基于空间定位的经皮肺穿刺图像引导关键技术研究与实现

发布时间：2018-06-26 18:18

本文选题：肺穿刺 + 手术导航　；参考：《东北大学》2013年硕士论文

【摘要】：肺部疾病和恶性肿瘤是目前全世界范围内致死率最高的疾病之一,而组织学诊断是肺部疾病定性诊断和治疗的金标准。目前CT引导的经皮肺穿刺手术是获取肺部病变组织的最有效手段。但目前传统肺穿刺手术会使病人反复被穿刺以及反复接受放射性辐射,并增加并发症和不良的影响的风险,因此研究肺穿刺手术的新方法有着十分重要的意义。本项目主要对经皮肺穿刺手术导航的关键技术和最佳手术路径规划展开了研究,包括对于医学DICOM图像体数据重建,三维可视化技术,图像分割技术,空间配准方法进行了研究。在这些技术研究的基础上,开发了一套应用于肺穿刺活检手术的计算机手术导航系统。本系统的难点在于整个系统框架的设计与实现,因为系统实现过程中包含许多图像处理算法和三维空间定位技术,涉及到的算法多,而且有一定的难度。同时在设计过程中要考虑实际的临床需要,尽量简化系统操作流程和软件操作流程,提供给医生一个简单、易用的图像引导手术导航系统。图像处理技术和可视化算法是手术导航的基础。研究的重点包括体数据处理,可视化技术,图像分割技术。在研究各种算法的基础上改进了相关的算法使其满足临床肺穿刺手术的需求,比如可视化技术加入了二维与三维融合显示,三维切割显示等功能。空间定位技术和空间坐标配准技术是手术导航系统的关键。空间定位技术和配准技术决定了手术导航系统的精确度,是决定手术导航系统成败的关键。在研究了系统中不同的坐标系统的关系后,通过基于外部标志点的方法实现了导航系统的空间配准,而且配准精度也能满足临床手术需求。最终实现了基于三维空间定位的肺穿刺图像引导系统,该系统在手术前能够帮助医生制定手术计划,同时来能够自动分析、设计手术路径,进行手术模拟,在术中能够实现实时导航,并且能够实现在不同三维视图下进行图像引导,同时根据临床需要设计出了靶向图和深度面图进行穿刺引导,最终进行实验验证了系统的精确性,满足临床需要。本文的创新点是提出了智能穿刺路径分析算法,解决血管、气管和肋骨遮挡的问题,并可进行穿刺手术术前路径规划,并且可以进行手术模拟和评估,可以不依赖于医生的操作手法和经验,大大提高穿刺的准确率,减少病人受穿刺的次数,降低并发症的机率,减少放射性辐射的次数,使穿刺手术更加规范化、标准化,提高手术效率和成功率,对肺部疾病的诊断和治疗有着十分重要的意义。
[Abstract]:Lung diseases and malignant tumors are one of the most fatal diseases in the world. Histologic diagnosis is the golden standard for qualitative diagnosis and treatment of lung diseases. At present, CT-guided percutaneous lung puncture is the most effective method to obtain lung lesions. But the traditional lung puncture surgery can make the patients repeatedly punctured and receive radiation repeatedly, and increase the risk of complications and adverse effects. Therefore, it is of great significance to study the new methods of lung puncture surgery. This project mainly focuses on the key techniques and optimal operation path planning of percutaneous lung puncture operation, including medical DICOM image volume data reconstruction, 3D visualization technology, image segmentation technology, spatial registration method. Based on these techniques, a computerized surgical navigation system was developed for lung biopsy. The difficulty of this system lies in the design and implementation of the whole system framework, because there are many image processing algorithms and three dimensional spatial positioning techniques in the implementation of the system, which involve many algorithms and have some difficulties. At the same time, we should consider the actual clinical needs in the design process, simplify the system operation flow and software operation flow as far as possible, and provide a simple and easy-to-use image-guided operation navigation system for doctors. Image processing technology and visualization algorithm are the basis of operation navigation. The research focuses on volume data processing, visualization and image segmentation. Based on the research of various algorithms, the related algorithms are improved to meet the needs of clinical lung puncture surgery. For example, the visualization technology includes 2D and 3D fusion display, 3D cutting display and so on. The technology of space positioning and coordinate registration is the key of surgical navigation system. The accuracy of surgical navigation system is determined by space positioning technology and registration technology, which is the key to the success or failure of surgical navigation system. After studying the relationship between different coordinate systems in the system, the spatial registration of the navigation system is realized based on the method of external mark points, and the registration accuracy can also meet the needs of clinical surgery. Finally, a lung puncture image guidance system based on three-dimensional positioning is realized. The system can help doctors to make operation plan before operation, and can automatically analyze, design and simulate the operation path. The real-time navigation can be realized during the operation, and the image guidance can be realized under different three-dimensional views. At the same time, the target map and depth plane map are designed to guide the puncture according to the clinical needs. Finally, the accuracy of the system is verified by experiments. To meet the clinical needs. The innovation of this paper is to put forward the intelligent puncture path analysis algorithm to solve the problems of occlusion of blood vessels, trachea and rib, and to plan the preoperative path of puncture operation, and to simulate and evaluate the operation. It can greatly improve the accuracy of puncture, reduce the frequency of puncture, reduce the probability of complications, reduce the frequency of radiation, and make the puncture operation more standardized and standardized. It is very important to improve the efficiency and success rate of operation for the diagnosis and treatment of pulmonary diseases.
【学位授予单位】：东北大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：TP391.41;R563

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