WO2022170927A1 - 一种手术显微镜诊疗系统 - Google Patents

一种手术显微镜诊疗系统 Download PDF

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Publication number
WO2022170927A1
WO2022170927A1 PCT/CN2022/072540 CN2022072540W WO2022170927A1 WO 2022170927 A1 WO2022170927 A1 WO 2022170927A1 CN 2022072540 W CN2022072540 W CN 2022072540W WO 2022170927 A1 WO2022170927 A1 WO 2022170927A1
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Prior art keywords
module
image
data
microscope
microscopic observation
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PCT/CN2022/072540
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English (en)
French (fr)
Inventor
王吉龙
纳多鲍比
李剑月
黄彬
杜雷
何进
Original Assignee
苏州速迈医学科技股份有限公司
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Application filed by 苏州速迈医学科技股份有限公司 filed Critical 苏州速迈医学科技股份有限公司
Priority to JP2023547528A priority Critical patent/JP2024507729A/ja
Priority to EP22752089.7A priority patent/EP4282379A1/en
Priority to US18/276,460 priority patent/US20240108416A1/en
Publication of WO2022170927A1 publication Critical patent/WO2022170927A1/zh

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    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B21/00—Microscopes
    • G02B21/06—Means for illuminating specimens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/06—Implements for therapeutic treatment
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • 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
    • A61B90/20—Surgical microscopes characterised by non-optical aspects
    • 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
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B21/00—Microscopes
    • G02B21/06—Means for illuminating specimens
    • G02B21/08—Condensers
    • G02B21/082—Condensers for incident illumination only
    • 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
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • 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
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • A61B2034/2057—Details of tracking cameras
    • 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
    • A61B2034/2046—Tracking techniques
    • A61B2034/2065—Tracking using image or pattern recognition
    • 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
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A61B2090/365—Correlation of different images or relation of image positions in respect to the body augmented reality, i.e. correlating a live optical image with another image

Definitions

  • the invention relates to the technical field of dental diagnosis and treatment, in particular to an operating microscope diagnosis and treatment system.
  • the operating microscope can be used for pulp and root canal inspection and treatment. It can clearly observe the position of the root canal orifice, the shape of the inner wall of the root canal, and the removal of pulp in the root canal, perform root canal preparation, filling, and take out the root canal Internal fracture instruments and periapical surgery. With sufficient illumination and clear magnification observation, the popularity of oral surgical microscopes has changed the traditional extensive operation based on experience and touch, root canal treatment, removal of metal blockages in root canals, root canal steps, root apex deviation, The success rate of treatment of medullary canal perforation has been greatly improved.
  • the cavity in the middle of the tooth contains soft tissue called the pulp.
  • the upper part of the cavity is wide, called the pulp cavity, and the lower part has a tubular root canal, which leads to the blood vessels of the tooth nerve and the nutrient nerve. Infection of the dental pulp can cause pain, infection of the jawbone, and eventually weaken the tooth due to the death of the dental nerve.
  • root canal treatment the doctor needs to completely open the pulp cavity, find and treat all the root canals.
  • Humans generally have 1-4 root canals per tooth, with the most root canals in the posterior teeth. Multiple root canal teeth are often difficult to find due to ageing changes or the deposition of reparative dentin, or pulp stone, or pulp cavity calcification, or root canal morphological variation, etc.
  • Stereoscopic anatomy understand and see the anatomy of the pulp cavity from all directions and positions; and use the X-ray films taken by various angle projection methods to understand and indicate the number, shape, position and direction of the root and root canal and curvature; root-to-crown relationship; possible variations in root and root canal anatomy.
  • the root canal needs to be estimated.
  • the essential collar is used to expose the position of the root canal orifice, that is, if there is calcification of the root canal orifice, it is even more necessary for the doctor to repeatedly test the possible positions, which will inevitably remove too much healthy tooth tissue.
  • preoperative dental films are often used to help doctors judge and determine the number and shape of root canals.
  • doctors need to devote part of their energy to memorizing the shape of root crowns, and even suspend the operation to look at the dental films.
  • the dental film is only a two-dimensional plane image, it cannot accurately reflect the three-dimensional shape of the root canal.
  • many root canals have multiple bends in the direction, which cannot be accurately positioned by the dental film.
  • the present application proposes an operating microscope diagnosis and treatment system, and the specific scheme is as follows:
  • An operating microscope diagnosis and treatment system comprising a microscopic observation module, a storage module and an enhanced information image injection module, the microscopic observation module is used to observe a target object to be observed; the storage module stores the radiation imaging of the target object A three-dimensional digital image of the structure; the enhanced information image injection module is used to project the digital image of the radiation imaging three-dimensional structure in the form of an optical image into the observation field of the microscopic observation module, and is used in the observation field of the microscopic observation module.
  • the microscopic optical images are superimposed to form a superimposed optical image.
  • the digital image switch of the radiation imaging three-dimensional structure is controllable, and the operator can choose to view the layered two-dimensional image or the 3D image of the target object as required.
  • the 3D imaging module is used to collect in real time the optical image under the microscope in the field of view observed by the microscopic observation module, and convert the optical image under the microscope into a three-dimensional digital image.
  • the image recognition processing module is used to identify the biological features in the three-dimensional digital image, and through the biometric comparison, the radiation imaging three-dimensional structure digital image that matches the three-dimensional digital image is sent to the enhanced information image
  • the injection module is then projected to set an area in the observation field of the microscopic observation module.
  • the microscopic observation module is provided with a large zoom objective lens and a magnification system, and the detection module is used to detect the focus position of the large zoom objective lens and the zoom system respectively.
  • the image recognition processing module determines the depth position of the radiation imaging three-dimensional structure digital image according to the focus position of the zoom large objective lens detected by the detection module, and the image recognition processing module determines the depth position of the digital image of the radiation imaging three-dimensional structure according to the detection module.
  • the detected magnification of the zoom system determines the depth range in which the radiographic three-dimensional structure digital image displays the current layer region.
  • the digital image of the radiation imaging three-dimensional structure is projected on the edge position of the observation field of the microscopic observation module, or the digital image of the radiation imaging three-dimensional structure is overlapped with the optical image under the microscope in the observation field of the microscopic observation module. It is shown that the transparency of the digital image of the radiographic three-dimensional structure can be adjusted.
  • the positioning and navigation detection module is used to detect the depth and spatial position data of the surgical instrument in real time
  • the image recognition processing module Compare the depth and spatial position data collected by the positioning navigation detection module with the biological features in the three-dimensional digital image to obtain real-time relative position data between the surgical instrument and the target object, and compare the obtained real-time relative position
  • the data is sent to the enhanced information image injection module, and then projected on the set position of the observation field of the microscopic observation module.
  • the depth and spatial position data of the surgical instrument and the status data of the surgical instrument are stored in the storage module in real time, and the status data of the surgical instrument can be sent to the enhanced information image injection module, Afterwards, it is projected on the set position of the observation field of the microscopic observation module.
  • the storage module also stores patient information data, root tester data, oral scanner data, electronic periodontal probe data and pulp vitality data.
  • the required data is projected on the set position of the observation field of the microscopic observation module through the enhanced information image injection module.
  • each data is projected on the set position of the observation field of view of the microscopic observation module in the form of a text symbol, a data table, a two-dimensional curve or a three-dimensional topographic map, and each data is divided into the observation field of view of the microscopic observation module.
  • the display transparency of each data and the size and position of the display window of each data can be adjusted.
  • the switch of the AI-assisted analysis module is controllable, the operator can choose to turn on or off the AI-assisted function according to needs, and the AI-assisted analysis module is used for the 3D imaging module.
  • the three-dimensional digital image is analyzed to identify the lesion condition of the target object, and mark or remind the target object according to the lesion condition.
  • the enhanced information image injection module is projected on the set position of the observation field of the microscopic observation module.
  • the camera module is used to collect the facial expression image data of the patient
  • the AI assisted analysis module analyzes the facial expression image data collected by the camera module, judges the comfort of the patient, and passes all the facial expressions.
  • the enhanced information image injection module projects real-time projection on the set position of the observation field of the microscopic observation module.
  • the microscopic observation module includes a surgical microscope
  • the enhanced information image injection module includes a projection device
  • the projection device can project additional information beams, and the additional information beams are connected to one or two channels in the surgical microscope.
  • the incident light beams are superimposed and then injected into the binocular lens barrel of the operating microscope to form a superimposed optical image.
  • the projection device includes a projection display component and an imaging lens group, the projection display component can project an additional optical image, and the additional optical image is converted into a parallel light beam through the imaging lens group to form the additional information beam .
  • the surgical microscope diagnosis and treatment system of the present application has one or more of the following beneficial effects:
  • the digital image switch of the three-dimensional structure of radiation imaging is controllable, and the operator can call up and view the 3D structure of the target object at any time according to needs, and can choose to view the specific layered images to determine the microscope.
  • the internal structure of the organization
  • the surgical microscope diagnosis and treatment system of the present application is provided with an image recognition processing module, which can automatically compare and register the three-dimensional digital image of the radiation imaging three-dimensional structure with the three-dimensional digital image of the optical image under the microscope through biological feature judgment;
  • the digital image of the three-dimensional structure of radiation imaging can be displayed superimposed on the optical image under the microscope, and a positioning and navigation detection device is installed in the surgical instrument to guide the surgical operation accurately and in place, which is convenient for the operator to confirm the operation in time. ,Improve efficiency;
  • the surgical microscope diagnosis and treatment system of the present application which can display patient information, root tester data, oral scanner data, electronic periodontal probe data, pulp vitality data, etc. at the set position of the observation field of view of the microscopic observation module data, which is convenient to provide reference for operators;
  • the surgical microscope diagnosis and treatment system of the present application is provided with an AI auxiliary module to realize AI-assisted diagnosis and display.
  • FIG. 1 is a schematic structural diagram of an operating microscope provided in Embodiment 1 of the application;
  • FIG. 2 is a schematic diagram of the superposition of optical paths of the operating microscope provided in Embodiment 1 of the present application;
  • FIG. 3 is a schematic diagram of the superposition of optical paths of the operating microscope provided in Embodiment 2 of the present application;
  • FIG. 4 is a schematic diagram of superposition of optical paths of the operating microscope provided in Embodiment 3 of the present application.
  • FIG. 5 is a schematic diagram of the superposition of optical paths of the operating microscope provided in Embodiment 4 of the present application.
  • FIG. 6 is a schematic diagram of the superposition of optical paths of the operating microscope provided in Embodiment 5 of the present application;
  • FIG. 7 is a schematic diagram of superposition of optical paths of the operating microscope provided in Embodiment 6 of the present application.
  • FIG. 8 is a schematic diagram of the superposition of optical paths of the operating microscope provided in Embodiment 7 of the present application.
  • FIG. 9 is a schematic diagram of superposition of optical paths of the operating microscope provided in Embodiment 8 of the present application.
  • Fig. 10 is the effect diagram after the optical path of the operating microscope provided by the ninth embodiment of the application is superimposed;
  • FIG. 11 is a flowchart of the operating microscope diagnosis and treatment system provided in Embodiment 9 of the application.
  • FIG. 15 is a flowchart of the operating microscope diagnosis and treatment system provided in the thirteenth embodiment of the present application.
  • the present application provides an operating microscope, which includes a microscope body 1 , a variable magnification lens group 2 and a superimposed lens group 3 built in the microscope lens body 1 , and a large objective lens group 4 connected to the microscope lens body 1 . , binocular tube 5 and projection device 6, as shown in Figure 1.
  • the operating microscope is a double-light design, and the variable magnification lens group 2 includes a first variable magnification lens group and a second variable magnification lens group.
  • the first incident light beam 91 passes through the large objective lens group 4 and the first variable magnification lens group and enters the binocular tube 5 in sequence, and the second incident light beam 92 passes through the large objective lens group 4 and the second incident light beam in sequence.
  • the variable magnification lens group is injected into the binocular tube 5, and the projection device 6 projects an additional information beam 94.
  • the additional information beam 94 passes through the stacking mirror group 3 and the first incident beam 91 and/or Or the second incident light beams are superimposed and then injected into the binocular lens barrel 5 .
  • the projection device 6 includes a projection display component 61 and an imaging mirror group 62, the projection display component 61 can project an additional optical image 93, and the additional optical image 93 is converted into a parallel light beam through the imaging mirror group 62 to form the The additional information beam 94 is described.
  • the projection display part 61 is preferably a micro projector.
  • the projection device in this embodiment is installed on the rear side of the microscope body 1 , as shown in FIG. It is installed between the operating microscope body 1 and the binocular tube 5 as an accessory.
  • the stacking mirror group 3 includes a first longitudinal beam splitter prism 301 .
  • the projection display part 61 is incident on the additional optical image 93 from the rear side of the microscope body 1 .
  • a turning mirror group 63 can be added to the imaging mirror group 62 as required,
  • the additional optical image 93 projected by the projection display component 61 can be directly incident into the first longitudinal beam splitting prism 301 after being converted by the imaging lens group 62 to form an additional information beam 94 .
  • the turning mirror group 63 used in the figure is two right-angle prisms.
  • the two direct prisms can also be replaced by rhombic prisms, plane mirrors, etc.
  • the additional information light beam 94 is superimposed with the first incident light beam 91 through the first longitudinal beam splitter prism 301 to form a first superimposed light beam 95 , and then the first superimposed light beam 95 is imaged through the binocular tube 5 , Through the eyepiece, the operator can observe a realistic optical image under the microscope superimposed with additional information.
  • a first transverse beam splitter prism 302 is added to the optical path of the second incident beam 92 in the stacking mirror group 3 .
  • the imaging device 7 is such as a camera, a video camera, a mobile phone, an assistant mirror, and the like.
  • a second transverse beam splitter prism 303 is added between the imaging mirror group 62 and the first longitudinal beam splitter prism 301 in the superimposing mirror group 3 , and the light beam 92 passes through the second path is added.
  • a second longitudinal beam splitter prism 305 is added on the way, and a first reflector 304 is added to the second transverse beam splitter prism 303 and the second longitudinal beam splitter prism 305 .
  • the additional information beam 94 is laterally split through the second transverse beam splitting prism 303, and a part of the additional information beam 94 continues to enter the first longitudinal beam splitting prism 301 and the first beam along the original optical path.
  • the incident light beam 91 is superimposed to form a first superimposed light beam 95 , and another part of the additional information light beam 94 is refracted by 90° and then reflected by the first reflecting mirror 304 , and then enters the second longitudinal beam splitter prism 305 and the second incident beam 92
  • the second superimposed light beam 96 is formed by superposition, and then the first superimposed light beam 95 and the second superimposed light beam 96 are imaged through the binocular tube 5 and observed through the eyepiece.
  • the light beams incident on the binocular lens barrel 5 are all superimposed light beams.
  • lateral beam channels are respectively added to the positions of the microscope lens body 1 corresponding to the first longitudinal beam splitting prism 301 and the second longitudinal beam splitting prism 305 .
  • the first superimposed light beam 95 is laterally split through the first longitudinal beam splitting prism 301 , a part of the first superimposed light beam 95 enters the binocular tube 5 , and the other part of the first superimposed light beam 95 passes through
  • the corresponding side beam channel is emitted
  • the second superimposed beam 96 is laterally split through the second longitudinal beam splitting prism 305, a part of the second superimposed beam 96 is injected into the binocular tube 5, and the other part of the second superimposed beam
  • the beams 96 are emitted through the corresponding lateral beam channels, and the first superimposed beams 95 and the second superimposed beams 96 emitted from the lateral beam channels can be captured by the imaging device 7 to provide the imaging device 7 with images.
  • the imaging device 7 is such as a camera,
  • the projection device is installed on the left or right side of the microscope body 1 .
  • the projection display unit 61 emits an additional optical image 93 from the left or right direction of the microscope body 1 .
  • the stacking mirror group 3 includes a third longitudinal beam splitter prism 306 , and the third longitudinal beam splitter prism 306 can be driven in the microscope body 1 along the left and right directions of the microscope body 1 Pan.
  • the additional information light beam 94 is superimposed with the first incident light beam 91 or the second incident light beam 92 through the third longitudinal beam splitter prism 306 to form a third superimposed light beam 97, and then the third superimposed light beam 97 passes through the Binocular tube 5 imaging.
  • the third longitudinal beam splitting prism 306 can be designed to be translated, so that the additional optical image 93 can be superimposed on any path of the operating microscope.
  • a lateral beam channel is added to the position of the microscope body 1 corresponding to the third longitudinal beam splitter prism 306 .
  • the third superimposed light beam 97 is laterally split through the third longitudinal beam splitting prism 306 , a part of the third superimposed light beam 97 enters the binocular tube 5 , and the other part of the third superimposed light beam 97 passes through
  • the corresponding side beam channel is emitted, and the third superimposed beam 97 emitted from the side beam channel can be collected by the imaging device 7 to provide the imaging device 7 with an image.
  • the imaging device 7 is such as a camera, a video camera, a mobile phone, an assistant mirror, and the like.
  • the image obtained by the imaging device 7 at this time is a superimposed image.
  • the projection device is installed on the lower side or inside of the microscope body 1 .
  • the stacking mirror group 3 includes a second reflecting mirror 307 , a third reflecting mirror 308 , a fourth longitudinal beam splitting prism 309 and a third lateral beam splitting prism 310 .
  • the additional information beam 94 is reflected by the second reflecting mirror 307 and enters the fourth longitudinal beam splitter prism 309 from the rear side of the microscope body 1 , and the additional information beam 94 passes through
  • the fourth longitudinal beam splitting prism 309 is superimposed with the first incident beam 91 to form a fourth superimposed beam 98 , and then the fourth superimposed beam 98 is imaged through the binocular tube 5 , and the second incident beam 98 is formed.
  • the beam After passing through the second variable magnification lens group, the beam is split laterally by the third transverse beam splitting prism 310, and a part of the second incident beam 92 continues to enter the binocular tube 5 along the original optical path, and the other part of the second beam
  • the second incident light beam 92 is reflected downward by the third reflector 308 and emitted downward, and part of the second incident light beam 92 emitted downward can be collected by the imaging device 7 to provide the imaging device 7 with an image.
  • a fourth transverse beam splitter prism 311 is added between the second reflection mirror 307 and the fourth longitudinal beam splitter prism 309 in the superimposing mirror group 3, and the third transverse beam splitter
  • a fifth transverse beam splitter prism 312 is added between the prism 310 , the third reflector 308 and the fourth transverse beam splitter prism 311 .
  • the additional information beam 94 reflected by the second reflecting mirror 307 is laterally split by the fourth transverse beam splitting prism 311, and a part of the additional information beam 94 enters the fourth beam along the original optical path.
  • the longitudinal beam splitting prism 309, another part of the additional information beam 94 is turned by 90° and then enters the fifth lateral beam splitting prism 312, and the part of the second incident beam 92 that is laterally split by the third lateral beam splitter prism 310 passes through the second beam splitting prism 310.
  • the five transverse beam splitting prisms 312 are superimposed with part of the additional information beams 94 incident on the fifth transverse beam splitting prism 312 to form a fifth superimposed beam 99 .
  • the fifth superimposed light beam 99 emerging downward can be captured by the imaging device 7 to provide the imaging device 7 with an image.
  • the image obtained by the imaging device 7 at this time is a superimposed image.
  • the imaging lens group 62 may also be provided with an optical zoom system, and the image size of the additional information beam 94 after imaging can be adjusted by adjusting the optical zoom system.
  • a filtering device 8 may also be arranged between the superimposing lens group 3 and the binocular lens barrel 5 .
  • the filtering device 8 mainly adjusts the brightness of the additional information image to match the brightness of the optical image of the operating microscope, which is convenient for observation.
  • optical filters can also be set to filter out or attenuate parts of the spectrum that are harmful to the human eye, such as reducing blue light damage.
  • Polarizing filters, or spatial filtering devices, such as different clear apertures, can also be placed as desired.
  • Various filter devices 8 can be switched by rotating the turntable or pushing and pulling.
  • the above embodiment is an example description for the structure of the operating microscope in the operating microscope diagnostic system. Next, the specific content of the operating microscope diagnostic system is described:
  • the surgical microscope diagnosis and treatment system includes a microscopic observation module, a storage module and an enhanced information image injection module.
  • the microscopic observation module is used to observe the target object to be observed, and the microscopic observation module is any of the operating microscopes in the above embodiments.
  • the digital image of the radiation imaging three-dimensional structure of the target object is imported into the storage module by means of external input or retrieval.
  • the digital image of the three-dimensional structure of radiation imaging is preferably a CBCT digital image, and the following embodiments all take the CBCT digital image as an example to illustrate the technical solution.
  • the enhanced information image injection module is used to project the digital image of the radiation imaging three-dimensional structure in the form of an optical image to the edge position in the observation field of the microscopic observation module, and the microscope observation module observes the mirror in the field of view.
  • the lower optical image is superimposed to form a superimposed optical image, as shown in Figure 10, which provides a real-time reference for the operator.
  • the system flow is shown in Figure 11.
  • the enhanced information image injection module that is, the projection device 6 described in the above embodiment, requires additional digital information to be integrated and transmitted to the projection display unit 61 through wired HDMI, SDI, network port, wireless wifi, Bluetooth, etc., Convert to optical image and output.
  • the CBCT digital image switch is controllable, and the operator can choose to view the layered two-dimensional image or 3D image of the target object as required, and the operator can choose to view the specific layered two-dimensional image to determine the internal structure of the tissue under the microscope.
  • an operator is required to manually compare and register the CBCT digital image with the optical image under the microscope.
  • the surgical microscope diagnosis and treatment system of this embodiment adds a 3D imaging module and an image recognition processing module.
  • the 3D imaging module is used to collect in real time the optical image under the microscope in the field of view observed by the microscopic observation module, and convert the optical image under the microscope into a three-dimensional digital image.
  • the image recognition processing module is used to identify the biometrics in the three-dimensional digital image, and through the biometric comparison, the CBCT digital image is automatically compared and registered with the three-dimensional digital image, and then will be compared with the three-dimensional digital image.
  • the matched CBCT digital image is sent to the enhanced information image injection module, and finally projected in the observation field of the microscopic observation module.
  • the system flow is shown in FIG. 12 .
  • the operating microscope diagnosis and treatment system of this embodiment further includes a detection module.
  • the detection module is used to respectively detect the focus position of the zoom large objective lens (ie the large objective lens group 4 ) and the magnification of the variable magnification system (ie the variable magnification lens group 2 ) of the operating microscope.
  • the detection module preferably adopts a position sensor, that is, a position sensor is added to the position of the large zoom objective lens and the variable magnification system of the operating microscope respectively, and the image recognition processing module is determined according to the focus position of the large zoom objective lens detected by the position sensor.
  • the image recognition processing module determines the depth range of the current layer region displayed by the CBCT digital image according to the magnification of the zoom system detected by the detection module.
  • the focal depth position of the operating microscope is automatically registered with the CBCT layer depth, that is, a certain plane structure is observed under the microscope, and the CBCT digital image automatically displays the CT digital image of the current layer (or current layer area).
  • the operating microscope diagnosis and treatment system of this embodiment is based on the tenth embodiment, and the CBCT digital image is displayed in a superimposed manner with the optical image under the microscope in the observation field of the microscopic observation module.
  • the CBCT digital image transparency is adjustable.
  • the surgical microscope diagnosis and treatment system of this embodiment further includes a positioning, navigation and detection module, and the positioning, navigation and detection module is installed on a surgical instrument, such as a dental handpiece.
  • the positioning, navigation and detection module is used to detect the depth and spatial position data of the surgical instrument in real time
  • the image recognition processing module combines the depth and spatial position data collected by the positioning and navigation detection module with the biological features in the three-dimensional digital image.
  • the biological characteristics such as the position, shape and root canal depth, direction and other tissue characteristics of the root canal, obtain the real-time relative position data between the surgical instrument and the target object, and transmit the obtained real-time relative position data.
  • the enhanced information image is injected into the module, and then projected on the set position of the observation field of view of the microscopic observation module.
  • the state data of the surgical instrument can also be introduced, such as the rotational speed of the mobile phone, the torque value, etc., and can also be projected on the set position of the observation field of the microscopic observation module through the enhanced information image injection module.
  • the position sensor set at the position of the zoom objective lens and the zoom system detects a change
  • the real-time data of the surgical instrument is automatically projected at the set position of the observation field of the microscopic observation module, so that the doctor can confirm the operation in time.
  • the depth and spatial position data of the surgical instrument and the state data of the surgical instrument can be stored in the storage module in real time.
  • the operating microscope diagnosis and treatment system of this embodiment is based on any one of the ninth to eleventh embodiments, and introduces more relevant data, such as patient information data, root tester data, oral scanner data, electronic periodontal probe
  • Multiple data information such as needle data and pulp vitality data can be stored in the storage module through external input or retrieval.
  • Each data is provided with a display switch, which can be individually switched and controllable.
  • the operator can project the required data through the enhanced information image injection module at the set position of the observation field of the microscopic observation module as required.
  • the system flow is as follows: Figure 14.
  • Each data can be projected on the set position of the observation field of the microscopic observation module in various ways such as text symbols, data tables, two-dimensional curves or three-dimensional topographic maps, and each data is divided into the observation field of the microscopic observation module.
  • the display transparency of each data and the size and position of the display window of each data can be adjusted.
  • Patient information data including the patient's basic information, contraindication reminders, etc., as well as monitoring information, blood pressure, blood oxygen saturation, etc.
  • Root measuring instrument data accurate measurement of the working length of the root canal is the basic condition for successful root canal treatment. According to the diagnosis, the end points of root canal preparation and filling for different conditions of the teeth are different, and the error range of ⁇ 0.5mm needs to be guaranteed. Therefore, the root canal measuring instrument is used for measurement, and the data can be selectively displayed for reference.
  • Oral scanner data high-resolution 3D morphology of oral structures.
  • Periodontal probing is an important method for basic oral diagnosis. Using periodontal probe to measure the depth of periodontal pocket and the level of attachment is the main method for evaluating the degree of periodontal damage in clinical practice, and it is also the clinical basis for judging the change of periodontal disease.
  • the Florida probe system can automatically measure the patient's periodontal pocket depth, attachment level, and attached gingival width under the operation of a medical staff, and record the full-mouth dentition, tooth mobility, gingival bleeding and suppuration, furcation lesions, Plaque distribution can reflect the degree of periodontal disease and prognostic indicators.
  • the system's own risk factor assessment function can effectively assess the patient's disease risk, which helps doctors to objectively formulate targeted treatment plans for patients.
  • Pulp vitality data The pulp is located in the pulp cavity surrounded by dentin, and is connected to the periapical tissue by a narrow apical foramen, which cannot be viewed directly, resulting in the inability to visually judge its specific state in clinical practice. .
  • Clinically, temperature and electrical stimulation of the nerve fibers of the pulp are used to judge its vitality state, and help doctors to choose, completely remove the necrotic pulp, or perform amputation to preserve the healthy part.
  • the operating microscope diagnosis and treatment system of this embodiment adds an AI-assisted analysis module on the basis of any one of Embodiments 9 to 12, so as to realize AI-assisted diagnosis and display.
  • the AI auxiliary analysis module switch is controllable, and the switch can be a main switch or a separate function switch, and the operator can choose to turn on or off the corresponding AI auxiliary function according to needs.
  • the AI-assisted analysis module is used to analyze the three-dimensional digital images collected by the 3D imaging module, identify the lesion condition of the target object, and mark or remind the target object according to the lesion condition. Each data is summarized and analyzed to generate additional AI auxiliary information.
  • the operator can project the additional AI auxiliary information through the enhanced information image injection module at the set position of the observation field of the microscopic observation module as needed.
  • the system flow is as follows: shown in Figure 15.
  • the oral cavity and dental lesions such as caries, cracks, plaque, discoloration, oral cancer, etc.
  • the marking method can be a separate method or a combination of different color text, frame, edge line, arrow, dyeing, etc.
  • it can be combined with the prompt sound.
  • the AI module can also automatically control the microscope to switch modes, and obtain images of the corresponding modes for further analysis.
  • the specific mode switching implementation can refer to patent CN211741708U, which will not be repeated here.
  • the surgical microscope diagnosis and treatment system of this embodiment can also add a camera module, such as a camera, etc., to obtain the patient's facial expression image data in real time, and analyze the facial expression image data collected by the camera module through the AI-assisted analysis module to judge the comfort level. , and is projected on the set position of the observation field of view of the microscopic observation module in real time through the enhanced information image injection module, so that the operator can know the patient's state at any time.
  • a camera module such as a camera, etc.

Abstract

一种手术显微镜诊疗系统，包括显微观察模块、存储模块和增强信息影像注入模块。显微观察模块用于观察待观察的目标对象。存储模块内存储有目标对象的辐射成像三维结构数字图像。增强信息影像注入模块用于将辐射成像三维结构数字图像以光学图像的形式投影至显微观察模块观察视野中，与显微观察模块观察视野内的镜下光学图像叠加形成叠加光学图像。手术显微镜诊疗系统能够在显微镜内的镜下光学图像上通过投影的方式叠加附加信息图像，在手术中操作者可以方便地对目标对象进行灵活观察，还可以快速地查看和手术相关的多种数据信息。

Description

一种手术显微镜诊疗系统 技术领域
本发明涉及牙科诊疗技术领域，尤其涉及一种手术显微镜诊疗系统。
背景技术
手术显微镜可用于牙髓、根管的检查和治疗，其可以清晰地观察到根管口的位置、根管内壁形态、根管内牙髓清除情况，进行根管的预备、充填，取出根管内折断器械以及根尖周手术等操作。凭借充足的照明和清晰的放大观察，口腔手术显微镜的普及改变了传统凭经验、靠手感的粗放式操作，根管治疗、根管内金属堵塞物的取出、根管台阶、根尖偏移、髓腔穿孔的处理成功率得到了极大的提高。
另一方面由于必须迁就患者的体位，医生无法保持正常舒适的姿态，持续进行精细操作会让肩、颈和背部肌肉疲劳酸痛，长期累积则可能产生严重的关节问题，甚至影响医生的职业寿命。手术显微镜的出现使得以上问题得以解决，其可以使医生在检查和治疗过程中保持符合人体工程学的正确姿势，消除肩、颈、背部疲劳，有效地提升了诊疗效率和质量。
不过传统的手术显微镜仅能观察到组织外层的结构，无法观测内部组织结构，有些操作需要反复试探，时间长，易遗漏根管或过多地去除健康牙齿组织。牙齿为立体结构，多层次组织，手术显微镜仅能观察组织外层细节特征，无法判断内层组织结构。
牙齿中间空洞的部分包含称为牙髓的软组织。空洞上部宽阔，称为牙髓腔，下部有管状的根管，由之导出牙神经和营养神经的血管。牙髓发生感染，会造成疼痛、颌骨感染，最终牙齿因为牙神经的死亡而变得脆弱。
以根管治疗为例，医生需要彻底打开髓腔，找到全部根管并加以处理。人类一般每颗牙齿有1-4个根管，后部的牙齿根管最多。多根管牙常因增龄性变化或修复性牙本质的沉积，或髓石，或髓腔钙化，或根管形态变异等情况，而使根管口不易查找时，需要借助于牙齿的三维立体解剖形态，从各个方向和位置来理解和看牙髓腔的解剖形态；并采用多种角度投照法所拍摄的X线片来了解 和指出牙根和根管的数目、形状、位置、方向和弯曲情况；牙根对牙冠的关系；牙根及根管解剖形态的各种可能的变异情况等。由于部分牙齿的根管数量可达四个，还可能存在侧支根管、副根管、根尖分歧和根尖分叉等复杂情况，即便在放大观察下也可能会遗漏；需要估计根管的可能位置，必要时可用小球钻在其根管可能或预期所在的发育沟部位除去少量牙本质，然后使用锐利探针试图刺穿任何钙化区，以指出根管口除去牙颈部的牙本质领圈以暴露根管口的位置，即如果存在根管口钙化等情况，就更需要医生对各可能位置进行反复试探，难免会过多地去除健康牙齿组织。
目前经常采用术前牙片的方式来帮助医生判断和确定根管数量和形态，首先，医生需要分出部分精力来记忆根冠形态，甚至暂停手术看重新观察牙片。此外由于牙片仅为二维平面图像，无法准确体现根管的立体形态，实际上，很多根管的走向存在多次弯曲，无法依靠牙片准确定位。
CBCT等立体图像复杂难于记忆，医生需要将牙齿结构的立体形态记忆在脑中，并在术中与显微镜下的实物进行对比、叠加、融合，需要付出很大的精力，而且很难保证准确性和精度。
因此，结合上述存在的技术问题，有必要提出一种新的技术方案。
发明内容
为解决现有技术中存在的技术问题，本申请提出了一种手术显微镜诊疗系统，具体方案如下：
一种手术显微镜诊疗系统，其包括显微观察模块、存储模块和增强信息影像注入模块，所述显微观察模块用于观察待观察的目标对象；所述存储模块内存储有目标对象的辐射成像三维结构数字图像；所述增强信息影像注入模块用于将所述辐射成像三维结构数字图像以光学图像的形式投影至所述显微观察模块观察视野中，与所述显微观察模块观察视野内的镜下光学图像叠加形成叠加光学图像。
进一步的，所述辐射成像三维结构数字图像开关可控，操作者可以根据需要选择查看目标对象的分层二维图像或3D图像。
进一步的，其包括3D成像模块和图像识别处理模块，所述3D成像模块用于实时采集所述显微观察模块观察视野中的镜下光学图像，并将所述镜下光学 图像转换为三维数字图像；所述图像识别处理模块用于识别所述三维数字图像中的生物特征，并通过生物特征对比，将与所述三维数字图像相匹配的辐射成像三维结构数字图像输送至所述增强信息影像注入模块，之后投影在所述显微观察模块观察视野中设定区域。
进一步的，其还包括检测模块，所述显微观察模块内设有变焦距大物镜和变倍系统，所述检测模块用于分别检测所述变焦距大物镜的对焦位置和所述变倍系统的倍率，所述图像识别处理模块根据所述检测模块检测到的所述变焦距大物镜的对焦位置确定所述辐射成像三维结构数字图像的深度位置，所述图像识别处理模块根据所述检测模块检测到的所述变倍系统的倍率确定所述辐射成像三维结构数字图像显示当前层区域的深度范围。
进一步的，所述辐射成像三维结构数字图像投影在所述显微观察模块观察视野的边缘位置，或所述辐射成像三维结构数字图像与所述显微观察模块观察视野内的镜下光学图像重合显示，所述辐射成像三维结构数字图像的透明度可调节。
进一步的，其还包括定位导航检测模块，所述定位导航检测模块安装在手术器械上，所述定位导航检测模块用于实时检测所述手术器械的深度和空间位置数据，所述图像识别处理模块将所述定位导航检测模块采集到的深度和空间位置数据与三维数字图像中的生物特征进行比对，获得所述手术器械与目标对象之间的实时相对位置数据，并将获得的实时相对位置数据输送至所述增强信息影像注入模块，之后投影在所述显微观察模块观察视野的设定位置。
进一步的，所述手术器械的深度和空间位置数据，以及所述手术器械的状态数据实时存储在所述存储模块中，所述手术器械的状态数据能够被输送至所述增强信息影像注入模块，之后投影在所述显微观察模块观察视野的设定位置。
进一步的，所述存储模块内还存储有患者信息数据、根测仪数据、口腔扫描仪数据、电子牙周探针数据及牙髓活力数据，各数据分别开关可控，操作者可根据需要将所需数据通过所述增强信息影像注入模块投影在所述显微观察模块观察视野的设定位置。
进一步的，各数据以文字符号、数据表、二维曲线或三位地形图的方式投影在所述显微观察模块观察视野的设定位置，各数据在所述显微观察模块观察视野内分屏显示，或在同一窗口内切换显示，各数据的显示透明度以及各数据 的显示窗口大小和位置可调节。
进一步的，其还包括AI辅助分析模块，所述AI辅助分析模块开关可控，操作者可以根据需要选择打开或关闭AI辅助功能，所述AI辅助分析模块用于对所述3D成像模块采集的三维数字图像进行分析，辨别目标对象的病变情况，并根据病变情况对目标对象进行标记或提醒，同时对所述存储模块内存储的各数据进行汇总分析，生成附加AI辅助信息，之后通过所述增强信息影像注入模块投影在所述显微观察模块观察视野的设定位置。
进一步的，其还包括摄像模块，所述摄像模块用于采集患者的表情图像数据，所述AI辅助分析模块对所述摄像模块采集的表情图像数据进行分析，判断患者的舒适度，并通过所述增强信息影像注入模块投影实时投影在所述显微观察模块观察视野的设定位置。
进一步的，所述显微观察模块包括手术显微镜，所述增强信息影像注入模块包括投影装置，所述投影装置能够投射出附加信息光束，所述附加信息光束与所述手术显微镜内的一路或两路入射光束叠加后射入所述手术显微镜的双目镜筒内，形成叠加光学图像。
进一步的，所述投影装置包括投影显示部件和成像镜组，所述投影显示部件能够投射出附加光学图像，所述附加光学图像经过所述成像镜组转换成平行光束，形成所述附加信息光束。
与现有技术相比，本申请的手术显微镜诊疗系统具有如下一个或多个有益效果：
(1)本申请的手术显微镜诊疗系统，其通过增强信息影像注入模块，一些辅助附加信息图像与显微镜观察视野中的镜下光学图像叠加，方便使用者在手术过程中可以快速的查看和手术相关的多种数据信息；
(2)本申请的手术显微镜诊疗系统，其辐射成像三维结构数字图像开关可控，操作者可根据需要随时调出和查看目标对象的3D结构，并可选择查看具体分层图像以确定镜下组织的内部结构；
(3)本申请的手术显微镜诊疗系统，其设置有图像识别处理模块，能够通过生物特征判断，将辐射成像三维结构数字图像与镜下光学图像的三维数字图像自动对比和配准；
(4)本申请的手术显微镜诊疗系统，其辐射成像三维结构数字图像能够与 镜下光学图像重合显示，并在手术器械中设置定位导航检测装置，引导手术操作准确到位，便于操作者及时确认操作，提高效率；
(5)本申请的手术显微镜诊疗系统，其可以在显微观察模块观察视野的设定位置显示患者信息、根测仪数据、口腔扫描仪数据、电子牙周探针数据、牙髓活力数据等数据，便于给操作者提供参考；
(6)本申请的手术显微镜诊疗系统，其设置有AI辅助模块，实现AI辅助诊断和显示。
附图说明
图1为本申请实施例一提供的手术显微镜的结构示意图；
图2为本申请实施例一提供的手术显微镜的光路叠加示意图；
图3为本申请实施例二提供的手术显微镜的光路叠加示意图；
图4为本申请实施例三提供的手术显微镜的光路叠加示意图；
图5为本申请实施例四提供的手术显微镜的光路叠加示意图；
图6为本申请实施例五提供的手术显微镜的光路叠加示意图；
图7为本申请实施例六提供的手术显微镜的光路叠加示意图；
图8为本申请实施例七提供的手术显微镜的光路叠加示意图；
图9为本申请实施例八提供的手术显微镜的光路叠加示意图；
图10为本申请实施例九提供的手术显微镜的光路叠加后的效果图；
图11为本申请实施例九提供的手术显微镜诊疗系统的流程图；
图12为本申请实施例十提供的手术显微镜诊疗系统的流程图；
图13为本申请实施例十一提供的手术显微镜诊疗系统的流程图；
图14为本申请实施例十二提供的手术显微镜诊疗系统的流程图；
图15为本申请实施例十三提供的手术显微镜诊疗系统的流程图。
其中，1-显微镜镜身，2-变倍镜组，3-叠加镜组，301-第一纵向分光棱镜，302-第一横向分光棱镜，303-第二横向分光棱镜，304-第一反射镜，305-第二纵向分光棱镜，306-第三纵向分光棱镜，307-第二反射镜，308-第三反射镜，309-第四纵向分光棱镜，310-第三横向分光棱镜，311-第四横向分光棱镜，312-第五横向分光棱镜，4-大物镜组，5-双目镜筒，51-目镜，6-投影装置，61-投影显示部件，62-成像镜组，63-转折镜组，64-罩壳，7-影像设备，8-滤波装置， 91-第一路入射光束，92-第二路入射光束，93-附加光学图像，94-附加信息光束，95-第一叠加光束，96-第二叠加光束，97-第三叠加光束，98-第四叠加光束，99-第五叠加光束。
具体实施方式
为更进一步阐述本实用新型为达成预定实用新型目的所采取的技术手段及功效，以下结合附图及较佳实施例，对依据本实用新型的具体实施方式、结构、特征及其功效，详细说明如下。
本申请提供一种手术显微镜，其包括显微镜镜身1、内置在所述显微镜镜身1内的变倍镜组2和叠加镜组3、连接在所述显微镜镜身1上的大物镜组4、双目镜筒5和投影装置6，如图1所示。所述手术显微镜为双光设计，所述变倍镜组2包括第一变倍镜组和第二变倍镜组。第一路入射光束91依次穿过所述大物镜组4和第一变倍镜组射入所述双目镜筒5，第二路入射光束92依次穿过所述大物镜组4和第二变倍镜组射入所述双目镜筒5，所述投影装置6投射出附加信息光束94，所述附加信息光束94通过所述叠加镜组3与所述第一路入射光束91和/或第二入射光束叠加后射入所述双目镜筒5。所述投影装置6包括投影显示部件61和成像镜组62，所述投影显示部件61能够投射出附加光学图像93，所述附加光学图像93经过所述成像镜组62转换成平行光束，形成所述附加信息光束94。所述投影显示部件61优选采用微型投影仪。
实施例一
本实施例的所述投射装置安装在所述显微镜镜身1的后侧，如图1所示，所述投影显示部件61和成像镜组62均位于所述投影装置6的罩壳64内，作为附件加装在手术显微镜镜身1和双目镜筒5之间。
如图2所示，所述叠加镜组3包括第一纵向分光棱镜301。所述投影显示部件61从所述显微镜镜身1的后侧方向射入附加光学图像93。需要知道的是，如果所述投影显示部件61投射的光路与所述第一纵向分光棱镜301不在同一光路，在具体实施时，可根据需要在所述成像镜组62内增加转折镜组63，使所述投影显示部件61投射的附加光学图像93经所述成像镜组62转换形成附加信息光束94后能够直接射入所述第一纵向分光棱镜301内。图中所使用的转折镜 组63为两个直角棱镜，当然在具体实施时，两个直接棱镜也可以用斜方棱镜、平面反射镜等替换。所述附加信息光束94通过所述第一纵向分光棱镜301与所述第一路入射光束91叠加形成第一叠加光束95，之后所述第一叠加光束95通过所述双目镜筒5成像，操作者通过目镜可观察到叠加有附加信息的镜下现实光学图像。
实施例二
本实施例是在实施例一的基础上，叠加镜组3在第二路入射光束92所经过的光路上增加一个第一横向分光棱镜302。如图3所示，所述第二路入射光束92穿过所述第二变倍镜组后，经所述第一横向分光棱镜302侧向分光，一部分第二路入射光束92继续沿原光路射入所述双目镜筒5，另一部分第二路入射光束92能够被影像设备7采集，给所述影像设备7提供图像。所述影像设备7如相机、摄像机、手机、助手镜等。
实施例三
本实施例是在实施例一的基础上，叠加镜组3在成像镜组62与第一纵向分光棱镜301之间增加一个第二横向分光棱镜303，在第二路入射光束92所经过的光路上增加一个第二纵向分光棱镜305，在所述第二横向分光棱镜303和第二纵向分光棱镜305增加一个第一反射镜304。如图4所示，所述附加信息光束94经过所述第二横向分光棱镜303侧向分光，一部分附加信息光束94继续沿原光路射入所述第一纵向分光棱镜301与所述第一路入射光束91叠加形成第一叠加光束95，另一部分附加信息光束94转折90°后被所述第一反射镜304反射，射入所述第二纵向分光棱镜305与所述第二路入射光束92叠加形成第二叠加光束96，之后所述第一叠加光束95和第二叠加光束96通过所述双目镜筒5成像，通过目镜观察。本实施例中入射至所述双目镜筒5的光束均为叠加光束。
实施例四
本实施例是在实施例三的基础上，在所述显微镜镜身1对应所述第一纵向分光棱镜301和第二纵向分光棱镜305的位置分别增加侧向光束通道。如图5所示，所述第一叠加光束95经过所述第一纵向分光棱镜301侧向分光，一部分第一叠加光束95射入所述双目镜筒5，另一部分第一叠加光束95通过对应的侧向光束通道射出，所述第二叠加光束96经过所述第二纵向分光棱镜305侧向 分光，一部分第二叠加光束96射入所述双目镜筒5，另一部分第二叠加光束96通过对应的侧向光束通道射出，从所述侧向光束通道射出的第一叠加光束95和第二叠加光束96能够被影像设备7采集，给所述影像设备7提供图像。所述影像设备7如相机、摄像机、手机、助手镜等。此时所述影像设备7所获得的图像是叠加图像。
实施例五
本实施例中所述投射装置安装在所述显微镜镜身1的左侧或右侧。所述投影显示部件61从所述显微镜镜身1的左侧或右侧方向射入附加光学图像93。如图6所示，所述叠加镜组3包括第三纵向分光棱镜306，所述第三纵向分光棱镜306能够在所述显微镜镜身1内被驱动的沿所述显微镜镜身1的左右方向平移。所述附加信息光束94通过所述第三纵向分光棱镜306与所述第一路入射光束91或第二路入射光束92叠加形成第三叠加光束97，之后所述第三叠加光束97通过所述双目镜筒5成像。所述第三纵向分光棱镜306可平移设计，可使得附加光学图像93与手术显微镜的任意一路进行图像叠加。
实施例六
本实施例是在实施例五的基础上，在所述显微镜镜身1对应所述第三纵向分光棱镜306的位置增加侧向光束通道。如图7所示，所述第三叠加光束97经过所述第三纵向分光棱镜306侧向分光，一部分第三叠加光束97射入所述双目镜筒5，另一部分第三叠加光束97通过对应的侧向光束通道射出，从所述侧向光束通道射出的第三叠加光束97能够被影像设备7采集，给所述影像设备7提供图像。所述影像设备7如相机、摄像机、手机、助手镜等。此时所述影像设备7所获得的图像是叠加图像。
实施例七
本实施例中，所述投射装置安装在所述显微镜镜身1的下侧或内部。所述叠加镜组3包括第二反射镜307、第三反射镜308、第四纵向分光棱镜309和第三横向分光棱镜310。如图8所示，所述附加信息光束94通过所述第二反射镜307反射从所述显微镜镜身1的后侧方向射入所述第四纵向分光棱镜309，所述附加信息光束94通过所述第四纵向分光棱镜309与所述第一路入射光束91叠加形成第四叠加光束98，之后所述第四叠加光束98通过所述双目镜筒5 成像，所述第二路入射光束92穿过所述第二变倍镜组后，经所述第三横向分光棱镜310侧向分光，一部分第二路入射光束92继续沿原光路射入所述双目镜筒5，另一部分第二路入射光束92通过所述第三反射镜308反射向下射出，向下射出的部分第二路入射光束92能够被影像设备7采集，给所述影像设备7提供图像。
实施例八
本实施例是在实施例七的基础上，所述叠加镜组3在所述第二反射镜307和第四纵向分光棱镜309之间增设第四横向分光棱镜311，在所述第三横向分光棱镜310与第三反射镜308和第四横向分光棱镜311间增设一个第五横向分光棱镜312。如图9所示，经所述第二反射镜307反射的所述附加信息光束94，经所述第四横向分光棱镜311侧向分光，一部分附加信息光束94沿原光路射入所述第四纵向分光棱镜309，另一部分附加信息光束94转折90°后射入所述第五横向分光棱镜312，经所述第三横向分光棱镜310侧向分光的部分第二路入射光束92通过所述第五横向分光棱镜312与射入所述第五横向分光棱镜312的部分附加信息光束94叠加形成第五叠加光束99，所述第五叠光束通过所述第三反射镜308反射向下射出，向下射出的第五叠加光束99能够被影像设备7采集，给所述影像设备7提供图像。此时所述影像设备7所获得的图像是叠加图像。
需要说明的是，在以上实施例中，所述成像镜组62中还可以设置光学变倍系统，通过调节所述光学变倍系统能够调节所述附加信息光束94在成像后的图像尺寸。
同时，还可以在所述叠加镜组3和双目镜筒5之间设置滤波装置8。所述滤波装置8主要是调整附加信息图像的亮度，使其与手术显微镜的光学图像亮度匹配，便于观察。此外也可以设置光学滤片滤除或削弱对人眼有害的的光谱部分，如减少蓝光伤害。还可以根据需要放置偏振滤波器，或空间滤波装置，如不同通光孔径光阑等。多种滤波装置8可通过转盘旋转或推拉等方式切换。
以上实施例为针对手术显微镜诊断系统中手术显微镜结构的举例描述，接下来对手术显微镜诊断系统的具体内容进行阐述：
实施例九
手术显微镜诊疗系统包括显微观察模块、存储模块和增强信息影像注入模块。所述显微观察模块用于观察待观察的目标对象，所述显微观察模块为上述实施例中的任意手术显微镜。通过外部输入或调取等方式，将目标对象的辐射成像三维结构数字图像导入至所述存储模块中。所述辐射成像三维结构数字图像优选为CBCT数字图像，以下实施例均已CBCT数字图像为例对技术方案进行举例说明。所述增强信息影像注入模块用于将所述辐射成像三维结构数字图像以光学图像的形式投影至所述显微观察模块观察视野中的边缘位置，与所述显微观察模块观察视野内的镜下光学图像叠加形成叠加光学图像，如图10所示，给操作者实时提供参考，系统流程如图11所示。所述增强信息影像注入模块即上述实施例中所述的投影装置6，需要附加的数字化信息整合后通过有线HDMI、SDI、网口，无线wifi、蓝牙等方式传输至所述投影显示部件61，转换成光学图像并输出。
所述CBCT数字图像开关可控，操作者可以根据需要选择查看目标对象的分层二维图像或3D图像，操作者可以通过选择查看具体分层二维图像以确定镜下组织的内部结构。本实施例中，需要操作者人工的将CBCT数字图像与所述镜下光学图像进行对比和配准。
实施例十
本实施例的手术显微镜诊疗系统在实施例九的基础上，增设3D成像模块和图像识别处理模块。所述3D成像模块用于实时采集所述显微观察模块观察视野中的镜下光学图像，并将所述镜下光学图像转换为三维数字图像。所述图像识别处理模块用来识别所述三维数字图像中的生物特征，并通过生物特征对比，将CBCT数字图像与所述三维数字图像进行自动对比和配准，之后将与所述三维数字图像相匹配的CBCT数字图像输送至所述增强信息影像注入模块，最后投影在所述显微观察模块观察视野中，系统流程如图12所示。
本实施例的手术显微镜诊疗系统还包括检测模块。所述检测模块用于分别检测所述手术显微镜的变焦距大物镜(即大物镜组4)的对焦位置和变倍系统(即变倍镜组2)的倍率。所述检测模块优选采用位置传感器，即在手术显微镜的变焦距大物镜和变倍系统位置分别增加位置传感器，所述图像识别处理模块根据位置传感器检测到的所述变焦距大物镜的对焦位置确定所述CBCT数字图像的深度位置，所述图像识别处理模块根据所述检测模块检测到的所述变倍系统的 倍率确定所述CBCT数字图像显示当前层区域的深度范围。手术显微镜焦点深度位置与CBCT分层深度自动配准，即镜下观察某个平面结构，CBCT数字图像自动显示当前层(或当前层区域)的CT数字图像。
实施例十一
本实施例的手术显微镜诊疗系统是在实施例十的基础上，所述CBCT数字图像与所述显微观察模块观察视野内的镜下光学图像重合显示。所述CBCT数字图像透明度可调节。
本实施例的手术显微镜诊疗系统还包括定位导航检测模块，所述定位导航检测模块安装在手术器械上，所述手术器械比如牙科手机。所述定位导航检测模块用于实时检测所述手术器械的深度和空间位置数据，所述图像识别处理模块将所述定位导航检测模块采集到的深度和空间位置数据与三维数字图像中的生物特征进行比对，所述生物特征如根管口位置、形状与根管深度、走向等组织特征，获得所述手术器械与目标对象之间的实时相对位置数据，并将获得的实时相对位置数据输送至所述增强信息影像注入模块，之后投影在所述显微观察模块观察视野的设定位置，系统流程如图13所示。同时还可以引入手术器械的状态数据，如手机转速、扭矩值等，也可以通过所述增强信息影像注入模块投影在所述显微观察模块观察视野的设定位置。当设置在变焦距大物镜和变倍系统位置的的位置传感器检测到变化时，在所述显微观察模块观察视野的设定位置自动投影所述手术器械的实时数据，便于医生及时确认操作，提高效率。所述手术器械的深度和空间位置数据，以及所述手术器械的状态数据都可以实时的存储在所述存储模块中。
实施例十二
本实施例的手术显微镜诊疗系统是在实施例九至十一中任一实施例的基础上，引入更多相关数据，比如患者信息数据、根测仪数据、口腔扫描仪数据、电子牙周探针数据及牙髓活力数据等多数据信息，都可以通过外部输入或调取等方式存储至所述存储模块。各数据分别设置有显示开关，均能够单独开关可控，操作者可根据需要将所需数据通过所述增强信息影像注入模块投影在所述显微观察模块观察视野的设定位置，系统流程如图14所示。
各数据可以以文字符号、数据表、二维曲线或三位地形图等多种方式投影 在所述显微观察模块观察视野的设定位置，各数据在所述显微观察模块观察视野内分屏显示，或在同一窗口内切换显示，各数据的显示透明度以及各数据的显示窗口大小和位置可调节。
患者信息数据：包括患者的基本信息、禁忌提醒等，也可以包括监控信息，血压、血氧饱和度等。
根测仪数据：准确测量根管工作长度是成功根管治疗的基本条件，根据诊断，对不同状况的患牙进行根管预备及填充的终点位置各异，需要保证±0.5mm的误差范围，因此采用根管测量仪进行测量，其数据可选择性显示，提供参考。
口腔扫描仪数据：高分辨率的口腔结构三维形态。
电子牙周探针数据：口腔健康牙周是基础是国际口腔医学界不争的事实。牙周探诊是口腔基础诊断的重要方法。用牙周探针测量牙周袋深度及附着水平是目前临床评价牙周破坏程度的主要方法，也是判断牙周病情变化的临床依据。Florida探针系统可以在一名医护人员的操作下自动测量患者牙周袋深度、附着水平、附着龈宽度，并记录全口牙列情况、牙齿松动度、牙龈出血与化脓、根分叉病变、菌斑分布等可反应牙周疾病程度及预后指标。系统自带风险因素评估功能可有效的对患者进行病情风险评估，有助于医生能够客观的为患者制定有针对性的治疗计划。
牙髓活力数据：牙髓是位于牙本质围成的牙髓腔内，借狭窄的根尖孔与根尖周组织相连，不能被直视，导致临床上无法直观的从视觉上判断其具体状态。牙髓内分布有丰富的神经，可以感受外界刺激，临床上利用温度和电刺激牙髓的神经纤维来判断其活力状态，帮助医生选择，完全去除坏死牙髓，或实施切断术保留健康部分。
实施例十三
本实施例的手术显微镜诊疗系统是在实施例九至十二中任一实施例的基础上增加AI辅助分析模块，实现AI辅助诊断和显示。所述AI辅助分析模块开关可控，该开关可以是总开关可以是单独功能开关，操作者可以根据需要选择打开或关闭对应的AI辅助功能。所述AI辅助分析模块用于对所述3D成像模块采集的三维数字图像进行分析，辨别目标对象的病变情况，并根据病变情况对目标对象进行标记或提醒，同时对所述存储模块内存储的各数据进行汇总分析， 生成附加AI辅助信息，操作者可根据需要将所述附加AI辅助信息通过所述增强信息影像注入模块投影在所述显微观察模块观察视野的设定位置，系统流程如图15所示。
比如仅针对所述3D成像模块采集的三维数字图像进行分析：
基于正常白光照明条件下的显微镜数字图像进行分析，分辨口腔与牙齿病变，比如龋齿、隐裂、菌斑、变色、口腔癌等，并标记或提示。标记方式可以为不同颜色文字、图框、边缘线、箭头、染色等单独方式或组合，同时可配合提示声音。自动标记需要进行进一步检查的疑似病变，并提醒操作者切换相应工作模式，如不同波段的荧光检测模式、偏振工作模式、或不同滤光模式等来进行检查。对于上述需要切换不同工作模式来进一步检查的，AI模块也可自动控制显微镜进行模式切换，并获得相应模式的图像进行进一步分析。具体模式切换实现方式可参见专利CN211741708U，在此不再赘述。
同时对其他导入数据进行汇总分析：综合分析患者信息(年龄、性别、血压、血氧饱和度、既往病史等)、CBCT、根测仪、电子牙周探针、牙髓活力数据等信息，基于专家系统对牙齿状态进行评价，提示可行的治疗方案和治疗步骤；结合手术器械的空间位置与深度信息，对备牙尺寸、深度、转速等进行指示或提醒，提高操作规范性；
本实施例的手术显微镜诊疗系统还可以增设摄像模块，比如摄像机等，实时获得患者的表情图像数据，通过所述AI辅助分析模块对所述摄像模块采集的表情图像数据进行分析，判断其舒适度，并通过所述增强信息影像注入模块实时投影在所述显微观察模块观察视野的设定位置，方便操作者随时了解患者状态。
在本文中，术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含，除了包含所列的那些要素，而且还可包含没有明确列出的其他要素。
在本文中，所涉及的前、后、上、下等方位词是以附图中零部件位于图中以及零部件相互之间的位置来定义的，只是为了表达技术方案的清楚及方便。应当理解，所述方位词的使用不应限制本申请请求保护的范围。
在不冲突的情况下，本文中上述实施例及实施例中的特征可以相互结合。
以上所述仅为本实用新型的较佳实施例，并不用以限制本实用新型，凡在 本实用新型的精神和原则之内，所作的任何修改、等同替换、改进等，均应包含在本实用新型的保护范围之内。

Claims (13)

  1. 一种手术显微镜诊疗系统，其特征在于，其包括显微观察模块、存储模块和增强信息影像注入模块，
    所述显微观察模块用于观察待观察的目标对象；
    所述存储模块内存储有目标对象的辐射成像三维结构数字图像；
    所述增强信息影像注入模块用于将所述辐射成像三维结构数字图像以光学图像的形式投影至所述显微观察模块观察视野中，与所述显微观察模块观察视野内的镜下光学图像叠加形成叠加光学图像。
  2. 根据权利要求1所述的手术显微镜诊疗系统，其特征在于，所述辐射成像三维结构数字图像开关可控，操作者可以根据需要选择查看目标对象的分层二维图像或3D图像。
  3. 根据权利要求2所述的手术显微镜诊疗系统，其特征在于，其包括3D成像模块和图像识别处理模块，所述3D成像模块用于实时采集所述显微观察模块观察视野中的镜下光学图像，并将所述镜下光学图像转换为三维数字图像；所述图像识别处理模块用于识别所述三维数字图像中的生物特征，并通过生物特征对比，将与所述三维数字图像相匹配的辐射成像三维结构数字图像输送至所述增强信息影像注入模块，之后投影在所述显微观察模块观察视野中设定区域。
  4. 根据权利要求3所述的手术显微镜诊疗系统，其特征在于，其还包括检测模块，所述显微观察模块内设有变焦距大物镜和变倍系统，所述检测模块用于分别检测所述变焦距大物镜的对焦位置和所述变倍系统的倍率，所述图像识别处理模块根据所述检测模块检测到的所述变焦距大物镜的对焦位置确定所述辐射成像三维结构数字图像的深度位置，所述图像识别处理模块根据所述检测模块检测到的所述变倍系统的倍率确定所述辐射成像三维结构数字图像显示当前层区域的深度范围。
  5. 根据权利要求3所述的手术显微镜诊疗系统，其特征在于，所述辐射成像三维结构数字图像投影在所述显微观察模块观察视野的边缘位置，或所述辐射成像三维结构数字图像与所述显微观察模块观察视野内的镜下光学图像重合显示，所述辐射成像三维结构数字图像的透明度可调节。
  6. 根据权利要求5所述的手术显微镜诊疗系统，其特征在于，其还包括定位导航检测模块，所述定位导航检测模块安装在手术器械上，所述定位导航检 测模块用于实时检测所述手术器械的深度和空间位置数据，所述图像识别处理模块将所述定位导航检测模块采集到的深度和空间位置数据与三维数字图像中的生物特征进行比对，获得所述手术器械与目标对象之间的实时相对位置数据，并将获得的实时相对位置数据输送至所述增强信息影像注入模块，之后投影在所述显微观察模块观察视野的设定位置。
  7. 根据权利要求6所述的手术显微镜诊疗系统，其特征在于，所述手术器械的深度和空间位置数据，以及所述手术器械的状态数据实时存储在所述存储模块中，所述手术器械的状态数据能够被输送至所述增强信息影像注入模块，之后投影在所述显微观察模块观察视野的设定位置。
  8. 根据权利要求1所述的手术显微镜诊疗系统，其特征在于，所述存储模块内还存储有患者信息数据、根测仪数据、口腔扫描仪数据、电子牙周探针数据及牙髓活力数据，各数据分别开关可控，操作者可根据需要将所需数据通过所述增强信息影像注入模块投影在所述显微观察模块观察视野的设定位置。
  9. 根据权利要求8所述的手术显微镜诊疗系统，其特征在于，各数据以文字符号、数据表、二维曲线或三位地形图的方式投影在所述显微观察模块观察视野的设定位置，各数据在所述显微观察模块观察视野内分屏显示，或在同一窗口内切换显示，各数据的显示透明度以及各数据的显示窗口大小和位置可调节。
  10. 根据权利要求9所述的手术显微镜诊疗系统，其特征在于，其还包括AI辅助分析模块，所述AI辅助分析模块开关可控，操作者可以根据需要选择打开或关闭AI辅助功能，所述AI辅助分析模块用于对所述3D成像模块采集的三维数字图像进行分析，辨别目标对象的病变情况，并根据病变情况对目标对象进行标记或提醒，同时对所述存储模块内存储的各数据进行汇总分析，生成附加AI辅助信息，之后通过所述增强信息影像注入模块投影在所述显微观察模块观察视野的设定位置。
  11. 根据权利要求10所述的手术显微镜诊疗系统，其特征在于，其还包括摄像模块，所述摄像模块用于采集患者的表情图像数据，所述AI辅助分析模块对所述摄像模块采集的表情图像数据进行分析，判断患者的舒适度，并通过所述增强信息影像注入模块投影实时投影在所述显微观察模块观察视野的设定位置。
  12. 根据权利要求1所述的手术显微镜诊疗系统，其特征在于，所述显微观察模块包括手术显微镜，所述增强信息影像注入模块包括投影装置(6)，所述投影装置(6)能够投射出附加信息光束(94)，所述附加信息光束(94)与所述手术显微镜内的一路或两路入射光束叠加后射入所述手术显微镜的双目镜筒(5)内，形成叠加光学图像。
  13. 根据权利要求12所述的手术显微镜诊疗系统，其特征在于，所述投影装置(6)包括投影显示部件(61)和成像镜组(62)，所述投影显示部件(61)能够投射出附加光学图像(93)，所述附加光学图像(93)经过所述成像镜组(62)转换成平行光束，形成所述附加信息光束(94)。
PCT/CN2022/072540 2021-02-10 2022-01-18 一种手术显微镜诊疗系统 WO2022170927A1 (zh)

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