深部脑刺激手术电极三维可视化定位

发布时间：2018-07-12 20:54

本文选题：核磁共振影像 + 电子计算机断层扫描影像　；参考：《中国科学院研究生院(长春光学精密机械与物理研究所)》2015年硕士论文

【摘要】：深部脑刺激(Deep Brain Stimulation,DBS)手术是许多重症神经、精神系统疾病的唯一有效治疗手段,而刺激电极植入的准确性是决定手术成功与否的关键因素。深部脑刺激手术电极植入靶点核团如丘脑底核,体积较小,给刺激电极精确植入带来比较大的困难。目前,临床上通常采用核磁共振影像(Magnetic Resonance Imaging,MRI)或者计算机断层扫描影像(Computed Tomography,CT)来辅助手术电极电位。靶点核团仅能在高分辨率核磁共振影像清晰显示,而术中、术后电极位置确认受金属材质电极影响,仅可采用低分辨率核磁共振设备和计算机断层扫描设备扫描,同时电极伪迹较大亦会给术中、术后电极定位带来很大的困难。因此,以术中、术后影像为基础,实现深部脑刺激手术清晰、直观、准确的电极定位对于临床手术治疗效果的提高具有十分重要的意义。本文以术中、术后核磁共振影像影像以及术后计算机断层扫描影像为基础,实现了深部脑刺激手术空间结构三维可视化算法的设计,为医生提供具有真实感的立体图像,便于刺激电极的位置确认。同时弥补了目前临床二维医学影像无法精确显示植入电极与靶点核团三维空间位置关系的缺陷,在保证精度和速度的前提下,可以满足临床深部脑刺激手术电极定位的需求。主要内容包括以下三个方面:1.针对术中、术后影像分辨率低,无法定位核团位置的难题,利用术前高分辨核磁共振扫描影像,将术中、术后影像分别与术前影像配准,进而将术中、术后影像空间标准化到标准立体定向空间,提高标准化算法精度。针对术中电极定位精度以及速度上的要求,采用三步线性算法实现术中核磁共振影像的空间标准化。针对术后影像电极伪迹大,脑组织部分形变的问题,采用DARTEL(Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra)非线性算法将术后核磁共振影像标准化到标准立体空间。针对术后CT影像,利用边缘检测算法与术前核磁共振影像配准,再采用DARTEL算法空间标准化。结果显示线性算法的匹配误差为1.29 mm,DARTEL算法的匹配误差为0.96 mm,小于一个像素点。2.采用阈值法利用标准化的轴位术中、术后MRI或者术后CT自动重建电极植入路径,采用互相关算法自动搜索电极触点,最后利用冠状影像检测、调整电极路径及触点位置,重建结果与临床影像表现一致。3.利用现有脑图谱数据,分割丘脑底核、苍白球内侧核等深部脑刺激靶点核团及附近主要神经核团,通过面绘制二值图像重建及伪彩色处理,实现脑组织神经核团的三维可视化,同时融合电极三维影像,完成深部脑刺激手术三维空间结构可视化。采用同样算法实现不同脑图谱相关核团三维可视化,对比刺激电极位置,并由医生判别,结果准确,方便医生多角度确认术中、术后电极位置。本文建立与深部脑刺激相关神经核团空间结构模型,为深部脑刺激神经外科手术功能区定位、最优靶点选择提供指导,为深部脑刺激调控参数优化提供依据,将提高深部脑刺激电极植入精度、改善临床治疗效果、减少副作用和节省电池使用寿命。
[Abstract]:Deep brain stimulation (Deep Brain Stimulation, DBS) is the only effective treatment for many severe nervous and mental diseases. The accuracy of the implantation of stimulating electrodes is the key factor determining the success of the operation. Deep brain stimulation electrodes implanted in the nucleus of the target, such as the nucleus of the hilar nucleus, are small in volume and implants to the stimulus electrode accurately. At present, the surgical electrode potential is usually assisted by Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). The target nucleus can only be clearly displayed in high resolution MRI, and the position of the electrode is confirmed by metal in the operation. The electrode can be scanned with a low resolution magnetic resonance device and a computed tomography device, and the electrode artifacts will also be very difficult in the operation. Therefore, a clear, intuitive and accurate electrode location for surgical treatment is performed on the basis of intraoperative and postoperative imaging. The improvement of the effect is of great significance. In this paper, the design of three-dimensional visualization algorithm for spatial structure of deep brain stimulation surgery is realized on the basis of intraoperative, postoperative magnetic resonance imaging and postoperative computed tomography, which provides a realistic image of the body for the doctors and facilitates the confirmation of the location of the stimulating electrode. It can make up for the defect that the clinical two-dimensional medical image can not accurately display the relationship between the implanted electrode and the three-dimensional space position of the target nucleus. Under the premise of ensuring the accuracy and speed, it can meet the needs of the clinical deep brain stimulation operation electrode location. The main contents include the following three sides: 1. in the operation, the image resolution after the operation is low and can not be used. In order to locate the position of the nucleus, the preoperative high resolution MRI images are used to register the intraoperative and postoperative images with the pre operation images, and then the image space in the operation is standardized to the standard stereotactic space, and the accuracy of the standardization algorithm is improved. Three steps are used to calculate the accuracy of the electrode location and the requirements of the speed. The method realizes the spatial standardization of MRI in the operation. Aiming at the problem of large artifacts and part of the brain tissue deformation after the operation, the DARTEL (Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra) nonlinear algorithm is used to apply the post operation NMR image to the standard stereoscopic space. Using the edge detection algorithm and pre operation NMR image registration, then using the DARTEL algorithm space standardization, the results show that the matching error of the linear algorithm is 1.29 mm, the matching error of the DARTEL algorithm is 0.96 mm, less than one pixel.2. using the threshold method using the standardized axial position, after operation MRI or after the CT automatic reconstruction electrode implantation after operation. The path, using the cross correlation algorithm to automatically search the electrode contacts, and finally use the coronary image detection, adjust the electrode path and contact position, the reconstruction results are consistent with the clinical images,.3. use the existing brain atlas data, divide the subthalamic nucleus, the pallidus medial nucleus and other deep brain stimulation target nuclei and the nearby major nucleus clusters, through surface drawing. Two value image reconstruction and pseudo color processing are used to realize the three-dimensional visualization of the brain tissue, and the three-dimensional visualization of the deep brain stimulation operation is fused with the three-dimensional image of the electrode. The three-dimensional visualization of the related nuclei of different brain atlas is realized by the same algorithm, and the location of the stimulated electrode is compared with the doctor, and the result is accurate and convenient. This paper establishes a spatial structure model of nerve nucleus associated with deep brain stimulation in order to provide guidance for the location of surgical functional areas in the deep brain stimulation Department of neurosurgery and the optimal target selection, and provide the basis for the optimization of the parameters of the deep brain stimulation, and will improve the precision of the deep brain stimulation electrode implantation, Gai Shanlin. Bed treatment effect, reduce side effects and save battery life.
【学位授予单位】：中国科学院研究生院(长春光学精密机械与物理研究所)
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1;TP391.41

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