外周超声探头进行确认,通过外周超声探头获取病灶影像。Step 102: Navigate according to the registration matrix, and use peripheral ultrasound probes to obtain lesion images. Specifically, the positioning wire carries the sheath to navigate to the vicinity of the lesion, the positioning wire is withdrawn, a peripheral ultrasound probe is inserted for confirmation, and the lesion image is acquired through the peripheral ultrasound probe.
步骤103、在获取到所述病灶影像的情况下,行经支气管镜刷检,并行现场细胞学评估。优选的,外周超声探头未显示病灶影像,即在未获取到病灶影像的情况下,撤出鞘管和气管镜,转步骤105执行。Step 103: Under the condition that the image of the lesion is acquired, perform a bronchoscopy test and perform on-site cytological assessment. Preferably, the peripheral ultrasound probe does not display the lesion image, that is, if the lesion image is not acquired, the sheath and bronchoscope are withdrawn, and step 105 is executed.
步骤104、若现场细胞学呈阴性,行支气管肺泡灌洗和经支气管镜活检。优选的,若现场细胞学呈阳性,行经支气管镜活检,操作结束。Step 104: If the on-site cytology is negative, perform bronchoalveolar lavage and bronchoscopy biopsy. Preferably, if the on-site cytology is positive, a bronchoscopy biopsy is performed and the operation is ended.
步骤105、向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息;Step 105: Import the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system;
步骤106、根据穿刺路径和注册配准信息,将穿刺针对准待检测者身上的目标穿刺点。目标穿刺点预先设置。Step 106: According to the puncture path and the registration registration information, aim the puncture at the target puncture point on the prospective examinee. The target puncture point is preset.
步骤107、调整穿刺针的空间角度。根据术前CT图像上显示的穿刺针位置和方向指示器,调整对准待检测者身上的穿刺针的空间角度。Step 107: Adjust the spatial angle of the puncture needle. According to the position and direction indicator of the puncture needle displayed on the CT image before surgery, adjust the spatial angle of the puncture needle aligned with the body of the patient to be detected.
步骤108、获取待检测者的呼吸曲线。待检测者身上设置有体位传感器, 通过体位传感器可获取待检测者的呼吸曲线。Step 108: Obtain the breathing curve of the person to be detected. A body position sensor is provided on the person to be detected, and the breathing curve of the person to be detected can be obtained through the body position sensor.
步骤109、当所述穿刺针的穿刺路径与导入的穿刺路径重合,且所述待检测者的呼吸时刻与CT时刻一致时,开始穿刺操作。即使用电磁导航穿刺针指导术中穿刺,使用呼吸门控技术指导术中穿刺时刻,可有效保证穿刺效果。Step 109: When the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time, the puncture operation is started. That is, the electromagnetic navigation puncture needle is used to guide the intraoperative puncture, and the respiratory gating technique is used to guide the intraoperative puncture time, which can effectively ensure the puncture effect.
步骤110、当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检。Step 110: After the puncture needle reaches a predetermined position, withdraw the puncture needle and perform needle biopsy.
本实施例中的肺部辅助诊断方法,根据术前CT图像获取电磁导航支气管镜的配准矩阵;根据所述配准矩阵,利用外周超声探头获取病灶影像;在获取到所述病灶影像的情况下,行经支气管镜刷检,并行现场细胞学评估;若现场细胞学呈阴性,行支气管肺泡灌洗和经支气管镜活检;向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息;根据穿刺路径和注册配准信息,将穿刺针对准待检测者身上的目标穿刺点;调整穿刺针的空间角度;获取待检测者的呼吸曲线;当所述穿刺针的穿刺路径与导入的穿刺路径重合,且所述待检测者的呼吸时刻与CT时刻一致时,开始穿刺操作;当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检。这样,在经支气管肺活检中结合经胸壁电磁导航系统的穿刺导航,使用电磁导航支气管镜的术前规划和术中导航信息来指导经胸壁穿刺活检,无需CT设备进行术中的信息采集和注册配准,可引导医生在TBLB无法到位的情况下或者在电磁导航支气管镜活检不理想的情况下,立即进行电磁导航引导的经胸壁穿刺活检,最大限度的减少患者中转时间和穿刺风险,并且术中无需CT设备辅助和引导,经胸壁穿刺活检在术中无需注册和配准,直接使用电磁导航支气管镜的配准信息。The lung assisted diagnosis method in this embodiment obtains the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image; according to the registration matrix, the peripheral ultrasound probe is used to obtain the lesion image; when the lesion image is obtained Next, perform a bronchoscopy test and perform on-site cytology assessment; if the on-site cytology is negative, perform bronchoalveolar lavage and transbronchoscope biopsy; import the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system According to the puncture path and registration registration information, aim the puncture at the target puncture point on the subject to be tested; adjust the spatial angle of the puncture needle; obtain the breathing curve of the subject to be tested; when the puncture path of the puncture needle and the introduced puncture path When the breathing time of the person to be detected coincides with the CT time, the puncture operation starts; when the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed. In this way, transbronchial lung biopsy combined with transthoracic electromagnetic navigation system puncture navigation, using electromagnetic navigation bronchoscopy preoperative planning and intraoperative navigation information to guide transthoracic wall biopsy, without CT equipment for intraoperative information collection and registration Registration can guide doctors to perform electromagnetic navigation-guided transthoracic puncture biopsy immediately when TBLB is not in place or when electromagnetic navigation bronchoscopy biopsy is not ideal, to minimize patient transfer time and puncture risk, and There is no need for CT equipment assistance and guidance. Transthoracic needle biopsy does not require registration and registration during the operation, and directly uses electromagnetic navigation bronchoscope registration information.
优选的,如图2所示,在步骤105,向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息的步骤之前,还包括:Preferably, as shown in FIG. 2, in step 105, before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, the method further includes:
步骤112、向经胸壁电磁导航系统导入穿刺针校准数据库、输入穿刺针型号、将电磁导航卡具安装在穿刺针尾部;Step 112: Import the puncture needle calibration database to the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture on the tail of the puncture needle;
步骤113、将穿刺针的针头对准待检测者身上的初选穿刺点;Step 113: Align the needle of the puncture needle to the primary puncture point on the subject to be tested;
步骤114、根据CT图像上显示的穿刺针位置和方向指示器调整对准待检测者的穿刺针的空间角度;Step 114: Adjust the spatial angle of the puncture needle aligned with the person to be detected according to the position and direction indicator of the puncture needle displayed on the CT image;
步骤115、当CT图像上显示的穿刺针的穿刺路径与对准待检测者的穿刺 针的穿刺路径重合时,在待检测者的皮肤上标记目标穿刺点。Step 115: When the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject, mark the target puncture point on the skin of the subject.
本实施例中,根据CT图像上显示的穿刺针位置和方向指示器调整对准待检测者的穿刺针的空间角度,当CT图像上显示的穿刺针的穿刺路径与对准待检测者的穿刺针的穿刺路径重合时,确定目标穿刺点,可有效保证目标穿刺点的精准度。In this embodiment, the spatial angle of the puncture needle aimed at the subject to be inspected is adjusted according to the position and direction indicator of the puncture needle displayed on the CT image. When the puncture path of the puncture needle displayed on the CT image is aligned with the puncture aimed at the subject to be inspected When the puncture paths of the needles coincide, determining the target puncture point can effectively ensure the accuracy of the target puncture point.
优选的,如图3所示,步骤101包括:Preferably, as shown in FIG. 3, step 101 includes:
步骤1011、若所述术前CT图像有标记物,则使用标记物进行点配准注册;否则,则使用定位导线采集主支气管进行点云配准注册; Step 1011, if there are markers in the preoperative CT image, use the markers for point registration registration; otherwise, use positioning wires to collect the main bronchus for point cloud registration registration;
步骤1012、记录电磁导航支气管镜的配准矩阵。Step 1012: Record the registration matrix of the electromagnetic navigation bronchoscope.
优选的,如图3所示,步骤102包括:Preferably, as shown in FIG. 3, step 102 includes:
步骤1021、根据所述配准矩阵,定位导线携带鞘管导航至病灶处,撤出定位导线,插入外周超声探头。Step 1021: According to the registration matrix, the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe.
步骤1022、利用外周超声探头获取病灶影像。Step 1022: Use a peripheral ultrasound probe to acquire the lesion image.
本实施例中,根据配准矩阵获取病灶影像,可获得病灶位置,从而对该位置进行现场细胞学评估。In this embodiment, the focus image is obtained according to the registration matrix, and the position of the focus can be obtained, so as to perform on-site cytological evaluation of the position.
优选的,如图3所示,步骤110包括:Preferably, as shown in FIG. 3, step 110 includes:
步骤1101,当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,且通过X线透视能看到穿刺针,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检; Step 1101, after the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, the navigation through the chest wall electromagnetic navigation system ends and the puncture needle is withdrawn , Needle biopsy;
步骤1102,若气管镜内的鞘管和外周超声探头未撤回,且通过外周超声探头能看到穿刺针时,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检。 Step 1102, if the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and a needle biopsy is performed.
本实施例中,在TBLB无法到位的情况下或者在电磁导航支气管镜活检不理想的情况下,立即进行电磁导航引导的经胸壁穿刺活检,最大限度的减少患者中转时间和穿刺风险。In this embodiment, when the TBLB is not in place or the electromagnetic navigation bronchoscope biopsy is not ideal, the electromagnetic navigation-guided transthoracic puncture biopsy is performed immediately to minimize the patient's transit time and puncture risk.
优选的,步骤110还包括:当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,撤回穿刺针,从经胸壁的鞘管插入外周超声探头或者气道光学相干成像小探头;Preferably, step 110 further includes: after the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or airway optical coherence from the sheath through the chest wall Small imaging probe;
若通过所述外周超声探头或者所述气道光学相干成像小探头获得病灶影 像,则经胸壁电磁导航系统的导航结束,撤回所述外周超声探头或者所述气道光学相干成像小探头,行针吸活检;If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;
若通过所述气道光学相干成像小探头未获得病灶影像,将穿刺针的针头对准患者身上标记的穿刺点。If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient.
本步骤中,通过所述外周超声探头或者所述气道光学相干成像小探头确认病灶影像,完全不需要X线辅助,可减少X线对患者身体的伤害。In this step, the peripheral ultrasound probe or the airway optical coherent imaging small probe is used to confirm the image of the lesion, and X-ray assistance is not required at all, which can reduce the damage of the X-ray to the patient's body.
请参见图4,图4是本公开实施例提供的一种肺部活检装置的结构图,如图4所示,本公开实施例提供一种肺部活检装置200,包括:Please refer to FIG. 4. FIG. 4 is a structural diagram of a lung biopsy device according to an embodiment of the present disclosure. As shown in FIG. 4, an embodiment of the present disclosure provides a lung biopsy device 200, including:
配准矩阵获取模块201,用于根据术前CT图像获取电磁导航支气管镜的配准矩阵;The registration matrix obtaining module 201 is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;
病灶影像获取模块202,用于根据所述配准矩阵,利用外周超声探头获取病灶影像;The lesion image acquisition module 202 is used to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix;
现场细胞学评估模块203,用于在获取到所述病灶影像的情况下,行经支气管镜刷检,并行现场细胞学评估;The on-site cytology evaluation module 203 is used to perform a bronchoscopy test and parallel on-site cytology evaluation when the lesion image is acquired;
第一活检模块204,用于若现场细胞学呈阴性,行支气管肺泡灌洗和经支气管镜活检;The first biopsy module 204 is used to perform bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;
第一信息导入模块205,用于向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息;The first information import module 205 is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system;
目标穿刺点对准模块206,用于根据穿刺路径和注册配准信息,将穿刺针对准待检测者身上的目标穿刺点;The target puncture point alignment module 206 is used to target the puncture to the target puncture point on the subject to be detected according to the puncture path and the registered registration information;
穿刺针第一调整模块207,用于调整穿刺针的空间角度;The first puncture needle adjustment module 207 is used to adjust the spatial angle of the puncture needle;
呼吸曲线获取模块208,用于获取待检测者的呼吸曲线;The breathing curve obtaining module 208 is used to obtain the breathing curve of the person to be detected;
穿刺模块209,用于当所述穿刺针的穿刺路径与导入的穿刺路径重合,且所述待检测者的呼吸时刻与CT时刻一致时,开始穿刺操作;The puncture module 209 is configured to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time;
第二活检模块210,用于当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检。The second biopsy module 210 is configured to withdraw the puncture needle and perform a needle biopsy after the puncture needle reaches a predetermined position.
优选的,如图5所示,上述肺部活检装置200还包括:Preferably, as shown in FIG. 5, the lung biopsy device 200 further includes:
第二信息导入模块211,用于向经胸壁电磁导航系统导入穿刺针校准数据库,输入穿刺针型号,将电磁导航卡具安装在穿刺针尾部;The second information import module 211 is used to import a puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;
初选穿刺点对准模块212,用于将穿刺针的针头对准待检测者身上的初选穿刺点;The primary puncture point alignment module 212 is used to align the needle of the puncture needle with the primary puncture point on the subject to be tested;
穿刺针第二调整模块213,用于根据CT图像上显示的穿刺针位置和方向指示器调整对准待检测者的穿刺针的空间角度;The puncture needle second adjustment module 213 is used to adjust the spatial angle of the puncture needle aligned with the subject according to the position and direction indicator of the puncture needle displayed on the CT image;
目标穿刺点确定模块214,用于当CT图像上显示的穿刺针的穿刺路径与对准待检测者的穿刺针的穿刺路径重合时,在待检测者的皮肤上标记目标穿刺点。The target puncture point determination module 214 is configured to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.
优选的,如图6所示,所述配准矩阵获取模块201包括:Preferably, as shown in FIG. 6, the registration matrix acquisition module 201 includes:
第一配准矩阵获取子模块2011,用于若所述术前CT图像有标记物,则使用标记物进行点配准注册;The first registration matrix acquisition sub-module 2011 is used to register the points using the markers if the pre-operative CT image has markers;
第二配准矩阵获取子模块2012,用于若所述术前CT图像没有标记物,则使用定位导线采集主支气管进行点云配准注册;The second registration matrix acquisition sub-module 2012 is used to acquire the main bronchus using the positioning wire for point cloud registration if the preoperative CT image has no markers;
配准矩阵获取子模块2013,用于记录电磁导航支气管镜的配准矩阵。The registration matrix acquisition submodule 2013 is used to record the registration matrix of the electromagnetic navigation bronchoscope.
优选的,如图6所示,所述病灶影像获取模块202包括:Preferably, as shown in FIG. 6, the lesion image acquisition module 202 includes:
第一病灶影像获取子模块2021,用于根据所述配准矩阵,定位导线携带鞘管导航至病灶处,撤出定位导线,插入外周超声探头;The first lesion image acquisition sub-module 2021 is used for navigating the positioning wire and carrying the sheath to the lesion according to the registration matrix, withdrawing the positioning wire, and inserting a peripheral ultrasound probe;
第二病灶影像获取子模块2022,利用外周超声探头获取病灶影像。The second lesion image acquisition submodule 2022 uses peripheral ultrasound probes to acquire the lesion image.
优选的,所述第二活检模块用于,当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,且通过X线透视能看到穿刺针,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检;Preferably, the second biopsy module is used to: when the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, then the electromagnet When the navigation of the navigation system ends, the puncture needle is withdrawn and a needle biopsy is performed;
若气管镜内的鞘管和外周超声探头未撤回,且通过外周超声探头能看到穿刺针时,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检。If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
优选的,所述第二活检模块还用于:Preferably, the second biopsy module is also used to:
当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,撤回穿刺针,从经胸壁的鞘管插入外周超声探头或者气道光学相干成像小探头;When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;
若通过所述外周超声探头或者所述气道光学相干成像小探头获得病灶影像,则经胸壁电磁导航系统的导航结束,撤回所述外周超声探头或者所述气道光学相干成像小探头,行针吸活检;If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;
若通过所述气道光学相干成像小探头未获得病灶影像,将穿刺针的针头对准患者身上标记的穿刺点。If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient.
肺部活检装置200是从肺实质穿刺建立的到肺部病灶的通道。肺部活检装置200也能用于介入治疗,如射频消融,冷冻等其他介入治疗手段中。The lung biopsy device 200 is a passage established from a lung parenchyma puncture to a lung lesion. The lung biopsy device 200 can also be used in interventional treatment, such as radiofrequency ablation, freezing, and other interventional treatment methods.
需要说明的是,上述实施例中的肺部活检装置可以实现图1-图5所示的方法实施例中任意实施方式,以及达到相同的有益效果,具体实施过程可参见图1-图5所对应的内容,此处不再赘述。It should be noted that the lung biopsy device in the above embodiment can implement any of the implementation methods in the method embodiments shown in FIGS. The corresponding content will not be repeated here.
以上所述是本公开的优选实施方式,应当指出,对于本技术领域的普通技术人员来说,在不脱离本公开所述原理的前提下,还可以作出若干改进和润饰,这些改进和润饰也应视为本公开的保护范围。The above is the preferred embodiment of the present disclosure. It should be noted that for those of ordinary skill in the art, without departing from the principles of the present disclosure, several improvements and retouches can be made. It should be regarded as the scope of protection of this disclosure.
Claims (12)
- 一种肺部辅助诊断方法,包括:A method for assisting diagnosis of the lungs, including:根据术前CT图像获取电磁导航支气管镜的配准矩阵;Obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;根据所述配准矩阵进行导航,利用外周超声探头获取病灶影像;Navigate according to the registration matrix and use peripheral ultrasound probes to obtain lesion images;在获取到所述病灶影像的情况下,行经支气管镜刷检,并行现场细胞学评估;In the case of acquiring the image of the lesion, perform a bronchoscopy brush test and perform on-site cytological assessment;若现场细胞学呈阴性,行支气管肺泡灌洗和经支气管镜活检;If the on-site cytology is negative, perform bronchoalveolar lavage and bronchoscopy biopsy;向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息;Import pre-acquired puncture path and registration information to the transthoracic electromagnetic navigation system;根据穿刺路径和注册配准信息,将穿刺针对准待检测者身上的目标穿刺点;According to the puncture path and registration registration information, aim the puncture at the target puncture point on the prospective examinee;调整穿刺针的空间角度;Adjust the spatial angle of the puncture needle;获取待检测者的呼吸曲线;Obtain the breathing curve of the person to be tested;当所述穿刺针的穿刺路径与导入的穿刺路径重合,且所述待检测者的呼吸时刻与CT时刻一致时,开始穿刺操作;When the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time, the puncture operation is started;当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检。When the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed.
- 根据权利要求1所述的肺部辅助诊断方法,其中,在所述向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息的步骤之前,还包括:The lung assisted diagnosis method according to claim 1, wherein before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, further comprising:向经胸壁电磁导航系统导入穿刺针校准数据库,输入穿刺针型号,将电磁导航卡具安装在穿刺针尾部;Import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture on the tail of the puncture needle;将穿刺针的针头对准待检测者身上的初选穿刺点;Align the needle of the puncture needle to the primary puncture point on the subject;根据CT图像上显示的穿刺针位置和方向指示器调整对准待检测者的穿刺针的空间角度;According to the position and direction indicator of the puncture needle displayed on the CT image, adjust the spatial angle of the puncture needle aimed at the examinee;当CT图像上显示的穿刺针的穿刺路径与对准待检测者的穿刺针的穿刺路径重合时,在待检测者的皮肤上标记目标穿刺点。When the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject, the target puncture point is marked on the skin of the subject.
- 根据权利要求1所述的肺部辅助诊断方法,其中,所述根据术前CT图像获取电磁导航支气管镜的配准矩阵的步骤,包括:The lung-assisted diagnosis method according to claim 1, wherein the step of acquiring the registration matrix of the electromagnetic navigation bronchoscope based on the preoperative CT image includes:若所述术前CT图像有标记物,则使用标记物进行点配准注册;If there are markers in the pre-operative CT image, use the markers for point registration registration;若所述术前CT图像没有标记物,则使用定位导线采集主支气管进行点 云配准注册;If there is no marker in the preoperative CT image, use the positioning wire to collect the main bronchus for point cloud registration;记录电磁导航支气管镜的配准矩阵。Record the registration matrix of the electromagnetic navigation bronchoscope.
- 根据权利要求1所述的肺部辅助诊断方法,其中,所述根据所述配准矩阵,利用外周超声探头获取病灶影像的步骤,包括:The lung-assisted diagnosis method according to claim 1, wherein the step of acquiring a lesion image using a peripheral ultrasound probe according to the registration matrix includes:根据所述配准矩阵,定位导线携带鞘管导航至病灶处,撤出定位导线,插入外周超声探头;According to the registration matrix, the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe;利用外周超声探头获取病灶影像。Use peripheral ultrasound probes to obtain lesion images.
- 根据权利要求1-4中任一项所述的肺部辅助诊断方法,其中,所述当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检的步骤,包括:The method for assisting diagnosis of a lung according to any one of claims 1 to 4, wherein the step of withdrawing the puncture needle and performing a needle biopsy after the puncture needle reaches a predetermined position includes:当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,且通过X线透视能看到穿刺针,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检;When the puncture needle reaches the predetermined position, if the sheath in the bronchoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and the needle Aspiration biopsy;若气管镜内的鞘管和外周超声探头未撤回,且通过外周超声探头能看到穿刺针时,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检。If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
- 根据权利要求5所述的肺部辅助诊断方法,其中,所述当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检的步骤,还包括:The lung auxiliary diagnosis method according to claim 5, wherein the step of withdrawing the puncture needle and performing needle aspiration biopsy after the puncture needle reaches a predetermined position, further comprising:当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,撤回穿刺针,从经胸壁的鞘管插入外周超声探头或者气道光学相干成像小探头;When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;若通过所述外周超声探头或者所述气道光学相干成像小探头获得病灶影像,则经胸壁电磁导航系统的导航结束,撤回所述外周超声探头或者所述气道光学相干成像小探头,行针吸活检;If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;若通过所述气道光学相干成像小探头未获得病灶影像,将穿刺针的针头对准患者身上标记的穿刺点。If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient.
- 一种肺部活检装置,包括:A lung biopsy device, including:配准矩阵获取模块,用于根据术前CT图像获取电磁导航支气管镜的配准矩阵;The registration matrix acquisition module is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;病灶影像获取模块,用于根据所述配准矩阵,利用外周超声探头获取病灶影像;A lesion image acquisition module, configured to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix;现场细胞学评估模块,用于在获取到所述病灶影像的情况下,行经支气管镜刷检,并行现场细胞学评估;On-site cytology evaluation module, used to perform bronchoscopy and parallel on-site cytology evaluation when the lesion image is acquired;第一活检模块,用于若现场细胞学呈阴性,行支气管肺泡灌洗和经支气管镜活检;The first biopsy module is used for bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;第一信息导入模块,用于向经胸壁电磁导航系统导入预获取的穿刺路径和注册配准信息;The first information import module is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system;目标穿刺点对准模块,用于根据穿刺路径和注册配准信息,将穿刺针对准待检测者身上的目标穿刺点;Target puncture point alignment module, which is used to target the puncture point to the target puncture point on the subject to be detected according to the puncture path and registered registration information;穿刺针第一调整模块,用于调整穿刺针的空间角度;The first adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle;呼吸曲线获取模块,用于获取待检测者的呼吸曲线;The breathing curve acquisition module is used to acquire the breathing curve of the person to be detected;穿刺模块,用于当所述穿刺针的穿刺路径与导入的穿刺路径重合,且所述待检测者的呼吸时刻与CT时刻一致时,开始穿刺操作;The puncture module is used to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path and the breathing time of the subject to be detected is consistent with the CT time;第二活检模块,用于当所述穿刺针到达预定位置后,撤回穿刺针,行针吸活检。The second biopsy module is used to withdraw the puncture needle after the puncture needle reaches a predetermined position and perform a needle biopsy.
- 根据权利要求7所述的装置,其中,还包括:The device according to claim 7, further comprising:第二信息导入模块,用于向经胸壁电磁导航系统导入穿刺针校准数据库,输入穿刺针型号,将电磁导航卡具安装在穿刺针尾部;The second information import module is used to import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;初选穿刺点对准模块,用于将穿刺针的针头对准待检测者身上的初选穿刺点;The primary puncture point alignment module is used to align the needle of the puncture needle with the primary puncture point on the subject;穿刺针第二调整模块,用于根据CT图像上显示的穿刺针位置和方向指示器调整对准待检测者的穿刺针的空间角度;The second adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle aimed at the examinee according to the position and direction indicator of the puncture needle displayed on the CT image;目标穿刺点确定模块,用于当CT图像上显示的穿刺针的穿刺路径与对准待检测者的穿刺针的穿刺路径重合时,在待检测者的皮肤上标记目标穿刺点。The target puncture point determination module is used to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.
- 根据权利要求7所述的装置,其中,所述配准矩阵获取模块,包括:The apparatus according to claim 7, wherein the registration matrix acquisition module includes:第一配准矩阵获取子模块,用于若所述术前CT图像有标记物,则使用标记物进行点配准注册;A first registration matrix acquisition sub-module, which is used for registration of point registration using the marker if the pre-operative CT image has a marker;第二配准矩阵获取子模块,用于若所述术前CT图像没有标记物,则使用定位导线采集主支气管进行点云配准注册;A second registration matrix acquisition sub-module, which is used to acquire the main bronchus by using a positioning wire for point cloud registration if the pre-operative CT image has no markers;配准矩阵获取子模块,用于记录电磁导航支气管镜的配准矩阵。The registration matrix acquisition submodule is used to record the registration matrix of the electromagnetic navigation bronchoscope.
- 根据权利要求7所述的装置,其中,所述病灶影像获取模块包括:The device according to claim 7, wherein the lesion image acquisition module includes:第一病灶影像获取子模块,用于根据所述配准矩阵,定位导线携带鞘管导航至病灶处,撤出定位导线,插入外周超声探头;The first lesion image acquisition sub-module is used for navigating the positioning lead and carrying the sheath to the lesion according to the registration matrix, withdrawing the positioning lead, and inserting a peripheral ultrasound probe;第二病灶影像获取子模块,利用外周超声探头获取病灶影像。The second lesion image acquisition submodule uses peripheral ultrasound probes to acquire lesion images.
- 根据权利要求7-10中任一项所述的装置,其中,所述第二活检模块用于,当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,且通过X线透视能看到穿刺针,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检;The device according to any one of claims 7-10, wherein the second biopsy module is used for, when the puncture needle reaches a predetermined position, if the sheath in the bronchoscope and the peripheral ultrasound probe are withdrawn, and X-ray fluoroscopy can see the puncture needle, then the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and the needle biopsy is performed;若气管镜内的鞘管和外周超声探头未撤回,且通过外周超声探头能看到穿刺针时,则经胸壁电磁导航系统的导航结束,撤回穿刺针,行针吸活检。If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
- 根据权利要求11所述的装置,其中,所述第二活检模块还用于:The device according to claim 11, wherein the second biopsy module is further used to:当所述穿刺针到达预定位置后,若气管镜内的鞘管和外周超声探头撤回,撤回穿刺针,从经胸壁的鞘管插入外周超声探头或者气道光学相干成像小探头;When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;若通过所述外周超声探头或者所述气道光学相干成像小探头获得病灶影像,则经胸壁电磁导航系统的导航结束,撤回所述外周超声探头或者所述气道光学相干成像小探头,行针吸活检;If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;若通过所述气道光学相干成像小探头未获得病灶影像,将穿刺针的针头对准患者身上标记的穿刺点If the image of the lesion is not obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient
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