立体视觉技术在耳显微外科的应用性研究

发布时间：2018-07-27 14:20

【摘要】：背景：耳显微外科所涉及的解剖结构基本都深藏于颞骨中，自身体积细小精微，形态多变而不规整。此外，许多颞骨内的结构，如：面神经、颈内动脉、颈内静脉、乙状窦等，行程绵延曲折、空间跨度较大，且与颅底、颅内、腮腺、上颈部等周围区域内的结构或直接沿续、或位置关系密切。因而，人们对耳显微外科所涉及的解剖结构常常是触之不及、窥之不见，难以建立直观、形象而具体的空间感受，学习和熟练掌握的难度较大。此外，目前应用于耳显微外科临床及解剖的图片及视频基本都是二维的，而在实际的临床工作中，术者所看到的真实术野是具有丰富的立体信息的。相对于原始的立体术野，二维媒体丢失了许多关键的立体信息，这些立体信息在辨识解剖结构、确定解剖方位等方面非常重要，当手术中遇到因出血或正常结构被破坏而导致解剖标志不清时这些立体信息尤为重要。因此，如何以恰当的方式保存和再现原始术野的立体信息，如何以最佳的角度展示耳显微外科涉及的解剖结构和解剖操作过程，是本课题需要解决的两个主要问题。目的：探索将立体视觉技术应用于耳显微外科的方法；探索以立体的表现形式展示颞骨内解剖结构及解剖操作的方法。方法：调查研究现有的多种立体视觉重建解决方案，并结合耳显微外科临床工作特点筛选可以应用于耳显微外科的立体视觉重建解决方案；在解剖及手术工作中验证选定的立体视觉重建解决方案的可行性，并对最终选定的解决方案进行规范化、流程化处理；开展规范的、系统的颞骨解剖，并按规范化流程采集并制作颞骨解剖和颞骨三维重建的立体素材，并通过合适的方式重现原始术野的立体信息。结果：我们成功的将立体视觉技术应用于耳显微外科，制定了适用于耳显微外科、并可推广至其他相关领域的立体视觉重建解决方案。基于此方案，我们对耳显微外科立体视觉重建系统所涉及的设备、软件、采集及制作方法等各个部分都进行了规范化、系统化处理，，形成了与耳显微外科立体视觉重建方案相匹配的软、硬件系统。我们按规范化的流程采集了1.2万余幅颞骨解剖及颞骨三维重建素材，制作了624幅高质量的颞骨解剖和颞骨三维重建立体图，而且这些立体图可以源源不断的增加并能保持持续更新，从而使耳显微外科立体视觉重建系统具备了临床实用价值。在现有技术手段基础上，我们还进一步探索性的开发了耳显微外科立体电视监视系统，目前该系统已实现本地及局域网内的立体实时监控，初步显现出其临床实用价值。结论：耳显微外科立体视觉技术可以应用于耳显微外科。耳显微外科立体视觉信息重建系统集成度高、操作简单、并能够很好的保存并重现原始术野的立体信息。耳显微外科立体视觉重建解决方案具备相当的临床实用价值。
[Abstract]:Background: the anatomical structures involved in ear microsurgery are mostly embedded in the temporal bone, small and delicate in size, variable in shape and irregular in shape. In addition, many structures in the temporal bone, such as the facial nerve, internal carotid artery, internal jugular vein, sigmoid sinus, etc., have a long and tortuous journey, and have a large spatial span and may be directly followed by the structures in the surrounding areas such as the skull base, the skull, the parotid gland, the upper neck, etc. Or location is closely related. Therefore, the anatomical structure involved in ear microsurgery is often not as close as touch, not to be seen, it is difficult to establish visual, image and specific spatial feeling, and it is difficult to learn and master skillfully. In addition, at present, the images and videos used in the clinical and anatomical analysis of ear microsurgery are basically two-dimensional, but in the actual clinical work, the true surgical field seen by the operator is rich in three-dimensional information. Compared with the original stereoscopic field, the two-dimensional media has lost a lot of key stereoscopic information, which is very important in identifying the anatomical structure, determining the anatomic orientation, and so on. The stereoscopic information is especially important when the anatomical signs are unclear due to bleeding or the destruction of normal structures. Therefore, how to preserve and reproduce the three-dimensional information of the original surgical field in a proper way, and how to display the anatomical structure and anatomic process involved in ear microsurgery from the best angle are two main problems to be solved in this paper. Objective: to explore the method of applying stereoscopic vision to the microsurgery of the ear, and to explore the method of displaying the anatomical structure and operation of the temporal bone in the form of stereoscopic presentation. Methods: a variety of existing stereo vision reconstruction solutions were investigated and selected according to the clinical features of ear microsurgery. To verify the feasibility of the selected stereo vision reconstruction solution in anatomy and surgery, and to standardize and process the final selected solution, to carry out standardized, systematic temporal bone anatomy, The three-dimensional materials of temporal bone anatomy and three-dimensional reconstruction of temporal bone were collected and made according to the standardized procedure, and the stereo information of the original surgical field was reproduced in a suitable way. Results: we successfully applied stereo vision technology to ear microsurgery and developed a stereo vision reconstruction solution which can be extended to other related fields. Based on this scheme, we have standardized and systematized the equipment, software, acquisition and manufacturing methods of the stereo vision reconstruction system for ear microsurgery. A software and hardware system is formed to match the stereo vision reconstruction scheme of ear microsurgery. According to the standard procedure, we collected more than 12000 temporal bone anatomy and three-dimensional reconstruction materials, and made 624 high-quality three-dimensional images of temporal bone anatomy and temporal bone three-dimensional reconstruction. Moreover, these stereoscopic images can be continuously increased and continuously updated, which makes the stereo vision reconstruction system of ear microsurgery have clinical practical value. On the basis of the existing techniques, we have further developed a stereoscopic television surveillance system for ear microsurgery. At present, this system has realized the stereoscopic real-time monitoring in local and local area networks, and has shown its clinical practical value. Conclusion: stereoscopic vision technique can be used in microsurgery. The stereo vision information reconstruction system of ear microsurgery is highly integrated, easy to operate, and can save and reproduce the stereo information of the original field well. The solution of stereoscopic vision reconstruction in ear microsurgery is of considerable clinical value.
【学位授予单位】：南开大学
【学位级别】：博士
【学位授予年份】：2012
【分类号】：R764

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