CN103006324A - 显示患者的检查区域中的血管或器官的成像方法和装置 - Google Patents
显示患者的检查区域中的血管或器官的成像方法和装置 Download PDFInfo
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Abstract
本发明涉及一种尤其在介入期间用于显示患者(6)的检查区域中的至少一个目标对象、特别是一个或多个血管和/或器官的成像方法。按照本发明的方法具有如下步骤:a)使用至少一个借助X射线设备对检查区域拍摄的透视图像,b)使用至少一个当前三维重建的雷达图像,该雷达图像从借助至少一个雷达接收器(21)探测的信号中产生,c)在透视图像中以及在雷达图像中识别目标对象,d)借助识别的结果配准雷达图像与透视图像,以及e)融合雷达图像与透视图像。在显示装置(15),例如显示器或监视器上显示融合图像。
Description
技术领域
本发明涉及特别是在介入期间用于显示至少一个目标对象,特别是患者的检查区域中的一个或多个血管和/或器官的一种成像方法和一种装置。
背景技术
二维和三维的数字减影-旋转血管造影(二维或三维-DSA-旋转血管造影)是用于在介入之前和期间估计血管的解剖结构的标准使用方法。在数字减影血管造影(DSA)中,在建立掩模图像、无造影剂的图像、以及填充图像、具有造影剂的图像之后将其互相相减,从而仅获得由于造影剂引起的时间上的变化,该变化显示血管。
这种在图1中作为示例描述的用于数字减影血管造影的C形臂X射线设备例如具有可在以六轴的工业机器人或铰接式臂机器人1(Knickarmroboter)形式的架子上旋转安装的C形臂2,在其端部安装了X射线辐射源,例如具有X射线管和准直器的X射线辐射器3,以及作为图像拍摄单元的X射线图像探测器4。
借助铰接式臂机器人1(该铰接式臂机器人1优选具有六个旋转轴并且由此具有六个自由度)可以任意空间地调整C形臂2,例如通过将该C形臂2围绕X射线辐射器3和X射线探测器4之间的旋转中心旋转。铰接式臂机器人1具有例如固定地安装在地板上的基架。在其上固定可围绕第一旋转轴旋转的转盘(Karussell)。在转盘上安装可围绕第二旋转轴摆动的机械摇杆(Roboterschwinge),在该机械摇杆上固定可围绕第三旋转轴旋转的机械臂(Roboterarm)。在机架臂的端部安装可围绕第四旋转轴旋转的机械手(Roboterhand)。机械手具有用于C形臂2的固定元件,该固定元件可以围绕第五旋转轴摆动并且可围绕与之垂直延伸的第六旋转轴旋转。
不依赖于工业机器人来实现X射线诊断装置。也可以使用通常的C形臂设备。
X射线图像探测器4可以是矩形或正方形的平面半导体探测器,该探测器优选由非晶(amorph)硅(a-Si)构成。但也可以使用积分的并且可能的计数的CMOS探测器。
在X射线辐射器3的辐射路径中,例如为了拍摄心脏将待检查的患者6作为检查对象放置患者卧榻5上。在X射线诊断装置上连接具有图像系统8的系统控制单元7,该图像系统8接收并处理X射线图像探测器4的图像信号(操作元件例如未示出)。然后在显示器9上观察X射线图像。作为一种实施方式,可以在顶棚上安装具有第一显示器14和至少一个其它显示器15的监视器装置13。
在放射学中也广泛使用两个C形臂。这就是所谓的双平面系统(Biplan-System)。
在X射线诊断中以二维显示透视的器官或血管。通过在连续拍摄的同时围绕器官或血管旋转C形臂能够得到三维图像。由此根据图像频率和旋转速度进行几百次二维X射线拍摄,然后将其换算为三维图像。
借助UWB雷达(Ultra Wideband Rader,超宽带雷达)已经能够利用各个X射线拍摄计算出第三维度。由此将患者置于较小的X射线剂量。
将X射线设备与UWB雷达融合得到的其它优点如下:
-无接触地监视患者和防止冲突,
-依据造影剂流量在没有透视或没有X射线辐射的情况下触发(发动或发起)X射线拍摄,和
-确定在没有X射线辐射的情况下的心脏的泵送容积。
如开头已经提到的那样,通过围绕患者旋转X射线设备来产生三维X射线拍摄。在此在每个旋转角度下进行X射线拍摄并且在计算机中(例如提到的图像系统8中)将其换算为三维。
例如通过将患者连接到EKG设备来监视患者。X射线辐射的开始通常具有时间延迟:医生注射造影剂并且根据其经验得知造影剂的扩散大约有多快。然后该医生触发X射线辐射。例如从心脏的左心室触发一系列的X射线拍摄,选择两个关注的心脏阶段并且计算泵送容积。
发明内容
本发明要解决的技术问题是,按照本文开始部分所述类型的方法以及医学装置改善了对位于检查区域的目标对象,例如血管的显示。
上述技术问题通过独立权利要求的对象来解决。本发明的有利扩展在从属权利要求的特征中给出。
通过按照本发明的UWB雷达与X射线设备的融合能够按照身体深度无接触地确定心脏和冠状血管的运动,并且能够利用X射线图像计算雷达图像。由此产生低剂量的三维图像。在显示装置,例如显示器或监视器上显示三维图像。
由于UWB雷达与X射线血管造影融合,获得了与现有技术相比改善了的位于检查区域的血管的当前显示,并且将患者置于较小的辐射。
同样能够无接触地监视患者。在治疗室中不需要患者监视器(例如EKG)。给出对于患者的扩展的冲突保护。可以通过患者中的造影剂流量来控制X射线设备的触发。可以在没有辐射的情况下测量并计算心脏的泵送容积。
附图说明
具有有利扩展的本发明的实施方式借助下面的附图作进一步说明,但不限制于此。附图中:
图1示例性示出了X射线设备,优选被构造为具有作为支承装置的工业机器人的X射线C形臂系统,和
图2示出了用于融合X射线诊断与超宽带雷达的按照本发明的装置。
具体实施方式
图2示例性示出了按照本发明的装置,该装置包括图1中所描述的系统的部件,并且附加地围绕用于超宽带雷达的部件构造。除了别的之外属于此的UWB传感器21和UWB发送器23和用于RTC(Real Time Controller,实时控制)X射线处理25的部件和用于RTC UWB处理27的部件互相耦合。这一点通过分析电子设备29的部件来表示,该分析电子设备可以被集成在计算机,例如图像计算机8中,其中可以在至少一个X射线显示器31(例如显示器14)上以及在至少一个雷达显示器Ⅰ33或雷达显示器Ⅱ35(例如显示器15)上显示图像作为结果。
相应地按照本发明可以如下进行:
1.心脏和冠状血管的运动探测
UWB是无线电调制技术,其基于具有极大带宽的极短持续时间(通常低于纳秒(<10-9s))的脉冲的发送和接收。利用接收天线或接收传感器探测从身体的不同深度反射的信号。由于心跳和由此产生的冠状血管的运动使器官的边界层(Grenzschicht)移动和变形,并且由此影响所测量的信号。根据该解剖学的运动可以获得测量数据并且可以取决于位置和取决于时间地重建器官运动和冠状运动。
如果利用低功率(<1mW)的宽带电磁脉冲从不同方向辐照患者,则其侵入到身体的不同深度并且在不同组织种类的相继的边界层上进行部分反射。
因为不同的人体组织种类典型地具有吸收性能和反射性能,能够由超宽带雷达系统精确地探测诸如心跳的器官运动和冠状血管(Koronarien)运动。
在具有计算机的分析电子设备中由UWB雷达系统的接收器产生信号(参见RTC UWB预处理27),这些信号类似心脏/冠状动脉的运动并且实现了运动的心脏的三维重建。现在可以将该三维数据组传输到X射线设备的图像计算机8并且利用该X射线图像进行计算。例如在西门子公司的名称为“Axiom Artis”的X射线设备中图像计算机8称为“AXIS”。
在图像计算机中将相关的雷达图像(雷达图像是三维的)对应于每个X射线图像或透视图像(这些图像是二维的)。也就是根据X射线图像与UWB雷达图像的融合形成新的三维图像,该三维图像兼有X射线图像的优点(较高的分辨率)与UWB雷达系统的优点(在没有辐射负担的情况下的三维图像)。
2.患者监视
可以借助UWB雷达无接触地监视患者的生死攸关的功能,诸如呼吸或心律。同样可以立即识别患者的可能的惊慌状态并且引入相应的措施。
3.冲突监视
此外,借助UWB雷达得到如下可能性:防止对检查室中的无菌设备的无意的触摸并且必要时触发警报。
同样可以利用系统来监视患者卧榻和X射线设备的运动。只要患者、操作人员或设备位于冲突区域,就可以停止运动和/或触发警报。
4.触发X射线辐射
因为不同的人体组织种类典型地具有吸收性能和反射性能,能够由优选四个超宽带雷达系统精确地探测并显示血管。可以通过所谓的多普勒效应(Dopplereffekt)来测量血液的流动或在血管中的造影剂。由此得到如下可能性:只有造影剂在血管中已经达到相应的位置,才触发X射线辐射。
5.在没有X射线辐射的情况下确定射血分数(Ejection Fraction)
可以确定心脏的左心室的泵送容积。(EF:英文Ejection Fraction=Auswurffraktion,射血分数)。
关注的心脏阶段是心脏舒张末期(=ED)和心脏收缩末期(=ES)。利用UWB雷达系统可以确定各个心脏阶段中的容积并且可以计算射血分数(EF)EF:英文Ejection Fraction=Auswurffraktion,射血分数)。
射血分数相应于EDV和ESV的差与EDV的比值的百分数,数学式如下:
100%×(EDV-ESV)/EDV,
其中EDV[ml]表示在ED阶段中的心室容积,并且ESV[ml]表示在ES阶段中的心室容积。
Claims (10)
1.一种用于显示患者的检查区域中的目标对象的成像方法,所述方法具有如下步骤:
a)使用至少一个借助X射线设备对检查区域拍摄的透视图像,
b)使用至少一个当前三维重建的雷达图像,该雷达图像从借助至少一个雷达接收器(21)探测的信号中产生,
c)在所述透视图像中以及在所述雷达图像中识别目标对象,
d)借助识别的结果配准所述雷达图像与所述透视图像,以及
e)融合所述雷达图像与所述透视图像。
2.根据权利要求1所述的方法,其特征在于,优选在至少一个显示装置(15)上三维地显示所述雷达图像与所述透视图像的融合。
3.根据权利要求2所述的方法,其特征在于,连续地三维显示图像融合。
4.根据上述权利要求中任一项所述的方法,其特征在于,所述步骤a)至e)按照可选的时间间隔一直重复进行直至该方法的结束。
5.根据上述权利要求中任一项所述的方法,其特征在于,连接地拍摄多个透视图像。
6.根据上述权利要求中任一项所述的方法,其特征在于,通过所谓的雷达多普勒效应来测量血液的流动和/或在检查区域的至少一个血管中的造影剂,其中,只有血液和/或造影剂在血管中已经达到适合于触发X射线辐射的位置,才触发用于拍摄至少一个透视图像的X射线辐射。
7.一种成像医学装置,其特征在于,
a)X射线设备,用于拍摄至少一个透视图像,
b)至少一个雷达发送器(23),用于发送信号,
c)至少一个雷达接收器(25),用于探测信号,
d)雷达图像处理级(27),用于从借助所述雷达接收器(21)探测的信号中产生三维重建的雷达图像,
e)图像存储装置,用于中间存储所述至少一个透视图像和/或所述三维重建图像,
f)图像处理级(27),用于在所述三维重建图像中识别目标对象,
g)图像处理级(25),用于在所述透视图像中识别目标对象,
h)配准装置,用于借助识别的数据来配准所述三维重建图像和所述透视图像,
i)融合装置,用于融合所提到的图像,以及
j)三维显示装置(15),用于显示融合后的图像。
8.根据上述权利要求所述的装置,其特征在于,测量装置,用于通过所谓的雷达多普勒效应来测量血液的流动和/或在至少一个血管中的造影剂,其中只有血液和/或造影剂在血管中已经达到适合于触发X射线辐射的位置,才触发用于拍摄至少一个透视图像的X射线辐射。
9.利用根据上述装置权利要求中任一项所述的装置来监视患者卧榻的运动,其中只要患者、操作人员或设备位于X射线设备的冲突区域,就停止运动和/或触发警报。
10.利用根据上述装置权利要求中任一项所述的装置来确定患者心脏的左心室的泵送容积。
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| DE102011083408A DE102011083408A1 (de) | 2011-09-26 | 2011-09-26 | Bildgebendes Verfahren und Vorrichtung zur Darstellung von Gefäßen bzw. Organen in einem Untersuchungsbereich eines Patienten |
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| WO2015127868A1 (zh) * | 2014-02-27 | 2015-09-03 | 科宝智慧医疗科技(上海)有限公司 | 一种体液有形成分分析仪 |
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| DE102014207124A1 (de) * | 2014-04-14 | 2015-10-15 | Siemens Aktiengesellschaft | Medizinische Bildgebungsvorrichtung |
| KR101626760B1 (ko) * | 2014-11-04 | 2016-06-02 | 삼성전자 주식회사 | 프로세싱 보드, 의료용 진단 장치, 및 의료용 진단 장치의 제어방법 |
| US9869644B2 (en) * | 2015-04-23 | 2018-01-16 | Los Alamos National Security, Llc | Ultrafast table-top dynamic radiography of spontaneous or stimulated events |
| DE102016202052B3 (de) * | 2016-02-11 | 2017-04-06 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Verfahren und Anordnung zur hochgenauen Positionierung einer robotergeführten Interaktionsvorrichtung mittels Radar |
| DE102020114502A1 (de) | 2020-05-29 | 2021-12-02 | Fresenius Medical Care Deutschland Gmbh | Medizinisches Set zum Überwachen eines Patienten mittels Radarwellen |
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| US20130077756A1 (en) | 2013-03-28 |
| DE102011083408A1 (de) | 2013-03-28 |
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