Patent Application
20220096196
The present disclosure relates to the field of medical marking positioning on surface of a human body, and more particularly relates to a three-dimensional craniocerebral positioning operation tool and a method of using the same.
Existing positioning methods mainly include free-hand paracentesis, simple device-assisted guidance, traditional framed stereotaxic instrument, neuronavigation or surgical robot, etc. The free-hand paraoentesis method relies on simple tools to draw lines manually, and positioning bases on experience. It has an advantage of convenience and being fast. While, it has a poor accuracy, a high error mate, and it is greatly affected by human factors. The most important advantage of the traditional framed stereotaxic instrument and the neuronavigation system is the high positioning accuracy. However the operation process is very complicated, it is difficult to master, and the equipment is expensive. In addition to the above two, methods, there are special surgical robots for brain surgery, such, as the ROSA developed by the French company Medtech SA and the domestic Ruimi robot. The advantage of the surgical robot is precision and intelligence, but the price is too high and it is difficult to popularize.
Thea main defects of the above methods are as follows: 1. The measurement and marking of the target site are either too rough or the process is too complicated; 2. Positioning operations depend either on experience or complex equipment. Convenience, accuracy and cost performance cannot be balanced.
1. Technical Problem to be Solved
In order to solve the problem that the measurement and marking of the target site are either too rough or the process is too complicated, the present disclosure provides a new method. The anatomical coordinate system is corresponded to the image coordinate system by using the distinguishable anatomical landmarks of the human body surface. Two sets of unified measurement coordinate systems having Corresponding origin positions and coordinate axis directions (the horizontal direction is X, the vertical direction is Y, and the up or down direction is Z) are set up, which are respectively called the image measurement coordinate system on the image and the anatomical measurement coordinate system on the human body. In such a way, the imaging measurement and anthropometric measurement can be unified For a head, as plane passing through the orbitomeatal base line (a connecting line of an external auditory canal and a midpoint of an eyeball) is used as the horizontal plane of the measurement coordinate system, and the midsagittal plane is used as the sagittal plane of the measurement coordinate system. The coronal plane passing through the external auditory canal and perpendicular to the above two planes is used as the coronal plane of the measurement coordinate system. In this way, the imaging and anatomy coordinate systems are consistent, and each point in the cerebral space corresponds to the same and unique three-dimensional coordinate values in the two three-dimensional coordinate systems. A new three-dimensional coordinate system is adopted, the image coordinates and anatomical coordinates are unified. A new method that can realize software automatic measurement of the target point is designed by using the characteristics of CT and MR images, avoiding the installation of the base ring and the review of CT or MR, pasting Marker, copying DICOM image data and other tedious processes, making image measurement easier and faster.
In order to solve the problem of inconvenient head marking, the present disclosure provides a specially designed marking ruler to quickly mark the projection position of the target point on the body surface.
In view of the problem that the positioning operations depend either on experience or complex equipment, the present disclosure provides two three-dimensional guide devices which are simple in structures, convenient to install, multifunctional, and do not affect the operation area. The two three-dimensional guide devices can complete most of the brain positioning functions, greatly reduce the complexity of positioning operations without affecting the accuracy.
The disclosure reduces the pre-operation preparation time and the operation tune during the operation from multiple links, the operation is more scientific, the positioning is more accurate, the time is saved, the operation cost is reduced, and the operation effect is improved.
To solve the above-mentioned problems the present disclosure adopts the following technical solutions.
Technology solution of target measurement.
Steps:
(1) setting a two-dimensional coordinate system (reference coordinate) on a cross sectional image by using a proportional scale; wherein an origin of the two-dimensional coordinate system can be any point on the proportional scale (preferably a starting point or an end point), and a coordinate origin on each cross-section must be consistent. The coordinate scale is the same as the proportional which represents the actual length (usually 1 cm):
(2) selecting a piece of axial CT or MRI showing an external auditor; canals crystalline lenses on both sides, determining at midpoint of a connecting line (X axis) of the external auditory canals on both sides, and measuring a two-dimensional coordinate value of this point (the origin of the image measurement coordinates) in the above reference coordinate based on the proportional scale: establishing the reference coordinate by using this point as the origin: wherein a vertical axis (Y axis) is consistent with a midsagittal line of a head (normally, it is straight up and down, if there is a tilt, it needs to be, rotated accordingly, and the rotation angle ∠ω is recorded);
(3) selecting another cross-section plane where the target is located, establishing a reference coordinate by using the same method based on the position and scale of the proportional scale, and marking the origin coordinate value of the measurement coordinate obtained in the previous step in the reference coordinate of the another cross-section plane: and establishing another image measurement coordinate for the origin of the another cross-section plane by the origin coordinate value; wherein the scale of this two-dimensional coordinate is the same as the reference coordinate; the direction of the vertical axis is also consistent with the midsagittal line of the head, and the rotation angle is the same as ∠ω;
(4) At this time, any point on the image can be positioned within this image measurement coordinate, and the abscissa (X) and ordinate (Y) of this point can be measured, as well as the angle of the long axis of the focus relative to the measurement coordinate;
(5) calculating a distance (Z) between the target point and the baseline plane based on the layer thickness and the number of layers frons the target point plane to the baseline plane;
(6) finally determining a three-dimensional coordinate value (X/Y/Z) for any point in the head.
Software can be used for automatical measurement in practical applications. Steps are as follows:
Step 1. taking pictures of the CT or MR image data, selecting a scanning plane (baseline plane) that shows the external auditory canals and crystalline lenses, creating a virtual proportional scale on the software, and overlapping the length and position of the virtual proportional scale with that of the proportional scale on the image data by manual or automatic recognition methods to obtain a scaling of the pictures, and at the same time using the position of the proportional scale on the image data as the reference object; in this way, the extraction of image data is realized, and the next step of coordinate positioning and length measurement can be carried out;
Step 2. drawing the connecting line of the midpoints f the external auditory canals on both sides and the mid-sagittal line manually or through the automatic recognition function of the software to form a cross line after the position is determined; using the intersection of the cross line as the origin of the measurement coordinates: measuring the relative position coordinates of this point relative to the proportional scale (reference coordinates) used as the reference object in step 1; if the picture is rotated, the cross line can be rotated for correction, and the rotation angle will be recorded by the software;
Step 3. selecting the scanning plane were the target to be positioned is located (the same photo or re-photographed photos cast be used), and displaying the virtual proportional settle on the software again, overlapping the virtual proportional scale with the proportional scale on the current image data by manual or automatic recognition function; calculating by software to automatically generate a two-dimensional coordinate with the coordinate Value of the intersection point as a center by using the two-dimensional coordinates of the intersection of the cross line in the reference coordinates and the rotation angle of the cross line; at this time, the generated two-dimensional coordinate is the measurement coordinate, the position of the measurement coordinate on the target plane is consistent with the position of the above cross line on the baseline plane;
Step 4. measuring the position of all point in the target plane by using the two-dimensional measurement coordinate generated in step 3, and clicking on any position to display the two-dimensional coordinate values;
Step 5. drawing a straight line with the target point as the starting point, and measuring an angle between the straight line and the two coordinate lines through the software, if the direction of the path to reach this point needs to be measured.
Technology solution of marking ruler.
The external auditory canal is used for marking of the target point on human body surface. The marking ruler includes a fixed marking ruler and a foldable marking ruler, the fixed marking ruler comprises a fixed horizontal ruler; and a fixed Z-axis ruler is fixedly connected to one end of the fixed horizontal ruler, and the fixed Z-axis ruler and the fixed horizontal ruler are perpendicular to each other; the fixed Z-axis ruler and the fixed horizontal ruler are both engraved with scale marks; zero-scale ends of the fixed Z-axis ruler and the fixed horizontal ruler are located at an intersection of the fixed Z-axis ruler and the fixed horizontal ruler; a main slider is sleeved on the fixed horizontal ruler, and the fixed horizontal ruler is matched with the main slider; the main slider is capable of moving slowly on the fixed horizontal ruler under an action of external force.
Further, the marking ruler may be a foldable marking ruler, the foldable marking ruler comprises a foldable horizontal ruler; one end of the foldable horizontal ruler is connected to a foldable Z-axis ruler, and the foldable Z-axis ruler is perpendicular to the foldable horizontal ruler: the foldable Z-axis ruler and the foldable horizontal ruler are both engraved with scale marks: zero-scale ends of the foldable Z-axis ruler and the foldable horizontal ruler are located at an intersection of the foldable Z-axis ruler and the foldable horizontal ruler; an L-shaped groove is formed on an end of the foldable Z-axis ruler close to the foldable horizontal ruler; an end of the foldable horizontal ruler close to the foldable Z-axis ruler is fixedly provided with two triangular plates, and the two triangular plates are respectively located on two sides of the foldable Z-axis ruler; a connecting shaft is fixedly connected between the two triangular plates, and the connecting shaft penetrates the L-shaped groove; the foldable Z-axis ruler and the foldable horizontal ruler are movably connected through the L-shaped groove and the connecting shaft. It is convenient for the medical staff to carry it daily, so that the marking ruler is not easy to be damaged by accidental bumps due to its excessive size.
Technology solution of three-dimensional guide device.
The quarter-bow guide device comprises a first quarter-h guide device; and the first quarter-bow guide device comprises a first main fixing frame and a first accessory fixing frame; a main square slot that fits the first accessory fixing frame is formed in the first main fixing frame, and the first accessory fixing frame is inserted in the main square slot; a main through hole slot is formed in an upper end of the first main fixing frame, and a main knob is inserted in the main through hole slot; and upper end of the first accessory fixing frame is fixedly connected with a main serrated block that fits the main knob: and the first main fixing frame and the first accessory fixing frame are fixedly connected by the main serrated block and the main knob therebetween; lower ends of the first main fixing frame and the first accessory fixing frame are fixedly connected with main head nails; and a side wall of the first main fixing frame is fixedly connected with a main connecting block; and one end of the main connecting block far away from the first main fixing frame is fixedly connected with a main quarter-bow: and a main positioning device is slidably connected on the main quarter-bow; and a main zero-degree midpoint is engraved on the main connecting block.
Further, the quarter-bow guide device comprises a second quarter-bow guide dev ice, and the second quarter-bow guide device comprises a second main fixing frame and a second accessory fixing frame: an accessory square hole slot that fits the second accessory fixing frame is formed in the second main fixing fame, and the second accessory fixing frame is inserted into the accessory square hole slot: a accessory through hole slot is formed in an upper end of the second main fixing frame, and upper end of the second main fixing frame is connected with an accessory knob; and the accessory knob penetrates the accessory through hole slot, and an upper end of the second main fixing frame is fixedly connected with an accessory serrated block that matches with the accessory knob; lower ends of the second main fixing frame and the second accessory fixing frame are respective fixedly connected with a short head nail and a long head nail; a sliding connection block is slidably connected to the long head nail, and the sliding connection block is located at an end of the long head nail away from the short head nail; the sliding connection block, is fixedly connected with an accessory quarter-bow, the accessory quarter-bow is slidably connected with an accessory positioning device, an accessory zero-degree midpoint is engraved on the accessory quarter-bow. The second quarter-bow guide device can assist in target positioning.
Further, an inner diameter and an outer diameter of main quarter-bow and the accessory quarter-bow are 180 mm-300 mm and 220 mm-400 mm respectively; and a width of the main quarter-bow and the accessory quarter-bow is 20 mm-50 mm; such that they can be applied to patients of different body types.
Further, a material, of the main quarter-bow and the accessory quarter-bow is selected from metal, plastic and polymer material; and tips of the main quarter-bow and the accessory quarter-bow are polished smoothly, so that the main quarter-bow and the accessory quarter-bow are not easy to paracentesis the patient.
Further, the main positioning device and the accessory positioning device have same structure: each of the main positioning device and the positioning devices comprises a positioning block: one end of the positioning block is engraved with a rotational sliding groove: and the positioning block is connected to the main quarter-bow or the accessory quarter-bow through the rotational sliding groove; and a slot is formed at an end of the positioning block away from the rotational sliding groove. It is convenient for the medical staff to slide the positioning block on the main quarter-bow or the accessory quarter-bow.
Further, an extension rod is inserted into the slot: and the extension rod comprises an L-shaped rod body: the L-shaped rod body comprises a main body part and an extension part; the extension part of the L-shaped rod body is fixedly connected with a plug-in block: and a positioning hole is formed in the plug-in block; and an axis of the positioning, hole is parallel to the main body part of the L-shaped rod body. The main body part has a length of 10-15 cm and a trapezoidal cross-section, and it can be inserted into the slot on the positioning block. The main body part has a scale on it, which can correspond to the paracentesis depth; and the extension part has a length of 3-5 cm.
Further, a pair of guide channels matches with each other are inserted into the positioning hole, and one end of the guide channel is fixedly connected a limited block. The two guide channels form a complete guide channel for guiding. The main body part of the L-shaped rod body is inserted into the slot in the positioning block, the insertion depth is adjusted as required: a pair of guide channels are inserted into the positioning hole, and the channel centers of the guide channels are aligned with the center of the semicircular-bow, the extension rod can slide on the semicircular-bow with the positioning block, and always the center points to the center of the semicircular-bow.
Further, the guide channel is inserted into a half-column groove, and the guide channel has a variety of models, and different models of the half-column groove have different diameters, which can be matched with guide channels with diameters of different sizes.
Further, the using method of the three-dimensional brain positioning operation tool is as follows:
S1. filming CT or MR data images, and transmitting the data images obtained to a computer or other processing terminal, and transferring the data images to corresponding processing software;
The specific steps are as follows:
(1) selecting a reference coordinate selecting a scanning plane (baseline plane) that shows the external auditory canals and eve lenses, creating a virtual scale ran the software, and overlapping the length and position of the scale on the image data by manual or automatic recognition methods to obtain the scaling of the pictures, and at the same time using the position of the scale on the image data as the reference object:
(2) determining the relative coordinates; drawing the connecting line of the midpoints of the external auditory canals on both sides and the mid-sagittal line manually or through the automatic recognition function of the software to form a cross line after the position is determined; using the intersection of the cross line as the origin of the measurement coordinates; measuring, the relative position coordinates of this point relative to the proportional scale (reference coordinates) used as the reference object in step 1: specially, if the picture is rotated, the cross line can be rotated for correction, and the rotation angle will be recorded by the software;
(3) determining a two-dimensional coordinates of the focus; selecting the scanning plane where the target to be positioned is located (the same photo or re-photographed photos can be used), and displaying the Virtual proportional scale on the software again, overlapping the virtual proportional scale with the proportional scale on the current image data by manual or automatic recognition function: calculating by software to automatically generate a two-dimensional coordinate with the coordinate value of the intersection point as a center by using the two-dimensional coordinates of the intersection of the cross line in the reference coordinates and the rotation angle of the cross line; at this time, the generated two-dimensional coordinate is the measurement coordinate, the position of the measurement coordinate on the target plane is consistent with the position of the above cross line on the baseline plane;
(4) determining the two-dimensional coordinate value of the focus; measuring the position of any point in the target plane by using the two-dimensional measurement coordinate generated in step 3, and clicking on any position to display the two-dimensional coordinate values;
S2. firstly drawing a scanning baseline on a body surface; the scanning baseline being an orbitomeatal base line which is a connecting line of an external auditory canal and a midpoint of an eyeball; and then marking two epieranium projection points, a midline and parallel lines beside the midline of a head by using the marking ruler;
S3. determining a paracentesis point by using the quarter-bow guide device.
Beneficial Effect.
Compared with the prior art, the advantages of the present disclosure are as follows.
The present disclosure has the following beneficial effects:
1. A new three-dimensional coordinate system is adopted, the image coordinates and anatomical coordinates are unified.
2. A new method that can realize software automatic measurement of the target point is designed by using the characteristics of CT and MR images, avoiding the installation of the base ring and the review of CT or MR, pasting Marker, copying DICOM image data and other tedious processes, making image measurement easier and faster.
3. The present disclosure provides a specially designed marking ruler to quickly mark the projection position of the target point on the body surface.
4. The three-dimensional guide devices are simple in structures, convenient to install, multifunctional, and, do not affect the operation area. The two three-dimensional guide devices can complete most of the brain positioning functions.
5. The pre-operation preparation time and the operation time during the operation are reduced from multiple links, the operation is more scientific, the positioning is more accurate.
6. The complexity of positioning operations is greatly reduced without affecting the accuracy, and the time is saved, the operation cost is reduced, and the operation effect is improved.
Explanation of reference signs in the figures:
101, first main fixing frame; 102, first accessory fixing frame; 103, main head nail; 104, main connecting block; 105, main quarter-bow; 106 main knob; 107, main zero-degree midpoint; 108, main positioning device; 201, second main fixing frame; 202, second accessory fixing frame; 203, short head nail; 204, long head nail; 205, accessory square hole slot; 206, accessory through hole slot; 207, accessory knob; 208, accessory serrated block; 209, sliding connection block; 210 accessory quarter-bow; 211, accessory positioning device: 212, accessory zero-degree midpoint; 301, fixed Z-axis ruler; 302, fixed horizontal ruler: 303, main slider: 401, foldable Z-axis ruler: 402, foldable horizontal ruler: 403. L-shaped groove; 404, triangular plate: 405, connecting shaft:, 5, positioning block; 6, rotational sliding groove: 7, slot; 8, guide channel: 9, limited blocks; 10, extension rod: 1001, L-shaped rod body: 1002, plug-in block; 1003, positioning hole.
The technical solutions in the embodiments of the present disclosure will be clearly and completely described below in conjunction with the accompanying drawings. Obviously, the described embodiments are only a part of the embodiments of the present disclosure, rather than all the embodiments. Based on the embodiments of the disclosure, all other embodiments obtained by those of ordinary skill in the art without creative work shall fall within the protection scope of the present disclosure.
In the description of the present disclosure, it should be noted that the directions or positional relationships indicated by the terms “upper”, “lower”, “inner”, “outer” and “top/bottom” are based on the directions shown in the drawings. The positional relationship is only for the convenience of describing the present disclosure and simplifying the description, rather than indicating or implying that the pointed device or element must have a specific: orientation, be constructed and operated in the specific orientation. Therefore it cannot be understood as a limitation of the present disclosure. In addition, the terms “first” and “second” are only used for descriptive purposes, and cannot be understood as indicating or implying relative importance.
In the description of the present disclosure, it should be noted that, unless otherwise clearly specified and limited, the terms “installed”, “provided with”, “sleeved/connected”, “connection”, etc., should be understood in a broad sense. For example, “connection” can be a fixed connection, a detachable connection, or an integral connection; it also can be a mechanical connection or an electrical connection; it also can be direct connection, indirect connection through an intermediate medium, gar connection within two components. For those of ordinary skill in the art, the specific meaning of the above-mentioned terms in the present disclosure can be understood in specific situations.
The three-dimensional brain positioning operation tool, its use method is:
S1. filming CT or MR data images, and transmitting the data images obtained to a computer or other processing terminal, and transferring the data images to corresponding processing software;
The specific steps are as follows:
(1) selecting a reference coordinate; selecting a scanning plane (baseline plane) that shows the external auditory canals and crystalline lenses, creating a virtual proportional scale on the software, and overlapping the length and position of the virtual proportional scale with that of the proportional scale on the image data by manual or automatic recognition methods to obtain a scaling of the pictures, and at the same time using the position of the proportional scale on the image data as the reference object please refer to
(2) determining the relative coordinates; drawing the connecting line of the midpoints of the external auditory canals on both sides and the mid-sagittal line manually or through the automatic recognition function of the software to Suing a cross line after the position is determined; using the intersection of the cross line as the origin of the measurement coordinates-, measuring the relative position coordinates of this point relative to the proportional scale (reference coordinates) used as the reference object in step specially, if the picture is rotated, the cross line can be rotated for correction, and the rotation angle will be recorded by the software: please refer to
(3) determining a two-dimensional coordinates of the focus, selecting the scanning plane where the target to be positioned is located (the same photo or re-photographed photos can be used), and displaying, the virtual proportional scale on the software again, overlapping the virtual proportional scale with the proportional scale on the current image data by manual or automatic recognition function; calculating, by software to automatically generate a two-dimensional coordinate with the coordinate value of the intersection point as a center by using, the two-dimensional coordinates of the intersection of the cross line in the reference coordinates and the rotation angle of the cross line: at this tinge, the generated two-dimensional coordinate is the measurement coordinate, the position of the measurement coordinate on the target plane is consistent with the position of the above cross line on the baseline plane; please refer to
(4) determining the two-dimensional coordinate value of the focus; measuring the position of any point in the target plane by using the two-dimensional measurement coordinate generated in step 3, and clicking on any position to display the two-dimensional coordinate values;
S2. firstly drawing a scanning baseline on a body surface; the scanning baseline being an orbitomeatal base line which is a connecting line of an external auditory canal and a midpoint of an eyeball; and then marking two epicranium projection points, a midline and parallel lines beside the midline of a head by using the marking ruler;
As shown in
At the same time, the marking ruler can also be a foldable marking ruler, as shown in
The using methods of two marking rulers are similar. The connecting line of the external ear canal and the midpoint of the eyeball is drawed according to the CT or MR film as a baseline. The earplug is slid to the corresponding scale according to the value of the coordinate value given by the App software. Then the earplug is inserted into one side of the external ear canal, the edge of the earplug is adjusted to be parallel to the baseline, and then the distance between the target plane and the reference plane based on the image data as the Z value is obtained. A dot mark is marked with a marker pen on a position corresponding to the scale of the other axle. The marking method, is the same on both sides of the skull. At this time, two points are marked on the epicranium. The two points are the projection of the target point on the epicranium. The midline and the parallel lines located X beside the midline of the skull are then drawn by a ruler.
S3. determining a paracentesis point by using the quarter-bow guide device.
As shown in
Similarly, the second quarter-bow guide device can be chosen as the positioning device of the target. The short head nail 203 and the long head nail 204 are respectively aligned with the dot marks on both sides of the head, and the two arms are folded together. The second main fixing frame 201 and the second accessory fixing frame 202 are fixed on the head, and the accessory quarter-bow 210 is moved left and right along the direction of the long head nail 204, so that the accessory zero-degree midpoint 212 is aligned with the parallel lines beside the midline, and paracentesis positioning is performed by the accessory positioning device 211, and the positioning direction always points to the center of the circular bow, that is, the target position, and the depth is the radius of the circular bow.
After the positioning is completed, a pair of guide channels 8 with suitable size can be inserted into the slot 7, and a guide channel 8 with a suitable size is inserted into the half-column groove of the guide channel 8, and the position of the slot 7 on the quarter-bow is adjusted to make the guide channel 8 have the best paracentesis angle, which is convenient for the medical personnel to take the sample biopsy.
As shown in
The above is only preferred embodiments of the present disclosure which do not limit the protection scope of the present disclosure. The equivalent substitution or change made by any person skilled in the art according to the technical solution and improvement concept of the present disclosure shall be included in the protection scope of the present disclosure.
This application is a continuation of International Patent Application No. PCT/CN2020/102553 with a filing date of Jul. 17, 2020, designating the United States, now pending, and further claims priority to Chinese Patent Application No. 201910504055.9 with a filing date of Jun. 12, 2019. The content of the aforementioned applications, including any intervening amendments thereto, are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/CN2020/102553 | Jul 2020 | US |
| Child | 17643911 | US |
