CN115005851A - Nodule positioning method and device based on triangulation positioning and electronic equipment - Google Patents
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Abstract
The invention provides a method and a device for locating a nodule based on triangulation location and electronic equipment, wherein the method comprises the following steps: acquiring a thin-layer CT image of a patient, and constructing a three-dimensional digital model of a target part of the patient based on the thin-layer CT image; determining projection points of nodules in a target triangulation location area and three target anatomical marking points corresponding to the target triangulation location area; determining the distances between the actual position of the nodule and the three target anatomical marker points based on the projection point of the nodule and the three target anatomical marker points; determining the actual position of the nodule based on three actual marking points and three distances corresponding to the three target anatomical marking points; the three actual marking points are positioned and determined inside the chest cavity of the patient in a triangular positioning mode. The anatomical marker points can be used as reference points to guide the nodule positioning and excision through the relative relationship between the projection points and the anatomical points of the nodule. Thereby avoiding the operation of puncture location before the operation, reducing the operation wound and the operation time, and being beneficial to the quick recovery after the operation.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to a method and a device for locating a nodule based on triangulation location and electronic equipment.
Background
At present, with the popularization of Computed Tomography (CT), the discovery rate of lung nodules and early lung cancer is increasing, and the number of cases requiring minimally invasive surgery is also increasing. Accurate removal of lung nodules requires assistance from modern imaging techniques such as thin-layer CT of the chest and digital reconstruction navigation techniques. Particularly, the sub-lobe resection of early lung cancer mainly comprises two surgical modes of lung wedge resection and lung segment resection at present. For most early lung cancer or benign nodules represented by ground glass nodules, the purpose of radical treatment can be achieved by row wedge-shaped excision. Wedge resection is faster, less traumatic, less recovery time, and more economical than lung surgery.
However, the current lung digital reconstruction navigation technology is mainly designed for lung segment surgery, and the lung segment where the nodule is located is determined according to lung blood vessel and trachea reconstruction so as to guide the surgery. However, the lung wedge resection needs to define the projection position of the lung nodule on the lung surface and can help a doctor to realize positioning in the operation, so that the existing lung digital reconstruction navigation method cannot guide the lung wedge resection.
At present, the lung wedge resection mainly depends on preoperative puncture under CT navigation, and a marker is placed at the lung surface projection position of a nodule to realize positioning. During operation, a doctor presumes the corresponding position of the nodule according to the position of the marker, so that accurate wedge-shaped excision is realized. However, compared with the digital reconstruction navigation, the preoperative puncture positioning also has many disadvantages, such as: (1) the patients suffer great pain and fear during the puncture (about 15-30 minutes) and during the waiting period of the operation after the puncture (tens of minutes to several hours); (2) repeated CT irradiation increases radiation exposure; (3) after puncture positioning, an anaesthetist and a nurse are required to carry out nursing management; (4) complications such as pneumothorax and hemorrhage cannot be handled in time, and the risk is high; (5) is limited by sites, equipment and personnel, and many hospitals cannot develop the technology, so the popularization of the precise pulmonary nodule resection operation is limited.
Disclosure of Invention
In view of this, the present invention provides a method, an apparatus and an electronic device for locating a nodule based on triangulation to avoid the operation of preoperative puncture location, reduce surgical trauma and surgical time, and facilitate postoperative rapid recovery.
In a first aspect, an embodiment of the present invention provides a nodule positioning method based on triangulation, where the method includes: acquiring a thin layer CT image of a patient, and constructing a three-dimensional digital model of a target part of the patient based on the thin layer CT image; the surface of the three-dimensional digital model comprises a plurality of anatomical marking points and a plurality of triangulation areas determined based on the determined anatomical marking points, and the three-dimensional digital model is marked with nodules; determining projection points of nodules in a target triangulation location area and three target anatomical marking points corresponding to the target triangulation location area; determining the distances between the actual position of the nodule and the three target anatomical marker points based on the projection point of the nodule and the three target anatomical marker points; determining the actual position of the nodule based on three actual marking points and three distances corresponding to the three target anatomical marking points; wherein, the three actual mark points are positioned and determined inside the chest cavity of the patient in a triangular positioning mode.
In a preferred embodiment of the present application, the target site is a lung, and the anatomical landmark points include a right lung anatomical landmark point and a left lung anatomical landmark point; the right lung anatomical marker points include at least one of: the apex of the upper lung apex, the apex of the intersection of the rear right upper lung segment and the back lower lung segment, the intersection of the horizontal fissure and the oblique fissure of the right lung, the intersection of the horizontal fissure and the inner side edge of the right upper lung, the first costal pressure trace point of the right upper lung, the intersection of the lower right lower lung edge and the thoracic vertebra pressure trace, the inner side endpoint of the lower right lower lung edge, the lowest right middle lung point, the lowest right upper pulmonary trachea pressure trace point, the right lower pulmonary vein pressure trace point and the outer side endpoint of the lower right lung edge; the left lung anatomical marker points include at least one of: a first rib track pressing point on the left side of the top point of the left upper lung cusp section, the top point of the intersection of the left upper lung posterior section and the left lower lung dorsal section, the lowest point of the left upper lung, the intersection of the left upper oblique fissure and the lower oblique fissure, the lowest point of the left lower oblique fissure, the intersection of the left lower lung lower edge and the aortic arch track, the intersection of the left lower lung mediastinal surface lower edge and the aortic arch track, the intersection of the left lower pulmonary vein track pressing point and the aortic arch track.
In a preferred embodiment of the present application, the step of determining the projection point of the nodule in the target triangulation locating area and the three target anatomical landmark points corresponding to the target triangulation locating area includes: determining a target triangulation location area and three target anatomical marking points corresponding to the target triangulation location area; constructing a plane based on the three target anatomical marker points; the projected points of the nodule where the actual location of the nodule is projected onto the plane are determined.
In a preferred embodiment of the present application, the step of determining distances between the actual position of the nodule and the three target anatomical landmark points based on the projection point of the nodule and the three target anatomical landmark points includes: determining first distances between the projection points and the three target anatomical marking points; determining a second distance between the projection point and the actual position of the nodule; distances of the actual location of the nodule from the three target anatomical marker points are determined based on the second distance and the three first distances.
In a preferred embodiment of the present application, the step of determining the actual position of the nodule based on three actual marker points and three distances corresponding to the three target anatomical marker points includes: determining three actual marking points corresponding to the three target anatomical marking points; determining a line segment shortening coefficient based on the distances between the three actual marking points and the distances between the three target anatomical marking points; determining the target distances between the actual position of the nodule and the three actual marking points by the distances between the actual position of the nodule and the three target anatomical marking points and the line segment shortening coefficient; the actual position of the nodule is determined based on the three actual marker points and the three target distances.
In a preferred embodiment of the present application, the step of determining the actual position of the nodule based on the three actual marker points and the three target distances includes: dividing three actual mark points into three groups; wherein each group comprises two actual marking points; the actual marker points included in different groups are not identical; for two actual mark points in each group, taking the two actual mark points as the circle centers to make circles and determining the intersection point of the two circles; the radius of a circle corresponding to the actual marking point is the target distance corresponding to the actual marking point; the actual location of the nodule is determined based on the three intersections for the three groups.
In a preferred embodiment of the present application, the step of determining the actual position of the nodule based on the three intersection points corresponding to the three groups includes: if the three intersection points corresponding to the three groups are different; the center positions of the three intersection points corresponding to the three groups are used as the actual positions of the nodules.
In a preferred embodiment of the present application, the method further includes: the actual location of the nodule is marked at the target site of the patient by electrocautery.
In a second aspect, an embodiment of the present invention further provides a nodule locating apparatus based on triangulation, where the apparatus includes: the model construction module is used for acquiring a thin layer CT image of a patient and constructing a three-dimensional digital model of a target part of the patient based on the thin layer CT image; the surface of the three-dimensional digital model comprises a plurality of anatomical marking points and a plurality of triangulation areas determined based on the determined anatomical marking points, and the three-dimensional digital model is marked with nodules; the projection point determining module is used for determining projection points of the nodules in the target triangulation locating area and three target anatomical marking points corresponding to the target triangulation locating area; the distance determination module is used for determining the distances between the actual position of the nodule and the three target anatomical marker points based on the projection point of the nodule and the three target anatomical marker points; the actual position determining module is used for determining the actual position of the nodule on the basis of three actual marking points and three distances corresponding to the three target anatomical marking points; wherein, the three actual mark points are positioned and determined inside the chest cavity of the patient in a triangular positioning mode.
In a third aspect, an embodiment of the present invention further provides an electronic device, where the electronic device includes: a processing device and a storage device; the storage means has stored thereon a computer program which, when run by a processing device, performs the above-described method of nodule localization based on triangulation.
The embodiment of the invention has the following beneficial effects:
the method, the device and the electronic equipment for locating the nodule based on the triangulation, which are provided by the embodiment of the invention, can utilize the anatomical mark points as reference points, and guide the nodule location and excision by measuring the relative relation between the projection points and the anatomical points of the nodule on the three-dimensional digital model of the target part of the patient. Thereby avoiding the operation of puncture location before the operation, reducing the operation wound and the operation time, and being beneficial to the quick recovery after the operation.
Additional features and advantages of the disclosure will be set forth in the description which follows, or in part may be learned by the practice of the above-described techniques of the disclosure, or may be learned by practice of the disclosure.
In order to make the aforementioned objects, features and advantages of the present disclosure more comprehensible, preferred embodiments accompanied with figures are described in detail below.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the embodiments or the prior art descriptions will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without creative efforts.
FIG. 1 is a schematic diagram of a lung nodule localization method based on triangulation provided by an embodiment of the present invention;
fig. 2 is a flowchart of a nodule locating method based on triangulation provided in an embodiment of the present invention;
FIG. 3 is a flowchart of another method for locating a nodule based on triangulation, according to an embodiment of the present invention;
FIG. 4 is a schematic diagram of a right lung anatomy marker provided in accordance with an embodiment of the present invention;
FIG. 5 is a schematic diagram of a left lung anatomy marker provided in accordance with an embodiment of the present invention;
FIG. 6 is a schematic diagram of a triangulated region of the right lung according to an embodiment of the present invention;
FIG. 7 is a schematic diagram of a triangulated region of the left lung according to an embodiment of the present invention;
FIG. 8 is a schematic diagram of a three-dimensional digital model according to an embodiment of the present invention;
FIG. 9 is a schematic diagram of a triangulated region of a right upper lung according to an embodiment of the present invention;
FIG. 10 is a schematic view of a nodule location provided by an embodiment of the present invention;
FIG. 11 is a schematic view of another nodule location provided by embodiments of the present invention;
FIG. 12 is a schematic diagram of a position of an intraoperative junction according to an embodiment of the present invention;
FIG. 13 is a schematic illustration of a technical path for lung nodule resection provided by an embodiment of the present invention;
FIG. 14 is a schematic structural diagram of a nodule locating apparatus based on triangulation location according to an embodiment of the present invention;
fig. 15 is a schematic structural diagram of an electronic device according to an embodiment of the present invention.
Detailed Description
To make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings, and it is apparent that the described embodiments are some, but not all embodiments of the present invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Currently, referring to fig. 1, a schematic diagram of a lung nodule localization method based on triangulation localization may be used to localize lung nodules by two ways, i.e., three-dimensional lung CT reconstruction or preoperative repetitive CT scan localization. However, the three-dimensional lung CT reconstruction method is very traumatic, time-consuming and labor-consuming for patients, slow in recovery of patients, and high in economic cost; the mode location in-process patient of repeated CT scanning location before the art is comparatively painful, can bring extra wound, has increased the radiation, needs positioning device and personnel, and the cost is higher.
Therefore, there is currently a clinical lack of noninvasive localization methods that enable lung nodule-to-lung surface projection. Based on the above, the embodiment of the invention provides a method, a device and electronic equipment for locating a nodule based on triangulation, and mainly provides a method for locating a nodule on a lung surface through a lung surface anatomical marker and a three-dimensional reconstruction model. By the method, the local lung resection operation can be guided by utilizing the existing lung three-dimensional reconstruction software, so that the preoperative puncture positioning operation is avoided, the operation wound is reduced, the operation time is reduced, and the postoperative rapid rehabilitation is facilitated. The embodiment can use a unique anatomical mark point in the lung as a reference point, and guide the positioning and ablation of the nodule by measuring the relative relation between a projection point of the lung nodule on the lung surface and the anatomical point on the lung digital reconstruction model.
In order to facilitate understanding of the present embodiment, a nodule locating method based on triangulation disclosed in the embodiments of the present invention will be described in detail first.
The first embodiment is as follows:
the embodiment of the invention provides a nodule positioning method based on triangulation, which is shown in a flow chart of the nodule positioning method based on triangulation shown in figure 2 and comprises the following steps:
step S202, a thin layer CT image of the patient is obtained, and a three-dimensional digital model of the target part of the patient is constructed based on the thin layer CT image.
Wherein the surface of the three-dimensional digital model comprises a plurality of anatomical landmark points and a plurality of triangulated regions determined based on the determined anatomical landmark points, the three-dimensional digital model being marked with nodules. CT is a technique that uses precisely collimated X-ray beams, gamma rays, ultrasonic waves, etc. to scan one section after another around a certain part of the human body together with a detector of extremely high sensitivity. Wherein, the lamella refers to the condition that the single scanning layer is less than or equal to 5mm, and the interval of each scanning of the lamella CT scanning is smaller.
From the thin-layer CT images of the thin-layer CT scan, a three-dimensional digital model of the target region of the patient can be constructed. The target site of the patient in this embodiment may be a lung of the patient, which is not described herein again.
The anatomical marking points are all points on the surface of the target part, and can be understood as the actual marking points of the patient and the points of the actual nodule position projected on the surface of the target part through the Euler space shortest module value projection algorithm. A plurality of actual marking points can be marked in advance on the lung of the patient, and the actual marking points correspond to the anatomical marking points in the three-dimensional digital model one to one.
The three anatomical marker points may form a triangulation area, in this embodiment, a plurality of triangulation areas may be arranged on the surface of the three-dimensional digital model, or the positions of nodules may be marked inside the three-dimensional digital model.
And step S204, determining projection points of the nodule in the target triangulation locating area and three target anatomical marking points corresponding to the target triangulation locating area.
In this embodiment, a three-dimensional positioning area may be selected as a target triangulation positioning area on the surface of the three-dimensional digital model, and three anatomical landmark points constituting the target triangulation positioning area are determined as target anatomical landmark points. Then, the nodule inside the three-dimensional digital model is projected to the target triangulation area, and the projection point of the nodule in the target triangulation area is determined.
And step S206, determining the distances between the actual position of the nodule and the three target anatomical marking points based on the projection points of the nodule and the three target anatomical marking points.
After determining the actual position of the nodule, the projected point of the nodule, and the three target anatomical landmark points, distances of the actual position of the nodule from the three target anatomical landmark points may be calculated to determine the actual position of the nodule based on the distances.
Step S208, determining the actual position of the nodule based on three actual marking points and three distances corresponding to the three target anatomical marking points; wherein, the three actual mark points are positioned and determined in the chest cavity of the patient in a triangular positioning mode.
The actual marker point may be understood as an actual point of the target site of the patient, which may not be the same as the anatomical marker point, since the target site is likely to have a collapse. In the actual operation process, three actual marking points corresponding to the three target anatomical marking points can be determined, and then the actual position of the nodule can be determined according to the distances between the actual position of the nodule and the three target anatomical marking points obtained by the calculation in the steps.
The three actual marking points in this embodiment are positioned and determined inside the patient's thorax by means of triangulation, that is, by means of a laser method.
According to the method for locating the nodule based on the triangulation provided by the embodiment of the invention, the anatomical mark points can be used as reference points, and the relative relation between the projection points and the anatomical points of the nodule is measured on the three-dimensional digital model of the target part of the patient to guide the nodule to locate and cut. Thereby avoiding the operation of puncture location before the operation, reducing the operation wound and the operation time, and being beneficial to the quick recovery after the operation.
Example two:
the present embodiment provides another method for locating a nodule based on triangulation, which is implemented on the basis of the above embodiments, and takes a flowchart of another method for locating a nodule based on triangulation shown in fig. 3, where the method for locating a nodule based on triangulation includes the following steps:
step S302, a thin layer CT image of the patient is obtained, and a three-dimensional digital model of the target part of the patient is constructed based on the thin layer CT image.
Specifically, the target site in this embodiment is a lung, and the anatomical marker points include a right lung anatomical marker point and a left lung anatomical marker point. The selected labeling of the anatomical marker points comprises: (1) anatomical points common to all cases; (2) the thoracoscope operation is easy to find; (3) its position is less affected by respiration or heart beat.
Referring to fig. 4, a schematic diagram of a right lung anatomical marker point is shown, where the right lung anatomical marker point includes at least one of: the upper right lung apex A, the apex B of the intersection of the rear upper lung section and the back lower lung section, the intersection C of the horizontal fissure of the right lung and the oblique fissure, the intersection D of the horizontal fissure and the inner side edge of the right upper lung, the first rib impression E of the right upper lung, the intersection F of the lower right lung edge and the thoracic vertebra impression, the inner side end G of the lower right lung edge, the lowest point H of the right middle lung, the lowest point I of the right upper pulmonary trachea impression, the vein impression point J of the right lower lung and the outer side end K of the lower right lung edge.
Referring to fig. 5, a schematic diagram of a left lung anatomical marker point is shown, where the left lung anatomical marker point includes at least one of: a left upper lung cusp section vertex A, a left first rib pressure trace point B, a vertex C at the intersection of a left upper lung posterior section and a left lower lung dorsal section, a left upper lung lowest point D, a left upper oblique fissure and lower oblique fissure intersection point E, a left lower oblique fissure lowest point F, a left lower lung lower edge and aortic arch pressure trace intersection point G, a left lower lung mediastinum surface lower edge and aortic arch pressure trace intersection point H, a left lower pulmonary vein pressure trace point I and a left lower lung upper edge and aortic arch pressure trace intersection point J.
Referring to the schematic diagram of the right lung triangulation region shown in fig. 6 and the schematic diagram of the left lung triangulation region shown in fig. 7, in this embodiment, the triangulation region may be selected according to an individualized reconstructed lung three-dimensional model, and the triangle region selection principle is to reduce the influence of the lung surface curved surface as much as possible (make the triangle region approach a plane as much as possible).
Referring to a schematic diagram of a three-dimensional digital model shown in fig. 8, the present embodiment may perform modeling according to a thin-layer CT image of a patient examination to generate a three-dimensional digital model. Firstly, the projection position of the nodule on the lung surface can be calculated, the projection position M of the nodule on the lung surface is marked, meanwhile, the area of a triangular plane where the projection position M is located is determined, and the projection position N of the projection position M on the triangular plane is marked.
Step S304, determining a target triangulation location area and three target anatomical marker points corresponding to the target triangulation location area; constructing a plane based on the three target anatomical marker points; the projected points of the nodule where the actual location of the nodule is projected onto the plane are determined.
Referring to fig. 9, a schematic diagram of a triangulation area of a right upper lung, taking the right upper lung as an example, a projection point position N of a lung nodule on a selected target triangular area plane and three target anatomical marker points A, B, C corresponding to the target triangulation area can be determined according to a three-dimensional digital model.
And step S306, determining the distances between the actual position of the nodule and the three target anatomical marker points based on the projection point of the nodule and the three target anatomical marker points.
Specifically, the present embodiment may determine a first distance between the projection point and the three target anatomical landmark points; determining a second distance between the projection point and the actual position of the nodule; distances of the actual location of the nodule from the three target anatomical marker points are determined based on the second distance and the three first distances.
Referring to fig. 10, a schematic diagram of a nodule position, in this embodiment, a triangulation method may be used to define a position of AN N point on a reconstructed lung three-dimensional model, and a plane coordinate set { (X) of AN is located using a point B as AN origin and a point BC as AN X axis A ,y A ),(0,0),(x C 0), and the coordinates of the N point are (x, y). Wherein, three first distances between the projection point and the three target anatomical marker points are respectively as follows: d1 2 ＝(x-x A ) 2 +(y-y A ) 2 ，d2 2 ＝x 2 +y 2 ，d3 2 ＝(x–x c ) 2 +y 2 。
Since the lung surface is now a curved surface with respect to the triangular plane, the distance d4 (i.e. the second distance between the projection point and the actual position of the nodule) of MN can be measured by the three-dimensional reconstruction software, and the distances AM, BM, and CM between the actual position of the nodule and the three target anatomical landmark points are d1 ', d2 ', and d3 ', respectively, as shown in fig. 11. d 1' 2 ＝d1 2 +d4 2 ，d2’ 2 ＝d2 2 +d4 2 ，d3’ 2 ＝d3 2 +d4 2 。
And step S308, determining the actual position of the nodule based on the three actual marking points and the three distances corresponding to the three target anatomical marking points.
Specifically, three actual marker points corresponding to the three target anatomical marker points may be determined; determining a line segment shortening coefficient based on the distance between the three actual marking points and the distance between the three target anatomical marking points; determining the target distances between the actual position of the nodule and the three actual marking points by the distances between the actual position of the nodule and the three target anatomical marking points and the line segment shortening coefficient; the actual position of the nodule is determined based on the three actual marker points and the three target distances.
In this embodiment, measurement can be performed by an auxiliary device during an operation, see a schematic diagram of the position of the junction in the operation shown in fig. 12, where a ', B ', and C ' in fig. 12 are actual mark points, and a certain length correction is required for the lung to have an equal proportion of slight collapse due to the effect of the artificial pneumothorax during the operation.
Firstly, a laser method or an ultrasonic method, an infrared method or an ultrasonic method for external use, a distance measuring method such as infrared, Bluetooth, ultrasonic, laser, ultra wide band and the like can be introduced into a patient, and a pulse laser distance measuring instrument combined reflector device, ultrasonic distance measuring or infrared distance measuring are respectively arranged at points A ', B ' and C '.
Taking the laser method as an example, a 'B', B 'C', a 'C' can be measured by a laser ranging method, and the line segment shortening factor after collapse alpha is (a 'B'/AB + B 'C'/BC + a 'C'/AC)/3.
As shown in FIG. 12, the projected point M 'of the nodule on the lung surface is separated from the points A', B 'and C' by r1, r2 and r3 respectively. Specifically, the present embodiment may divide three actual mark points into three groups; wherein each group comprises two actual marking points; the actual marker points included in different groups are not identical; for two actual mark points in each group, taking the two actual mark points as the circle centers to make circles and determining the intersection point of the two circles; the radius of a circle corresponding to the actual marking point is the target distance corresponding to the actual marking point; the actual location of the nodule is determined based on the three intersections for the three groups.
Theoretically, three circles with r1, r2 and r3 as radii should intersect with one point, namely M', but due to slight difference of lung collapse ratio, the three circles may intersect with each other in pairs, and the intersection points are M1, M2 and M3.
A laser reflecting screen can be placed on the surface of the lung, the reflecting screen is moved to search for an M1 point at the approximate position of the M ' point, so that B ' M1 is r2, C ' M1 is r3, and M1 points are marked by electrocautery; moving the reflecting screen again to search for an M2 point, enabling A 'M2 to be r1 and C' M2 to be r3, and marking M2; repeatedly moving the reflecting screen to search for an M3 point, enabling A 'M3 to be r1 and B' M3 to be r2, and marking an M3 point. Wherein, M1, M2, M3 are three intersections corresponding to the three groups.
If the three intersection points corresponding to the three groups are different; the center position of three intersection points corresponding to the three groups may be taken as the actual position of the nodule. Points M' in FIG. 12 are the midpoint positions of the triangles M1, M2 and M3, and can be marked by electrocautery.
Wherein the position F (x) of the intersection M1 of the circle B' and the circle C 1 ，y 1 ) The solution can be solved by the following formula: (x) 1 -x B ’) 2 +(y 1 -y B ) 2 ＝r 2 2 ，(x 1 -x C ’) 2 +(y 1 -y C ) 2 ＝r 3 2 ，(x 1 -x A ’) 2 +(y 1 -y A ) 2 ≤r 3 2 . The positions (x) of points M2 and M3 are determined in the same manner 2 ，y 2 ) (x3, y 3). The location of the nodule on the lung surface (X, Y) is X ═ X 1 +x 2 +x 3 )/3,Y＝(y 1 +y 2 +y 3 )/3。
In addition, the present embodiment may mark the actual location of the nodule at the target site of the patient by electrocautery. Referring to fig. 13, a schematic diagram of a technical path of pulmonary nodule ablation is shown, in a coordinate system defined by points a ', B', and C ', M' points are found on the lung surface according to coordinates by using distance measurement methods such as infrared, bluetooth, ultrasound, laser, ultra-wideband and the like, and are marked by electrocautery.
The traditional lung three-dimensional reconstruction navigation is mainly used for lung section resection operation, and is not suitable for cases requiring precise wedge resection, such as lung nodule biopsy or early lung cancer. At present, in order to realize the pulmonary nodule positioning, a puncture method is mainly guided by CT, the method needs additional CT equipment before an operation, needs a professional to operate, and a patient repeatedly receives additional ray irradiation and often has intolerable pain, and risks such as pneumothorax and hemorrhage are also accompanied in the puncture process, so that the safety of minimally invasive surgery is reduced.
Therefore, the embodiment of the invention provides a novel measurement positioning method according to anatomical points in the lung, which uses specific anatomical identification points in the lung as reference to complete the positioning of the projection of the nodule on the surface of the lung through accurate measurement, thereby achieving the same effect as the puncture positioning under the guidance of CT, but completely avoiding the defects of the traditional puncture positioning method of the pulmonary nodule under the guidance of CT, and leading a patient to complete the nodule positioning under the general anesthesia state, and having the characteristics of safety, non-wound performance and accuracy. The method specifically comprises the following steps:
(1) reduction of radiation exposure: the conventional CT guiding method requires an additional CT scan before the operation after the initial diagnosis CT is completed, and the CT irradiation is repeated during the puncture process to determine the position of the positioning marker. The method provided by the embodiment only needs one-time initial diagnosis CT to carry out three-dimensional modeling, and radioactive damage is greatly reduced.
(2) Relieving pain: local anesthesia of a patient in the traditional CT auxiliary positioning method often causes intolerable pain, a metal mark is left in the body after puncture is finished, and the patient needs to wait for the start of an operation in a waking state again, so that the pain is further increased. In the positioning process of the method provided by the embodiment, the patient is in a general anesthesia state in the whole course, no additional wound is added, and no pain is caused.
(3) And (3) reducing the risk: the traditional CT guided puncture positioning method may cause damages to lungs, blood vessels and the like in the puncture process, and risks such as pneumothorax, hemorrhage and the like of a patient, and risks such as shock and the like may be caused if related complications cannot be treated in time when the patient completes a puncture waiting operation. The embodiment can complete positioning in the operation, does not relate to a puncture process, and avoids the risks of hemothorax and pneumothorax.
(4) And (3) preventing cross infection: the traditional CT guiding method has the problem that a plurality of patients can share one CT to finish operation when positioned before an operation, so that the risk of cross infection of medical care and the patients in the operation process is greatly increased. The invention realizes individual positioning without sharing a puncture device, thereby avoiding the risk of cross infection in the positioning process.
(5) And (3) time reduction: the traditional CT positioning method takes about 30 minutes, the positioning time of the embodiment can be controlled within 5-10 minutes, and the time required by positioning is greatly reduced.
(6) Manpower cost: the traditional CT positioning method needs to add extra radiology department medical care to assist in completing the operation, which wastes labor cost, and the method provided by the embodiment only needs a surgeon to complete the operation in the operation, so that the labor cost is reduced.
(7) The device relies on: the operation does not need high-volume fixed equipment such as CT and the like, reduces the dependence of the positioning technology on the equipment and is beneficial to the popularization of the technology.
Example three:
in the foregoing method embodiment, an embodiment of the present invention provides a nodule locating apparatus based on triangulation, referring to fig. 14, which shows a schematic structural diagram of the nodule locating apparatus based on triangulation, and the nodule locating apparatus based on triangulation includes:
a model construction module 1401, configured to acquire a thin layer CT image of a patient, and construct a three-dimensional digital model of a target site of the patient based on the thin layer CT image; the surface of the three-dimensional digital model comprises a plurality of anatomical marking points and a plurality of triangulation areas determined based on the determined anatomical marking points, and the three-dimensional digital model is marked with nodules;
a projection point determination module 1402, configured to determine projection points of the nodule in the target triangulation location area and three target anatomical marker points corresponding to the target triangulation location area;
a distance determining module 1403, configured to determine distances between the actual position of the nodule and the three target anatomical landmark points based on the projection point of the nodule and the three target anatomical landmark points;
an actual position determining module 1404, configured to determine an actual position of the nodule based on three actual marker points and three distances corresponding to the three target anatomical marker points; wherein, the three actual mark points are positioned and determined inside the chest cavity of the patient in a triangular positioning mode.
The nodule positioning device based on the triangulation positioning can utilize the anatomical mark points as reference points, and guide the nodule positioning and excision by measuring the relative relation between the projection points and the anatomical points of the nodule on the three-dimensional digital model of the target part of the patient. Thereby avoiding the operation of puncture location before the operation, reducing the operation wound and the operation time, and being beneficial to the quick recovery after the operation.
The target part is a lung, and the anatomical mark points comprise a right lung anatomical mark point and a left lung anatomical mark point; the right lung anatomical marker points include at least one of: the apex of the upper lung apex, the apex of the intersection of the rear right upper lung segment and the back lower lung segment, the intersection of the horizontal fissure and the oblique fissure of the right lung, the intersection of the horizontal fissure and the inner side edge of the right upper lung, the first costal pressure trace point of the right upper lung, the intersection of the lower right lower lung edge and the thoracic vertebra pressure trace, the inner side endpoint of the lower right lower lung edge, the lowest right middle lung point, the lowest right upper pulmonary trachea pressure trace point, the right lower pulmonary vein pressure trace point and the outer side endpoint of the lower right lung edge; the left lung anatomical marker points include at least one of: a first rib track pressing point on the left side of the top point of the left upper lung cusp section, the top point of the intersection of the left upper lung posterior section and the left lower lung dorsal section, the lowest point of the left upper lung, the intersection of the left upper oblique fissure and the lower oblique fissure, the lowest point of the left lower oblique fissure, the intersection of the left lower lung lower edge and the aortic arch track, the intersection of the left lower lung mediastinal surface lower edge and the aortic arch track, the intersection of the left lower pulmonary vein track pressing point and the aortic arch track.
The projection point determining module is used for determining a target triangulation location area and three target anatomical marker points corresponding to the target triangulation location area; constructing a plane based on the three target anatomical marker points; the projected points of the nodule where the actual location of the nodule is projected onto the plane are determined.
The distance determining module is used for determining first distances between the projection point and the three target anatomical marker points; determining a second distance between the projection point and the actual position of the nodule; distances of the actual location of the nodule from the three target anatomical marker points are determined based on the second distance and the three first distances.
The actual position determining module is used for determining three actual marking points corresponding to the three target anatomical marking points; determining a line segment shortening coefficient based on the distance between the three actual marking points and the distance between the three target anatomical marking points; determining the target distances between the actual position of the nodule and the three actual marking points by the distances between the actual position of the nodule and the three target anatomical marking points and the line segment shortening coefficient; the actual position of the nodule is determined based on the three actual marker points and the three target distances.
The actual position determining module is used for dividing the three actual marking points into three groups; wherein each group comprises two actual marking points; the actual marker points included in different groups are not identical; for two actual mark points in each group, taking the two actual mark points as the circle centers to make circles and determining the intersection point of the two circles; the radius of a circle corresponding to the actual marking point is the target distance corresponding to the actual marking point; the actual location of the nodule is determined based on the three intersections for the three groups.
The actual position determining module is used for determining whether the three intersection points corresponding to the three groups are different; the center positions of the three intersections corresponding to the three groups are used as the actual positions of the nodules.
The above-mentioned device still includes: an electrocautery marking module for marking an actual location of a nodule at a target site of a patient by electrocautery.
It can be clearly understood by those skilled in the art that, for convenience and brevity of description, the specific working process of the above-described nodule locating apparatus based on triangulation may refer to the corresponding process in the embodiment of the above-described nodule locating method based on triangulation, and will not be described herein again.
Example four:
the embodiment of the invention also provides electronic equipment, which is used for operating the nodule positioning method based on the triangulation positioning; referring to fig. 15, an electronic device is shown, which includes a memory 100 and a processor 101, wherein the memory 100 is configured to store one or more computer instructions, and the one or more computer instructions are executed by the processor 101 to implement the above-mentioned triangulation-based nodule locating method.
Further, the electronic device shown in fig. 15 further includes a bus 102 and a communication interface 103, and the processor 101, the communication interface 103, and the memory 100 are connected by the bus 102.
The Memory 100 may include a high-speed Random Access Memory (RAM) and may further include a non-volatile Memory (non-volatile Memory), such as at least one disk Memory. The communication connection between the network element of the system and at least one other network element is realized through at least one communication interface 103 (which may be wired or wireless), and the internet, a wide area network, a local network, a metropolitan area network, and the like can be used. The bus 102 may be an ISA bus, PCI bus, EISA bus, or the like. The bus may be divided into an address bus, a data bus, a control bus, etc. For ease of illustration, only one double-headed arrow is shown in FIG. 15, but that does not indicate only one bus or one type of bus.
The processor 101 may be an integrated circuit chip having signal processing capabilities. In implementation, the steps of the above method may be performed by integrated logic circuits of hardware or instructions in the form of software in the processor 101. The Processor 101 may be a general-purpose Processor, and includes a Central Processing Unit (CPU), a Network Processor (NP), and the like; the device can also be a Digital Signal Processor (DSP), an Application Specific Integrated Circuit (ASIC), a Field Programmable Gate Array (FPGA) or other Programmable logic device, a discrete Gate or transistor logic device, or a discrete hardware component. The various methods, steps and logic blocks disclosed in the embodiments of the present invention may be implemented or performed. A general purpose processor may be a microprocessor or the processor may be any conventional processor or the like. The steps of the method disclosed in connection with the embodiments of the present invention may be directly implemented by a hardware decoding processor, or implemented by a combination of hardware and software modules in the decoding processor. The software module may be located in ram, flash memory, rom, prom, or eprom, registers, etc. storage media as is well known in the art. The storage medium is located in the memory 100, and the processor 101 reads the information in the memory 100, and completes the steps of the method of the foregoing embodiment in combination with the hardware thereof.
Embodiments of the present invention further provide a computer-readable storage medium, where the computer-readable storage medium stores computer-executable instructions, and when the computer-executable instructions are called and executed by a processor, the computer-executable instructions cause the processor to implement the above-mentioned method for locating a nodule based on triangulation, and specific implementation may refer to method embodiments, and is not described herein again.
The method, the apparatus, and the computer program product for electronic device for locating a nodule based on triangulation provided in the embodiments of the present invention include a computer-readable storage medium storing program codes, where instructions included in the program codes may be used to execute the method in the foregoing method embodiments, and specific implementation may refer to the method embodiments, and will not be described herein again.
It is clear to those skilled in the art that, for convenience and brevity of description, the specific working processes of the system and/or the apparatus described above may refer to the corresponding processes in the foregoing method embodiments, and are not described herein again.
In addition, in the description of the embodiments of the present invention, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.
The functions, if implemented in the form of software functional units and sold or used as a stand-alone product, may be stored in a computer readable storage medium. Based on such understanding, the technical solution of the present invention may be embodied in the form of a software product, which is stored in a storage medium and includes instructions for causing a computer device (which may be a personal computer, a server, or a network device) to execute all or part of the steps of the method according to the embodiments of the present invention. And the aforementioned storage medium includes: a U-disk, a removable hard disk, a Read-Only Memory (ROM), a Random Access Memory (RAM), a magnetic disk or an optical disk, and other various media capable of storing program codes.
In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc., indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of description and simplicity of description, but do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.
Finally, it should be noted that: the above-mentioned embodiments are only specific embodiments of the present invention, which are used for illustrating the technical solutions of the present invention and not for limiting the same, and the protection scope of the present invention is not limited thereto, although the present invention is described in detail with reference to the foregoing embodiments, those skilled in the art should understand that: any person skilled in the art can modify or easily conceive the technical solutions described in the foregoing embodiments or equivalent substitutes for some technical features within the technical scope of the present disclosure; such modifications, changes or substitutions do not depart from the spirit and scope of the embodiments of the present invention, and they should be construed as being included therein. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.
Claims (10)
1. A method for locating a nodule based on triangulation, the method comprising:
acquiring a thin-layer CT image of a patient, and constructing a three-dimensional digital model of a target part of the patient based on the thin-layer CT image; wherein a surface of the three-dimensional digital model includes a plurality of anatomical marker points and a plurality of triangulated regions determined based on determining the anatomical marker points, the three-dimensional digital model being marked with a nodule;
determining a projection point of the nodule in a target triangulation location area and three target anatomical marking points corresponding to the target triangulation location area;
determining distances between the actual position of the nodule and the three target anatomical marker points based on the projection point of the nodule and the three target anatomical marker points;
determining the actual position of the nodule based on three actual marking points corresponding to the three target anatomical marking points and the three distances; and the three actual mark points are positioned and determined inside the chest cavity of the patient in a triangular positioning mode.
2. The method of claim 1, wherein the target site is a lung, and the anatomical marker points include a right lung anatomical marker point and a left lung anatomical marker point;
the right lung anatomical marker points include at least one of: the apex of the upper lung apex, the apex of the intersection of the rear right upper lung segment and the back lower lung segment, the intersection of the horizontal fissure and the oblique fissure of the right lung, the intersection of the horizontal fissure and the inner side edge of the right upper lung, the first costal pressure trace point of the right upper lung, the intersection of the lower right lower lung edge and the thoracic vertebra pressure trace, the inner side endpoint of the lower right lower lung edge, the lowest right middle lung point, the lowest right upper pulmonary trachea pressure trace point, the right lower pulmonary vein pressure trace point and the outer side endpoint of the lower right lung edge;
the left lung anatomical marker points include at least one of: the left side first rib pressure trace point of the top point of the left upper lung cusp section, the top point of the intersection of the left upper lung posterior section and the left lower lung dorsal section, the lowest point of the left upper lung, the intersection point of the upper oblique fissure and the lower oblique fissure of the left lung, the lowest point of the lower oblique fissure of the left lung, the intersection point of the lower edge of the left lower lung and the aortic arch pressure trace, the intersection point of the lower edge of the left lower lung mediastinal surface and the aortic arch pressure trace, the left lower pulmonary vein pressure trace point and the intersection point of the upper edge of the left lower lung and the aortic arch pressure trace.
3. The method of claim 1, wherein the step of determining the projection point of the nodule on the target triangulation area and the three target anatomical landmark points corresponding to the target triangulation area comprises:
determining a target triangulation location area and three target anatomical marking points corresponding to the target triangulation location area;
constructing a plane based on the three target anatomical marker points;
determining a projection point of the nodule where the actual location of the nodule is projected onto the plane.
4. The method of claim 1, wherein the step of determining distances of the actual location of the nodule from three of the target anatomical landmark points based on the projected point of the nodule and the three of the target anatomical landmark points comprises:
determining first distances between the projection point and the three target anatomical marker points;
determining a second distance of the projection point from the actual location of the nodule;
determining distances of the actual location of the nodule from the three target anatomical marker points based on the second distance and the three first distances.
5. The method of claim 1, wherein the step of determining the actual location of the nodule based on three actual marker points corresponding to three target anatomical marker points and three of the distances comprises:
determining three actual marking points corresponding to the three target anatomical marking points;
determining a line segment shortening coefficient based on the distance between the three actual marking points and the distance between the three target anatomical marking points;
the distances between the actual position of the nodule and the three target anatomical marker points and the target distances between the actual position of the nodule and the three actual marker points are determined by the line segment shortening coefficient;
determining an actual position of the nodule based on the three actual marker points and the three target distances.
6. The method of claim 5, wherein the step of determining the actual position of the nodule based on three of the actual marker points and three of the target distances comprises:
dividing three actual marking points into three groups; wherein each group comprises two of the actual mark points; the actual marker points included in different groups are not identical;
for two actual mark points in each group, taking the two actual mark points as circle centers to make circles and determining the intersection point of the two circles; the radius of a circle corresponding to the actual marking point is the target distance corresponding to the actual marking point;
the actual location of the nodule is determined based on the three intersections for the three groups.
7. The method of claim 6, wherein the step of determining the actual location of the nodule based on three intersection points for three groups comprises:
if the three intersection points corresponding to the three groups are different;
and taking the central positions of the three intersection points corresponding to the three groups as the actual positions of the nodules.
8. The method of claim 1, further comprising:
the actual location of the nodule is marked at the target site of the patient by electrocautery.
9. A nodule locating apparatus based on triangulation, the apparatus comprising:
the model building module is used for obtaining a thin-layer CT image of a patient and building a three-dimensional digital model of a target part of the patient based on the thin-layer CT image; wherein a surface of the three-dimensional digital model comprises a plurality of anatomical landmark points and a plurality of triangulated regions determined based on determining the anatomical landmark points, the three-dimensional digital model being marked with a nodule;
the projection point determining module is used for determining projection points of the nodule in a target triangulation location area and three target anatomical marker points corresponding to the target triangulation location area;
a distance determination module for determining the distances between the actual position of the nodule and the three target anatomical marker points based on the projection point of the nodule and the three target anatomical marker points;
the actual position determining module is used for determining the actual position of the nodule on the basis of three actual marking points and three distances corresponding to the three target anatomical marking points; and the three actual mark points are positioned and determined inside the chest cavity of the patient in a triangular positioning mode.
10. An electronic device, characterized in that the electronic device comprises: a processing device and a storage device;
the storage means has stored thereon a computer program which, when executed by the processing apparatus, performs the method of triangulation-based nodule localization according to any of claims 1 to 8.
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| PCT/CN2023/099274 WO2023237074A1 (en) | 2022-06-09 | 2023-06-09 | Ultrasonic positioning-based nodule positioning method and apparatus, and electronic device |
| PCT/CN2023/099278 WO2023237075A1 (en) | 2022-06-09 | 2023-06-09 | Triangulation-based nodule positioning method and apparatus, and electronic device |
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