CN116158852A - Spatial registration method based on neural navigation spatial registration guide plate - Google Patents
Spatial registration method based on neural navigation spatial registration guide plate Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
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Abstract
The invention relates to a spatial registration method based on a nerve navigation spatial registration guide plate, which comprises the following steps: s1, performing image scanning on the head of a patient to obtain craniofacial three-dimensional data of the patient; s2, designing a 3D model of the craniofacial part of a patient and a virtual guide plate through computer modeling software according to the three-dimensional data obtained in the step S1, and designing at least three virtual registration points on the virtual guide plate according to the 3D model of the craniofacial part and printing the entity guide plate through a 3D printer; s4, guiding the 3D model of the craniofacial part of the patient and the virtual guide plate into nerve navigation software, fixing the head of the patient, and tightly attaching the physical guide plate to the face of the patient; s5, placing the reference frame on the side of the head of the patient, and placing the optical positioning instrument at a position where the reference frame can be detected; s6, clicking virtual alignment points of the virtual guide plate one by using a mouse to obtain space coordinates of the virtual alignment points; s7, clicking corresponding entity registration points on the entity guide plate by using the probe to obtain space coordinates of the entity registration points; and S8, completing registration of the entity space and the 3D model space of the patient.
Description
Technical Field
The invention relates to a spatial registration method based on a nerve navigation spatial registration guide plate, belonging to the technical field of diagnosis and treatment.
Background
Spatial registration is a precondition for using images to locate and guide surgical procedures. Spatial registration errors are the primary source of errors in nerve navigation clinical application, and inaccurate spatial registration results in inaccurate navigation positioning, which can cause operation failure and affect life safety of patients. How to achieve accurate, stable and convenient spatial registration has been the most critical, important core problem in the field of neuronavigation.
Current neuronavigation systems generally use spatial registration methods based on point matching for spatial registration. Point-matching spatial registration uses rotation and translation to bring a set of two-by-two corresponding marker points in two spaces to spatial positional consistency. Neural navigation systems commonly use point-matching methods based on artificial markers for spatial registration. Clinically, markers that can be clearly imaged in CT or MRI are often used as artificial markers, which need to be attached to the skin where it is not easily offset. The preoperative doctor sticks 6-8 markers on the head of the patient and then performs image scanning. When in registration, a doctor acquires the coordinates of the markers in the patient space by using a probe, manually selects the coordinates of the corresponding markers in the image space, matches the coordinates in one-to-one correspondence by adopting a distance minimum criterion, calculates the coordinate transformation relationship of the two spaces, and thus completes registration from the patient space to the image space. The point matching method based on the artificial marker has higher precision and simple operation, but has the following defects: (1) The patient needs to be marked on his head before surgery and then scanned for images. This requires a further image scan for special navigation prior to surgery, which increases the economic burden on the patient and also makes some emergency procedures impossible. If CT images are scanned, the extent to which the patient is irradiated is increased. (2) The markers stuck on the skin are easily displaced or even fall off due to the influence of skin deflection or expansion, so that large registration errors are caused, and even navigation cannot be performed. (3) The doctor needs to repeatedly fine tune the coordinates acquired in the registration process, so that the time consumption is long, and the operation time and the workload of the doctor are increased.
In order to overcome the drawbacks of the manual marker-based point matching method, a point matching method based on anatomical marker points has been proposed. Anatomical features that are easily identified on both the surface of the human body and the navigation image are often referred to as anatomical landmark points. The registration method based on the anatomical marker points does not need to do image scanning for navigation, does not need to use artificial markers, but can hardly accurately determine specific positions of the anatomical marker points in image space and patient space, thereby causing inconsistency of point pairs, and has the defect of low registration accuracy and little clinical use. There is also a point matching method based on bone implantable markers (titanium nails) that can provide high registration accuracy. This method requires implantation of some titanium nails into the skull under local anesthesia. The titanium nails implanted into the skull are not affected by skin deflection and cannot fall off from the head, so that the registration accuracy is high, but the method has a certain damage to a patient, and the method is avoided as much as possible clinically.
Disclosure of Invention
The invention aims to provide a spatial registration method based on a nerve navigation spatial registration guide plate, which does not need to paste an artificial marker for registration or specially do image scanning for navigation, can be reused, improves registration accuracy and comfort level of use of a patient, and is particularly suitable for brain drug delivery and nerve regulation guided by nerve navigation which needs repeated treatment under a non-anesthesia state.
The technical aim of the invention is mainly solved by the following technical scheme: a spatial registration method based on a nerve navigation spatial registration guide plate comprises the following steps:
s1, CT or MRI imaging scanning is carried out on the head of a patient to obtain three-dimensional data of the cranium and the face of the patient, wherein the scanning range comprises the level from the top of the cranium to the tip of the nose;
s2, designing a 3D model of the craniofacial part of the patient and a virtual guide plate through computer modeling software according to the three-dimensional data obtained in the step S1;
s3, designing at least three virtual alignment points on the virtual guide plate according to the craniofacial 3D model, and printing the entity guide plate through a 3D printer;
s4, guiding the 3D model of the craniofacial part of the patient and the virtual guide plate into nerve navigation software, fixing the head of the patient, and tightly attaching the printed entity guide plate to the face of the patient;
s5, placing the reference frame on the side of the head of the patient, and placing the optical positioning instrument at a position where the reference frame can be detected;
s6, clicking virtual alignment points of the virtual guide plate one by one on a nerve navigation software operation interface, and displaying space coordinates of each virtual alignment point by an operation interface list;
and S7, clicking corresponding entity alignment points on the entity guide plate through the probes according to the sequence of the virtual alignment points displayed in the list in the step S6, and completing one-to-one correspondence between all the alignment points on the entity guide plate and all the alignment points on the virtual guide plate. The optical positioning instrument tracks the reference frame and the probe in real time, obtains the space coordinates of the entity alignment points and synchronizes to the nerve navigation software;
and S8, registering the entity space represented by the head of the patient with the 3D model space of the patient in the nerve navigation software.
According to the method, the registration guide plate is used for replacing the manual marker, so that the preoperative preparation flow is simplified, the patient is prevented from scanning the image again for navigation, the registration precision is improved, the navigation operation is convenient, and the operation reliability is ensured.
Preferably, in the step S1, after performing image scanning on the head of the patient, image data in DICOM medical image file format is imported into modeling software to reconstruct into a virtual 3D model of the craniofacial face of the patient; accurate data of the craniofacial part of the patient is accurately reconstructed, and subsequent operation is convenient.
Preferably, in the step S2, a virtual guide plate is designed according to the 3D model of the craniofacial part of the patient, so that the virtual guide plate can be closely attached to the face of the 3D model of the craniofacial part of the patient; the virtual guide plate is tightly attached to the 3D model of the craniofacial part of the patient, so that the printed entity guide plate is tightly attached to the face of the patient, and the position of the guide plate is kept consistent with the face of the patient in the 3D model.
Preferably, five virtual alignment points are designed on the virtual guide plate in the step S3; five virtual registration points are designed on the virtual guide plate, so that the registration effect on the physical guide plate can be increased, and the registration precision is improved.
Preferably, the optical positioner in the step S5 is placed at a position where the reference frame can be detected; the optical positioning instrument is placed at a position where the reference frame can be detected, so that the space coordinates of the registration points on the entity guide plate can be acquired conveniently.
Preferably, four reflective balls distributed at the end part in a cross structure are arranged on the reference frame in the S5, and the reflective balls face the optical positioning instrument; the reference frame is provided with a reflective ball, so that the optical positioning instrument can determine the spatial coordinates of the craniofacial part of the patient and the solid guide plate through the reflective ball on the reference frame.
Preferably, in the step S7, the spatial coordinates of the physical alignment points on the physical guide plate are obtained by clicking the probe tip on the physical alignment points on the physical guide plate; the space coordinates of the registration points on the entity guide plate can be obtained by tracking the reference frame and the probe in real time through the optical positioning instrument, and positioning is more convenient.
Preferably, the probe in the step S7 is provided with four reflective balls distributed at the end in a Y-shaped structure, and the reflective balls face the optical positioning instrument; the probe is provided with a plurality of reflecting balls which are not on the same straight line, so that the optical positioning instrument can conveniently obtain the space coordinates of the probe.
Preferably, after the spatial coordinates of each of the physical registration points on the physical guide plate in step S7 are obtained, the neural navigation software automatically registers the spatial coordinates of the physical registration points with the spatial coordinates of the virtual registration points; the entity registration points and the virtual registration points are automatically registered through the nerve navigation software, so that the registration speed is higher, and the accuracy is higher.
Therefore, the invention simplifies the preoperative preparation flow, prevents the patient from scanning the image again for navigation, has simple manufacture of the registration guide plate, high registration accuracy and high comfort level for the patient, and is particularly suitable for brain drug delivery and nerve regulation guided by nerve navigation which requires repeated treatment under non-anesthesia state.
Drawings
FIG. 1 is a workflow diagram of the present method;
FIG. 2 is a perspective view of a neuronavigation spatial registration fence in the present method.
Detailed Description
The technical scheme of the invention is further specifically described below through examples and with reference to the accompanying drawings.
As shown in fig. 1, a spatial registration method based on a neural navigation spatial registration guide plate includes the following steps:
s1, CT or MRI image scanning is carried out on the head of a patient to obtain three-dimensional data of the craniofacial part of the patient, wherein the scanning range comprises the level from the craniofacial top to the nasal tip;
s2, designing a 3D model of the craniofacial part of the patient and a virtual guide plate through computer modeling software according to the three-dimensional data obtained in the step S1;
s3, designing at least three virtual alignment points on the virtual guide plate according to the craniofacial 3D model, and printing the entity guide plate through a 3D printer;
s4, guiding the 3D model of the craniofacial part of the patient and the virtual guide plate into nerve navigation software, fixing the head of the patient, and tightly attaching the printed entity guide plate to the face of the patient;
s5, placing the reference frame on the side of the head of the patient, and placing the optical positioning instrument on a position where the reference frame can be detected;
s6, clicking virtual alignment points of the virtual guide plate one by one on the operation interface of the nerve navigation software, and displaying space coordinates of each virtual alignment point on the operation interface list;
and S7, clicking corresponding entity alignment points on the entity guide plate through the probes according to the sequence of the virtual alignment points displayed in the list in the step S6, and completing one-to-one correspondence between all the alignment points on the entity guide plate and all the alignment points on the virtual guide plate. The optical positioning instrument tracks the reference frame and the probe in real time, obtains the space coordinates of the entity alignment points and synchronizes to the nerve navigation software;
and S8, registering the entity space represented by the head of the patient with the 3D model space of the patient in the nerve navigation software.
After the imaging examination is carried out on the head of the patient in the step S1, the image data in the DICOM medical image file format are imported into modeling software and reconstructed into a virtual 3D model of the craniofacial part of the patient, after the modeling of the virtual guide plate in the step S2 is finished, the virtual guide plate is closely attached to the face of the 3D model of the craniofacial part of the patient, five virtual registration points are designed on the virtual guide plate in the step S3, and the optical locator in the step S5 is aligned with the reference frame. And four reflecting balls which are distributed at the end part in a cross structure are arranged on the reference frame in the step S5, the space coordinates of the entity alignment points on the entity guide plate in the step S7 are obtained by clicking the entity alignment points on the entity guide plate through the probe tip, the probe in the step S7 is in a Y-shaped structure, four reflecting balls which are not on the same straight line are arranged on the probe, and after the space coordinates of the entity alignment points on the entity guide plate in the step S7 are obtained, the nerve navigation software automatically registers the space coordinates of the entity alignment points with the space coordinates of the virtual alignment points.
Before registration, the patient needs to complete one CT or MRI image scan, and the scanning range comprises the level from the top of the cranium to the tip of the nose; importing DICOM-format image data into modeling software, reconstructing the DICOM-format image data into a craniofacial 3D model, and storing the DICOM-format image data into an STL format; according to the craniofacial 3D model, a virtual registration guide plate is designed, and a first registration point, a second registration point, a third registration point, a fourth registration point and a fifth registration point are respectively designed on a registration positioning part, a first registration fixing part, a second registration fixing part and a third registration fixing part of the virtual guide plate. And finally, storing the virtual registration guide plate into an STL format, printing out the entity guide plate by using a 3D printer, and placing the entity guide plate on the craniofacial part of a patient to be tightly fixed.
After the entity guide plate is clung to the face of the patient, the 3D model of the craniofacial face of the patient and the virtual registration guide plate are led into the nerve navigation software; placing a reference frame on the head edge of a patient, establishing a physical space coordinate system, and placing an optical positioning instrument on a position where the reference frame can be detected; the virtual guide plate in the nerve navigation software is clung to the surface of the 3D model of the craniofacial part of the patient, three-dimensional coordinates of a first registration point, a second registration point, a third registration point, a fourth registration point and a fifth registration point on the virtual guide plate are respectively obtained by using a mouse, three-dimensional coordinates of the first registration point, the second registration point, the third registration point, the fourth registration point and the fifth registration point on the physical guide plate are respectively obtained by using probes matched with the optical positioning instrument, and through five pairs of registration points corresponding to one another, the registration of the physical space and the 3D model space of the patient is automatically completed by utilizing an SVD algorithm, so that a doctor can judge the relative position relationship between the real surgical instrument and the patient by observing the position of the virtual surgical instrument on the image.
After registration is complete, neural navigation may help the physician locate the lesion location and guide the surgical procedure. And after registration is completed, the guide plate can be removed, so that the operation of doctors in the operation process is not hindered. In nerve navigation guided brain drug delivery and neuromodulation, the registration guide may be used repeatedly without the need to scan the image for registration each time.
As shown in fig. 2, a nerve navigation space registration guide plate comprises a registration positioning part 1 overlapped with a nose tip part and a nose root part, wherein a first registration point 11 is arranged on the registration positioning part 1 corresponding to the nose tip part, a second registration point 12 is arranged on the registration positioning part 1 corresponding to the nose root part, at least one first registration fixing part 13 extends from the side edge of the registration positioning part 1, a third registration point 131 is arranged on the first registration fixing part 13, a second registration fixing part 14 is arranged on the side edge of the registration positioning part 1, a fourth registration point 141 is arranged on the second registration fixing part 14, a third registration fixing part 15 is arranged on the side edge of the registration positioning part 1, and a fifth registration point 151 is arranged on the third registration fixing part 15.
The guide plate is made of 3D printing resin, so that the guide plate is light and free of invasiveness; the registration fixing parts are manufactured according to the scanned images of the head of the patient, and can be tightly attached to the surface of the head of the patient.
The first registration point 11, the second registration point 12, the third registration point 131, the fourth registration point 141 and the fifth registration point 151 are all in a hole-shaped structure, and the diameters of the first registration point 11, the second registration point 12, the third registration point 131, the fourth registration point 141 and the fifth configuration point 151 are all 1mm; the first, second, third, fourth and fifth registration points may be used for probe insertion to obtain registration point coordinates.
Claims (9)
1. The spatial registration method based on the neural navigation spatial registration guide plate is characterized by comprising the following steps of:
s1, CT or MRI image scanning is carried out on the head of a patient to obtain three-dimensional data of the craniofacial part of the patient, wherein the scanning range comprises the level from the craniofacial top to the nasal tip;
s2, designing a 3D model of the craniofacial part of the patient and a virtual guide plate through computer modeling software according to the three-dimensional data obtained in the step S1;
s3, designing at least three virtual alignment points on the virtual guide plate according to the craniofacial 3D model, and printing the entity guide plate through a 3D printer;
s4, guiding the 3D model of the craniofacial part of the patient and the virtual guide plate into nerve navigation software, fixing the head of the patient, and tightly attaching the printed entity guide plate to the face of the patient;
s5, placing the reference frame on the side of the head of the patient, and placing the optical positioning instrument on a position where the reference frame can be detected;
s6, clicking virtual alignment points of the virtual guide plate one by one on a nerve navigation software operation interface, and displaying space coordinates of each virtual alignment point by an operation interface list;
s7, clicking corresponding entity alignment points on the entity guide plate through probes according to the sequence of the virtual alignment points displayed in the list in the step S6, and completing one-to-one correspondence between all the alignment points on the entity guide plate and all the alignment points on the virtual guide plate; the optical positioning instrument tracks the reference frame and the probe in real time, obtains the space coordinates of the entity alignment points and synchronizes to the nerve navigation software;
and S8, registering the entity space represented by the head of the patient with the 3D model space of the patient in the nerve navigation software.
2. The spatial registration method based on a neuronavigation spatial registration guide as set forth in claim 1, wherein: after the head of the patient is scanned in the step S1, the image data in the DICOM medical image file format is imported into modeling software to be reconstructed into a virtual 3D model of the craniofacial part of the patient.
3. The spatial registration method based on a neuronavigation spatial registration guide as set forth in claim 2, wherein: in the step S2, the virtual guide plate is designed according to the 3D model of the craniofacial part of the patient, so that the virtual guide plate can be tightly attached to the face of the 3D model of the craniofacial part of the patient.
4. A spatial registration method based on a neuronavigation spatial registration guide as in claim 3, wherein: five virtual registration points are designed on the virtual guide plate in the step S3.
5. The spatial registration method based on a neuronavigation spatial registration guide as set forth in claim 1, wherein: the optical positioner in step S5 is placed in a position where the reference frame can be detected.
6. The spatial registration method based on a neuronavigation spatial registration guide of claim 1 or 5, wherein: and four reflective balls which are distributed at the end part in a cross structure are arranged on the reference frame in the S5, and the reflective balls face the optical positioning instrument.
7. The spatial registration method based on a neuronavigation spatial registration guide as set forth in claim 1, wherein: in the step S7, the spatial coordinates of the physical alignment points on the physical guide plate are obtained by clicking the physical alignment points on the physical guide plate with the probe tip.
8. The spatial registration method based on a neuronavigation spatial registration guide as set forth in claim 1 or 7, wherein: and the probe in the step S7 is provided with four reflective balls which are distributed at the end part in a Y-shaped structure, and the reflective balls face the optical positioning instrument.
9. The spatial registration method based on a neuronavigation spatial registration guide as set forth in claim 1, wherein: after the spatial coordinates of each physical registration point on the physical guide plate in step S7 are obtained, the neural navigation software automatically registers the spatial coordinates of the physical registration points with the spatial coordinates of the virtual registration points.
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