多模态影像融合导航配准速度及配准精准性的实验及初步临床研究

发布时间：2018-04-15 00:19

本文选题：多模态影像 + 融合配准　；参考：《中国人民解放军医学院》2016年博士论文

【摘要】：目的1、研发一种超声图像与CT图像融合配准的导航软件-"OBERON影像引导手术导航系统”,并通过腹部仿真体模实验验证其配准的精准性与耗时。2、通过腹部多点间的相对位姿变化获取呼吸运动规律,并通过动物实验验证OBERON软件在特定呼吸时相下融合配准的精准性。3、研究反映人体体表呼吸运动最敏感的位置点的组合,并通过初步临床研究验证OBERON软件在特定呼吸时相下进行精确融合配准的可行性。材料和方法1、在磁导航条件下,对腹部仿真体模进行超声与CT图像融合配准实验,对比OBERON软件和商业化软件在配准误差及耗时方面的差异,验证OBERON软件在腹部仿真体模配准中的精准性。2、运用数学算法获取体表传感器的位姿信息,经计算机处理来实现对呼吸运动的监测,并转换成呼吸时相的误差；建立巴马小型猪原位碘化油模拟肝肿瘤模型,选取肝内不同位置(左外叶近肝表面、左外叶内部、右外叶近肝表面、右外叶内部)及不同大小(直径5mm和15mm)的8个点作为配准的目标点,在呼吸运动条件下,采用OBERON软件分别对加呼吸监测模块(实验组)及不加呼吸监测模块(对照组)的各个点进行融合配准,并将两组及实验组内各点的配准误差分别进行比较,考察OBERON软件的呼吸监测模块降低呼吸运动造成的配准误差的能力。3、通过体表多个传感器的实时位姿变化荻取反映呼吸运动最为敏感的体表位置点的组合;选取符合入组条件的18例病人,采用与术中相同的体位,并用定位袋对体位进行固定,应用OBERON软件分别对加呼吸监测模块(实验组)及不加呼吸监测模块(对照组)的各个点进行融合配准,并将两组的配准误差分别进行比较,验证OBERON软件的呼吸监测模块在临床应用中的可行性。结果1、OBERON软件在腹部仿真体模的多模态影像融合配准中得到了较好的实现,共进行了74组实验操作,实验组融合配准误差为(3.21±0.79)mm,耗时为(37.82±15.06)s,对照组的融合配准误差为(3.32±0.58)mm,耗时为(91.69±33.81)s,两组配准误差差异无统计学意义(P0.05),两组配准时间差异有统计学意义(P0.01)。2、OBERON软件能够较好的显示呼吸时相的误差;两组实验猪肝内8个点的目标点的融合配准操作均顺利完成,实验组在每个点的配准误差均小于对照组(P0.01);实验组内,肝左外叶内、右外叶近肝表面及右外叶内的目标点配准误差大小相当(P0.05),但肝左外叶近表面的目标点的配准误差大于其余各点的误差(P0.05)。3、本研究中18例男性病人,体表最佳位置点的组合能够敏感地反应患者呼吸运动;两组配准误差大小分别为：实验组(3.41±0.39)mm,对照组(3.71±0.34)mm,,两组误差大小差异有统计学意义(P0.01)。结论1、OBERON软件可顺利进行融合配准工作,配准误差可以控制在理想的范围内,同时耗时较目前商业化软件缩短。2、应用OBERON软件可以实时监测呼吸运动,并将其转化为误差;应用呼吸监测模块可在肝内不同目标点的融合配准中减小呼吸运动导致的配准误差,但是对于肝左外叶近表面的目标点,配准误差大于其他目标点。3、OBERON软件内的呼吸监测模块能够较好的反映呼吸时相误差,可在一定程度上减小呼吸运动造成的配准误差。
[Abstract]:1, the development of a ultrasonic image and CT image fusion technique and navigation software - "OBERON image guided surgical navigation system", and through the simulation of abdominal phantom experiment verify the registration accuracy and time-consuming.2 through abdominal multi-point between the relative position and attitude change for respiratory motion law, and through the animal experiment OBERON software in the specific respiratory phase under the accurate registration of.3 fusion, reflecting a combination of the most sensitive points of human body respiratory movement, and through the preliminary clinical study on verification of OBERON software in specific respiratory phase under the feasibility of precise integration registration. Materials and methods 1, the magnetic navigation conditions of registration experiment on abdominal ultrasound and CT image simulation phantom, comparison of OBERON software and commercial software in the registration error and time difference, verification of OBERON software in the abdomen phantom registration precision simulation .2 position information acquisition sensor surface using mathematical algorithms, through computer processing to achieve the monitoring of the respiratory motion, the phase error and converted into breathing; Bama miniature pig orthotopic liver tumor lipiodol simulation model, selecting different positions within the liver (internal left lateral lobe near the surface of the liver, and the left lateral lobe right hepatic lobe near the surface, the right lateral lobe) and different size (diameter 5mm and 15mm) of the 8 points as the registration target, the respiratory motion conditions, respectively on respiratory monitoring module using OBERON software (experimental group) and without respiratory monitoring module (control group) of each point of registration, and the registration error of each point of the two group and the experimental group were compared, the respiratory monitoring module inspects the OBERON software to reduce the registration error caused by respiratory movement ability of the.3, through the real-time pose change Di surface multiple sensors measuring call The combination of surface suction sensitive points of motion; choose 18 patients were eligible, by the same operation posture, and positioning bags on position fixed, uses OBERON software to add respiratory monitoring module (experimental group) and without respiratory monitoring (control group) of each module for registration, and the registration error of two groups were compared, the feasibility of respiratory monitoring module verification of OBERON software in clinical application. The results of 1 OBERON software for multi modality imaging in abdomen simulation phantom registration was realized in a good, there are 74 group experimental operation, experimental group registration error is (3.21 + 0.79) mm, (37.82 + 15.06) time is s, the control group for the fusion of the registration error (3.32 + 0.58) mm, (91.69 + 33.81) time for s, two sets of registration error had no significant difference between the two groups (P0.05), registration time difference Statistical significance (P0.01).2, OBERON software can display the error phase when breathing better fusion; registration operation 8 points in the two groups of experimental liver targets were successfully completed, the experimental group was less than the control group in the registration error of each point (P0.01); experimental group, hepatic left lateral lobe, right leaf near liver surface and right lobe registration error target size (P0.05), but the registration error of the left liver lobe near the surface of the target is larger than the error of the remaining points (.3, P0.05) in this study, 18 cases of male patients, the best combination of surface points can be sensitive to the reaction of respiratory movement two; group registration error size were: the experimental group (3.41 + 0.39) mm, the control group (3.71 + 0.34) mm, the two groups was statistically significant difference (P0.01) error. Conclusion 1, OBERON software can be smoothly carried out registration, registration error can be controlled in an ideal range At the same time, it is the commercial software using OBERON software can shorten.2, real-time monitoring of respiratory motion and transformed into error; application of respiratory monitoring module can reduce the registration error of respiration induced in the liver of different target registration, but for the left liver lobe near the surface of the target, registration the error is greater than other targets.3, respiratory monitoring module within the OBERON software can better reflect the respiratory phase error, can reduce the registration error caused by respiratory movement in a certain extent.

【学位授予单位】：中国人民解放军医学院
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R735.7

【相似文献】