WO2020249136A1 - 三维颅脑定位操作工具及其使用方法 - Google Patents

三维颅脑定位操作工具及其使用方法 Download PDF

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Publication number
WO2020249136A1
WO2020249136A1 PCT/CN2020/102553 CN2020102553W WO2020249136A1 WO 2020249136 A1 WO2020249136 A1 WO 2020249136A1 CN 2020102553 W CN2020102553 W CN 2020102553W WO 2020249136 A1 WO2020249136 A1 WO 2020249136A1
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WO
WIPO (PCT)
Prior art keywords
main
ruler
fixing frame
folding
quarter
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PCT/CN2020/102553
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English (en)
French (fr)
Inventor
魏大年
Original Assignee
魏大年
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Publication date
Application filed by 魏大年 filed Critical 魏大年
Publication of WO2020249136A1 publication Critical patent/WO2020249136A1/zh
Priority to US17/643,911 priority Critical patent/US20220096196A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B2090/103—Cranial plugs for access to brain
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/374—NMR or MRI
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • A61B2090/3762—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy using computed tomography systems [CT]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3937—Visible markers

Definitions

  • the invention relates to the field of marking positioning on the body surface of a medical human body, and more specifically, to a three-dimensional craniocerebral positioning operation tool and a use method thereof.
  • Existing positioning methods mainly include free-hand puncture, simple device-assisted guidance, traditional framed stereotaxic instrument, neuronavigation or surgical robot, etc.
  • the free-hand puncture method is to rely on simple tools to manually draw lines and rely on experience for positioning.
  • the advantage is convenience Fast, the disadvantage is that the accuracy is poor, the error rate is high, and it is greatly affected by human factors.
  • the biggest advantage of the traditional framed stereotactic instrument and neuronavigation system is high positioning accuracy, but the operation process is very complicated, difficult to master, and the equipment is expensive.
  • surgical robots dedicated to brain surgery such as French Medtech ROSA developed by SA company and domestic Ruimi robot.
  • the advantage is precision and intelligence, but the price is too high and it is more difficult to popularize.
  • the purpose of the present invention is to provide a three-dimensional brain positioning operation tool and its use method, which can realize the use of a new three-dimensional coordinate system, the image coordinates and anatomical coordinates are unified, using CT and MR
  • the characteristics of the image film designed a new method that can realize the software to automatically measure the target point, avoiding the cumbersome process of installing the base ring, reviewing CT or MR, pasting the Marker, and copying the DICOM image data, making the image measurement easier and faster.
  • the designed marker ruler can quickly mark the body surface projection position of the target point.
  • the three-dimensional guide device has simple structure, convenient installation, multi-function, and the operation area is not affected. It can complete most of the brain positioning functions without affecting the accuracy. This greatly reduces the complexity of the positioning operation and simplifies the pre-operative preparation and operation time during the operation from multiple links. The operation is more scientific, the positioning is more accurate, time saving, surgical cost reduction, and surgical efficacy improved.
  • the present invention adopts the following technical solutions.
  • a three-dimensional craniocerebral positioning operation tool and a method of use thereof include a marking ruler and a quarter-bow guide device, the marking ruler includes a fixed marking ruler, the fixed marking ruler includes a fixed level, and one end of the fixed level is fixed A fixed Z-axis ruler is connected, and the fixed Z-axis ruler and the fixed level are perpendicular to each other, the fixed Z-axis ruler and the fixed level are both engraved with scale lines, and the fixed Z-axis ruler and the fixed level are connected The position is the zero-scale end of the fixed Z-axis ruler and the fixed level.
  • the fixed level is sleeved with a main slider, and there is an interference fit between the fixed level and the main slider.
  • the main slider can be Under the action of moving slowly on a fixed level, the quarter bow guiding device includes a first quarter bow guiding device, and the first quarter bow guiding device includes a first main fixing frame and a first A secondary fixing frame, the first main fixing frame is excavated with a main square empty slot matching the first auxiliary fixing frame, and the first auxiliary fixing frame is inserted into the main square empty slot, the first main fixing frame A main through hole groove is excavated at the upper end of the main through hole groove, a main knob is inserted into the main through hole groove, a main sawtooth block matching the main knob is fixedly connected to the upper end of the first auxiliary fixing frame, and the first main fixing frame It is fixedly connected with the first auxiliary fixing frame through the main knob and the main serrated block.
  • the lower ends of the first main fixing frame and the first auxiliary fixing frame are both fixedly connected with main head nails, and the side of the first main fixing frame
  • a main connecting block is fixedly connected to the wall, an end of the main connecting block away from the first main fixing frame is fixedly connected with a main quarter bow, and a main positioning device is slidably connected to the main quarter bow.
  • the main zero degree midpoint is engraved on the main connecting block.
  • a new three-dimensional coordinate system can be adopted, the image coordinates and anatomical coordinates are unified, and a new method that can realize software automatic measurement of the target point is designed using the characteristics of CT and MR images, avoiding the installation of the base ring, the review of CT or The cumbersome process of MR, pasting Marker, and copying DICOM image data makes image measurement easier and faster.
  • Using a specially designed marker ruler can quickly mark the projection position of the target point.
  • the three-dimensional guide device has a simple structure, convenient installation and functions. Multi-purpose, the operation area is not affected, it can complete most of the brain positioning functions, greatly reducing the complexity of the positioning operation without affecting the accuracy, and simplifying the pre-operative preparation and the operation time during the operation from multiple links. More scientific, more accurate positioning, save time, reduce surgical cost, and improve surgical efficacy.
  • the marker ruler can be a folding marker ruler
  • the folding marker ruler includes a folding level ruler
  • one end of the folding level ruler is connected with a folding level ruler
  • the folding Z axis ruler and the folding level ruler are perpendicular to each other, so Both the folding Z-axis ruler and the folding level ruler may have scale marks, and the junction of the folding Z-axis ruler and the folding level ruler is the zero-scale end of the folding Z-axis ruler and the folding level ruler, and the folding Z-axis ruler is close to An L-shaped groove is excavated at one end of the folding level.
  • One end of the folding level close to the folding Z-axis ruler is fixedly connected to a pair of triangular plates.
  • the two triangular plates are respectively located on both sides of the folding Z-axis ruler.
  • the quarter bow guiding device can also be a second quarter bow guiding device, and the second quarter bow guiding device includes a second main fixing frame and a second auxiliary fixing frame, so The second main fixing frame is excavated with an auxiliary square hole slot matching the second auxiliary fixing frame, and the second auxiliary fixing frame is inserted into the auxiliary square hole groove, and the upper end of the second main fixing frame is cut with an auxiliary Through hole slot, the upper end of the second main fixing frame is inserted with the auxiliary knob, and the auxiliary knob penetrates the auxiliary through hole groove, and the upper end of the second auxiliary fixing frame is fixedly connected with an auxiliary serrated block matching the auxiliary knob,
  • the lower ends of the second main fixing frame and the second auxiliary fixing frame are respectively fixedly connected with short-head nails and long-head nails, a sliding connection block is slidably connected to the long-head nails, and the sliding connection block is located far away from the short-head nails.
  • a secondary quarter bow is fixedly connected to the sliding connecting block, a secondary positioning device is slidably connected to the secondary quarter bow, and a secondary zero degree is engraved on the secondary quarter bow.
  • the midpoint can assist in target positioning.
  • main quarter bow and the secondary quarter bow can be designed to have an inner diameter of 180mm-300mm and an outer diameter of 220mm-400mm as required.
  • the width is 20mm-50mm to suit patients of different body types.
  • the material of the main quarter bow and the secondary quarter bow can be metal, plastic or polymer material, etc., and the tips of the main quarter bow and the secondary quarter bow need to be polished. Smooth, so that the main quarter bow and the secondary quarter bow are not easy to puncture the patient
  • the main positioning device and the auxiliary positioning device have the same structure, and the main positioning device and the auxiliary positioning device both include a positioning block, one end of the positioning block is excavated with a rotating chute, and the positioning block slides by rotating
  • the groove is slidably connected with the main quarter bow or the auxiliary quarter bow, and the positioning block has a slot at one end away from the rotating chute, which is convenient for the staff to use the main quarter bow or the auxiliary quarter bow. Slide the positioning block up.
  • an extension rod is inserted into the slot, the extension rod includes an L-shaped rod body, the L-shaped rod body includes a main body part and an extension part, and the extension part of the L-shaped rod body is fixedly connected with a plug block, A positioning hole is excavated in the plug-in block, and the axis of the positioning hole is parallel to the main part of the L-shaped rod.
  • the main part is 10-15cm in length and has a trapezoidal cross-section. It can be inserted into the slot on the positioning block. There is a scale to correspond to the puncture depth, and the extension part is 3-5cm.
  • a pair of matching drainage half pipes is inserted into the positioning hole, a section of the drainage half pipe is fixedly connected with a limiting block, and the two drainage half pipes form a complete drainage pipe for guiding, L Insert the main part of the rod body into the slot in the positioning block, adjust the depth as required, insert a pair of drainage half pipes into the positioning hole, the channel center of the drainage tube is aligned with the center of the semicircular arch, and the extension rod can slide on the semicircular arch with the positioning block , Its direction is always the center of the semicircular bow.
  • the drainage half tube has a variety of models, and the diameter of the semi-column groove excavated inside the drainage half tube of different models is different, and can be matched with the diameter of the puncture tube of different sizes.
  • S1 Take CT or MR data images, and transmit the data images obtained by shooting to a computer or other processing terminal, and transmit the data to the corresponding processing software;
  • the coordinate system is determined, a reference coordinate is established with the position and zoom ratio of the scale on the CT and MR image slices as the reference object, and then the measurement coordinates are determined based on the reference coordinate, and the target position is defined in the measurement coordinates, using electronic devices such as mobile phones Photographing and calculation functions of the camera, taking pictures of the image, and automatically processing the picture information to calculate the coordinates of the target point of the lesion, and mark it as (X, Y, Z);
  • Step (2) Determine the relative coordinates. Draw the connecting line and the median sagittal line of the midpoints of the external auditory meatus on both sides manually or through the software automatic recognition function. After the position is determined, a cross line is formed, and the intersection of the cross line is used as the measurement coordinate The origin is measured by the software. Step (1) Select the relative position coordinates between the scale (reference coordinates) of the reference object in the reference coordinates. In particular, if the picture is rotated, you can rotate the crosshairs for correction, and The rotation angle is recorded by the software;
  • step (3) Determine the two-dimensional coordinates of the lesion, select the scan plane where the lesion to be located is located (the same time to take a picture or retake a photo), and also display the virtual scale on the software again, using the manual or automatic recognition function and the scale on the current image data Perform position coincidence, and then use step (2) to determine the two-dimensional coordinates of the intersection of the crosshairs recorded in the relative coordinates in the reference coordinates and the rotation angle of the crosshairs, through software calculations, automatically generate one with the coordinates of the intersection as the center Two-dimensional coordinates.
  • the two-dimensional coordinates generated at this time are measured coordinates.
  • the position of this measured coordinate on the target level is consistent with the position of the above cross line on the reference level;
  • the two-dimensional measurement coordinate generated by the two-dimensional coordinate determination of the lesion can measure the position of any point in the target plane, and click on any position to display its two-dimensional coordinate value;
  • This solution can realize the establishment of a spatial three-dimensional coordinate system through CT or MR images of the patient's lesion, and then the position of the lesion in the spatial three-dimensional coordinate system realizes the location of the lesion.
  • a reference line is drawn on the patient's body surface through a marker, and then passed
  • the guiding device realizes alignment, determines the location of the lesion, and facilitates puncture, biopsy and other operations.
  • the entire operation process does not need to rely on complicated equipment, and can be operated with simple tools, which greatly reduces the complexity of positioning operations without affecting positioning accuracy. Reduce positioning costs.
  • Figure 1 is a front view of the first quarter bow guiding device of the present invention
  • Figure 2 is a side sectional view of the first quarter bow guiding device of the present invention
  • Figure 3 is a front view of the second quarter bow guiding device of the present invention.
  • FIG. 4 is a front cross-sectional view of the connection between the first bracket and the second bracket of the second quarter bow of the present invention
  • Figure 5 is a schematic structural view of the positioning slider of the quarter bow guide device of the present invention.
  • Fig. 6 is a structural schematic diagram of the guide channel of the quarter bow guide device of the present invention.
  • Figure 7 is a front view of the extension rod of the present invention.
  • FIG. 8 is a schematic diagram of the structure of the extension rod of the present invention when it is inserted into the existing quarter bow guiding device
  • Figure 9 is a front view of the non-foldable marker ruler of the present invention.
  • Figure 10 is a front view of the foldable marker ruler of the present invention.
  • Figure 11 is a schematic diagram of the establishment of reference coordinates of the present invention.
  • Figure 12 is a schematic diagram of the establishment of target coordinates of the present invention.
  • marker ruler includes fixed marker ruler
  • fixed marker ruler includes fixed level ruler 302.
  • One end of the fixed level ruler 302 is fixedly connected with a fixed Z-axis ruler 301, and the fixed Z-axis ruler 301 and the fixed level ruler 302 are perpendicular to each other.
  • Both the fixed Z-axis ruler 301 and the fixed level ruler 302 are engraved with scale lines,
  • the connection between the fixed Z-axis ruler 301 and the fixed level 302 is the zero-scale end of the fixed Z-axis ruler 301 and the fixed level 302.
  • the fixed level 302 is sleeved with a main slider 303, and the fixed level 302 and the main slide There is an interference fit between the blocks 303.
  • the main slider 303 can move slowly on the fixed level 302 under the action of external force.
  • the quarter bow guiding device includes the first quarter bow guiding device and the first quarter bow guiding device.
  • the bow guiding device includes a first main fixing frame 101 and a first auxiliary fixing frame 102.
  • the first main fixing frame 101 has a main square slot that matches the first auxiliary fixing frame 102, and the first auxiliary fixing frame 102 is inserted.
  • the upper end of the first main fixing frame 101 is drilled with a main through hole slot, the main through hole slot is inserted into the main knob 106, and the upper end of the first auxiliary fixing frame 102 is fixedly connected with the main knob 106
  • the first main fixing frame 101 and the first auxiliary fixing frame 102 are fixedly connected with the main sawtooth block through the main knob 106.
  • the lower ends of the first main fixing frame 101 and the first auxiliary fixing frame 102 are both The main head nail 103 is fixedly connected, the main connecting block 104 is fixedly connected to the side wall of the first main fixing frame 101, and the main quarter bow 105 is fixedly connected to the end of the main connecting block 104 away from the first main fixing frame 101, The main quarter arch 105 is slidably connected to the main positioning device 108, and the main zero-degree midpoint 107 is engraved on the main connecting block 104, which can realize the establishment of a spatial three-dimensional coordinate system through CT or MR images of the patient’s lesion. The position in the spatial three-dimensional coordinate system realizes the location of the lesion.
  • the reference line is drawn on the patient's body surface through the marker ruler, and then the alignment is realized through the guiding device to determine the location of the lesion, which is convenient for operations such as puncture and biopsy.
  • Complicated equipment can be operated with the help of simple tools, which greatly reduces the complexity of positioning operations and reduces positioning costs without affecting positioning accuracy.
  • the main nail 103 and the main connecting block 104 are connected by direct insertion and can be screwed in and out, and can only be inserted in one direction from the outside to the inside.
  • the elastic serrated device fixedly connected to the inner wall of the main connecting block 104 is used to restrict the Moving inward and outward, the serrations are arc-shaped threads, and the cross-section of the serrations is a right-angle trapezoid, which corresponds to the thread with a right-angle trapezoidal cross-section on the main head nail 103, which limits the one-way locking of the main head nail 103 and can also act as a nut thread. It corresponds to the thread on the main head nail 103 and can be rotated with each other.
  • the connection mode between the short head nail 203 and the second main fixing frame 201 and the long head nail 204 and the second auxiliary fixing frame 202 is the same as the main
  • the connection mode between the head nail 103 and the main connection block 104 is the same.
  • the marker ruler can be a folding marker ruler
  • the folding marker ruler includes a folding level ruler 402
  • one end of the folding level ruler 402 is connected with a folding level ruler 402
  • the folding Z axis ruler 401 and the folding level ruler 402 are perpendicular to each other.
  • Both the folding Z-axis ruler 401 and the folding level ruler 402 can have scale marks.
  • the junction of the folding Z-axis ruler 401 and the folding level ruler 402 is the zero-scale end of the folding Z-axis ruler 401 and the folding level ruler 402.
  • the folding Z-axis ruler An L-shaped groove 403 is excavated at one end of the 401 near the folding level 402.
  • the end of the folding level 402 near the folding Z-axis ruler 401 is fixedly connected to a pair of triangular plates 404.
  • the two triangular plates 404 are respectively located on both sides of the folding Z-axis ruler 401.
  • a connecting shaft 405 is fixedly connected between the two triangular plates 404, and the connecting shaft 405 penetrates the L-shaped groove 403.
  • the folding Z-axis ruler 401 and the folding level 402 are movably connected by the L-shaped groove 403 and the connecting shaft 405, which is convenient for the daily staff. Carrying, so that the marking ruler is not easy to be damaged due to accidental bumps due to excessive volume.
  • the quarter bow guiding device can also use the second quarter bow guiding device.
  • the second quarter bow guiding device includes a second main fixing frame 201 and a second auxiliary fixing frame 202 ,
  • the second main fixing frame 201 is excavated with an auxiliary square hole 205 matching the second auxiliary fixing frame 202, and the second auxiliary fixing frame 202 is inserted into the auxiliary square hole 205, and the second main fixing frame 201
  • a secondary through-hole slot 206 is excavated at the upper end
  • a secondary knob 207 is inserted into the upper end of the second main fixing frame 201, and the secondary knob 207 penetrates the secondary through-hole slot 206, and the upper end of the second secondary fixing frame 202 is fixedly connected with the secondary knob 207
  • the matching auxiliary serrated block 208, the lower ends of the second main fixing frame 201 and the second auxiliary fixing frame 202 are respectively fixedly connected with a short head nail 203 and a long head nail 204, and a sliding connection block 209 is slidingly connected
  • the main quarter bow 105 and the secondary quarter bow 210 can be designed with an inner diameter of 180mm-300mm and an outer diameter of 220mm-400mm as required to suit patients of different body types, the main quarter The width of the bow 105 and the sub-quarter bow 210 is 20mm-50mm.
  • the material of the main quarter bow 105 and the sub-quarter bow 210 can be metal, plastic or polymer materials, and the main quarter bow The tips of the first quarter bow 105 and the second quarter bow 210 need to be polished smoothly, so that the main quarter bow 105 and the second quarter bow 210 are not easy to puncture the patient.
  • the main quarter bow 105 and the auxiliary positioning device 211 have the same structure, the main positioning device 108 and the auxiliary positioning device 211 both include a positioning block 5, one end of the positioning block 5 is excavated with a rotating chute 6 , The positioning block 5 is slidably connected to the main quarter bow 105 or the secondary quarter bow 210 through the rotating chute 6.
  • the positioning block 5 has a slot 7 at one end away from the rotating chute 6, which is convenient for the staff
  • the positioning block 5 slides on the one-quarter bow 105 or the sub-quarter bow 210.
  • an extension rod 10 is inserted into the socket 7.
  • the extension rod 10 includes an L-shaped rod body 1001.
  • the L-shaped rod body 1001 includes a main part and an extension part.
  • the extension part of the L-shaped rod body 1001 is fixedly connected with a plug Block 1002, a positioning hole 1003 is excavated in the plug-in block 1002, and the axis of the positioning hole 1003 is parallel to the main part of the L-shaped rod body 1001.
  • the main part is 10-15cm in length and has a trapezoidal cross-section, which can be inserted into the positioning block 5.
  • the extension part is 3-5cm
  • the direction of the axis of the positioning hole 1003 is the center of the semicircular bow frame
  • the middle of the main body of the extension rod is a hollow slot
  • a pair of matching drainage half pipes 8 are inserted in the positioning hole 1003
  • a section of the drainage half pipe 8 is fixedly connected to the limiting block 9, and the two drainage half pipes 8 form a complete drainage pipe
  • the main part of the L-shaped rod body 1001 is inserted into the slot 7 of the positioning block 5, and the depth is adjusted as needed.
  • a pair of drainage half tubes 8 are inserted into the positioning hole 1003.
  • the channel center of the drainage tube is aligned with the center of the semicircular arch and is extended
  • the rod 10 can slide on the semicircular arch with the positioning block 5, and its direction is always the center of the semicircular arch, and the puncture depth is the scale position marked on the main body of the positioning block 5.
  • the length of the drainage half tube 8 can be based on the size of the patient's skull Depending on the size of the selected main quarter bow 105 or the second main fixing frame 201, it can be adapted to patients of different body types.
  • the drainage half tube 8 has a variety of models. Different models of the drainage half tube 8 have a semi-column slot excavated inside.
  • the diameter of the belt is different and can be matched with the diameter of the puncture tube of different sizes.
  • the three-dimensional brain positioning operation tool its use method is:
  • S1 Take CT or MR data images, and transmit the data images obtained by shooting to a computer or other processing terminal, and transmit the data to the corresponding processing software;
  • the coordinate system is determined, a reference coordinate is established with the position and zoom ratio of the scale on the CT and MR image slices as the reference object, and then the measurement coordinates are determined based on the reference coordinate, and the target position is defined in the measurement coordinates, using electronic devices such as mobile phones Photographing and calculation functions of the camera, taking pictures of the image, and automatically processing the picture information to calculate the coordinates of the target point of the lesion, and mark it as (X, Y, Z);
  • Step (2) Determine the relative coordinates. Draw the connecting line and the median sagittal line of the midpoints of the external auditory meatus on both sides manually or through the software automatic recognition function. After the position is determined, a cross line is formed, and the intersection of the cross line is used as the measurement coordinate The origin is measured by the software. Step (1) Select the relative position coordinates between the scale (reference coordinates) of the reference object in the reference coordinates. In particular, if the picture is rotated, you can rotate the crosshairs for correction, and The rotation angle is recorded by the software, please refer to Figure 12 at this time;
  • step (3) Determine the two-dimensional coordinates of the lesion, select the scan plane where the lesion to be located is located (the same time to take a picture or retake a photo), and also display the virtual scale on the software again, using the manual or automatic recognition function and the scale on the current image data Perform position coincidence, and then use step (2) to determine the two-dimensional coordinates of the intersection of the crosshairs recorded in the relative coordinates in the reference coordinates and the rotation angle of the crosshairs, through software calculations, automatically generate one with the coordinates of the intersection as the center Two-dimensional coordinates.
  • the two-dimensional coordinates generated at this time are measured coordinates.
  • the position of this measured coordinate on the target level is consistent with the position of the above cross line on the reference level. Please refer to Figure 12 at this time;
  • the two-dimensional measurement coordinate generated by the two-dimensional coordinate determination of the lesion can measure the position of any point in the target plane, and click on any position to display its two-dimensional coordinate value;
  • the marking ruler can be a fixed marker ruler, L-shaped, and the fixed Z-axis ruler 301 and the fixed level ruler 302 are perpendicular to each other.
  • the fixed level ruler 302 is slidably connected with a main slider 303, and the main slide
  • Each side of the block 303 has an earplug part for inserting into the ear, and the center point of the earplug part is at the intersection of two mutually perpendicular scale lines.
  • the main slider 303 is pushed to the corner, the center position of the earplug is at At the intersection of the vertical scale lines on the fixed Z-axis ruler 301 and the fixed horizontal ruler 302, the Y side of the special fixed horizontal ruler 302 is the Z side.
  • the marker ruler can also be a foldable marker ruler, as shown in Figure 8, where the folding Z axis ruler 401 is the Z side, and the folding horizontal ruler 402 is the Y side.
  • the notch can ensure that the two sides are vertical. Status, and the start of the scale on the two sides coincide.
  • the two marker rulers use similar methods. Draw the line connecting the external ear canal and the midpoint of the eyeball according to the CT or MR film as a baseline. Slide the earplug to the corresponding scale according to the Y value of the coordinate value given by the App software. Then insert the earplug into one side of the external ear canal, adjust the edge of the earplug to be parallel to the baseline, and then obtain the distance between the target level and the reference level based on the image data as the Z value, which corresponds to the corresponding scale on the other side Mark the position of the scalp with a marker pen. The marking method on both sides of the skull is the same. At this time, two points are marked on the scalp. These two points are the projection of the target point on the scalp. Use a ruler to draw the midline and side of the skull. Parallel to X.
  • the quarter bow guiding device can be the first quarter bow guiding device.
  • the two main head nails 103 are respectively aligned with the two marking points on both sides of the head, and the arms are closed.
  • the main knob 106 is used to fix the position of the main quarter bow 105.
  • the rated position of the main positioning device 108 always points to the center of the ring bow, that is, the target point position, and the depth is the radius of the ring bow.
  • the staff can choose the second quarter bow guide device as the target positioning device.
  • the short-head nail 203 and the long-head nail 204 are respectively aligned with the two marking points on both sides of the head, and the two arms are folded together.
  • the two main fixing frame 201 and the second auxiliary fixing frame 202 are fixed on the head, and the auxiliary quarter bow 210 is moved left and right along the direction of the spike 204, so that the auxiliary zero-degree midpoint 212 is aligned with the opening line beside the center line, and the auxiliary positioning
  • the device 211 performs puncture positioning, and the positioning direction always points to the center of the circular bow, that is, the target position, and the depth is the radius of the circular bow.
  • a pair of appropriate drainage half tubes 8 can be inserted into the slot 7, and a puncture tube of appropriate size can be inserted into the semi-column slot of the drainage half tube 8, and the slot 7 can be adjusted in quarters.
  • the position on a bow makes the puncture tube have the best puncture angle, which is convenient for the staff to take the sample biopsy.

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Abstract

三维颅脑定位操作工具，包括标记尺和四分之一弓引导装置，其中标记尺用于在病患身体上描画基准线，而四分之一弓引导装置则利用基准线实现病灶定位，该三维颅脑定位操作工具可以实现通过对应的软件，将患者病灶处的CT或MR的影像建立空间立体坐标系，利用病灶在空间立体坐标系内的位置实现病灶定位，使用时首先通过标记尺在患者体表画出基准对照线，最后通过引导装置实现对位，确定病灶位置，方便后续的穿刺、活检等操作，整个操作过程无需依靠复杂设备，可以借助简单的工具进行操作，在不影响定位精度的前提下大幅降低定位操作的复杂程度，减小定位成本。

Description

三维颅脑定位操作工具及其使用方法 技术领域
本发明涉及医疗人体体表标记定位领域，更具体地说，涉及三维颅脑定位操作工具及其使用方法。
 背景技术
现有定位方法主要包括徒手穿刺、简单装置辅助导引、传统有框架立体定向仪、神经导航或手术机器人等方法，其中徒手穿刺方法是依靠简单工具手工划线，靠经验进行定位，优点是方便快速，缺点是精确性差、失误率高、受人为因素影响较大，而传统有框架立体定向仪和神经导航系统最大优点是定位精度高，但是操作过程非常复杂、不易被掌握，而且设备昂贵，初上述两种方法之外，目前还有脑科手术专用的手术机器人，如法国Medtech SA公司开发的ROSA和国产的睿米机器人。优点是精确、智能，但价格太高更加难以普及。
现如今的靶点测量和标记不是太粗糙就是过程太复杂，定位操作不是依靠经验就是依靠复杂的设备，在方便性、精确性和性价比上无法兼顾。
发明内容
1．要解决的技术问题
针对现有技术中存在的问题，本发明的目的在于提供三维颅脑定位操作工具及其使用方法，它可以实现采用了新的三维坐标系，是影像坐标和解剖坐标统一起来，利用CT和MR影像片的特点设计了全新的可实现软件自动测量靶点的方法，避免了安装基环、复查CT或MR、黏贴Marker、拷贝DICOM影像数据等繁琐过程，使影像测量更简单快捷，利用专门设计的标记尺可以迅速把靶点的体表投影位置标记出来，三维导向装置结构简单，安装方便，功能多用，手术区域不受影响，可完成大部分颅脑定位功能，在不影响精度的前提下大幅减低定位操作的复杂程度，从多个环节上简化了手术前准备和手术中的操作时间，操作更加科学，定位更加准确，节省时间，减少手术成本，提高手术疗效。
2．技术方案
为解决上述问题，本发明采用如下的技术方案。
三维颅脑定位操作工具及其使用方法，包括标记尺和四分之一弓引导装置，所述标记尺包括固定标记尺，所述固定标记尺包括固定水平尺，所述固定水平尺的一端固定连接有固定Z轴尺，且固定Z轴尺与固定水平尺之间相互垂直，所述固定Z轴尺与固定水平尺上均刻有刻度纹，所述固定Z轴尺与固定水平尺的连接处为固定Z轴尺和固定水平尺的零刻度端，所述固定水平尺上套接有主滑块，且固定水平尺与主滑块之间过盈配合，所述主滑块可以在外力作用下在固定水平尺上缓慢移动，所述四分之一弓引导装置包括第一四分之一弓引导装置，所述第一四分之一弓引导装置包括第一主固定架和第一副固定架，所述第一主固定架内开凿有与第一副固定架相匹配的主方形空槽，且第一副固定架插接在主方形空槽内，所述第一主固定架的上端开凿有主通孔槽，所述主通孔槽内插接有主旋钮，所述第一副固定架的上端固定连接有与主旋钮相匹配的主锯齿块，且第一主固定架与第一副固定架之间通过主旋钮和主锯齿块固定连接，所述第一主固定架与第一副固定架的下端均固定连接有主头钉，所述第一主固定架的侧壁上固定连接有主连接块，所述主连接块远离第一主固定架的一端固定连接有主四分之一弓，所述主四分之一弓上滑动连接有主定位装置，所述主连接块上刻有主零度中点。
可以实现采用了新的三维坐标系，是影像坐标和解剖坐标统一起来，利用CT和MR影像片的特点设计了全新的可实现软件自动测量靶点的方法，避免了安装基环、复查CT或MR、黏贴Marker、拷贝DICOM影像数据等繁琐过程，使影像测量更简单快捷，利用专门设计的标记尺可以迅速把靶点的体表投影位置标记出来，三维导向装置结构简单，安装方便，功能多用，手术区域不受影响，可完成大部分颅脑定位功能，在不影响精度的前提下大幅减低定位操作的复杂程度，从多个环节上简化了手术前准备和手术中的操作时间，操作更加科学，定位更加准确，节省时间，减少手术成本，提高手术疗效。
进一步的，所述标记尺可选用折叠标记尺，所述折叠标记尺包括折叠水平尺，所述折叠水平尺一端连接有折叠水平尺，且折叠Z轴尺与折叠水平尺之间相互垂直，所述折叠Z轴尺与折叠水平尺上均可以有刻度纹，所述折叠Z轴尺与折叠水平尺的连接处为折叠Z轴尺和折叠水平尺的零刻度端，所述折叠Z轴尺靠近折叠水平尺的一端开凿有L型槽，所述折叠水平尺靠近折叠Z轴尺的一端固定连接一对三角板，两个所述三角板分别位于折叠Z轴尺的两侧，两个所述三角板之间固定连接有连接轴，且连接轴贯穿L型槽，所述折叠Z轴尺与折叠水平尺之间通过L型槽和连接轴活动连接，方便工作人员日常携带，使标记尺不易因体积过大而发生意外磕碰而导致标记尺损坏。
进一步的，所述四分之一弓引导装置还可选用第二四分之一弓引导装置，所述第二四分之一弓引导装置包括第二主固定架和第二副固定架，所述第二主固定架上开凿有与第二副固定架相匹配的副方形孔槽，且第二副固定架插接在副方形孔槽内，所述第二主固定架的上端开凿有副通孔槽，所述第二主固定架的上端插接有副旋钮，且副旋钮贯穿副通孔槽，所述第二副固定架的上端固定连接有与副旋钮相匹配的副锯齿块，所述第二主固定架与第二副固定架的下端分别固定连接有短头钉和长头钉，所述长头钉上滑动连接有滑动连接块，且滑动连接块位于长头钉远离短头钉的一端，所述滑动连接块上固定连接有副四分之一弓，所述副四分之一弓上滑动连接有副定位装置，所述副四分之一弓上刻有副零度中点，可以辅助进行目标靶点定位工作。
进一步的，所述主四分之一弓和副四分之一弓可以根据需要设计为内径180mm-300mm，外径220mm-400mm，所述主四分之一弓和副四分之一弓的宽度为20mm-50mm，以适应不同体型的患者。
进一步的，所述主四分之一弓和副四分之一弓的材质可以可以为金属、塑料或高分子材料等，且主四分之一弓和副四分之一弓的尖端需打磨平滑，使主四分之一弓和副四分之一弓不易戳伤患者
进一步的，所述主定位装置和副定位装置具有相同的结构，所述主定位装置和副定位装置均包括定位块，所述定位块的一端开凿有转动滑槽，所述定位块通过转动滑槽与主四分之一弓或副四分之一弓滑动连接，所述定位块远离转动滑槽的一端开凿有插槽，方便工作人员在主四分之一弓或副四分之一弓上滑动定位块。
进一步的，所述插槽内插接有延长杆，所述延长杆包括L型杆体，所述L型杆体包括主体部分和延伸部分，所述L型杆体的延伸部分固定连接有插接块，所述插接块内开凿有定位孔，且定位孔的轴心与L型杆体的主体部分平行，其中主体部分长度10-15cm，截面为梯形，可插入定位块上插槽，主体部分上面带有刻度，可对应穿刺深度，延伸部分3-5cm。
进一步的，所述定位孔内插接有一对相互匹配的引流半管，所述引流半管的一段固定连接有限位块，两个所述引流半管组成完整的引流管，用于导向，L型杆体的主体部分插入定位块内插槽，根据需要调节深度，定位孔内插入一对引流半管，引流管的通道中心对准半圆弓的圆心，延长杆可随定位块在半圆弓上滑动，其方向恒为半圆弓的圆心。
进一步的，所述引流半管具有多种型号，不同型号的所述引流半管内部开凿的半柱槽的直径带下不同，可以与不同尺寸的穿刺管的直径相匹配。
进一步的，其使用方法为：
S1，拍摄CT或MR资料影像，并将拍摄获得的资料影像传输到电脑或其他处理终端中，并将资料传输到对应的处理软件中；
S2、坐标系确定，以CT和MR影像片上比例尺的位置和缩放比例为参照物建立一个参考坐标，以此参考坐标再确定测量坐标，在测量坐标内定义靶点的位置，利用手机等电子设备的拍照和运算功能，将影像图片进行拍照，通过对图片信息进行自动化处理，计算出病灶靶点坐标，标记为（X,Y,Z）；
其具体步骤为：
（一）选取参考坐标，选取显示外耳道和眼球晶状体的扫描层面（参考层面），软件上虚拟一个比例尺，用手工或自动识别方式与影像资料上的比例尺进行长度和位置重合，以此取得图片缩放比例，同时将影像资料上的比例尺位置作为参照物；
（二）确定相对坐标，手工或通过软件自动识别功能画出双侧外耳道中点的联线及正中矢状线，位置确定后形成一个十字交叉线，将此十字交叉线的交点作为测量坐标的原点，由软件测量出此点相对步骤（一）选取参考坐标中作为参照物的比例尺（参考坐标）之间的相对位置坐标，特别的，如果图片有旋转，可旋转十字交叉线进行校正，并由软件记录旋转角度；
（三）病灶二维坐标确定，选取拟定位的病灶所在扫描平面（可用同一次拍照图片或重新拍照），同样再次显示软件上的虚拟比例尺，用手工或自动识别功能与当前影像资料上的比例尺进行位置重合，然后使用步骤（二）确定相对坐标中记录的十字交叉线的交点在参考坐标里的二维坐标以及十字交叉线的旋转角度，通过软件运算，以交点坐标值为中心自动生成一个二维坐标，此时生成的二维坐标为测量坐标，此测量坐标在靶点层面上的位置和以上十字交叉线在参考层面上的位置是一致的；
（四）病灶二维坐标值确定、利用步骤（三）病灶二维坐标确定生成的二维测量坐标，可测量目标层面内任意点的位置，点击任意位置可显示出其二维坐标值；
S3、人体体表标记，先在体表上画出扫描基线（通常为听眦线----外耳道和眼球中点联线），之后再利用标记尺标记出两个头皮投影点、头颅正中线和旁开平行线；
S4、目标靶点定位，利用四分之一弓引导装置，确定穿刺点。
3．有益效果
相比于现有技术，本发明的优点在于：
本方案可以实现通过患者病灶处的CT或MR的影像建立空间立体坐标系，之后病灶在空间立体坐标系内的位置实现病灶定位，首先通过标记尺在患者体表画出基准对照线，再通过引导装置实现对位，确定病灶位置，方便进行穿刺、活检等操作，整个操作过程无需依靠复杂设备，可以借助简单的工具进行操作，在不影响定位精度的前提下大幅降低定位操作的复杂程度，减小定位成本。
附图说明
图1为本发明的第一四分之一弓引导装置的正视图；
图2为本发明的第一四分之一弓引导装置的侧面剖视图；
图3为本发明的第二四分之一弓引导装置的正视图；
图4为本发明的第二四分之一弓的第一支架和第二支架连接处的正面剖视图；
图5为本发明的四分之一弓引导装置的定位滑块的结构示意图；
图6为本发明的四份之一弓引导装置的导向通道的结构示意图；
图7为本发明的延长杆的正视图；
图8为本发明的延长杆插接在现有的四分之一弓引导装置上时的结构示意图
图9为本发明的不可折叠标记尺的正视图；
图10为本发明的可折叠标记尺的正视图；
图11为本发明基准坐标建立的示意图；
图12为本发明目标坐标建立的示意图；
图中标号说明：
101第一主固定架、102第一副固定架、103主头钉、104主连接块、105主四分之一弓、106、主旋钮、107主零度中点、108主定位装置、201第二主固定架、202第二副固定架、203短头钉、204长头钉、205副方形孔槽、206副通孔槽、207副旋钮、208副锯齿块、209滑动连接块、210副四分之一弓、211副定位装置、212副零度中点、301固定Z轴尺、302固定水平尺、303主滑块、401折叠Z轴尺、402折叠水平尺、403 L型槽、404三角板、405连接轴、5定位块、6转动滑槽、7插槽、8引流半管、9限位块、10延长杆、1001 L型杆体、1002插接块、1003定位孔。
具体实施方式
下面将结合本发明实施例中的附图；对本发明实施例中的技术方案进行清楚、完整地描述；显然；所描述的实施例仅仅是本发明一部分实施例；而不是全部的实施例，基于本发明中的实施例；本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例；都属于本发明保护的范围。
在本发明的描述中，需要说明的是，术语“上”、“下”、“内”、“外”、“顶/底端”等指示的方位或位置关系为基于附图所示的方位或位置关系，仅是为了便于描述本发明和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本发明的限制。此外，术语“第一”、“第二”仅用于描述目的，而不能理解为指示或暗示相对重要性。
在本发明的描述中，需要说明的是，除非另有明确的规定和限定，术语“安装”、“设置有”、“套设/接”、“连接”等，应做广义理解，例如“连接”，可以是固定连接，也可以是可拆卸连接，或一体地连接；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通。对于本领域的普通技术人员而言，可以具体情况理解上述术语在本发明中的具体含义。
实施例1：
请参阅图1-2和图9，三维颅脑定位操作工具及其使用方法，包括标记尺和四分之一弓引导装置和标记尺，标记尺包括固定标记尺，固定标记尺包括固定水平尺302，固定水平尺302的一端固定连接有固定Z轴尺301，且固定Z轴尺301与固定水平尺302之间相互垂直，固定Z轴尺301与固定水平尺302上均刻有刻度纹，固定Z轴尺301与固定水平尺302的连接处为固定Z轴尺301和固定水平尺302的零刻度端，固定水平尺302上套接有主滑块303，且固定水平尺302与主滑块303之间过盈配合，主滑块303可以在外力作用下在固定水平尺302上缓慢移动，四分之一弓引导装置包括第一四分之一弓引导装置，第一四分之一弓引导装置包括第一主固定架101和第一副固定架102，第一主固定架101内开凿有与第一副固定架102相匹配的主方形空槽，且第一副固定架102插接在主方形空槽内，第一主固定架101的上端开凿有主通孔槽，主通孔槽内插接有主旋钮106，第一副固定架102的上端固定连接有与主旋钮106相匹配的主锯齿块，且第一主固定架101与第一副固定架102之间通过主旋钮106和主锯齿块固定连接，第一主固定架101与第一副固定架102的下端均固定连接有主头钉103，第一主固定架101的侧壁上固定连接有主连接块104，主连接块104远离第一主固定架101的一端固定连接有主四分之一弓105，主四分之一弓105上滑动连接有主定位装置108，主连接块104上刻有主零度中点107，可以实现通过患者病灶处的CT或MR的影像建立空间立体坐标系，之后病灶在空间立体坐标系内的位置实现病灶定位，首先通过标记尺在患者体表画出基准对照线，再通过引导装置实现对位，确定病灶位置，方便进行穿刺、活检等操作，整个操作过程无需依靠复杂设备，可以借助简单的工具进行操作，在不影响定位精度的前提下大幅降低定位操作的复杂程度，减小定位成本。
其中主头钉103和主连接块104的连接方式为直接插入并且可旋进旋出，且只能由外向内单向插入，插入时利用主连接块104内壁固定连接的弹性锯齿样装置限制由内向外移动，锯齿为弧形螺纹样，锯齿横切面呈直角梯形，与主头钉103上截面为直角梯形的螺纹相对应，限制主头钉103单向锁定，同时还可以起到螺母螺纹的作用，和主头钉103上的螺纹对应，相互之间可进行旋转，而短头钉203与第二主固定架201和长头钉204与第二副固定架202之间的连接方式和主头钉103与主连接块104之间的连接方式一致。
请参阅图10，标记尺可选用折叠标记尺，折叠标记尺包括折叠水平尺402，折叠水平尺402一端连接有折叠水平尺402，且折叠Z轴尺401与折叠水平尺402之间相互垂直，折叠Z轴尺401与折叠水平尺402上均可以有刻度纹，折叠Z轴尺401与折叠水平尺402的连接处为折叠Z轴尺401和折叠水平尺402的零刻度端，折叠Z轴尺401靠近折叠水平尺402的一端开凿有L型槽403，折叠水平尺402靠近折叠Z轴尺401的一端固定连接一对三角板404，两个三角板404分别位于折叠Z轴尺401的两侧，两个三角板404之间固定连接有连接轴405，且连接轴405贯穿L型槽403，折叠Z轴尺401与折叠水平尺402之间通过L型槽403和连接轴405活动连接，方便工作人员日常携带，使标记尺不易因体积过大而发生意外磕碰而导致标记尺损坏。
请参阅图3-4，四分之一弓引导装置还可选用第二四分之一弓引导装置，第二四分之一弓引导装置包括第二主固定架201和第二副固定架202，第二主固定架201上开凿有与第二副固定架202相匹配的副方形孔槽205，且第二副固定架202插接在副方形孔槽205内，第二主固定架201的上端开凿有副通孔槽206，第二主固定架201的上端插接有副旋钮207，且副旋钮207贯穿副通孔槽206，第二副固定架202的上端固定连接有与副旋钮207相匹配的副锯齿块208，第二主固定架201与第二副固定架202的下端分别固定连接有短头钉203和长头钉204，长头钉204上滑动连接有滑动连接块209，且滑动连接块209位于长头钉204远离短头钉203的一端，滑动连接块209上固定连接有副四分之一弓210，副四分之一弓210上滑动连接有副定位装置211，副四分之一弓210上刻有副零度中点212，可以辅助进行目标靶点定位工作。
请参阅图1-4，主四分之一弓105和副四分之一弓210可以根据需要设计为内径180mm-300mm，外径220mm-400mm，以适应不同体型的患者，主四分之一弓105和副四分之一弓210的宽度为20mm-50mm，主四分之一弓105和副四分之一弓210的材质可以可以为金属、塑料或高分子材料等，且主四分之一弓105和副四分之一弓210的尖端需打磨平滑，使主四分之一弓105和副四分之一弓210不易戳伤患者。
请参阅图5-6，主四分之一弓105和副定位装置211具有相同的结构，主定位装置108和副定位装置211均包括定位块5，定位块5的一端开凿有转动滑槽6，定位块5通过转动滑槽6与主四分之一弓105或副四分之一弓210滑动连接，定位块5远离转动滑槽6的一端开凿有插槽7，方便工作人员在主四分之一弓105或副四分之一弓210上滑动定位块5。
请参阅图5-8，插槽7内插接有延长杆10，延长杆10包括L型杆体1001，L型杆体1001包括主体部分和延伸部分，L型杆体1001的延伸部分固定连接有插接块1002，插接块1002内开凿有定位孔1003，且定位孔1003的轴心与L型杆体1001的主体部分平行，其中主体部分长度10-15cm，截面为梯形，可插入定位块5上插槽7，主体部分上面带有刻度，可对应穿刺深度，延伸部分3-5cm，定位孔1003的轴心所对的方向为半圆形弓架的圆心，延长杆延长杆主体部分中间为空槽，用于旋进螺栓固定位置，定位孔1003内插接有一对相互匹配的引流半管8，引流半管8的一段固定连接有限位块9，两个引流半管8组成完整的引流管，用于导向，L型杆体1001的主体部分插入定位块5内插槽7，根据需要调节深度，定位孔1003内插入一对引流半管8，引流管的通道中心对准半圆弓的圆心，延长杆10可随定位块5在半圆弓上滑动，其方向恒为半圆弓的圆心，而穿刺深度则为定位块5在主体部分上标记的刻度位置，引流半管8的长度可以根据患者头骨大小和选用的主四分之一弓105或第二主固定架201尺寸决定，可以适应不同体型的患者，引流半管8具有多种型号，不同型号的引流半管8内部开凿的半柱槽的直径带下不同，可以与不同尺寸的穿刺管的直径相匹配。
三维颅脑定位操作工具，其使用方法为：
S1，拍摄CT或MR资料影像，并将拍摄获得的资料影像传输到电脑或其他处理终端中，并将资料传输到对应的处理软件中；
S2、坐标系确定，以CT和MR影像片上比例尺的位置和缩放比例为参照物建立一个参考坐标，以此参考坐标再确定测量坐标，在测量坐标内定义靶点的位置，利用手机等电子设备的拍照和运算功能，将影像图片进行拍照，通过对图片信息进行自动化处理，计算出病灶靶点坐标，标记为（X,Y,Z）；
其具体步骤为：
（一）选取参考坐标，选取显示外耳道和眼球晶状体的扫描层面（参考层面），软件上虚拟一个比例尺，用手工或自动识别方式与影像资料上的比例尺进行长度和位置重合，以此取得图片缩放比例，同时将影像资料上的比例尺位置作为参照物，此时请参阅图11；
（二）确定相对坐标，手工或通过软件自动识别功能画出双侧外耳道中点的联线及正中矢状线，位置确定后形成一个十字交叉线，将此十字交叉线的交点作为测量坐标的原点，由软件测量出此点相对步骤（一）选取参考坐标中作为参照物的比例尺（参考坐标）之间的相对位置坐标，特别的，如果图片有旋转，可旋转十字交叉线进行校正，并由软件记录旋转角度，此时请参阅图12；
（三）病灶二维坐标确定，选取拟定位的病灶所在扫描平面（可用同一次拍照图片或重新拍照），同样再次显示软件上的虚拟比例尺，用手工或自动识别功能与当前影像资料上的比例尺进行位置重合，然后使用步骤（二）确定相对坐标中记录的十字交叉线的交点在参考坐标里的二维坐标以及十字交叉线的旋转角度，通过软件运算，以交点坐标值为中心自动生成一个二维坐标，此时生成的二维坐标为测量坐标，此测量坐标在靶点层面上的位置和以上十字交叉线在参考层面上的位置是一致的，此时请参阅图12；
（四）病灶二维坐标值确定、利用步骤（三）病灶二维坐标确定生成的二维测量坐标，可测量目标层面内任意点的位置，点击任意位置可显示出其二维坐标值；
S3、人体体表标记，先在体表上画出扫描基线（通常为听眦线----外耳道和眼球中点联线），之后再利用标记尺标记出两个头皮投影点、头颅正中线和旁开平行线；
如图7所示，标记用尺可是固定标记尺，为L型，且固定Z轴尺301与固定水平尺302之间相互垂直，其中固定水平尺302上滑动连接有主滑块303，主滑块303的两边各带有一个耳塞部分，用于塞入耳朵，且耳塞部分的中心点在两条相互垂直刻度线的交点上，主滑块303在推向拐角部位时，耳塞的中心位置在固定Z轴尺301和固定水平尺302上相互垂直刻度线的交点上，特别的固定水平尺302Y边，固定Z轴尺301为Z边。
同时，标记用尺同样可以选用可折叠标记尺，如图8所示，其中折叠Z轴尺401为Z边，折叠水平尺402为Y边，折叠标记尺打开时，靠缺口可以保证两边呈垂直状态，而且两条边上的刻度起始端位置重合。
而两种标记尺的使用方法大致类似，根据CT或MR片分别画出两边外耳道和眼球中点的联线，作为基线，根据App软件给出的坐标值的Y数值，将耳塞滑动到相应刻度上，然后将耳塞塞入一侧外耳道，将耳塞所在的边调整为与基线平行，再根据影像资料得出靶点层面距离参考层面的距离作为Z值，在另外一条边上的相应刻度处所对应的位置用标记笔做一点状标记，头颅两边标记方法相同，此时头皮上标记出两个点，此两点即为靶点在头皮上的投影，利用尺子再画出头颅正中线和旁开为X的平行线。
S4、目标靶点定位，利用四分之一弓引导装置，确定穿刺点。
如图1-2所示，四分之一弓引导装置可以是第一四分之一弓引导装置，将两根主头钉103分别对准头部两边的两个标记点，合拢两臂，将第一主固定架101和第一副固定架102固定于头部，以主连接块104为轴心左右转动主四分之一弓105，使主零度中点107对准中线旁开线，利用主旋钮106固定主四分之一弓105的位置，此时主定位装置108额定位方向始终指向环形弓的中心，即靶点位置，深度为环形弓的半径。
同样的，工作人员可以选用第二四分之一弓引导装置作为目标靶点定位装置，短头钉203和长头钉204分别对准头部两边的两个标记点，合拢两臂，将第二主固定架201和第二副固定架202固定于头部，沿长头钉204的方向左右移动副四分之一弓210，使副零度中点212对准中线旁开线，通过副定位装置211进行穿刺定位，定位方向始终指向环形弓的中心，即靶点位置，深度为环形弓的半径。
在定位工作完成后，可以向插槽7内插入一对合适的引流半管8，并向引流半管8的半柱槽内插入合适尺寸的穿刺管，并适当调节插槽7在四分之一弓上的位置，使穿刺管具有最佳入刺角度，方便工作人员进取样活检。
以上所述；仅为本发明较佳的具体实施方式；但本发明的保护范围并不局限于此；任何熟悉本技术领域的技术人员在本发明揭露的技术范围内；根据本发明的技术方案及其改进构思加以等同替换或改变；都应涵盖在本发明的保护范围内。

Claims (10)

  1. 三维颅脑定位操作工具，包括标记尺和四分之一弓引导装置和标记尺，其特征在于：所述标记尺包括固定标记尺，所述固定标记尺包括固定水平尺（302），所述固定水平尺（302）的一端固定连接有固定Z轴尺（301），且固定Z轴尺（301）与固定水平尺（302）之间相互垂直，所述固定Z轴尺（301）与固定水平尺（302）上均刻有刻度纹，所述固定Z轴尺（301）与固定水平尺（302）的连接处为固定Z轴尺（301）和固定水平尺（302）的零刻度端，所述固定水平尺（302）上套接有主滑块（303），且固定水平尺（302）与主滑块（303）之间过盈配合，所述主滑块（303）可以在外力作用下在固定水平尺（302）上缓慢移动，所述四分之一弓引导装置包括第一四分之一弓引导装置，所述第一四分之一弓引导装置包括第一主固定架（101）和第一副固定架（102），所述第一主固定架（101）内开凿有与第一副固定架（102）相匹配的主方形空槽，且第一副固定架（102）插接在主方形空槽内，所述第一主固定架（101）的上端开凿有主通孔槽，所述主通孔槽内插接有主旋钮（106），所述第一副固定架（102）的上端固定连接有与主旋钮（106）相匹配的主锯齿块，且第一主固定架（101）与第一副固定架（102）之间通过主旋钮（106）和主锯齿块固定连接，所述第一主固定架（101）与第一副固定架（102）的下端均固定连接有主头钉（103），所述第一主固定架（101）的侧壁上固定连接有主连接块（104），所述主连接块（104）远离第一主固定架（101）的一端固定连接有主四分之一弓（105），所述主四分之一弓（105）上滑动连接有主定位装置（108），所述主连接块（104）上刻有主零度中点（107）。
  2. 根据权利要求1所述的三维颅脑定位操作工具，其特征在于：所述标记尺可选用折叠标记尺，所述折叠标记尺包括折叠水平尺（402），所述折叠水平尺（402）一端连接有折叠水平尺（402），且折叠Z轴尺（401）与折叠水平尺（402）之间相互垂直，所述折叠Z轴尺（401）与折叠水平尺（402）上均可以有刻度纹，所述折叠Z轴尺（401）与折叠水平尺（402）的连接处为折叠Z轴尺（401）和折叠水平尺（402）的零刻度端，所述折叠Z轴尺（401）靠近折叠水平尺（402）的一端开凿有L型槽（403），所述折叠水平尺（402）靠近折叠Z轴尺（401）的一端固定连接一对三角板（404），两个所述三角板（404）分别位于折叠Z轴尺（401）的两侧，两个所述三角板（404）之间固定连接有连接轴（405），且连接轴（405）贯穿L型槽（403），所述折叠Z轴尺（401）与折叠水平尺（402）之间通过L型槽（403）和连接轴（405）活动连接。
  3. 根据权利要求1所述的三维颅脑定位操作工具，其特征在于：所述四分之一弓引导装置还可选用第二四分之一弓引导装置，所述第二四分之一弓引导装置包括第二主固定架（201）和第二副固定架（202），所述第二主固定架（201）上开凿有与第二副固定架（202）相匹配的副方形孔槽（205），且第二副固定架（202）插接在副方形孔槽（205）内，所述第二主固定架（201）的上端开凿有副通孔槽（206），所述第二主固定架（201）的上端插接有副旋钮（207），且副旋钮（207）贯穿副通孔槽（206），所述第二副固定架（202）的上端固定连接有与副旋钮（207）相匹配的副锯齿块（208），所述第二主固定架（201）与第二副固定架（202）的下端分别固定连接有短头钉（203）和长头钉（204），所述长头钉（204）上滑动连接有滑动连接块（209），且滑动连接块（209）位于长头钉（204）远离短头钉（203）的一端，所述滑动连接块（209）上固定连接有副四分之一弓（210），所述副四分之一弓（210）上滑动连接有副定位装置（211），所述副四分之一弓（210）上刻有副零度中点（212）。
  4. 根据权利要求1或3所述的三维颅脑定位操作工具，其特征在于：所述主四分之一弓（105）和副四分之一弓（210）可以根据需要设计为内径180mm-300mm，外径220mm-400mm，所述主四分之一弓（105）和副四分之一弓（210）的宽度为20mm-50mm。
  5. 根据权利要求1或3所述的三维颅脑定位操作工具，其特征在于：所述主四分之一弓（105）和副四分之一弓（210）的材质可以可以为金属、塑料或高分子材料等，且主四分之一弓（105）和副四分之一弓（210）的尖端需打磨平滑。
  6. 根据权利要求1或3所述的三维颅脑定位操作工具，其特征在于：所述主定位装置（108）和副定位装置（211）具有相同的结构，所述主定位装置（108）和副定位装置（211）均包括定位块（5），所述定位块（5）的一端开凿有转动滑槽（6），所述定位块（5）通过转动滑槽（6）与主四分之一弓（105）或副四分之一弓（210）滑动连接，所述定位块（5）远离转动滑槽（6）的一端开凿有插槽（7）。
  7. 根据权利要求6所述的三维颅脑定位操作工具，其特征在于：所述插槽（7）内插接有延长杆（10），所述延长杆（10）包括L型杆体（1001），所述L型杆体（1001）包括主体部分和延伸部分，所述L型杆体（1001）的延伸部分固定连接有插接块（1002），所述插接块（1002）内开凿有定位孔（1003），且定位孔（1003）的轴心与L型杆体（1001）的主体部分平行。
  8. 根据权利要求7所述的三维颅脑定位操作工具，其特征在于：所述定位孔（1003）内插接有一对相互匹配的引流半管（8），所述引流半管（8）的一段固定连接有限位块（9）。
  9. 根据权利要求8所述的三维颅脑定位操作工具，其特征在于：所述半柱槽内插接有穿刺管，所述引流半管（8）具有多种型号，不同型号的所述引流半管（8）内部开凿的半柱槽的直径带下不同。
  10. 根据权利要求1所述的三维颅脑定位操作工具，其特征在于：其使用方法为：
    S1，拍摄CT或MR资料影像，并将拍摄获得的资料影像传输到电脑或其他处理终端中，并将资料传输到对应的处理软件中；
    S2、以CT和MR影像片上比例尺的位置和缩放比例为参照物建立一个参考坐标，以此参考坐标再确定测量坐标，在测量坐标内定义靶点的位置，利用手机等电子设备的拍照和运算功能，将影像图片进行拍照，通过对图片信息进行自动化处理，计算出病灶靶点坐标，标记为（X,Y,Z）；
    S3、人体体表标记，先在体表上画出扫描基线（通常为听眦线----外耳道和眼球中点联线），之后再利用标记尺标记出两个头皮投影点、头颅正中线和旁开平行线；
    S4、目标靶点定位，利用四分之一弓引导装置，确定穿刺点。
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