本文選題：肺穿刺 + 手術(shù)導(dǎo)航　； 參考：《東北大學(xué)》2013年碩士論文

【摘要】：肺部疾病和惡性腫瘤是目前全世界范圍內(nèi)致死率最高的疾病之一,而組織學(xué)診斷是肺部疾病定性診斷和治療的金標(biāo)準(zhǔn)。目前CT引導(dǎo)的經(jīng)皮肺穿刺手術(shù)是獲取肺部病變組織的最有效手段。但目前傳統(tǒng)肺穿刺手術(shù)會(huì)使病人反復(fù)被穿刺以及反復(fù)接受放射性輻射,并增加并發(fā)癥和不良的影響的風(fēng)險(xiǎn),因此研究肺穿刺手術(shù)的新方法有著十分重要的意義。 本項(xiàng)目主要對(duì)經(jīng)皮肺穿刺手術(shù)導(dǎo)航的關(guān)鍵技術(shù)和最佳手術(shù)路徑規(guī)劃展開了研究,包括對(duì)于醫(yī)學(xué)DICOM圖像體數(shù)據(jù)重建,三維可視化技術(shù),圖像分割技術(shù),空間配準(zhǔn)方法進(jìn)行了研究。在這些技術(shù)研究的基礎(chǔ)上,開發(fā)了一套應(yīng)用于肺穿刺活檢手術(shù)的計(jì)算機(jī)手術(shù)導(dǎo)航系統(tǒng)。 本系統(tǒng)的難點(diǎn)在于整個(gè)系統(tǒng)框架的設(shè)計(jì)與實(shí)現(xiàn),因?yàn)橄到y(tǒng)實(shí)現(xiàn)過程中包含許多圖像處理算法和三維空間定位技術(shù),涉及到的算法多,而且有一定的難度。同時(shí)在設(shè)計(jì)過程中要考慮實(shí)際的臨床需要,盡量簡(jiǎn)化系統(tǒng)操作流程和軟件操作流程,提供給醫(yī)生一個(gè)簡(jiǎn)單、易用的圖像引導(dǎo)手術(shù)導(dǎo)航系統(tǒng)。 圖像處理技術(shù)和可視化算法是手術(shù)導(dǎo)航的基礎(chǔ)。研究的重點(diǎn)包括體數(shù)據(jù)處理,可視化技術(shù),圖像分割技術(shù)。在研究各種算法的基礎(chǔ)上改進(jìn)了相關(guān)的算法使其滿足臨床肺穿刺手術(shù)的需求,比如可視化技術(shù)加入了二維與三維融合顯示,三維切割顯示等功能。 空間定位技術(shù)和空間坐標(biāo)配準(zhǔn)技術(shù)是手術(shù)導(dǎo)航系統(tǒng)的關(guān)鍵。空間定位技術(shù)和配準(zhǔn)技術(shù)決定了手術(shù)導(dǎo)航系統(tǒng)的精確度,是決定手術(shù)導(dǎo)航系統(tǒng)成敗的關(guān)鍵。在研究了系統(tǒng)中不同的坐標(biāo)系統(tǒng)的關(guān)系后,通過基于外部標(biāo)志點(diǎn)的方法實(shí)現(xiàn)了導(dǎo)航系統(tǒng)的空間配準(zhǔn),而且配準(zhǔn)精度也能滿足臨床手術(shù)需求。 最終實(shí)現(xiàn)了基于三維空間定位的肺穿刺圖像引導(dǎo)系統(tǒng),該系統(tǒng)在手術(shù)前能夠幫助醫(yī)生制定手術(shù)計(jì)劃,同時(shí)來能夠自動(dòng)分析、設(shè)計(jì)手術(shù)路徑,進(jìn)行手術(shù)模擬,在術(shù)中能夠?qū)崿F(xiàn)實(shí)時(shí)導(dǎo)航,并且能夠?qū)崿F(xiàn)在不同三維視圖下進(jìn)行圖像引導(dǎo),同時(shí)根據(jù)臨床需要設(shè)計(jì)出了靶向圖和深度面圖進(jìn)行穿刺引導(dǎo),最終進(jìn)行實(shí)驗(yàn)驗(yàn)證了系統(tǒng)的精確性,滿足臨床需要。 本文的創(chuàng)新點(diǎn)是提出了智能穿刺路徑分析算法,解決血管、氣管和肋骨遮擋的問題,并可進(jìn)行穿刺手術(shù)術(shù)前路徑規(guī)劃,并且可以進(jìn)行手術(shù)模擬和評(píng)估,可以不依賴于醫(yī)生的操作手法和經(jīng)驗(yàn),大大提高穿刺的準(zhǔn)確率,減少病人受穿刺的次數(shù),降低并發(fā)癥的機(jī)率,減少放射性輻射的次數(shù),使穿刺手術(shù)更加規(guī)范化、標(biāo)準(zhǔn)化,提高手術(shù)效率和成功率,對(duì)肺部疾病的診斷和治療有著十分重要的意義。
[Abstract]:Lung diseases and malignant tumors are one of the most fatal diseases in the world. Histologic diagnosis is the golden standard for qualitative diagnosis and treatment of lung diseases. At present, CT-guided percutaneous lung puncture is the most effective method to obtain lung lesions. But the traditional lung puncture surgery can make the patients repeatedly punctured and receive radiation repeatedly, and increase the risk of complications and adverse effects. Therefore, it is of great significance to study the new methods of lung puncture surgery. This project mainly focuses on the key techniques and optimal operation path planning of percutaneous lung puncture operation, including medical DICOM image volume data reconstruction, 3D visualization technology, image segmentation technology, spatial registration method. Based on these techniques, a computerized surgical navigation system was developed for lung biopsy. The difficulty of this system lies in the design and implementation of the whole system framework, because there are many image processing algorithms and three dimensional spatial positioning techniques in the implementation of the system, which involve many algorithms and have some difficulties. At the same time, we should consider the actual clinical needs in the design process, simplify the system operation flow and software operation flow as far as possible, and provide a simple and easy-to-use image-guided operation navigation system for doctors. Image processing technology and visualization algorithm are the basis of operation navigation. The research focuses on volume data processing, visualization and image segmentation. Based on the research of various algorithms, the related algorithms are improved to meet the needs of clinical lung puncture surgery. For example, the visualization technology includes 2D and 3D fusion display, 3D cutting display and so on. The technology of space positioning and coordinate registration is the key of surgical navigation system. The accuracy of surgical navigation system is determined by space positioning technology and registration technology, which is the key to the success or failure of surgical navigation system. After studying the relationship between different coordinate systems in the system, the spatial registration of the navigation system is realized based on the method of external mark points, and the registration accuracy can also meet the needs of clinical surgery. Finally, a lung puncture image guidance system based on three-dimensional positioning is realized. The system can help doctors to make operation plan before operation, and can automatically analyze, design and simulate the operation path. The real-time navigation can be realized during the operation, and the image guidance can be realized under different three-dimensional views. At the same time, the target map and depth plane map are designed to guide the puncture according to the clinical needs. Finally, the accuracy of the system is verified by experiments. To meet the clinical needs. The innovation of this paper is to put forward the intelligent puncture path analysis algorithm to solve the problems of occlusion of blood vessels, trachea and rib, and to plan the preoperative path of puncture operation, and to simulate and evaluate the operation. It can greatly improve the accuracy of puncture, reduce the frequency of puncture, reduce the probability of complications, reduce the frequency of radiation, and make the puncture operation more standardized and standardized. It is very important to improve the efficiency and success rate of operation for the diagnosis and treatment of pulmonary diseases.
【學(xué)位授予單位】：東北大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：TP391.41;R563

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