CN101918855A - 使用外科手术工具的预定义数据和mri图像数据的实时可视化的mri外科手术系统 - Google Patents
使用外科手术工具的预定义数据和mri图像数据的实时可视化的mri外科手术系统 Download PDFInfo
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Abstract
Description
描述 |
开始步骤可以提供用于选择过程偏侧化的UI(用户界面)。 |
开始步骤可以提供用于选择目标的UI:STN、Gpi或定制。 |
开始步骤可以提供用于指定限定大小的扫描仪开孔直径或扫描仪类型的UI。 |
开始步骤可以提供用于输入来自一次性使用的硬件工具箱的硬件标识符数据(例如版本代码)的UI。如果该版本与软件支持的版本不匹配,则可以示出错误,并且应用仍被禁用。 |
描述 |
当数据被发送到应用时,可以禁用UI。 |
给定整个人头部的三维MR序列,应用可以自动标识AC、PC和MSP点 |
该应用可以显示与当前AC、PC和MSP点对准的重新确定格式的冠状、矢状以及轴向视图。 |
在该步骤中可以在任何MPR视图中编辑AC、PC和MSP点。在改变这些点时,可以更新视图以重新与ACPC坐标系统对准。 |
如果在该步骤的时候发送新的序列,则它将代替现有的序列并且清除所有绘注。 |
当检测到AC、PC和MSP点时,可以禁用UI。 |
如果发送属于当前三维MR序列的附加数据,则可以自动重新计算AC、PC和MSP点。 |
描述 |
该应用可以提供将位置坐标保存为STN和Gpi目标的默认值的能力。最初这些默认值被设置为0,0,0。所保存的值可以看作使用该目标的后续过程的默认值。 |
该应用还可以提供不对其供应默认坐标的定制目标。当选择这一选项时,用户将能够限定与单个入口点相关联的定制名称的目标集。 |
该应用可以显示解剖的冠状、矢状以及轴向视图。 |
可以在该步骤中可以在任何MPR视图中编辑目标点。 |
该应用可以提供自动将脑图谱配准到患者体积、生成与所选择的目标相关联的结构的轮廓以及在MPR视图上显示相应外形的功能。 |
该应用可以提供界面来手动地缩放并且偏移脑图谱配准以更好地匹配所观察到的患者解剖结构。 |
描述 |
对于每个给定的目标点,用户可以指定相应的入口点。 |
该应用可以显示与所提议的轨迹对准的倾斜的重新确定格式的冠状、矢状以及轴向视图 |
在该步骤中可以在倾斜矢状或冠状视口上编辑入口点。 |
倾斜的轴向视图可以提供电影院功能以动画制作沿着轨迹的飞越。 |
该应用还可以提供解剖轴向视图。 |
解剖和倾斜的轴向视图的相应位置可以由倾斜矢状和冠状视图上的线表示。 |
当已为入口点限定多个目标(定制目标)时,该应用可以提供用于选择要显示的当前目标的装置。对该入口点的编辑将改变所有相关联目标的入口点。 |
如果用户试图将轨迹设置成在不穿透开孔的情况下不能插入探针,则可以示出错误并且将不设置该轨迹。这使用通常在开始步骤输入的开孔大小。 |
该应用可以提供用于限定在该步骤内命名的轨迹的装置。可以从命名的轨迹列表中选择轨迹以在该步骤中显示。 |
如果用户将入口点移离网格的边缘,则将示出警报文本。 |
描述 |
该应用可以显示示出计划体积的三维体积视图。对于双侧过程可以示出2个这样的视图,左侧在左视口中,右侧在右视口中。 |
该应用可以可选地显示标记网格的网格坐标。 |
该应用可以可选地显示叠加图以在视觉上标识网格方形内的边缘和位置。 |
该应用可以在每个视图上显示相应的入口点。 |
该应用可以自动地对准三维视图以使得用户的视点沿着从入口朝向目标的轨迹观看。在多个定制目标的情况下,可以使用到第一目标的轨迹。 |
该应用可以设置体积的可视化参数以使得用户可以看到网格本身。 |
初始的缩放水平可以确保整个头部是可见的。 |
描述 |
计划目标AC-PC步骤可以如计划AC-PC步骤那样查看和运行。然而,在该步骤中接收的数据可以被存储为重新计划的体积。可以保持从重新计划的体积导出的AC、PC和MSP绘注以及所得到的变换与在计划AC-PC步骤中确定的那些不同。 |
描述 |
计划目标步骤可以如计划步骤那样运行,但是其具有支持薄层数据融合的附加功能。 |
计划目标步骤可以接受DICOM薄层(slab)数据。 |
当接收到薄层数据时,可以禁用UI,并且应该示出消息来指示正在进行数据传输。 |
计划目标步骤可以提供以它们的获取顺序列出序列的缩略图栏。选择缩略图栏中的序列将使得它看起来与重新计划体积相融合。选择计划目标体积可以使得它通过其自身来显示。 |
经过融合的数据可以在视口中与计划目标体积图像一起出现,并且将被定位且缩放成与计划目标体积的位置和标度精确一致。 |
控制面板可以包含在混合视口中控制两个序列的相对强度的滑动块。 |
该步骤可以为通过当前目标的解剖轴向薄层显示扫描平面参数。 |
需求描述 |
计划目标轨迹检查步骤可以如计划轨迹检查步骤那样运行,其中仅有下述例外:-薄层融合支持-从框架标记分割出枢轴点-将枢轴点位置用作(不可编辑的)固定入口点 |
计划目标轨迹步骤可以接受DICOM薄层数据。 |
当接收薄层数据时,可以禁用UI。 |
计划目标轨迹检查步骤可以提供以它们的获取顺序列出序列的缩略图栏。选择缩略图栏中的序列将使得它看起来与重新计划的体积相融合。选择重新计划的体积可以使得它通过其自身来显示。 |
经过融合的数据将在视口中与体积图像一起出现,并且将被定位且缩放成与重新计划的体积的位置和标度精确一致。 |
控制面板可以包含在混合视口中控制每个序列的相对强度的滑动块。 |
如果软件出于任何原因不能标识框架标记以找出枢轴点,则可以显示警报。 |
该步骤可以为下述薄层显示扫描平面参数:-沿着轨迹的倾斜矢状薄层-沿着轨迹的倾斜冠状薄层 |
该步骤可以显示相对于解剖冠状和矢状平面的轨迹角度。 |
描述 |
该步骤可以提示用户在远处获取通过近端套管的小的高分辨率薄层,以使得它甚至以最大角度和最大偏移示出该近端套管的横截面。该薄层最少可以具有4个切片。(例如给定套管83mm长、+/-35度的最大角度以及4mm的最大偏移,则从远端套管标记向上65mm的扫描平面将足以确保该套管在该薄层中可见。) |
该应用还可以提示用户获取具有下述属性的小的高分辨率薄层扫描:·与框架标记的平面对准的平面(这可以基于为轨迹检查步骤而完成的框架分割)。·平面中心被定位在旋转机械中心处。·薄层厚度足够大以便甚至在最大角度和偏移下包括所有远端套管标记(例如,给定+/-35度的最大角度、4mm的最大偏移、以及7.1mm的远端套管标记大小,所需的总厚度将是11.6mm,所以可以使用任何更大的值,例如13mm)。·切片间隔可以是大约1mm。 |
该应用可以标识近端和远端套管的位置。 |
使用在计划目标体积中检测到的框架标记的位置,该应用可以将所观察到的远端套管的位置与旋转机械中心相比较。因为锁销可以被用来确保不存在偏移,所以高于低阈值的值可以使得显示警报。(例如警报文本:“没有在预期的位置处找到远端套管标记。检验套管被锁定到“向下”位置并且重新获取远端套管扫描”。) |
如果没有可以被标识的枢轴点标记,则将提示用户检验该套管被锁定到“向下”位置并且重新获取薄层扫描”。 |
该步骤可以提供3个MPR视口,在所述视口中显示所获取的薄层。这些视口将被定向以使得它们的基准平面与所检测到的套管轴对准。 |
该步骤可以提供缩略图栏以允许用户选择显示哪个所获取的薄层。 |
描述 |
该应用可以提示具有下述属性的对准扫描: |
·扫描平面垂直于计划的轨迹·扫描平面以轨迹为中心·设置扫描平面位置以使得甚至在最大角度和最大偏移下示出近端套管的横截面·可以获取单个二维图像 |
该应用可以显示通过当前所选择的目标的解剖轴向视图。 |
用户可以选择切换显示器以示出轨迹轴向视图。 |
当接收到套管顶部的二维图像时,该应用可以自动标识套管顶部在三维空间中的位置。使用该位置、先前确定的枢轴点、以及先前确定的偏移,该应用可以画出表示当前轨迹和包含计划目标的图像平面的相交的绘注(annotation)。 |
该步骤可以显示从当前投影的目标到计划目标的线,其指示如果独立地旋转俯仰和滚动轮,所投影的目标将会行进的路线(track)。这些线可以着色以分别与俯仰和滚动的控制轮上的颜色匹配。(例如弹出式)工具贴士可以提供文本来描述所建议的动作。(例如“向左旋转滚动旋钮”) |
在重新计算所投影的目标点时,误差值可以指示该所投影的目标点和当前显示的平面上的计划目标点之间的面内线性距离。 |
没有正确地定向到所请求的扫描平面的图像可以导致警报。在这种情况下,可能不会显示绘注和误差测量。 |
在其中不能标识目标套管的图像可以导致警报。可能不会显示绘注和误差测量。 |
当已为入口点限定了多个目标时,该应用可以提供用于选择要显示的当前轨迹的装置。 |
当画出套管路径的当前投影和目标时,可以画出绘注以与探针直径的物理大小相匹配。 |
描述 |
该应用可以提供在插入之前要在限深档块上设置的深度值。 |
该应用可以用扫描参数提示与轨迹对准的倾斜冠状和矢状平面。而且用于与该轨迹垂直的倾斜轴。 |
在接收到冠状或矢状图像时,该应用可以显示指示计划轨迹的叠加图形。在1×2显示中可以一起出现最近的冠状和矢状图像。 |
在接收到垂直于轨迹的轨迹轴向扫描时,该应用可以分割出探针的横截面以确定该探针正遵循的实际路径。 |
在接收到垂直于轨迹的轨迹轴向扫描时,该应用可以显示包含下述的两个视口:·具有图形叠加的轴向堆栈,所述图形叠加在每个图像上示出所检测的探针路径·通过目标的解剖轴向视图,其示出计划目标以及从所检测的探针路径投影的目标。误差值可以示出当前投影目标和计划目标之间的距离。 |
如果已为单个入口限定了多个轨迹,则该应用可以显示在插入期间当前对准的轨迹。 |
当进入插入步骤时,该应用可以命令用户确保他们是否正使用作为内部线圈连接到扫描仪的成像探针。不这样做将导致加热该线圈并且伤害患者。用户必须明确点击按钮以确认他们理解该警报。 |
描述 |
该步骤可以提示i)使用成像探针获取高分辨率二维图像,或者ii)通过目标区域的高分辨率薄层。相关联的扫描平面参数可以指定以目标为中心的轨迹轴向图像。 |
该应用可以提供用于标识探针(或管心针)的尖端的装置,并且提供轴向解剖平面中从探针到计划目标点的线性距离的误差值。 |
该应用可以提供UI来设置已更新的目标点。 |
用户可以选择进行X-Y调整步骤,返回到对准步骤以对准到另一个目标,或者前进到管理步骤。 |
当接受当前位置时,一旦已放置了MR不兼容的DBS引线(如果它们是不兼容的或潜在不兼容的),可以向用户示出警报不进行扫描。对于双侧情况,用户继续进行以在放置引线之前完成在两侧上的探针插入。该消息可以指示利用MR不兼容的引线的扫描可以导致严重的伤害或死亡。 |
如果用户修改目标点,则该步骤可以提示用户确认在进行到下一步骤之 |
前偏移锁销从目标框架的移除。 |
描述 |
X-Y调整步骤可以显示当前目标以及投影点,以作为在目标精化步骤期间获取的图像数据的绘注。 |
该步骤可以提示用户使用扫描平面参数获取二维图像,以便图像垂直于轨迹并且通过枢轴点。 |
在接收到通过枢轴点的二维图像时,该步骤可以计算当前投影目标并且显示关于来自成像探针的二维图像的绘注。 |
该步骤可以显示从当前投影目标到已修改目标的线,所述线指示在独立旋转X和Y偏移轮的情况下投影目标将会行进的路线。可以为这些线着色以分别与X和Y偏移的控制轮上的颜色相匹配。(例如弹出式)工具贴士可以提供文本来描述必需的动作。(例如“向左旋转X偏移旋钮”) |
该步骤可以显示指示原始计划目标的位置的绘注。 |
当画出套管路径的当前投影和目标时,可以画出与探针直径的物理大小相匹配的绘注。 |
描述 |
在完成X-Y调整之后,该应用可以提供工作流程步骤来引导插入。这基本上与上面的插入步骤的第一示例相同。 |
描述 |
在已经放置了探针(或者对于双侧情况已放置了两个探针)并且用户已经接受了位置之后,用户可以进行引线放置步骤。 |
该步骤可以为用户提供放置引线的深度值。 |
该步骤可以建议用户一旦已放置了引线就可以不执行扫描,因为引线中的加热将造成患者的伤害或死亡。 |
描述 |
该步骤可以提供用于存档与该过程有关的数据的装置。这包括:·轨迹计划数据·具有病例数据的日志文件·图像数据 |
该步骤可以提供用于自动生成已执行的过程的报告文件的功能。该报告可以包括:·患者信息·(所检测的,以及在用户修改的情况下用户指定的)MR空间中的MSP、AC和PC点·在MR和ACPC空间中的计划并且校正的目标·过程的已逝去时间·医生病例注释(可选的)·在过程期间截取的任何屏幕截图 |
还可以自动生成匿名的报告版本,其中患者姓名以及id已移除。 |
该步骤可以提供UI,由此用户可以:·选择目标·以MR坐标指定表示引线尖端的位置·限定指示电极从引线尖端的偏移的偏移的集合对于每个偏移值,该步骤可以找出提供ACPC坐标,所述ACPC坐标对应于沿着引线轨迹返回时从尖端位置偏移的点。这些值对应于ACPC空间中的电极位置。可以将这些值添加到患者报告。 |
管理步骤可以包括用于在完成该过程时关闭应用的按钮。可能不允许用户以其他方式关闭该应用。 |
该应用可以具有用于在关闭时指定所有的患者数据是否都从系统中清除的配置值。 |
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US8208993B2 (en) | 2012-06-26 |
CA2700529A1 (en) | 2009-04-02 |
US20090079431A1 (en) | 2009-03-26 |
CN101918855B (zh) | 2013-07-17 |
US8175677B2 (en) | 2012-05-08 |
EP2193384A1 (en) | 2010-06-09 |
CA2700607A1 (en) | 2009-04-02 |
US20090112082A1 (en) | 2009-04-30 |
WO2009042131A1 (en) | 2009-04-02 |
EP2195676A2 (en) | 2010-06-16 |
JP5632286B2 (ja) | 2014-11-26 |
US9097756B2 (en) | 2015-08-04 |
US7602190B2 (en) | 2009-10-13 |
WO2009042152A1 (en) | 2009-04-02 |
JP2010540021A (ja) | 2010-12-24 |
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