本文選題：前列腺根切術(shù) + 超聲圖像��； 參考：《哈爾濱工業(yè)大學(xué)》2017年碩士論文

【摘要】：隨著前列腺腫瘤的發(fā)病率逐年提升,發(fā)病群體趨于年輕化,對(duì)前列腺的精確治療逐漸受到人們的關(guān)注。在微創(chuàng)手術(shù)機(jī)器人輔助前列腺根切術(shù)中,醫(yī)生通過觀看病灶部位的圖像來開展相應(yīng)的手術(shù)操作。由于前列腺周圍組織內(nèi)部的血管神經(jīng)束(Neurovascular Bundle,NVB)不能在內(nèi)窺鏡圖像中呈現(xiàn),在切割過程中容易對(duì)NVB造成損傷,影響術(shù)后患者排尿及性功能。因此,本文通過微器械與組織接觸變形,進(jìn)行超聲探頭操作機(jī)構(gòu)與手術(shù)機(jī)器人的配準(zhǔn),實(shí)現(xiàn)對(duì)微器械的實(shí)時(shí)跟蹤,獲取器械操作部位組織的超聲圖像,根據(jù)超聲圖像提供的信息減少對(duì)NVB的損傷。本文根據(jù)前列腺微創(chuàng)手術(shù)過程中的患者體位、直腸超聲探頭的尺寸及成像要求,對(duì)直腸超聲探頭操作機(jī)構(gòu)進(jìn)行結(jié)構(gòu)和控制單元的設(shè)計(jì)。將超聲探頭操作機(jī)構(gòu)、超聲設(shè)備與主控臺(tái)集成,構(gòu)建術(shù)中超聲圖像輔助系統(tǒng),制定了超聲圖像輔助系統(tǒng)在前列腺根切手術(shù)中的操作流程。由于人工提取微器械特征點(diǎn)的過程受醫(yī)生主觀經(jīng)驗(yàn)影響,提取精度隨機(jī)性較大,本文采用自動(dòng)提取方法來獲取超聲圖像中微器械的特征點(diǎn)。在該方法中,利用HAMMER算法進(jìn)行有器械和無器械圖像的彈性配準(zhǔn),對(duì)配準(zhǔn)后的圖像進(jìn)行減影,獲得器械的大致輪廓和位置。提出基于J散度的各向異性擴(kuò)散去噪算法,對(duì)超聲圖像進(jìn)行去噪處理。結(jié)合微器械末端先驗(yàn)輪廓知識(shí),提出基于先驗(yàn)知識(shí)的參數(shù)活動(dòng)輪廓算法,以減影后的輪廓為初始輪廓,對(duì)微器械輪廓進(jìn)行分割。通過計(jì)算分割后的微器械輪廓內(nèi)部區(qū)域像素坐標(biāo)均值,提取出微器械特征點(diǎn)。本文采用經(jīng)典的N型模板標(biāo)定結(jié)構(gòu),完成對(duì)超聲探頭的內(nèi)外參標(biāo)定。利用標(biāo)定得到的超聲圖像與超聲探頭操作機(jī)構(gòu)末端坐標(biāo)系的位姿轉(zhuǎn)換矩陣,多次獲得微器械末端特征點(diǎn)在超聲探頭操作機(jī)構(gòu)與微創(chuàng)手術(shù)機(jī)器人基坐標(biāo)系下的坐標(biāo),采用Levenberg-Marquardt算法完成超聲探頭操作機(jī)構(gòu)與微創(chuàng)手術(shù)機(jī)器人的配準(zhǔn)。在獲得探頭內(nèi)外參標(biāo)定矩陣和配準(zhǔn)結(jié)果的基礎(chǔ)上,結(jié)合微創(chuàng)手術(shù)機(jī)器人與超聲探頭操作機(jī)構(gòu)運(yùn)動(dòng)學(xué),實(shí)現(xiàn)超聲圖像對(duì)微器械的跟蹤。為了驗(yàn)證超聲圖像輔助手術(shù)器械跟蹤技術(shù)的可行性,對(duì)術(shù)中超聲圖像輔助系統(tǒng)及其關(guān)鍵技術(shù)開展實(shí)驗(yàn)研究。結(jié)合實(shí)驗(yàn)室現(xiàn)有的微創(chuàng)手術(shù)機(jī)器人,搭建超聲圖輔助手術(shù)器械跟蹤實(shí)驗(yàn)平臺(tái)。開展超聲圖像中微器械特征點(diǎn)提取實(shí)驗(yàn),驗(yàn)證超聲圖像中微器械特征點(diǎn)自動(dòng)提取方法的精確性和穩(wěn)定性。開展超聲探頭內(nèi)外參數(shù)的標(biāo)定以及手術(shù)機(jī)器人與探頭操作機(jī)構(gòu)的配準(zhǔn)實(shí)驗(yàn),得到標(biāo)定矩陣和配準(zhǔn)結(jié)果。開展超聲圖像對(duì)微器械的跟蹤實(shí)驗(yàn),驗(yàn)證超聲圖像輔助手術(shù)器械跟蹤技術(shù)的有效性。
[Abstract]:With the incidence of prostate cancer increasing year by year, the incidence of prostate cancer population tends to be younger, and the accurate treatment of prostate has been paid more and more attention.In minimally invasive robotic assisted prostatectomy, the doctor performs the operation by looking at the image of the lesion.Because the neurovascular bundles of nerves and nerves in periprostatic tissue can not be seen in endoscope images, it is easy to damage NVB in the course of cutting, which affects the urination and sexual function of the patients after operation.Therefore, through the contact deformation between the microinstruments and tissues, the ultrasonic probe operating mechanism is registered with the surgical robot, and the real-time tracking of the microinstruments is realized, and the ultrasonic images of the operating parts of the instruments are obtained.According to the information provided by ultrasound images, the damage to NVB is reduced.According to the position of the patient during the minimally invasive prostate surgery, the size and imaging requirements of the rectal ultrasound probe, the structure and control unit of the rectal ultrasonic probe operating mechanism were designed.The ultrasonic probe operating mechanism, ultrasonic equipment and the main control desk were integrated to construct an intraoperative ultrasound image assistant system, and the operation flow of the ultrasonic image assistant system in prostatectomy was established.Because the process of manually extracting the feature points of microinstruments is influenced by the doctors' subjective experience and the accuracy of extraction is randomness, this paper adopts the automatic extraction method to obtain the feature points of microdevices in ultrasonic images.In this method, the elastic registration of the images with and without instruments is carried out by using HAMMER algorithm, and the subtraction of the images after registration is carried out to obtain the approximate contour and position of the instruments.An anisotropic diffusion denoising algorithm based on J divergence is proposed for ultrasonic image denoising.Combining with the prior contour knowledge of the end of microinstruments, a parameter active contour algorithm based on the prior knowledge is proposed. The contour of the microdevice is segmented with the contour of the subtraction as the initial contour.By calculating the average pixel coordinates of the inner region of the segmented micro device contour, the feature points of the micro device are extracted.In this paper, the internal and external parameters of ultrasonic probe are calibrated by using the classical N-template calibration structure.By using the position and pose transformation matrix of the calibrated ultrasonic image and the end-coordinate system of the ultrasonic probe operating mechanism, the coordinates of the terminal characteristic points of the micro-instrument in the ultrasonic probe operating mechanism and the minimally invasive surgical robot coordinate system are obtained many times.The Levenberg-Marquardt algorithm is used to complete the registration of ultrasonic probe operating mechanism and minimally invasive surgical robot.On the basis of the calibration matrix and registration results of the internal and external parameters of the probe, combined with the kinematics of the micro-invasive surgical robot and the ultrasonic probe, the tracking of microinstruments by ultrasonic images is realized.In order to verify the feasibility of ultrasonic image assisted surgical instrument tracking technique, an experimental study was carried out on the intraoperative ultrasound image aid system and its key techniques.Combined with the existing minimally invasive surgical robot in the laboratory, an experimental platform for ultrasonic assisted surgical instrument tracking was built.In order to verify the accuracy and stability of the automatic extraction method of microinstrument feature points in ultrasonic images, an experiment was carried out to extract the feature points of microinstruments in ultrasonic images.The calibration of internal and external parameters of ultrasonic probe and the registration experiment of surgical robot and probe operating mechanism are carried out, and the calibration matrix and registration results are obtained.The ultrasonic image tracking experiment was carried out to verify the effectiveness of the ultrasonic image assisted surgical instrument tracking technique.
【學(xué)位授予單位】：哈爾濱工業(yè)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.25;R445.1;TP391.41

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