Disclosure of Invention
The present invention aims to solve at least one of the technical problems existing in the prior art. Therefore, the invention provides a spine parameter processing method and a spine parameter processing system based on sagittal spine images; according to the method, the sagittal spine image is processed from a semi-automatic angle, corresponding parameters are automatically calculated through simple marking of the sagittal spine image, intelligent measurement and accurate measurement are effectively realized, and any measurement requirement of a clinician on the spine image can be met; meanwhile, the pre-operation spine image is processed in a semi-automatic mode, and related post-operation spine measurement parameter indexes and spine states after osteotomy can be directly obtained based on the pre-operation semi-automatic processing, so that effective behavior guidance is provided for orthopedic operation implementation.
The first aspect of the application discloses a spine parameter processing method based on sagittal spine images, the method comprising:
s1, acquiring pre-operative sagittal plane spine measurement parameters; the pre-operative sagittal spinal measurement parameters include one or more of the following: a front waist lobe and a rear chest lobe;
s2, determining an osteotomy vertex and an initial osteotomy angle based on a 6-level spine osteotomy classification standard and the preoperative sagittal plane spine measurement parameter, and determining an osteotomy upper edge line, an osteotomy lower edge line and a datum line according to the osteotomy vertex and the initial osteotomy angle; the included angle between the upper edge line of the osteotomy and the lower edge line of the osteotomy is the initial osteotomy angle;
s3, respectively rotating images positioned at the upper end and/or the lower end of the reference line by taking the osteotomy vertex as a center to obtain an image after simulation operation;
s4, obtaining the spine measurement parameters after simulation operation according to the images after simulation operation.
The method for determining the osteotomy upper edge line, the osteotomy lower edge line and the datum line according to the osteotomy vertex and the initial osteotomy angle comprises the following steps: respectively determining an upper edge line and a lower edge line of the osteotomy according to the osteotomy vertex and the initial osteotomy angle, wherein the upper edge line and the lower edge line are not collinear; and determining the datum line according to the upper osteotomy edge line, the lower osteotomy edge line and the initial osteotomy angle.
The pre-operative sagittal spinal measurement parameters and/or the simulated post-operative spinal measurement parameters may further comprise any one or more of the following: anterior cervical lobe, jaw angle, sagittal axis SVA, C7 plumb line.
After obtaining the measured parameters of the spine after the simulation operation according to the image after the simulation operation, the method further comprises the following steps:
comparing the spine measurement parameters after simulation operation with a spine parameter evaluation system to obtain a result of whether the spine measurement parameters after simulation operation accord with the spine parameter evaluation system;
if the obtained simulation post-operation spine measurement parameters accord with the spine parameter evaluation system, namely the initial osteotomy angle is a final osteotomy angle, and the positions of the upper edge line and the lower edge line are the final osteotomy range; if the obtained simulation post-operation spine measurement parameters do not accord with the spine parameter evaluation system, executing the S2-S4 of the first aspect of the application at least once again to obtain the simulation post-operation spine measurement parameters after the re-execution, and comparing the simulation post-operation spine measurement parameters after the re-execution with the spine parameter evaluation system until the obtained simulation post-operation spine measurement parameters accord with the spine parameter evaluation system, and determining a final osteotomy angle and a final osteotomy range;
optionally, the final osteotomy range is a closed figure.
The acquiring of the preoperative sagittal spinal measurement parameters includes:
acquiring a pre-operative sagittal spine image;
receiving at least two groups of starting points and end points selected by a user from the pre-operation sagittal spine image; connecting each group of starting points and ending points into at least two lines; obtaining an included angle between the at least two lines based on the at least two lines, or processing based on the at least two lines to regenerate the included angle, or a vertical distance between the at least two lines; the included angle or the vertical distance is one of the pre-operation sagittal plane spine measurement parameters;
optionally, the generating an included angle based on the processing of the at least two lines includes: respectively making at least two perpendicular lines of the at least two lines, and forming an included angle between the at least two perpendicular lines; the included angle is one of the pre-operation sagittal plane spine measurement parameters;
optionally, the receiving at least two sets of starting points and ending points selected by the user in the pre-operative sagittal spine image includes: the method comprises the steps of monitoring position information of each point which is passed by a user in the dragging operation process of a display interface through a mouse pointer or a touch screen contact in real time, taking the position information of an odd point of the dragging operation as a starting point in each group selected by the user, and taking an even point in the dragging operation process as an end point in each group selected by the user.
The simulation post-operation spine measurement parameters are obtained based on points and lines determined in the pre-operation sagittal plane spine image, and the method for obtaining the simulation post-operation spine measurement parameters comprises the following steps:
receiving at least two groups of starting points and end points selected by a user from the pre-operation sagittal spine image; connecting each group of starting points and ending points into at least two lines; obtaining an included angle between the at least two lines based on the at least two lines, or processing based on the at least two lines to regenerate the included angle, or a vertical distance between the at least two lines; the included angle or the vertical distance is one of the parameters for simulating post-operation spine measurement;
optionally, the simulated post-operative spine measurement parameters include simulated post-operative lumbar anterior lobes and/or simulated post-operative thoracic posterior lobes; the method for acquiring the simulated postoperative lumbar anterior lobe or the simulated postoperative thoracic posterior lobe comprises the following steps: and forming an included angle based on the connecting line between the first group of starting points and the terminal points and the connecting line between the second group of starting points and the terminal points, namely the simulated postoperative lumbar anterior lobe or the simulated postoperative thoracic lobe.
The rotating the images at the upper end and/or the lower end of the reference line by taking the osteotomy vertex as a center respectively comprises the following steps:
rotating the image positioned at the upper end of the reference line clockwise or anticlockwise by taking the osteotomy vertex as a center;
or, rotating the image positioned at the lower end of the datum line anticlockwise or clockwise by taking the osteotomy vertex as a center;
or, rotating the image positioned at the lower end of the datum line clockwise or anticlockwise by taking the osteotomy vertex as a center, and rotating the image positioned at the lower end of the datum line anticlockwise or clockwise by taking the osteotomy vertex as a center;
optionally, an angle between an image lower edge of the upper end of the reference line and an image upper edge of the lower end of the reference line in the simulated postoperative image is equal to the initial osteotomy angle.
A second aspect of the present application discloses a spine parameter processing system based on sagittal spine images, comprising a computer program which, when executed by a processor, implements the steps of the spine image processing method described in the first aspect of the present application.
A third aspect of the present application discloses a spinal parameter processing apparatus based on sagittal spine images, the apparatus comprising: a memory and a processor; the memory is used for storing program instructions; the processor is configured to invoke program instructions, which when executed, are configured to perform the steps of the spine parameter processing method based on sagittal spine images described in the first aspect of the present application.
A fourth aspect of the present application discloses a computer-readable storage medium, on which a computer program is stored, which when being executed by a processor, implements the steps of the method for processing spine parameters based on sagittal spine images according to the first aspect of the present application.
The application has the following beneficial effects:
1. the application creatively discloses a spine parameter processing method based on a sagittal spine image, which processes the sagittal spine image from a semiautomatic angle, and a user can automatically calculate corresponding parameters by simply marking the sagittal spine image, so that intelligent measurement and accurate measurement are effectively realized, and any measurement requirement of a clinician on the spine image is met; the method provides great convenience for clinicians, provides more accurate data for operation embodiments of patients, and effectively solves the problems that in the prior art, related indexes such as Cobb angles are manually measured through tools such as a ruler, and the like, and errors are large and are difficult to modify due to manual measurement.
2. The method creatively fuses a plurality of spinal measurement parameter indexes describing the spinal curve angle on the sagittal plane, and provides more accurate behavioral guidance for performing orthopedic operations.
3. According to the method, the traditional mode that related indexes of spine measurement parameters after osteotomy are simulated and implemented by manually cutting drawings or directly drawing on the drawings and spine states after osteotomy is changed creatively in the prior art, the steps of respectively obtaining an osteotomy vertex, an osteotomy angle, an upper edge line, a lower edge line and a datum line based on 6-level spine osteotomy classification standards and sagittal spine images, then performing rotary operation on the spine images, effectively simulating spine state images after osteotomy, automatically obtaining spine measurement parameters after the operation, and simultaneously repeatedly changing the osteotomy vertex, the osteotomy angle, the upper edge line, the lower edge line and the datum line by continuously comparing the spine parameter parameters after the simulation operation with a clinically recognized spine parameter evaluation system, and finally obtaining the most suitable osteotomy angle and osteotomy range. Effective behavior guidance is provided for the implementation of the orthopedic surgery, the acquisition efficiency of related indexes is obviously improved, the workload is greatly reduced, and intelligent measurement and accurate measurement can be achieved.
Detailed Description
In order to enable those skilled in the art to better understand the present invention, the following description will make clear and complete descriptions of the technical solutions according to the embodiments of the present invention with reference to the accompanying drawings.
In some of the flows described in the specification and claims of the present invention and in the foregoing figures, a plurality of operations occurring in a particular order are included, but it should be understood that the operations may be performed out of order or performed in parallel, with the order of operations such as 101, 102, etc., being merely used to distinguish between the various operations, the order of the operations themselves not representing any order of execution. In addition, the flows may include more or fewer operations, and the operations may be performed sequentially or in parallel. It should be noted that, the descriptions of "first" and "second" herein are used to distinguish different messages, devices, modules, etc., and do not represent a sequence, and are not limited to the "first" and the "second" being different types.
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments according to the invention without any creative effort, are within the protection scope of the invention.
Fig. 1 is a schematic flow chart of a spine parameter processing method based on a sagittal spine image according to an embodiment of the present invention, specifically, the method includes the following steps:
s1: acquiring preoperative sagittal plane spine measurement parameters; the pre-operative sagittal spinal measurement parameters include one or more of the following: a front waist lobe and a rear chest lobe;
in one embodiment, the acquiring pre-operative sagittal spinal measurement parameters includes:
acquiring a pre-operative sagittal spine image;
receiving at least two groups of starting points and end points selected by a user from the pre-operation sagittal spine image; connecting each group of starting points and ending points into at least two lines; obtaining an included angle between the at least two lines based on the at least two lines, or processing based on the at least two lines to regenerate the included angle, or a vertical distance between the at least two lines; the included angle or the vertical distance is one of the pre-operation sagittal plane spine measurement parameters;
optionally, the generating an included angle based on the processing of the at least two lines includes: respectively making at least two perpendicular lines of the at least two lines, and forming an included angle between the at least two perpendicular lines; the included angle is one of the pre-operation sagittal plane spine measurement parameters;
optionally, the receiving at least two sets of starting points and ending points selected by the user in the pre-operative sagittal spine image includes: the method comprises the steps of monitoring position information of each point which is passed by a user in the dragging operation process of a display interface through a mouse pointer or a touch screen contact in real time, taking the position information of an odd point of the dragging operation as a starting point in each group selected by the user, and taking an even point in the dragging operation process as an end point in each group selected by the user.
Optionally, the pre-operative sagittal spine image is an image obtained by scanning a sample; the scanning method comprises one or more of the following steps: x-ray, CT, MRI;
in one embodiment, the pre-operative sagittal spinal measurement parameters further include any one or more of the following: anterior cervical lobe, jaw angle, sagittal axis SVA, C7 plumb line.
S2: determining an osteotomy vertex and an initial osteotomy angle based on a level 6 spine osteotomy classification standard and the preoperative sagittal plane spine measurement parameter, and determining an osteotomy upper edge line, an osteotomy lower edge line and a reference line according to the osteotomy vertex and the initial osteotomy angle; the included angle between the upper edge line of the osteotomy and the lower edge line of the osteotomy is the initial osteotomy angle;
in one embodiment, the determining the upper osteotomy edge line, the lower osteotomy edge line, and the reference line from the apex of the osteotomy and the initial osteotomy angle includes: respectively determining an upper edge line and a lower edge line of the osteotomy according to the osteotomy vertex and the initial osteotomy angle, wherein the upper edge line and the lower edge line are not collinear; and determining the datum line according to the upper osteotomy edge line, the lower osteotomy edge line and the initial osteotomy angle.
In one embodiment, the class 6 spinal osteotomy classification consists essentially of:
the SPO of level 1 is mainly used for cutting off the spinous process, the cone plate and the articular process of the rear part of the vertebral body, and retaining the pedicle structure; in level 1 osteotomies, the apex of the osteotomy is located in front of the inferior articular processes. Grade 2 Ponte, mainly cutting off articular processes, resecting cone plates and ligamentum flavum (treatment for ankylosing spondylitis lumbar curvature disappearance; ineffective for thoracic kyphosis.); in level 2 osteotomies, the apex of the osteotomy is located in front of the inferior articular processes. Level 1/level 2 osteotomies are all posterior structures of the vertebral body, also known as PCO, posterior column osteotomies. The level 3 PSO, the single cone PSO can correct the backward convexity of about 20-30 degrees, the level 3 is the internal osteotomy of the cone, the level 1 and the level 2 cut the structures of the posterior column such as the articular process, the vertebral lamina, the spinous process and the like, and the level 3 is compared with the level 1/the level 2 osteotomy and then cuts a part of the anterior middle column; in level 3 osteotomies, the apex of the osteotomy is located at the anterior edge/center of the vertebral body. Level 4 BDBO, in addition to cutting part of the vertebral body, resects the upper/lower disc to obtain a greater kyphosis correction angle; in level 4 osteotomies, the apex of the osteotomy is located at the anterior edge of the vertebral body. A 5-level VCR thoroughly removes a vertebral body, an upper disc and a lower disc, and the thoracic vertebrae also comprise ribs with the same sequence; the backward protruding orthopedic can reach 50 degrees; in level 5 osteotomies, the apex of the osteotomy is located at the anterior edge of the vertebral body, pressurized first, and then rotated. Class 6 VCRs are class 5 osteotomies of multiple vertebral bodies.
S3: respectively rotating images positioned at the upper end and/or the lower end of the reference line by taking the osteotomy vertex as a center to obtain an image after simulation operation;
in one embodiment, the rotating the images at the upper end and/or the lower end of the reference line with the osteotomy vertex as a center includes:
rotating the image positioned at the upper end of the reference line clockwise or anticlockwise by taking the osteotomy vertex as a center;
or, rotating the image positioned at the lower end of the datum line anticlockwise or clockwise by taking the osteotomy vertex as a center;
or, rotating the image positioned at the lower end of the datum line clockwise or anticlockwise by taking the osteotomy vertex as a center, and rotating the image positioned at the lower end of the datum line anticlockwise or clockwise by taking the osteotomy vertex as a center;
optionally, an angle between an image lower edge of the upper end of the reference line and an image upper edge of the lower end of the reference line in the simulated postoperative image is equal to the initial osteotomy angle.
S4: obtaining simulation post-operation spine measurement parameters according to the simulation post-operation images;
in one embodiment, the simulated post-operative spinal column measurement parameters are obtained based on points and lines determined in the pre-operative sagittal plane spinal column image, and the method for obtaining the simulated post-operative spinal column measurement parameters comprises:
receiving at least two groups of starting points and end points selected by a user from the pre-operation sagittal spine image; connecting each group of starting points and ending points into at least two lines; obtaining an included angle between the at least two lines based on the at least two lines, or processing based on the at least two lines to regenerate the included angle, or a vertical distance between the at least two lines; the included angle or the vertical distance is one of the parameters for simulating post-operation spine measurement;
optionally, the simulated post-operative spine measurement parameters include simulated post-operative lumbar anterior lobes and/or simulated post-operative thoracic posterior lobes; the method for acquiring the simulated postoperative lumbar anterior lobe or the simulated postoperative thoracic posterior lobe comprises the following steps: and forming an included angle based on the connecting line between the first group of starting points and the terminal points and the connecting line between the second group of starting points and the terminal points, namely the simulated postoperative lumbar anterior lobe or the simulated postoperative thoracic lobe. Lumbar anterior lobe LL-L loredo 1 (cobb angle between upper L1 edge and lower S1 edge); chest lobe TK-Tkypho 1 (cobb angle between the upper and lower edges of T4 and T12 as in cobb measurement).
In one embodiment, normal lordosis enhances the ability of the cervical spine to withstand axial pressure, and the increase in normal lordosis of the cervical spine is manifested as a compression of the neck, i.e., compression of the vertebrae together. A crease behind the patient's neck may prove the presence of cervical spine hyperlordosis. The anterior cervical lobe is an indication of whether the cervical spine is normally increasing. The method for acquiring the preoperative cervical vertebra front convex angle comprises the following steps: receiving a first group of starting points and end points selected by a user from the pre-operation sagittal spine image, and a second group of starting points and end points; connecting a first set of starting point and ending point wires (C7 lower endplate vertex wires or C2 lower endplate vertex wires), and connecting a second set of starting point and ending point wires (C2 lower endplate vertex wires or C7 lower endplate vertex wires); and respectively making two perpendicular lines of the two lines, wherein an included angle formed between the two perpendicular lines is a cervical vertebra anterior lobe.
In one embodiment, the jaw eyebrow angle is the angle between the jaw eyebrow line and the vertical line of the body; the method is commonly used for the osteotomy orthopedic evaluation of patients with ankylosing spondylitis and kyphosis deformity; in the past, it was generally believed that the angle of the jaw eyebrow was between-10 and 10, allowing a better horizontal view. However, it was found that although there is a horizontal view, a satisfactory view cannot be obtained in the case where downstairs, cooking, table-keeping work and the like require a downward view, and therefore, it has been proposed that the work and life can be completed better at a jaw angle of 10 to 20 °. The method for acquiring the preoperative jaw eyebrow angle comprises the following steps: receiving a first group of starting points and end points selected by a user from the pre-operation sagittal spine image, and a second group of starting points and end points; connecting a first group of starting points and ending points to form a line (connecting the lower jaw with the forehead), and making a plumb line passing through the lower jaw; the included angle generated between the two lines is the angle of the jaw eyebrow before operation.
In one embodiment, the sagittal axis SVA refers to the vertical distance of the vertical line (C7 PL) of the neck 7 from the upper posterior angle through S1 measured on a standing scoliosis X-ray film. When C7PL is located behind S1, it is negative, and when C7PL is located in front of S1, it is positive, and C7PL may just pass through the upper rear corner of S1. The method for acquiring the preoperative SVA comprises the following steps: and receiving a first group of starting points (midpoint S1 or midpoint C7) and end points (midpoint C7 or midpoint S1) selected by a user in the pre-operation sagittal spine image, and respectively making plumb lines passing through the starting points and the end points to obtain the distance between the plumb lines passing through the starting points and the end points.
In one embodiment, the C7 plumb line includes C7 plumb lines of coronal and sagittal planes, and a straight line from the center of the C7 vertebral body perpendicular down parallel to the X-ray film border depicts the spatial position of the head.
Optionally, the simulated post-operative spine measurement parameters further include any one or more of the following: anterior cervical lobe, jaw angle, sagittal axis SVA, C7 plumb line. The method for acquiring the cervical spine angle after the simulation operation comprises the following steps: and the included angle generated between the two perpendicular lines is the cervical vertebra anterior lobe after operation. The method for obtaining the simulated postoperative jaw eyebrow angle comprises the following steps: and the included angle generated between the two lines is the angle of the jaw eyebrow after operation. The method for acquiring the SVA after the simulation operation comprises the following steps: and obtaining the distance between the two plumb lines based on the two plumb lines.
In one embodiment, after obtaining the post-simulation spine measurement parameters from the post-simulation image, the method further comprises:
comparing the spine measurement parameters after simulation operation with a spine parameter evaluation system to obtain a result of whether the spine measurement parameters after simulation operation accord with the spine parameter evaluation system;
if the obtained simulation post-operation spine measurement parameters accord with the spine parameter evaluation system, namely the initial osteotomy angle is a final osteotomy angle, and the positions of the upper edge line and the lower edge line are the final osteotomy range; if the obtained simulation post-operation spine measurement parameters do not accord with the spine parameter evaluation system, executing the S2-S4 of the first aspect of the application at least once again to obtain the simulation post-operation spine measurement parameters after the re-execution, and comparing the simulation post-operation spine measurement parameters after the re-execution with the spine parameter evaluation system until the obtained simulation post-operation spine measurement parameters accord with the spine parameter evaluation system, and determining a final osteotomy angle and a final osteotomy range; the specific flow is shown in fig. 4.
Optionally, the final osteotomy range is a closed figure.
Fig. 2 is a spinal parameter processing apparatus provided in an embodiment of the present invention, the apparatus including: a memory and a processor; the memory is used for storing program instructions; the processor is used for calling program instructions, and when the program instructions are executed, the processor is used for executing the spine parameter processing method.
A second aspect of the present application discloses a spine parameter processing system based on sagittal spine images, comprising a computer program which, when executed by a processor, implements the spine parameter processing method steps of the first aspect of the present application; as shown in fig. 3, the system includes:
a parameter acquisition unit 301 for acquiring preoperative sagittal plane spine measurement parameters; the pre-operative sagittal spinal measurement parameters include one or more of the following: a front waist lobe and a rear chest lobe;
a first parameter determining unit 302, configured to determine an osteotomy vertex and an initial osteotomy angle based on a level 6 spine osteotomy classification standard and the preoperative sagittal plane spine measurement parameter, and determine an osteotomy upper edge line, an osteotomy lower edge line, and a reference line according to the osteotomy vertex and the initial osteotomy angle; the included angle between the upper edge line of the osteotomy and the lower edge line of the osteotomy is the initial osteotomy angle;
an image processing unit 303, configured to rotate images located at the upper end and/or the lower end of the reference line with the osteotomy vertex as a center, so as to obtain a post-simulation image;
and a second parameter determining unit 304, configured to obtain a post-simulation spine measurement parameter according to the post-simulation image.
A computer readable storage medium having stored thereon a computer program which when executed by a processor implements the above-described spine parameter processing method based on sagittal spine images.
The embodiment of the invention also discloses a computer program product, which comprises a computer program, wherein the computer program realizes the steps of the spine parameter processing method based on the sagittal spine image when being executed by a processor.
The results of the verification of the present verification embodiment show that assigning an inherent weight to an indication may moderately improve the performance of the present method relative to the default settings.
It will be clear to those skilled in the art that, for convenience and brevity of description, specific working procedures of the above-described systems, apparatuses and units may refer to corresponding procedures in the foregoing method embodiments, which are not repeated herein.
In the several embodiments provided in this application, it should be understood that the disclosed systems, apparatuses, and methods may be implemented in other ways. For example, the apparatus embodiments described above are merely illustrative, e.g., the division of the units is merely a logical function division, and there may be additional divisions when actually implemented, e.g., multiple units or components may be combined or integrated into another system, or some features may be omitted or not performed. Alternatively, the coupling or direct coupling or communication connection shown or discussed with each other may be an indirect coupling or communication connection via some interfaces, devices or units, which may be in electrical, mechanical or other form.
The units described as separate units may or may not be physically separate, and units shown as units may or may not be physical units, may be located in one place, or may be distributed on a plurality of network units. Some or all of the units may be selected according to actual needs to achieve the purpose of the solution of this embodiment.
In addition, each functional unit in the embodiments of the present invention may be integrated in one processing unit, or each unit may exist alone physically, or two or more units may be integrated in one unit. The integrated units may be implemented in hardware or in software functional units.
Those of ordinary skill in the art will appreciate that all or part of the steps in the various methods of the above embodiments may be implemented by a program to instruct related hardware, the program may be stored in a computer readable storage medium, and the storage medium may include: read Only Memory (ROM), random access Memory (RAM, random Access Memory), magnetic or optical disk, and the like.
Those of ordinary skill in the art will appreciate that all or a portion of the steps in implementing the methods of the above embodiments may be implemented by a program to instruct related hardware, where the program may be stored in a computer readable storage medium, where the storage medium may be a read only memory, a magnetic disk or optical disk, etc.
While the foregoing describes a computer device provided by the present invention in detail, those skilled in the art will appreciate that the foregoing description is not meant to limit the invention thereto, as long as the scope of the invention is defined by the claims appended hereto.