CN106510845B - Medical path navigation methods and systems - Google Patents
Medical path navigation methods and systems Download PDFInfo
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- CN106510845B CN106510845B CN201611042472.9A CN201611042472A CN106510845B CN 106510845 B CN106510845 B CN 106510845B CN 201611042472 A CN201611042472 A CN 201611042472A CN 106510845 B CN106510845 B CN 106510845B
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- 230000003902 lesion Effects 0.000 claims abstract description 111
- 238000012545 processing Methods 0.000 claims description 42
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- 210000000621 bronchi Anatomy 0.000 claims description 26
- VNWKTOKETHGBQD-UHFFFAOYSA-N methane Chemical compound C VNWKTOKETHGBQD-UHFFFAOYSA-N 0.000 claims description 6
- 230000010339 dilation Effects 0.000 claims description 3
- 239000003345 natural gas Substances 0.000 claims description 3
- 210000001631 vena cava inferior Anatomy 0.000 claims description 3
- 239000007789 gas Substances 0.000 claims 1
- 230000002685 pulmonary effect Effects 0.000 abstract description 4
- 238000001574 biopsy Methods 0.000 description 19
- 238000010586 diagram Methods 0.000 description 18
- 238000002679 ablation Methods 0.000 description 15
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- 201000003144 pneumothorax Diseases 0.000 description 3
- 206010067484 Adverse reaction Diseases 0.000 description 2
- 230000009471 action Effects 0.000 description 2
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- 210000001367 artery Anatomy 0.000 description 2
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- 206010058467 Lung neoplasm malignant Diseases 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
- A61B2010/009—Various features of diagnostic instruments
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- Animal Behavior & Ethology (AREA)
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Abstract
The embodiment of the present application provides a kind of medical path navigation methods and systems.Wherein, method includes: the path planning stage, determines the puncture starting point led on lesion region path and punctures target point；The path navigation stage, electromagnetic navigation is combined with puncture, balloon expandable, get through the channel for leading to lesion region through pulmonary parenchyma, to which guiding catheter is navigated to lesion region, it solves the problems, such as that the lesion locations sensible without obvious natural air flue can not be reached, guiding catheter can be navigated to any lesion region of intrapulmonary.
Description
Technical field
This application involves field of medical technology more particularly to a kind of medical path navigation methods and systems.
Background technique
The diagnosing and treating of pulmonary nodule has had more and more important meaning for the early detection and treatment of lung cancer.
Conventional pulmonary nodule biopsy mode is that puncture needle is inserted directly into lung by the way of percutaneous puncture to obtain biopsy sample, this
Kind puncture mode has the risk for generating pneumothorax.Some researches show that, in lung's percutaneous puncture, there is the pneumothorax incidence of 20-40%, and
Pneumothorax is a kind of serious adverse reaction, it is possible to fatal.Safer mode is through natural air flue using bronchoscope to lung
Portion's tubercle carries out biopsy, can reduce the risk of adverse reaction generation.
But some lesion locations are more special, such as sensible without apparent natural air flue, cause bronchoscope can not
Lesion locations are reached, biopsy or treatment can not be implemented.
Summary of the invention
The many aspects of the application provide a kind of medical path navigation methods and systems, lead will position conduit or treatment
Pipe navigates to the lesion locations sensible without obvious natural air flue.
The embodiment of the present application provides a kind of medical path air navigation aid, comprising:
According to the threedimensional model of the bronchial tree gone out by CT data reconstruction and the threedimensional model of intrapulmonary blood vessel, determines and lead to disease
Become the puncture starting point and puncture target point on zone routing, and plans by main knuckle through natural air flue to the puncture starting point
Leading bit path and from it is described puncture starting point to it is described puncture target point puncture path；
Under the guidance of the leading bit path, guiding catheter is sent into based on the positioning conduit with alignment sensor and is led to
Into the natural air flue for puncturing starting point；
During the guiding catheter is mobile in the natural air flue, passed based on the supravasal positioning of positioning
Sensor positions position and direction of the guiding catheter in the natural air flue, and according to the guiding catheter in the nature
The offset relation of the leading bit path of position and direction and the planning in air flue, adjusts the guiding catheter in the nature
Position and direction in air flue, until the guiding catheter is navigated to the puncture starting point；
Puncture conduit with alignment sensor is sent into the guiding catheter to reach the puncture starting point, is based on institute
It states and punctures the direction that supravasal alignment sensor positions the puncture conduit, adjust the direction for puncturing conduit until described
Conduit is punctured towards until the puncture target point, and controls the puncture conduit and stabs the puncture along the puncture path
Target point, to obtain puncture；
After taking out the puncture conduit, foley's tube is sent into the guiding catheter to reach the puncture, and control
Make puncture described in the inferior vena cava balloon dilation；
After taking out the foley's tube, the tool of the subsequent processing with alignment sensor is sent into the guiding catheter, base
The guiding catheter is positioned in the puncture after the expansion with the alignment sensor on tool in the subsequent processing
Position and direction adjust position and direction of the guiding catheter in the puncture after the expansion, until by the finger
Guiding tube navigates to the lesion region.
The embodiment of the present application also provides a kind of medical path navigation system, comprising: path planning apparatus, path navigation dress
It sets, guiding catheter, positioning conduit, puncture conduit and foley's tube with alignment sensor with alignment sensor；
The path planning apparatus, for the threedimensional model and intrapulmonary blood vessel according to the bronchial tree gone out by CT data reconstruction
Threedimensional model, determine lead to lesion region path on puncture starting point and puncture target point, and plan by main knuckle pass through from
Right air flue is to the leading bit path for puncturing starting point and from the puncture starting point to the puncture road for puncturing target point
Diameter；
The guiding catheter, for carrying the positioning conduit, the puncture in the air flue for leading to the lesion region
Conduit or the foley's tube；
The route guiding device, comprising: path navigation module punctures control module and sprawl and control module；
The path navigation module, for being based on during the guiding catheter is mobile in the natural air flue
The supravasal alignment sensor of the positioning being arranged in the guiding catheter positions the guiding catheter in the natural gas
Position and direction in road, and according to position and direction of the guiding catheter in the natural air flue and the leading air route
The offset relation of diameter adjusts position and direction of the guiding catheter in the natural air flue, until by the guiding catheter
Navigate to the puncture starting point；
The puncture control module, for being passed based on the supravasal positioning of the puncture being arranged in the guiding catheter
Sensor positions the direction for puncturing conduit, adjusts the direction for puncturing conduit until the puncture conduit is towards the puncture
It until target point, and controls the puncture conduit and stabs the puncture target point along the puncture path, puncture wound to obtain
Mouthful；
The sprawl and control module is worn described in the inferior vena cava balloon dilation being arranged in the guiding catheter for controlling
Stab mouth；
The path navigation module is also used to based on determining on the subsequent processing tool being arranged in the guiding catheter
Level sensor positions position and direction of the guiding catheter in the puncture after the expansion, adjusts the guiding catheter
Position and direction in the puncture after the expansion, until the guiding catheter is navigated to the lesion region.
In the embodiment of the present application, in the path planning stage, determine through puncture starting point on lesion region path and
Puncture target point；During the navigation process, electromagnetic navigation is combined with puncture, balloon expandable, is got through towards the logical of lesion region
Road, so that guiding catheter is navigated to lesion region, solving can not be arrived without the sensible lesion locations of obvious natural air flue
Guiding catheter can be navigated to any lesion region of lung by problem.
Detailed description of the invention
The drawings described herein are used to provide a further understanding of the present application, constitutes part of this application, this Shen
Illustrative embodiments and their description please are not constituted an undue limitation on the present application for explaining the application.In the accompanying drawings:
Fig. 1 a is the flow diagram for the medical path air navigation aid that one embodiment of the application provides；
Fig. 1 b- Fig. 1 i is the schematic diagram for the medical path navigation procedure that one embodiment of the application provides；
Fig. 2 a is the flow diagram for the medical path air navigation aid that another embodiment of the application provides；
Fig. 2 b is the schematic diagram of auxiliary magnet and assisting navigation path that another embodiment of the application provides；
Fig. 3 is the schematic diagram that ablation is carried out to puncture target point that the another embodiment of the application provides；
Fig. 4 is the structural schematic diagram for the medical path navigation system that the another embodiment of the application provides；
Fig. 5 is the structural schematic diagram for the medical path navigation system that the another embodiment of the application provides.
Specific embodiment
To keep the purposes, technical schemes and advantages of the application clearer, below in conjunction with the application specific embodiment and
Technical scheme is clearly and completely described in corresponding attached drawing.Obviously, described embodiment is only the application one
Section Example, instead of all the embodiments.Based on the embodiment in the application, those of ordinary skill in the art are not doing
Every other embodiment obtained under the premise of creative work out, shall fall in the protection scope of this application.
The embodiment of the present application provides a kind of medical path air navigation aid, in the three-dimensional of the bronchial tree gone out by CT data reconstruction
On the basis of the threedimensional model of model and intrapulmonary blood vessel, by based on alignment sensor path navigation and puncture, balloon expandable phase
In conjunction with, it is some special lesion locations, such as the lesion locations sensible without obvious natural air flue, a reachable channel is provided,
Allow guiding catheter to reach these lesion locations, provides condition for the treatment of these lesion locations.
In the following embodiment of the application, alignment sensor can be related to, such as be set to the supravasal positioning of positioning and pass
Sensor is set to and punctures supravasal alignment sensor etc..Firstly, being carried out to the alignment sensor that each embodiment of the application is related to
Introduce explanation:
These alignment sensors use electromagnetic navigation (Electromagnetic Navigation) principle, are different from common
Magnetic navigation (Magnetic Navigation) principle.Magnetic navigation principle is mainly: attracting or repel ablation by external magnetic field
Permanent magnet in conduit is to influence the moving direction of ablation catheter.The working principle master of alignment sensor in the embodiment of the present application
If: in response to space where it magnetic field and export electric current to external control system, so that control system positions corresponding pipe
Position.For in detail, alignment sensor is electrically connected with control system by conducting wire.The control system includes magnetic field
Generator, to generate magnetic field in a certain range of located space；Alignment sensor itself is without magnetic, in alignment sensor
Coil for experiencing magnetic field caused by magnetic field generator.Wherein, magnetic field generator produces in a certain range of located space
Raw changing magnetic field, and guarantee that the magnetic signature of every bit in located space is unique.Coil in alignment sensor is becoming
Electric current is generated in magnetizing field, is conducted by the conducting wire of alignment sensor to control system, control system conversion and analyzing and positioning sensing
Device transmits next electric current to determine the exact position and direction of corresponding pipe.
Fig. 1 a is the flow diagram for the medical path air navigation aid that one embodiment of the application provides.As shown in Figure 1a, should
Method includes:
101, it according to the threedimensional model of the bronchial tree gone out by CT data reconstruction and the threedimensional model of intrapulmonary blood vessel, determines logical
Toward the puncture starting point on lesion region path and target point is punctured, and plans and is punctured through natural air flue to described by main knuckle
The leading bit path of initial point and from it is described puncture starting point to it is described puncture target point puncture path.
102, under the guidance of leading bit path, guiding catheter is sent into based on the positioning conduit with alignment sensor and is led to
Into the natural air flue for puncturing starting point.
103, during guiding catheter is mobile in the natural air flue, based on the supravasal alignment sensor of positioning
Position position and direction of the guiding catheter in the natural air flue, and the position according to guiding catheter in the natural air flue
With the offset relation in direction and leading bit path, position and direction of the guiding catheter in the natural air flue are adjusted, until inciting somebody to action
Guiding catheter navigates to the puncture starting point.
104, the puncture conduit with alignment sensor is sent into guiding catheter to reach puncture starting point, is led based on puncture
The direction of alignment sensor localised puncture conduit on pipe, adjustment puncture the direction of conduit until puncturing conduit towards puncture target
It until point, and controls puncture conduit and stabs puncture target point along puncture path, to obtain puncture.
105, it takes out after puncturing conduit, foley's tube is sent into guiding catheter to reach puncture, and control sacculus and lead
Enlargement of pipe puncture.
106, after taking out foley's tube, the tool of the subsequent processing with alignment sensor is sent into guiding catheter, is based on
The position and direction in the puncture of alignment sensor positioning guiding catheter after expansion on subsequent processing tool, adjustment
Position and direction in the puncture of guiding catheter after expansion, until guiding catheter is navigated to lesion region.
Before treating to diseased organ, need to navigate to guiding catheter the lesion region of diseased organ, subsequent place
Reason can reach lesion region by guiding catheter with tool.The diseased organ can be lung or structure similar to lung
Other organs etc..For some special lesion regions, such as the lesion region sensible without obvious natural cavity, sometimes referred to as guide
Pipe can not directly reach lesion region.
For the special lesion region that those guiding catheters can not be reached directly, the present embodiment provides a kind of by guiding catheter
The method for navigating to lesion region, this method include following several stages: path planning stage, first path navigation stage, road
Diameter gets through stage and the second path navigation stage.
The path planning stage:
Firstly, importing the CT data of diseased organ, by the threedimensional model of CT data building bronchial tree, as shown in Figure 1 b；
Threedimensional model based on bronchial tree determines the lesion region on diseased organ.In Figure 1b, gray area indicates diseased region
Domain.In the present embodiment, lesion region can be defined as the simply connected closing 3D region of arbitrary shape, such as can be rule
The simply connected of shape closes 3D region, such as elliposoidal；Alternatively, the simply connected envelope of any irregular shape can also be defined as
Close 3D region.
In the present embodiment, guiding catheter can not directly reach identified lesion region, such as usual lesion region
Some stop on path, or sensible without obvious natural air flue.For this, threedimensional model and lung's blood based on bronchial tree
The threedimensional model of pipe, determine lead to lesion region path on puncture starting point and puncture target point, the punctures starting point with
Puncture the barrier zone that target point identification leads on lesion region path.Barrier zone, which can be, cannot directly pass through or difficult
With the region passed through, such as pulmonary parenchyma, needs to puncture starting point using certain way and puncture target point and get through.In this implementation
In example, by the way of puncture and balloon expandable.
In order to which guiding catheter is navigated to lesion region, need to plan the path for leading to lesion region.In this implementation
Example in, planning lead to lesion region path, mainly include through natural air flue lead to puncture starting point leading bit path and
From starting point is punctured to the puncture path for puncturing target point, but it is not limited to this.It, can be using such as in an optional embodiment
Under type punctures starting point and puncture target point to determine:
According to the threedimensional model of bronchial tree, lesion region is planned；Out of lesion region, select a little as puncture target
Point；According to the threedimensional model of intrapulmonary blood vessel, selected in the bronchus for avoiding blood vessel a bit, as puncture starting point.Such as Fig. 1 c
It is shown, to determine a kind of exemplary diagram for puncturing starting point and puncturing target point using the embodiment.In figure 1 c, it is located at grey
"+" in lesion region indicates to puncture target point, indicates to puncture starting point positioned at the intrabronchial "+" close to lesion region.
In above-mentioned optional embodiment, the point of middle most convenient subsequent operation in lesion region can choose as puncture mesh
Punctuate.For example, doing biopsy if necessary, then least it is easy to get the point except lesion region range when can choose biopsy.Again
For example, can choose the point for being easiest to cover entire lesion region when treatment, usually in lesion region if necessary to treat
Heart point.
In above-mentioned optional embodiment, it can select to puncture starting point in bronchus near lesion region.For example, can
With in the higher level's bronchus for leading to lesion region direction, these higher level's bronchuses are relatively thick, led convenient for guiding catheter, positioning
The front ends such as pipe, puncture conduit, which are easily aligned, punctures target point.In view of the particularity of puncture, in order to prevent in puncture process
Damage blood vessel cause to bleed profusely, can in conjunction with intrapulmonary blood vessel threedimensional model come select puncture starting point.For example, to puncture
Initial point facilitates conduit arrival to the line (straightway) for puncturing target point and is as far as possible selection mesh far from the blood vessel that can be told
Mark, to select to puncture starting point.In the specific implementation process, the threedimensional model of intrapulmonary blood vessel can be constructed in conjunction with CT data, it is main
It to include artery and vein threedimensional model；In the bronchus near lesion region, select subsequent piercing step that can avoid blood
The bronchus of pipe；In the selected bronchus for avoiding blood vessel, selection convenient for subsequent piercing step implement a bit, such as with wear
The line of dazzling punctuate is far from can recognize blood vessel and be more easily aligned the point (such as bronchial crotch) of target point, as wearing
Pierce starting point.It is described recognize blood vessel can be blood vessel CT images and based on CT images rebuild threedimensional model in can by people naked eyes
The blood vessel identified, is primarily referred to as arteries and vein blood vessel, and but it is not limited to this.
Preferably, the threedimensional model of the threedimensional model of bronchial tree and intrapulmonary blood vessel can be superimposed upon same threedimensional model
In, and bronchus and blood vessel are distinguished by different attribute values (such as color or transparency), in this way convenient for observation.
Determine puncture starting point, puncture target point and plan it is good to the leading bit path for puncturing starting point and from puncture
After starting point to the puncture path for puncturing target point, first path navigation stage can be entered.
First path navigation stage:
After cooking up the leading bit path for puncturing starting point, it can pass through under the guidance for dominating bit path
Guiding catheter is sent into the natural air flue for leading to and puncturing starting point by the positioning conduit with alignment sensor, and guiding catheter can be
It is moved in air flue.Wherein, positioning conduit is arranged in inside guiding catheter.
The above-mentioned natural air flue for leading to puncture starting point includes main trachea-bronchial epithelial cell and junior's bronchus etc..
Starting point is punctured in order to reach exactly along the leading bit path cooked up, on the basis of leading bit path
On, it navigates in conjunction with the included alignment sensor of positioning conduit to guiding catheter.Specifically, being moved in air flue in guiding catheter
In dynamic process, it is in running order to position supravasal alignment sensor, can position guiding catheter based on alignment sensor
Position and direction in air flue；According to position and direction of the guiding catheter in air flue and based on the threedimensional model of bronchial tree
The offset relation for the leading bit path cooked up adjusts position and direction of the guiding catheter in air flue, leads until that will guide
Pipe navigates to puncture starting point, as shown in Figure 1 d.Fig. 1 d, which is shown, navigates to guiding catheter the result shape after puncturing starting point
State.In Fig. 1 d, in bronchus is guiding catheter, and the round and smooth head that guiding catheter exposes is the head for positioning conduit.
It is worth noting that diseased organ is in the positioning magnetic field of magnetic field generator transmitting, which has oneself
Coordinate system, referred to as magnetic system of coordinates.Position and direction of the guiding catheter in air flue can be by guiding catheter head in magnetic field
Position coordinates in coordinate system indicate.Correspondingly, the threedimensional model of the bronchial tree gone out by CT data reconstruction also has oneself
Coordinate system, referred to as CT/ coordinate systems in image.Various paths that threedimensional model based on bronchial tree is planned (including leading boat
Path, puncture path) etc. can be indicated by position coordinates of these paths in CT/ coordinate systems in image.
Based on above description, position and direction of the guiding catheter in air flue are advised with the threedimensional model based on bronchial tree
The offset relation of the leading bit path marked by position coordinates of the guiding catheter head in magnetic system of coordinates and can be dominated
Position coordinates of the bit path in CT/ coordinate systems in image embody.
Magnetic system of coordinates and CT/ coordinate systems in image are different coordinate system, then can first be registrated to two coordinate systems,
With the mapping relations established between two coordinate systems, the position coordinates of the two are mapped to the same coordinate system based on the mapping relations
In, it is then compared in the coordinate system be mappeding to, so that it is determined that above-mentioned offset relation.
It can be seen that it is based on above-mentioned registration process, and it can be corresponding with bronchus by the guidance path of planning, according to navigation
Position and direction of the adjustable guiding catheter in path in air flue, until guiding catheter is navigated to puncture starting point.Work as finger
After guiding tube reaches puncture starting point, positioning conduit is withdrawn from from guiding catheter, and conduit will be punctured and be sent into guiding catheter, it
Access path gets through the stage afterwards.
The stage is got through in path:
After puncture conduit is admitted to guiding catheter, it can be reached by guiding catheter and puncture starting point, and be ready to carry out puncture
Operation.In the present embodiment, it punctures conduit to need to stab puncture target point along puncture path, so it should be understood that puncturing conduit
Direction.The puncture conduit of the present embodiment, can be with localised puncture conduit based on the alignment sensor with alignment sensor
Position and direction, and it is adjustable puncture conduit direction until puncture conduit towards puncture target point until, and then control
It punctures conduit and stabs puncture target point along puncture path, to obtain puncture, as shown in fig. le.In Fig. 1 e, guide is led
It is the puncture needle for puncturing conduit that pipe, which exposes, which is just stabbing puncture target point.Optionally, (multi-cavity) conduit can be passed through
The means that interior steel wire manipulates puncture the bending of catheter head to control, it is easier to which alignment punctures target point.
It is worth noting that puncture conduit can pierce puncture target point when stopping, or can not reach puncture
Stop when target point, or can stop after passing through puncture target point, it can be according to application demand Adaptive Control.It punctures
Wound is relatively small, and guiding catheter generally can not still pass through.
After obtaining puncture, conduit will be punctured and withdrawn from from guiding catheter, and foley's tube is sent into guiding catheter,
To be expanded to the puncture, as shown in Figure 1 f.In Fig. 1 f, guiding catheter exposing is the head of foley's tube.
By guiding catheter, foley's tube can be reached at puncture, and control foley's tube can be with dilated penetration wound.For example, can
To inflate to foley's tube with dilating sacculus, and then achieve the purpose that dilated penetration wound, as shown in Figure 1 g.In Fig. 1 g, ball
It is expanded on the head of ductus bursae.Optionally, according to application demand, it can be the expansion of a certain time, be also possible to
It is expanded by several times by different pressures, is stepped up the expansion that sacculus is gradually expanded in pressure stage by stage, led to obtain and guide enough
The wound that pipe passes through.Puncture after expansion is relatively large, so that guiding catheter passes through.
Second path navigation stage:
In the navigation stage, need to take out foley's tube, as shown in figure 1h, to take out the state after foley's tube.By band
The subsequent processing of alignment sensor is sent into guiding catheter with tool, and guiding catheter needs to move in puncture after expansion.
It, can be based on the alignment sensor on subsequent processing tool during mobile in the puncture of guiding catheter after expansion
The position and direction in the puncture of guiding catheter after expansion are positioned, are adjusted in the puncture of guiding catheter after expansion
Position and direction, until guiding catheter is navigated to lesion region.
Wherein, subsequent processing refers to the subsequent conduit for needing to carry out lesion region diagnosis or treatment with tool, such as
It can be but not limited to: ablation catheter, delivery catheter or biopsy tool etc..
In an optional embodiment, if the puncture after balloon expandable is deep enough, guiding catheter can reach lesion
Region can directly lead the subsequent processing tool with alignment sensor, such as ablation catheter, administration then after balloon expandable
Pipe or biopsy tool are sent into guiding catheter, and guiding catheter is guided to enter in the wound after expanding, until reaching lesion region, and
Subsequent processing, such as ablation, administration or biopsy sampling are carried out to lesion region with tool by subsequent processing.It is worth noting that
Biopsy tool can have alignment sensor, it is also possible to without alignment sensor.For the biopsy without alignment sensor
Tool can first pass through the positioning conduit with alignment sensor for guiding catheter and navigate to lesion region, take out positioning conduit
Afterwards, then by biopsy tool it is sent into guiding catheter, executes biopsy sampling.
In an optional embodiment, it may be needed according to the characteristic of subsequent processing tool deeper than puncturing target point
Enter, for example, if subsequent melted, then needs that ablating electrode center is allowed to reach puncturing target point, at this time before ablation catheter
End can be more than to puncture target point, deeper into the ablation areas that just ablation catheter can in this way generated is effective over entire lesion
Region.Based on this, if the puncture after balloon expandable is not deep enough, does not reach and puncture target point or fail deeper into then taking
Out after foley's tube, and before subsequent processing is sent into guiding catheter with tool, it can will puncture conduit and be fed again into finger
Guiding tube, based on the direction for puncturing supravasal alignment sensor localised puncture conduit, adjustment punctures the direction of conduit until wearing
It until piercing conduit direction puncture target point, and controls puncture conduit and stabs puncture target point along puncture path is secondary, to insert
Enter depths to reach puncture target point or more than target point is punctured, diagnosed or treated the condition of offer with tool for subsequent processing.
As shown in figure 1i, be secondary puncture when status diagram.
Optionally, puncture target point can be a bit in lesion region, then guiding catheter is navigated to lesion region,
Can be understood as navigating to guiding catheter puncture target point or its near.
Optionally, it punctures target point to be located at except lesion region, and is located in front of lesion region, then guiding catheter navigates
To lesion region, it can be understood as guiding catheter needs to continue to move to lesion region by puncturing target point.
From the foregoing, it can be seen that in the present embodiment, it is sensible for there is obstruction on some paths, or without obvious natural air flue
Lesion region determine through the puncture starting point on lesion region path and puncture target point in the path planning stage；It is leading
During boat, electromagnetic navigation is combined with puncture, balloon expandable, the channel towards lesion region is got through, so that guide be led
Pipe navigates to lesion region, and solving can not reach without the sensible lesion locations of apparent (or thick enough) natural air flue
Guiding catheter can be navigated to any lesion region by problem.
Fig. 2 a is the flow diagram for the medical path air navigation aid that another embodiment of the application provides.As shown in Figure 2 a,
This method comprises:
201, it according to the threedimensional model of the bronchial tree gone out by CT data reconstruction and the threedimensional model of intrapulmonary blood vessel, determines logical
Toward the puncture starting point on lesion region path and target point is punctured, and is planned by main knuckle through natural air flue to puncture starting point
Leading bit path and from puncture starting point to puncture target point puncture path.
202, according to the threedimensional model of bronchial tree, auxiliary magnet is selected out of bronchus around lesion region, and is planned
From starting point is punctured to the assisting navigation path of auxiliary magnet.
203, under the guidance of leading bit path, guiding catheter is sent into based on the positioning conduit with alignment sensor and is led to
Into the natural air flue for puncturing starting point.
204, during guiding catheter is mobile in the natural air flue, based on the supravasal alignment sensor of positioning
Position position and direction of the guiding catheter in the natural air flue, and the position according to guiding catheter in the natural air flue
With the offset relation in direction and leading bit path, position and direction of the guiding catheter in the natural air flue are adjusted, until inciting somebody to action
Guiding catheter navigates to puncture starting point.
205, guiding catheter is navigated to from starting point is punctured by auxiliary magnet based on the supravasal alignment sensor of positioning, to obtain
The natural air flue practical bronchial path corresponding with assisting navigation path is obtained, and according to practical bronchial path and planning
The comparison in assisting navigation path, amendment puncture starting point and puncture the position of target point.
206, the puncture conduit with alignment sensor is sent into guiding catheter to reach puncture starting point, is led based on puncture
The direction of alignment sensor localised puncture conduit on pipe, adjustment puncture the direction of conduit until puncturing conduit towards puncture target
It until point, and controls puncture conduit and stabs puncture target point along puncture path, to obtain puncture.
207, it takes out after puncturing conduit, foley's tube is sent into guiding catheter to reach puncture, and control sacculus and lead
Puncture described in enlargement of pipe.
208, after taking out foley's tube, the tool of the subsequent processing with alignment sensor is sent into guiding catheter, after being based on
The position and direction in the puncture of alignment sensor positioning guiding catheter after expansion on continuous processing tool, adjustment refer to
Position and direction in the puncture of guiding tube after expansion, until guiding catheter is navigated to lesion region.
It is worth noting that described position in air flue, or practical bronchial path etc. are all the magnetic where air flue
Position coordinates in the coordinate system of field.Correspondingly, bit path is dominated, assisting navigation path generally refers in CT/ coordinate systems in image
Position coordinates.
Before treating to diseased organ, need to navigate to guiding catheter the lesion region of diseased organ, subsequent place
Reason can reach lesion region by guiding catheter with tool.The diseased organ can be lung or structure similar to lung
Other organs etc..For some special lesion regions, such as the lesion region sensible without obvious natural air flue, sometimes referred to as guide
Pipe can not directly reach lesion region.
For the special lesion region that those guiding catheters can not be reached directly, the present embodiment provides a kind of by guiding catheter
The method for navigating to lesion region, this method include following several stages: path planning stage, first path navigation stage, road
Diameter gets through stage and the second path navigation stage.
The path planning stage in path planning stage in the present embodiment, with Fig. 1 a illustrated embodiment is essentially identical, area
It is not: further includes the threedimensional model based on bronchial tree, determine the bronchus around lesion region, and from the lesion region
Auxiliary magnet is selected in the bronchus of surrounding, plans the operation from puncture starting point to the assisting navigation path of auxiliary magnet.
In above-mentioned program operation, it can choose near lesion locations but be originated with puncturing according to application demand
Point compare the more deep bronchus in direction with target point is punctured, and selects auxiliary magnet out of identified bronchus, and planning from
Starting point is punctured to the path of this auxiliary magnet, referred to as assisting navigation path.Wherein, selected auxiliary magnet will be as far as possible from difference
Direction surrounds lesion region, and such assisting navigation path can surround lesion region, needs to reach in order to assist in
Puncture the coordinate range of target point.As shown in Figure 2 b, in addition to puncturing target point and puncturing starting point, in grey lesion region week
Enclose than puncture starting point and puncture target point deeper into direction there are two auxiliary magnet, such as Fig. 2 b mesobronchus end
Shown in "+"；In addition, indicating assisting navigation path to the dotted line two auxiliary magnets from starting point is punctured in Fig. 2 b.
About other descriptions in path planning stage, reference can be made to Fig. 1 a illustrated embodiment, details are not described herein.
First path navigation stage:
The basic phase of first path navigation stage in path planning stage in the present embodiment, with Fig. 1 a illustrated embodiment
Together, difference is: further including that amendment punctures starting point and punctures target point after guiding catheter to be navigated to puncture starting point
Position operation.
After guiding catheter to be navigated to puncture starting point, before it will puncture conduit and be sent into guiding catheter, Ke Yigen
Guiding catheter is navigated into auxiliary magnet from starting point is punctured according to supravasal alignment sensor is positioned, to obtain from puncture starting point
To the practical bronchial path of auxiliary magnet, which corresponds to assisting navigation path.Practical bronchial path with
The difference in assisting navigation path is: practical bronchial path is a paths true in air flue, which can pass through
Position coordinates indicate in magnetic system of coordinates where air flue；And assisting navigation path is that the threedimensional model based on bronchial tree is advised
The path marked, the path can be indicated by the position coordinates in CT/ coordinate systems in image where threedimensional model.It is originated to puncturing
Point and puncture target point for, be also based on bronchial tree threedimensional model cook up come, so need according to practical branch
Tracheae path, amendment puncture starting point and puncture the position of target point.Thus it is possible to be led according to practical bronchial path with auxiliary
The comparison of bit path adjusts the mapping relations of magnetic system of coordinates and CT/ coordinate systems in image, and then corrects and puncture starting point and puncture
The position of target point executes puncture for subsequent puncture conduit and provides foundation.
Stage, the second path navigation stage are got through in other descriptions and path about first path navigation stage, can join
See Fig. 1 a illustrated embodiment, details are not described herein.
In the present embodiment, in the path planning stage, in addition to determining through puncture starting point on lesion region path and
It punctures except target point, also determines and surround the auxiliary magnet of lesion region from different directions and plan assisting navigation path；In path
Navigation stage gets through towards except the channel of lesion region in addition to combining electromagnetic navigation with puncture, balloon expandable, goes back base
Comparison between assisting navigation path and practical bronchial path, amendment puncture starting point and puncture the position of target point, no
Address only the problem of can not reaching without obvious natural air flue sensible lesion locations, and advantageously reduce position error and
The error of piercing step later improves the accuracy of entire navigation procedure.
On the basis of the various embodiments described above, after guiding catheter is navigated to lesion region, it is also necessary to use subsequent processing
Subsequent processing, such as ablation, administration or biopsy sampling are carried out to lesion region with tool.Based on this, navigate by guiding catheter
To lesion region, further includes: the position based on the alignment sensor adjustment subsequent processing tool on subsequent processing tool
And direction, target point is punctured until subsequent processing tool reaches, after control subsequent processing carries out puncture target point with tool
Continuous processing, such as ablation, administration or biopsy sampling.If carrying out biopsy sampling, cytobrush, cell clamp, biopsy can be used
Needle etc..If therapeutic conduit is ablation catheter, it can control ablation catheter and melted to target point is punctured, such as Fig. 3 institute
Show.After treatment end, therapeutic conduit and guiding catheter can be successively withdrawn from.
Fig. 4 is the structural schematic diagram for the medical path navigation system that the another embodiment of the application provides.As shown in figure 4, should
System includes: path planning apparatus 41, route guiding device 42, guiding catheter 43, positioning conduit 44, band with alignment sensor
The puncture conduit 45 and foley's tube 46 of alignment sensor.
Path planning apparatus 41, for according to the threedimensional model of the bronchial tree gone out by CT data reconstruction and intrapulmonary blood vessel
Threedimensional model determines the puncture starting point led on lesion region path and punctures target point, and plans by main knuckle through nature
Air flue is to the leading bit path for puncturing starting point and from starting point is punctured to the puncture path for puncturing target point.
Guiding catheter 43, in the air flue for leading to lesion region, carrying positioning conduit 44 to puncture conduit 45 or sacculus
Conduit 46.
Route guiding device 42, comprising: path navigation module 421 punctures control module 422 and sprawl and control module
423。
Wherein, path navigation module 421, for during guiding catheter 43 is mobile in air flue, based on being arranged in
Position and direction of the alignment sensor positioning guiding catheter 43 in air flue on positioning conduit 44 in guiding catheter 43, and root
According to the offset relation of guiding catheter 43 position and direction in air flue and leading bit path, guiding catheter 43 is adjusted in air flue
Position and direction, until guiding catheter 43 is navigated to puncture starting point.
Control module 422 is punctured, for based on the alignment sensor punctured on conduit 45 being arranged in guiding catheter 43
The direction of localised puncture conduit 45, adjustment puncture conduit 45 direction until puncture conduit 45 towards puncture target point until, and
Control punctures conduit 45 and stabs puncture target point along puncture path, to obtain puncture.
Sprawl and control module 423, for controlling the 46 dilated penetration wound of foley's tube being arranged in guiding catheter 43.
Path navigation module 421 is also used to based on the positioning on the subsequent processing tool being arranged in guiding catheter 43
Sensor positions the position and direction in the puncture after expansion of guiding catheter 43, and adjustment guiding catheter 43 is after expansion
Position and direction in puncture, until guiding catheter 43 is navigated to lesion region.
In an optional embodiment, path planning apparatus 41 is when determining puncture starting point and puncturing target point, specifically
For: according to the threedimensional model of bronchial tree, plan lesion region；Out of lesion region, select a little as puncture target point；
According to the threedimensional model of intrapulmonary blood vessel, selected in the bronchus for avoiding blood vessel a bit, as puncture starting point.
Further, path planning apparatus 41 is specifically used for: near the lesion region when selection punctures starting point
In bronchus, select subsequent piercing step that can avoid the bronchus of blood vessel；Out of described the bronchus for avoiding blood vessel, selection is just
In a bit (such as bronchial crotch) that subsequent piercing step is implemented, as the puncture starting point.
In an optional embodiment, path planning apparatus 41 is also used to: according to the threedimensional model of bronchial tree, from lesion
Auxiliary magnet is selected in bronchus around region, and is planned from starting point is punctured to the assisting navigation path of auxiliary magnet.
Correspondingly, path navigation module 421 is also used to: during guiding catheter 43 is moved in air flue, being based on
Guiding catheter 43 is navigated to auxiliary magnet from starting point is punctured by the alignment sensor on positioning conduit 44, with acquisition and assisting navigation
The corresponding practical bronchial path in path, and according to the mapping relations of practical bronchial path and assisting navigation path, amendment is worn
It pierces starting point and punctures the position of target point.
In an optional embodiment, punctures control module 422 and be also used to: based on the puncture being arranged in guiding catheter 43
The direction of alignment sensor localised puncture conduit 45 on conduit 45, adjustment puncture the direction of conduit 45 until puncturing 45 court of conduit
Until puncturing target point, and controls puncture conduit 45 and stab puncture target point along puncture path is secondary.
In an optional embodiment, as shown in figure 5, route guiding device 42 further include: treatment control module 425.
Control module 425 is treated, for adjusting subsequent processing recruitment based on the alignment sensor on subsequent processing tool
The position and direction of tool puncture target point until subsequent processing is reached with tool, and control subsequent processing tool for puncture mesh
Punctuate carries out subsequent processing.
Optionally, subsequent processing is ablation catheter, delivery catheter or biopsy tool with tool, and correspondingly, subsequent processing can
To be ablation, administration or biopsy sampling.
Medical path navigation system provided in this embodiment can be used for executing the medical path of above method embodiment offer
The process of air navigation aid.
Medical path navigation system provided in this embodiment determines in the path planning stage by lesion region path
Puncture starting point and puncture target point；During the navigation process, electromagnetic navigation is combined with puncture, balloon expandable, is got through logical
Toward the channel of lesion region, so that guiding catheter is navigated to lesion region, solving can not be reached without obvious natural air flue
The problem of sensible lesion locations, guiding catheter can be navigated to any lesion region of lung.
It should be understood by those skilled in the art that, the embodiment of the present invention can provide as method, system or computer program
Product.Therefore, complete hardware embodiment, complete software embodiment or reality combining software and hardware aspects can be used in the present invention
Apply the form of example.Moreover, it wherein includes the computer of computer usable program code that the present invention, which can be used in one or more,
The computer program implemented in usable storage medium (including but not limited to magnetic disk storage, CD-ROM, optical memory etc.) produces
The form of product.
The present invention be referring to according to the method for the embodiment of the present invention, the process of equipment (system) and computer program product
Figure and/or block diagram describe.It should be understood that every one stream in flowchart and/or the block diagram can be realized by computer program instructions
The combination of process and/or box in journey and/or box and flowchart and/or the block diagram.It can provide these computer programs
Instruct the processor of general purpose computer, special purpose computer, Embedded Processor or other programmable data processing devices to produce
A raw machine, so that being generated by the instruction that computer or the processor of other programmable data processing devices execute for real
The device for the function of being specified in present one or more flows of the flowchart and/or one or more blocks of the block diagram.
These computer program instructions, which may also be stored in, is able to guide computer or other programmable data processing devices with spy
Determine in the computer-readable memory that mode works, so that it includes referring to that instruction stored in the computer readable memory, which generates,
Enable the manufacture of device, the command device realize in one box of one or more flows of the flowchart and/or block diagram or
The function of being specified in multiple boxes.
These computer program instructions also can be loaded onto a computer or other programmable data processing device, so that counting
Series of operation steps are executed on calculation machine or other programmable devices to generate computer implemented processing, thus in computer or
The instruction executed on other programmable devices is provided for realizing in one or more flows of the flowchart and/or block diagram one
The step of function of being specified in a box or multiple boxes.
In a typical configuration, calculating equipment includes one or more processors (CPU), input/output interface, net
Network interface and memory.
Memory may include the non-volatile memory in computer-readable medium, random access memory (RAM) and/or
The forms such as Nonvolatile memory, such as read-only memory (ROM) or flash memory (flash RAM).Memory is computer-readable medium
Example.
Computer-readable medium includes permanent and non-permanent, removable and non-removable media can be by any method
Or technology come realize information store.Information can be computer readable instructions, data structure, the module of program or other data.
The example of the storage medium of computer includes, but are not limited to phase change memory (PRAM), static random access memory (SRAM), moves
State random access memory (DRAM), other kinds of random access memory (RAM), read-only memory (ROM), electric erasable
Programmable read only memory (EEPROM), flash memory or other memory techniques, read-only disc read only memory (CD-ROM) (CD-ROM),
Digital versatile disc (DVD) or other optical storage, magnetic cassettes, tape magnetic disk storage or other magnetic storage devices
Or any other non-transmission medium, can be used for storage can be accessed by a computing device information.As defined in this article, it calculates
Machine readable medium does not include temporary computer readable media (transitory media), such as the data-signal and carrier wave of modulation.
It should also be noted that, the terms "include", "comprise" or its any other variant are intended to nonexcludability
It include so that the process, method, commodity or the equipment that include a series of elements not only include those elements, but also to wrap
Include other elements that are not explicitly listed, or further include for this process, method, commodity or equipment intrinsic want
Element.In the absence of more restrictions, the element limited by sentence "including a ...", it is not excluded that including described want
There is also other identical elements in the process, method of element, commodity or equipment.
It will be understood by those skilled in the art that embodiments herein can provide as method, system or computer program product.
Therefore, complete hardware embodiment, complete software embodiment or embodiment combining software and hardware aspects can be used in the application
Form.It is deposited moreover, the application can be used to can be used in the computer that one or more wherein includes computer usable program code
The shape for the computer program product implemented on storage media (including but not limited to magnetic disk storage, CD-ROM, optical memory etc.)
Formula.
The above description is only an example of the present application, is not intended to limit this application.For those skilled in the art
For, various changes and changes are possible in this application.All any modifications made within the spirit and principles of the present application are equal
Replacement, improvement etc., should be included within the scope of the claims of this application.
Claims (6)
1. a kind of medical path navigation system characterized by comprising path planning apparatus, route guiding device, guide are led
Pipe, positioning conduit, puncture conduit and foley's tube with alignment sensor with alignment sensor；
The path planning apparatus, for according to the three of the threedimensional model of the bronchial tree gone out by CT data reconstruction and intrapulmonary blood vessel
Dimension module determines the puncture starting point led on lesion region path and punctures target point, and plans by main knuckle through natural gas
Road is to the leading bit path for puncturing starting point and from the puncture starting point to the puncture path for puncturing target point；
The guiding catheter, for carrying the positioning conduit, the puncture conduit in the air flue for leading to the lesion region
Or the foley's tube；
The route guiding device, comprising: path navigation module punctures control module and sprawl and control module；
Wherein, the path navigation module, for being based on during the guiding catheter is mobile in the natural air flue
The supravasal alignment sensor of the positioning being arranged in the guiding catheter positions the guiding catheter in the natural gas
Position and direction in road, and according to position and direction of the guiding catheter in the natural air flue and the leading air route
The offset relation of diameter adjusts position and direction of the guiding catheter in the natural air flue, until by the guiding catheter
Navigate to the puncture starting point；
The puncture control module, for based on the supravasal alignment sensor of the puncture being arranged in the guiding catheter
The direction for puncturing conduit is positioned, adjusts the direction for puncturing conduit until the puncture conduit is towards the puncture target
It until point, and controls the puncture conduit and stabs the puncture target point along the puncture path, to obtain puncture；
The sprawl and control module punctures wound for controlling described in the inferior vena cava balloon dilation being arranged in the guiding catheter
Mouthful；
The path navigation module is also used to pass based on the positioning on the subsequent processing tool being arranged in the guiding catheter
Sensor positions position and direction of the guiding catheter in the puncture after the expansion, adjusts the guiding catheter in institute
The position and direction in puncture after stating expansion, until the guiding catheter is navigated to the lesion region.
2. system according to claim 1, which is characterized in that the path planning apparatus is specifically used for:
According to the threedimensional model of the bronchial tree, lesion region is planned；
Out of described lesion region, select a little as the puncture target point；
According to the threedimensional model of the intrapulmonary blood vessel, select a bit, to originate as the puncture in the bronchus for avoiding blood vessel
Point.
3. system according to claim 2, which is characterized in that the path planning apparatus is specifically used for:
In the bronchus near the lesion region, the bronchus of blood vessel is avoided in selection；From the bronchus for avoiding blood vessel
It is interior, crotch a bit is selected, as the puncture starting point.
4. system according to claim 1, which is characterized in that the path planning apparatus is also used to: according to the branch gas
The threedimensional model of Guan Shu, from select auxiliary magnet in the bronchus around the lesion region, and plan from punctures starting
Point arrives the assisting navigation path of the auxiliary magnet；
The path navigation module is also used to: during the guiding catheter is moved in the natural air flue, being based on
The guiding catheter is navigated to the auxiliary magnet from the puncture starting point by the supravasal alignment sensor of positioning, to obtain
The natural air flue practical bronchial path corresponding with the assisting navigation path is obtained, and according to the practical bronchial path
With the comparison in the assisting navigation path, the starting point and the target point that punctures of puncturing is corrected in the position of the natural air flue
It sets.
5. system according to claim 1-4, which is characterized in that the puncture control module is also used to: being based on
The supravasal alignment sensor of the puncture being arranged in the guiding catheter positions the direction for puncturing conduit, adjusts institute
The direction for puncturing conduit is stated until the puncture conduit is towards the puncture target point, and control the puncture conduit along
The puncture path is secondary to stab the puncture target point.
6. system according to claim 1-4, which is characterized in that
The route guiding device further include: treatment control module；
The treatment control module, for adjusting the subsequent processing based on the alignment sensor on the subsequent processing tool
With the position and direction of tool until the subsequent processing tool arrival puncture target point, controls the subsequent processing and use
Tool needle carries out subsequent processing to the puncture target point.
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| CN201611042472.9A CN106510845B (en) | 2016-11-23 | 2016-11-23 | Medical path navigation methods and systems |
| PCT/CN2016/113922 WO2018094849A1 (en) | 2016-11-23 | 2016-12-30 | Medical path navigation method and system |
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| CN201611042472.9A CN106510845B (en) | 2016-11-23 | 2016-11-23 | Medical path navigation methods and systems |
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| CN110537960A (en) * | 2018-05-29 | 2019-12-06 | 上海联影医疗科技有限公司 | Puncture path determination method, storage device and robot-assisted surgery system |
| CN108013934B (en) * | 2018-01-19 | 2020-02-11 | 上海联影医疗科技有限公司 | Endoluminal interventional system for interventional objects |
| CN109620303B (en) * | 2018-11-26 | 2022-09-02 | 苏州朗开医疗技术有限公司 | Lung auxiliary diagnosis method and device |
| CN109620302A (en) * | 2018-11-26 | 2019-04-16 | 苏州朗开医疗技术有限公司 | A kind of lung biopsy apparatus and system |
| CN114066906B (en) * | 2020-07-31 | 2025-04-29 | 上海微创卜算子医疗科技有限公司 | Navigation path planning method, system and readable storage medium |
| CN112378421B (en) * | 2020-11-20 | 2022-07-08 | 山东威高医疗科技有限公司 | Device and method for testing positioning accuracy of electromagnetic navigation system |
| CN114073581B (en) * | 2021-06-29 | 2022-07-12 | 成都科莱弗生命科技有限公司 | Bronchus electromagnetic navigation system |
| CN114305680B (en) * | 2021-12-02 | 2024-11-01 | 杭州堃博生物科技有限公司 | In-vivo path planning and navigation data processing method, device and navigation system |
| CN114027984B (en) * | 2022-01-06 | 2022-03-11 | 极限人工智能有限公司 | Tortuous blood vessel crossing control device and vascular robot system |
| CN114041741B (en) * | 2022-01-13 | 2022-04-22 | 杭州堃博生物科技有限公司 | Data processing unit, processing device, surgical system, surgical instrument, and medium |
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| US9370398B2 (en) * | 2012-08-07 | 2016-06-21 | Covidien Lp | Microwave ablation catheter and method of utilizing the same |
| US20140188440A1 (en) * | 2012-12-31 | 2014-07-03 | Intuitive Surgical Operations, Inc. | Systems And Methods For Interventional Procedure Planning |
| US9993231B2 (en) * | 2013-11-20 | 2018-06-12 | Covidien Lp | Devices, systems, and methods for navigating a biopsy tool to a target location and obtaining a tissue sample using the same |
| US10792100B2 (en) * | 2014-08-20 | 2020-10-06 | Covidien Lp | Systems and methods for spherical ablations |
| US20160051221A1 (en) * | 2014-08-25 | 2016-02-25 | Covidien Lp | System and Method for Planning, Monitoring, and Confirming Treatment |
| CN104306072B (en) * | 2014-11-07 | 2016-08-31 | 常州朗合医疗器械有限公司 | Medical treatment navigation system and method |
| CN105796161A (en) * | 2016-03-02 | 2016-07-27 | 赛诺威盛科技（北京）有限公司 | Method for conducting puncture navigation in CT interventional therapy and puncture navigation device |
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