本文選題：多模態(tài)影像 + 融合配準(zhǔn)　； 參考：《中國人民解放軍醫(yī)學(xué)院》2016年博士論文

【摘要】：目的1、研發(fā)一種超聲圖像與CT圖像融合配準(zhǔn)的導(dǎo)航軟件-"OBERON影像引導(dǎo)手術(shù)導(dǎo)航系統(tǒng)”,并通過腹部仿真體模實(shí)驗(yàn)驗(yàn)證其配準(zhǔn)的精準(zhǔn)性與耗時(shí)。2、通過腹部多點(diǎn)間的相對(duì)位姿變化獲取呼吸運(yùn)動(dòng)規(guī)律,并通過動(dòng)物實(shí)驗(yàn)驗(yàn)證OBERON軟件在特定呼吸時(shí)相下融合配準(zhǔn)的精準(zhǔn)性。3、研究反映人體體表呼吸運(yùn)動(dòng)最敏感的位置點(diǎn)的組合,并通過初步臨床研究驗(yàn)證OBERON軟件在特定呼吸時(shí)相下進(jìn)行精確融合配準(zhǔn)的可行性。材料和方法1、在磁導(dǎo)航條件下,對(duì)腹部仿真體模進(jìn)行超聲與CT圖像融合配準(zhǔn)實(shí)驗(yàn),對(duì)比OBERON軟件和商業(yè)化軟件在配準(zhǔn)誤差及耗時(shí)方面的差異,驗(yàn)證OBERON軟件在腹部仿真體模配準(zhǔn)中的精準(zhǔn)性。2、運(yùn)用數(shù)學(xué)算法獲取體表傳感器的位姿信息,經(jīng)計(jì)算機(jī)處理來實(shí)現(xiàn)對(duì)呼吸運(yùn)動(dòng)的監(jiān)測,并轉(zhuǎn)換成呼吸時(shí)相的誤差；建立巴馬小型豬原位碘化油模擬肝腫瘤模型,選取肝內(nèi)不同位置(左外葉近肝表面、左外葉內(nèi)部、右外葉近肝表面、右外葉內(nèi)部)及不同大小(直徑5mm和15mm)的8個(gè)點(diǎn)作為配準(zhǔn)的目標(biāo)點(diǎn),在呼吸運(yùn)動(dòng)條件下,采用OBERON軟件分別對(duì)加呼吸監(jiān)測模塊(實(shí)驗(yàn)組)及不加呼吸監(jiān)測模塊(對(duì)照組)的各個(gè)點(diǎn)進(jìn)行融合配準(zhǔn),并將兩組及實(shí)驗(yàn)組內(nèi)各點(diǎn)的配準(zhǔn)誤差分別進(jìn)行比較,考察OBERON軟件的呼吸監(jiān)測模塊降低呼吸運(yùn)動(dòng)造成的配準(zhǔn)誤差的能力。3、通過體表多個(gè)傳感器的實(shí)時(shí)位姿變化荻取反映呼吸運(yùn)動(dòng)最為敏感的體表位置點(diǎn)的組合;選取符合入組條件的18例病人,采用與術(shù)中相同的體位,并用定位袋對(duì)體位進(jìn)行固定,應(yīng)用OBERON軟件分別對(duì)加呼吸監(jiān)測模塊(實(shí)驗(yàn)組)及不加呼吸監(jiān)測模塊(對(duì)照組)的各個(gè)點(diǎn)進(jìn)行融合配準(zhǔn),并將兩組的配準(zhǔn)誤差分別進(jìn)行比較,驗(yàn)證OBERON軟件的呼吸監(jiān)測模塊在臨床應(yīng)用中的可行性。結(jié)果1、OBERON軟件在腹部仿真體模的多模態(tài)影像融合配準(zhǔn)中得到了較好的實(shí)現(xiàn),共進(jìn)行了74組實(shí)驗(yàn)操作,實(shí)驗(yàn)組融合配準(zhǔn)誤差為(3.21±0.79)mm,耗時(shí)為(37.82±15.06)s,對(duì)照組的融合配準(zhǔn)誤差為(3.32±0.58)mm,耗時(shí)為(91.69±33.81)s,兩組配準(zhǔn)誤差差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組配準(zhǔn)時(shí)間差異有統(tǒng)計(jì)學(xué)意義(P0.01)。2、OBERON軟件能夠較好的顯示呼吸時(shí)相的誤差;兩組實(shí)驗(yàn)豬肝內(nèi)8個(gè)點(diǎn)的目標(biāo)點(diǎn)的融合配準(zhǔn)操作均順利完成,實(shí)驗(yàn)組在每個(gè)點(diǎn)的配準(zhǔn)誤差均小于對(duì)照組(P0.01);實(shí)驗(yàn)組內(nèi),肝左外葉內(nèi)、右外葉近肝表面及右外葉內(nèi)的目標(biāo)點(diǎn)配準(zhǔn)誤差大小相當(dāng)(P0.05),但肝左外葉近表面的目標(biāo)點(diǎn)的配準(zhǔn)誤差大于其余各點(diǎn)的誤差(P0.05)。3、本研究中18例男性病人,體表最佳位置點(diǎn)的組合能夠敏感地反應(yīng)患者呼吸運(yùn)動(dòng);兩組配準(zhǔn)誤差大小分別為：實(shí)驗(yàn)組(3.41±0.39)mm,對(duì)照組(3.71±0.34)mm,,兩組誤差大小差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論1、OBERON軟件可順利進(jìn)行融合配準(zhǔn)工作,配準(zhǔn)誤差可以控制在理想的范圍內(nèi),同時(shí)耗時(shí)較目前商業(yè)化軟件縮短。2、應(yīng)用OBERON軟件可以實(shí)時(shí)監(jiān)測呼吸運(yùn)動(dòng),并將其轉(zhuǎn)化為誤差;應(yīng)用呼吸監(jiān)測模塊可在肝內(nèi)不同目標(biāo)點(diǎn)的融合配準(zhǔn)中減小呼吸運(yùn)動(dòng)導(dǎo)致的配準(zhǔn)誤差,但是對(duì)于肝左外葉近表面的目標(biāo)點(diǎn),配準(zhǔn)誤差大于其他目標(biāo)點(diǎn)。3、OBERON軟件內(nèi)的呼吸監(jiān)測模塊能夠較好的反映呼吸時(shí)相誤差,可在一定程度上減小呼吸運(yùn)動(dòng)造成的配準(zhǔn)誤差。
[Abstract]:1, the development of a ultrasonic image and CT image fusion technique and navigation software - "OBERON image guided surgical navigation system", and through the simulation of abdominal phantom experiment verify the registration accuracy and time-consuming.2 through abdominal multi-point between the relative position and attitude change for respiratory motion law, and through the animal experiment OBERON software in the specific respiratory phase under the accurate registration of.3 fusion, reflecting a combination of the most sensitive points of human body respiratory movement, and through the preliminary clinical study on verification of OBERON software in specific respiratory phase under the feasibility of precise integration registration. Materials and methods 1, the magnetic navigation conditions of registration experiment on abdominal ultrasound and CT image simulation phantom, comparison of OBERON software and commercial software in the registration error and time difference, verification of OBERON software in the abdomen phantom registration precision simulation .2 position information acquisition sensor surface using mathematical algorithms, through computer processing to achieve the monitoring of the respiratory motion, the phase error and converted into breathing; Bama miniature pig orthotopic liver tumor lipiodol simulation model, selecting different positions within the liver (internal left lateral lobe near the surface of the liver, and the left lateral lobe right hepatic lobe near the surface, the right lateral lobe) and different size (diameter 5mm and 15mm) of the 8 points as the registration target, the respiratory motion conditions, respectively on respiratory monitoring module using OBERON software (experimental group) and without respiratory monitoring module (control group) of each point of registration, and the registration error of each point of the two group and the experimental group were compared, the respiratory monitoring module inspects the OBERON software to reduce the registration error caused by respiratory movement ability of the.3, through the real-time pose change Di surface multiple sensors measuring call The combination of surface suction sensitive points of motion; choose 18 patients were eligible, by the same operation posture, and positioning bags on position fixed, uses OBERON software to add respiratory monitoring module (experimental group) and without respiratory monitoring (control group) of each module for registration, and the registration error of two groups were compared, the feasibility of respiratory monitoring module verification of OBERON software in clinical application. The results of 1 OBERON software for multi modality imaging in abdomen simulation phantom registration was realized in a good, there are 74 group experimental operation, experimental group registration error is (3.21 + 0.79) mm, (37.82 + 15.06) time is s, the control group for the fusion of the registration error (3.32 + 0.58) mm, (91.69 + 33.81) time for s, two sets of registration error had no significant difference between the two groups (P0.05), registration time difference Statistical significance (P0.01).2, OBERON software can display the error phase when breathing better fusion; registration operation 8 points in the two groups of experimental liver targets were successfully completed, the experimental group was less than the control group in the registration error of each point (P0.01); experimental group, hepatic left lateral lobe, right leaf near liver surface and right lobe registration error target size (P0.05), but the registration error of the left liver lobe near the surface of the target is larger than the error of the remaining points (.3, P0.05) in this study, 18 cases of male patients, the best combination of surface points can be sensitive to the reaction of respiratory movement two; group registration error size were: the experimental group (3.41 + 0.39) mm, the control group (3.71 + 0.34) mm, the two groups was statistically significant difference (P0.01) error. Conclusion 1, OBERON software can be smoothly carried out registration, registration error can be controlled in an ideal range At the same time, it is the commercial software using OBERON software can shorten.2, real-time monitoring of respiratory motion and transformed into error; application of respiratory monitoring module can reduce the registration error of respiration induced in the liver of different target registration, but for the left liver lobe near the surface of the target, registration the error is greater than other targets.3, respiratory monitoring module within the OBERON software can better reflect the respiratory phase error, can reduce the registration error caused by respiratory movement in a certain extent.

【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735.7

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