CN104771246A - Visual knee joint cruciate ligament reconstruction method - Google Patents

Visual knee joint cruciate ligament reconstruction method Download PDF

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Publication number
CN104771246A
CN104771246A CN201510191749.3A CN201510191749A CN104771246A CN 104771246 A CN104771246 A CN 104771246A CN 201510191749 A CN201510191749 A CN 201510191749A CN 104771246 A CN104771246 A CN 104771246A
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visual
cruciate ligament
image
mri
ligament reconstruction
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CN104771246B (en
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陈刚
李箭
宁净
张慧滔
唐新
李棋
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West China Hospital of Sichuan University
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West China Hospital of Sichuan University
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Abstract

The invention discloses a visual knee joint cruciate ligament reconstruction method which comprises the steps of data acquisition, coordinate system unification, cruciate ligament spatial coordinate extraction, visual cruciate ligament reconstruction based on images, image measurement and the like. The method is capable of realizing CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) digital fusion, is simple and effective, and is capable of guiding knee join ligament surgery without increasing the burden of patients.

Description

A kind of method of visual cruciate ligament reconstruction
Technical field
The present invention relates to medical domain, particularly relate to a kind of method of visual cruciate ligament reconstruction.
Background technology
Graft should be fixed on it by desirable cruciate ligaments of knee joint reconstruction operations dissects stop and simulates its normal morphology, and this just needs the anatomical data, the particularly situation of target ligament and adjacent bone structures thereof that fully understand individual.In various image technology, CR scanning (CT) is relatively good to bone structure development, and the soft tissue resolution of nuclear magnetic resonance (MRI) is higher.Because the image-forming principle of MRI with CT is different, be difficult to realize integrating, so still do not have CT and MRI all-in-one to occur in world wide.Run into when not only needing CT but also need MRI clinically, often both can only be put together, be understood by rule of thumb by medical worker, such subjectivity is just stronger, and may produce certain error, very limited to the help of individual operation.In order to address this problem, the people such as domestic Zhang Qiang once utilized double source CT research ligamentaum cruciatum, and had gone out the stop structure of anterior cruciate ligament based on CT image rendering, but the also non-digitalization reconstruction of its essence, its stop is also that researcher is according to experience Freehandhand-drawing.And the research of the people such as Hu Yanjun is also only used these two kinds of imaging methods of CT and MRI, both images are carried out simple concatenation, do not realize real visual fusion.External Bowers etc. also once reported that the meniscus of knee joint based on MRI was rebuild, but did not use image fusion technology.
Still do not have a kind of effective method MRI and CT image can be carried out digitized fusion at present, also do not have MRI and CT all-in-one to occur.Mostly existing ligamentaum cruciatum imaging study method is to utilize MRI or CT wherein a kind of image reconstruction carrying out target site, can not rebuild soft tissue and bone structure in same image simultaneously.And the existing method by both combinations is also only after MRI and CT scan are carried out respectively in same position, its image is carried out simple overlap, or some target site in piece image wherein is simply sheared, then pastes in correspondence image and go.These methods have two large drawbacks: the first, and it is not digitized fusion image truly, subjective, and poor accuracy, is only equivalent to " paper-cut " to a certain extent; The second, complicated operation, inefficiency, cannot realize batch process.
Summary of the invention
The present invention aims to provide a kind of method of cruciate ligament reconstruction, and the digitized that can realize CT and MRI merges, and simply effectively, knee ligament can be instructed to perform the operation, and can not increase patient's burden.
For achieving the above object, the present invention realizes by the following technical solutions:
The method of visual cruciate ligament reconstruction disclosed by the invention, comprises the following steps:
Step 1, data acquisition: target knee joint be fixed on and stretch 0 ° of position, successively carried out CT and MRI scanning continuously, and derive respective Dicom data in 30 minutes;
Step 2, unified coordinate system: on CT and MRI image, choose 3 indication points, the coordinate position of 3 points is extracted respectively after mark, then the principle in face is determined according to 3, with a face that point is determined, 3 on MRI or CT for reference, try to achieve the transfer functions between two coordinate systems, according to transfer functions by corresponding image spatial data a little carry out conversion revise;
Step 3, ligamentaum cruciatum space coordinates are extracted: carry out frame choosing to ligamentaum cruciatum image structure shown on sagittal plane, coronalplane and transverse section every aspect, extract all position coordinateses meeting the point of threshold range in the range of choice;
Step 4, visual image reconstruction ligamentaum cruciatum: again import in CT after each point data gray value of extraction is increased predetermined value, reconstruct the cruciate ligaments of knee joint two dimension with adjacent bone structures and 3-D view in CT;
Step 5, radiographic measurement: ligamentaum cruciatum and stop structure thereof in reconstruction image are measured, obtains the measurement data of individuation.
Further, before step 4, also comprise checking conversion data, the synchronous two dimensional image rebuilding CT and MRI, choose identical aspect, carry out overlap by pixel extraction to two images, the image that degree of overlapping reaches preset range is considered to transform successfully, enters follow-up processing flow.
Preferably, in step 4, the predetermined value that described gray value increases is 2000.
Preferably, described 3 indication points are all on bone structure.
Preferably, in step 1, carry out CT and MRI scanning and adopt 64 row's spiral CT machine and 1.5T superconducting magnetic resonances respectively, MRI scanning selects T2 phase three-dimensional can carry out sagittal plain scanning, sweep parameter by fast acquisition interleaved spin echo: TR 1300ms, TE 39ms, resolution 320, matrix 320*224, encourages 1 time, thickness 1mm, overlapping 50%; CT scan parameter: 120kV, 35mA, collimator width 0.6mm, pitch 0.9, thickness 1mm, overlapping 50%, every layer sweep time 500ms.
Preferably, in step 2, according to transfer functions by corresponding image spatial data a little carry out transforming that to revise the instrument that adopts be matlab7.0 software.
Preferably, the preset range of described degree of overlapping is: transverse direction and longitudinal error are all less than 1mm.
Preferably, in step 4, reconstructing with the cruciate ligaments of knee joint two dimension of adjacent bone structures and the instrument that adopts of 3-D view in CT is ImageJ 1.48 software.
Preferably, in steps of 5, be ImageJ 1.48 software in reconstruction image, ligamentaum cruciatum and stop structure thereof measure adopted instrument.
Preferably, the instrument that the two dimensional image of described synchronous reconstruction CT and MRI adopts is Xiphoid software.
Kneed for homonymy CT and MRI image can be carried out digitized fusion by the present invention exactly, be convenient to observe accordingly and measure, for clinical service, particularly ligament reconstructive or reparation provide data refer accurately, avoid because of the simple measured deviation relying on CT or MRI to cause, thus improve surgical effect, help to greatest extent to recover limbs of patient function; This technology extends to other articular ligament of whole body, also can be later stage 3D printing technique simultaneously and provides iconography support in the application of ligament surgery.
Accompanying drawing explanation
Fig. 1 is flow chart of the present invention.
Detailed description of the invention
In order to make object of the present invention, technical scheme and advantage clearly understand, below in conjunction with accompanying drawing, the present invention is further elaborated.
As shown in Figure 1, the method for visual cruciate ligament reconstruction disclosed by the invention, specific implementation is carried out according to following steps:
1, data acquisition: use 64 row's spiral CT machines and 1.5T superconducting magnetic resonance to obtain raw video data, target knee joint is fixed on and stretches 0 ° of position (mode that straight plastic plate colligation is fixing can be adopted), successively consecutive row CT and MRI scanning in 30 minutes.MRI adopts special extremity coil, select T2 phase three-dimensional can carry out sagittal plain scanning by fast acquisition interleaved spin echo (sampling perfection withapplication-optimized contrasts by using different flip angleevolutions, SPACE).Sweep parameter: TR 1300ms, TE 39ms, resolution 320, matrix 320*224, encourages 1 time, thickness 1mm, and overlapping 50%.CT scan parameter: 120kV, 35mA, collimator width 0.6mm, pitch 0.9, thickness 1mm, overlapping 50%, every layer sweep time 500ms.Carry software by image documentation equipment after having scanned Dicom data is derived.
2, each point on CT and MRI is utilized all to have this characteristic of unique three-dimensional coordinate, CT and MRI image is chosen 3 identifications higher and all can the indication point of clear display (preferably choose on bone structure, the point displacement avoiding soft tissue to produce due to compressing distortion is moved), extract the coordinate position of 3 points respectively after mark.Then determine the principle in face according to 3, with a face that point is determined, 3 on MRI or CT for reference, try to achieve the transfer functions between two coordinate systems.According to transfer functions, utilize matlab7.0 software (U.S. MathWorks) coding by corresponding image spatial data a little carry out conversion revise, the space coordinates of CT and MRI are completely unified, and formed image space positions is completely overlapping.
3, after above-mentioned conversion, the space layout of two images should be completely the same in theory, and the image after reconstruction should high superposed.In order to verify the effect of first two steps work, use Xiphoid software (for Medical Image Processing, by rather only writing and provide free) the synchronous two dimensional image rebuilding CT and MRI, choose identical aspect, by pixel extraction function, overlap is carried out to two images, the image of degree of overlapping high (transverse direction and longitudinal error are lower than 1mm) is considered to transform successfully, can enter follow-up processing flow.
4, Xiphoid software image function 2-d reconstruction MRI image is used.This software value is used to cover function (the lower threshold 0 of regulation, upper-level threshold 250), rough frame choosing is carried out to ligamentaum cruciatum image structure shown on sagittal plane, coronalplane and transverse section every aspect, extract all position coordinateses meeting the point of threshold range in the range of choice, and coordinate data is derived.
5, each point data gray value of extraction is improved after 2000 again import in CT, use ImageJ1.48 software (NIH) in CT, reconstruct cruciate ligaments of knee joint two dimension with adjacent bone structures and 3-D view.
6, use the measurement function of ImageJ 1.48 software to measure ligamentaum cruciatum and stop structure thereof in reconstruction image, obtain the measurement data of individuation.。
Certainly; the present invention also can have other various embodiments; when not deviating from the present invention's spirit and essence thereof; those of ordinary skill in the art can make various corresponding change and distortion according to the present invention, but these change accordingly and are out of shape the protection domain that all should belong to the claim appended by the present invention.

Claims (10)

1. a method for visual cruciate ligament reconstruction, is characterized in that, comprises the following steps:
Step 1, data acquisition: target knee joint be fixed on and stretch 0 ° of position, successively carried out CT and MRI scanning continuously, and derive respective Dicom data in 30 minutes;
Step 2, unified coordinate system: on CT and MRI image, choose 3 indication points, the coordinate position of 3 points is extracted respectively after mark, then the principle in face is determined according to 3, with a face that point is determined, 3 on MRI or CT for reference, try to achieve the transfer functions between two coordinate systems, according to transfer functions by corresponding image spatial data a little carry out conversion revise;
Step 3, ligamentaum cruciatum space coordinates are extracted: carry out frame choosing to ligamentaum cruciatum image structure shown on sagittal plane, coronalplane and transverse section every aspect, extract all position coordinateses meeting the point of threshold range in the range of choice;
Step 4, visual image reconstruction ligamentaum cruciatum: again import in CT after each point data gray value of extraction is increased predetermined value, reconstruct the cruciate ligaments of knee joint two dimension with adjacent bone structures and 3-D view in CT;
Step 5, radiographic measurement: ligamentaum cruciatum and stop structure thereof in reconstruction image are measured, obtains the measurement data of individuation.
2. the method for visual cruciate ligament reconstruction according to claim 1, it is characterized in that, checking conversion data was also comprised before step 4, the two dimensional image of synchronous reconstruction CT and MRI, choose identical aspect, carry out overlap by pixel extraction to two images, the image that degree of overlapping reaches preset range is considered to transform successfully, enters follow-up processing flow.
3. the method for visual cruciate ligament reconstruction according to claim 1, is characterized in that, in step 4, the predetermined value that described gray value increases is 2000.
4. the method for visual cruciate ligament reconstruction according to claim 1, is characterized in that, described 3 indication points are all on bone structure.
5. the method for visual cruciate ligament reconstruction according to claim 1, it is characterized in that, in step 1, carry out CT and MRI scanning and adopt 64 row's spiral CT machine and 1.5T superconducting magnetic resonances respectively, MRI scanning selects T2 phase three-dimensional can carry out sagittal plain scanning by fast acquisition interleaved spin echo, sweep parameter: TR 1300ms, TE 39ms, resolution 320, matrix 320*224, encourage 1 time, thickness 1mm, overlapping 50%; CT scan parameter: 120kV, 35mA, collimator width 0.6mm, pitch 0.9, thickness 1mm, overlapping 50%, every layer sweep time 500ms.
6. the method for visual cruciate ligament reconstruction according to claim 1, is characterized in that, in step 2, according to transfer functions by corresponding image spatial data a little carry out transforming that to revise the instrument that adopts be matlab7.0 software.
7. the method for visual cruciate ligament reconstruction according to claim 2, is characterized in that, the preset range of described degree of overlapping is: transverse direction and longitudinal error are all less than 1mm.
8. the method for visual cruciate ligament reconstruction according to claim 1, it is characterized in that, in step 4, reconstructing with the cruciate ligaments of knee joint two dimension of adjacent bone structures and the instrument that adopts of 3-D view in CT is ImageJ 1.48 software.
9. the method for visual cruciate ligament reconstruction according to claim 1, is characterized in that, in steps of 5, is ImageJ 1.48 software in reconstruction image, ligamentaum cruciatum and stop structure thereof measure adopted instrument.
10. the method for visual cruciate ligament reconstruction according to claim 2, is characterized in that, the instrument that the two dimensional image of described synchronous reconstruction CT and MRI adopts is Xiphoid software.
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN115778629A (en) * 2023-02-07 2023-03-14 四川大学华西医院 Spinal interspinous composite ligament

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CN102940530A (en) * 2012-11-16 2013-02-27 昆明医科大学第一附属医院 Method for virtually building anterior cruciate ligament on femur and tibia tunnels
US20140187908A1 (en) * 2012-11-24 2014-07-03 Jutta Ellermann System and Method for Patient-Specific Planar Visualization of Volumetric MRI Data
CN104510474A (en) * 2014-12-22 2015-04-15 北京大学第三医院 Three-dimensional measurement method and system for patella osteotomy

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US5739811A (en) * 1993-07-16 1998-04-14 Immersion Human Interface Corporation Method and apparatus for controlling human-computer interface systems providing force feedback
US5791907A (en) * 1996-03-08 1998-08-11 Ramshaw; Bruce J. Interactive medical training system
CN101320526A (en) * 2008-07-11 2008-12-10 深圳先进技术研究院 Apparatus and method for operation estimation and training
CN102940530A (en) * 2012-11-16 2013-02-27 昆明医科大学第一附属医院 Method for virtually building anterior cruciate ligament on femur and tibia tunnels
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CN104510474A (en) * 2014-12-22 2015-04-15 北京大学第三医院 Three-dimensional measurement method and system for patella osteotomy

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Publication number Priority date Publication date Assignee Title
CN115778629A (en) * 2023-02-07 2023-03-14 四川大学华西医院 Spinal interspinous composite ligament

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