JP2005253706A - Magnetic resonance imaging equipment with surgical navigation device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To three-dimensionally recognize the anatomical structure and the running of the nerve fibers during a surgery and perform a surgical navigation corresponding to the movement/deformation of the organ. <P>SOLUTION: This magnetic resonance imaging equipment arbitrarily images during the surgery to provide images allowing the understanding of the anatomical structure and images drawing the nerve fibers. The nerve fiber image is taken by impressing vertical MPG (Motion Proving Gradient) pulses to the running surface of the interested nerve fiber. Alternatively, diffusion tensor imaging is performed. Three cross sections orthogonally crossing the obtained anatomical image are displayed and the nerve fiber image is three-dimensionally displayed by a 3D volume rendering. On the images, the position of the distal end of an indicator operated by a surgeon is displayed and allows the surgeon to recognize the anatomical structure corresponding to the movement/deformation of the organ during the surgery, the positional relation among the nerve fibers, and an operating point. In particular, the nerve fiber image is constituted to display a desired cross section including the distal end of the indicator. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a magnetic resonance imaging apparatus provided with a surgical navigation apparatus, and more particularly to a technique for performing surgical navigation by displaying a place where a surgical operation is performed on a nerve fiber image.

Surgery that supports the operator's anatomical spatial recognition by displaying the location of the operator's surgical operation on the image of the subject taken with an MRI or X-ray CT device during surgery Navigation devices have been developed and applied to operations that require highly precise surgical operations such as neurosurgery.
For example, in [Patent Document 1], there is a method that enables more intuitive space recognition by displaying the subject image in three orthogonal cross sections and simultaneously displaying the image in 3D by volume rendering processing. It is disclosed.

  In particular, in neurosurgery and the like, it is required to remove as much of the tumor as possible while preserving important brain functions such as the language and motor areas when removing the tumor. Therefore, it is required to confirm the running of nerve fibers related to these brain functions during the operation. A nerve fiber image can be acquired by diffusion weighted imaging or diffusion tensor imaging in a preoperative MRI examination.

These imagings assume that nerve fibers are highly diffused in the fiber direction and that diffusion is restricted in the direction perpendicular to the fiber. In diffusion weighted imaging, there is a method in which a plane on which a target nerve fiber is running is a slice plane, and a Motion Proving Gradient (hereinafter abbreviated as MPG) pulse is applied in a direction perpendicular to the plane. This technique uses the fact that if there is diffusion in the direction in which the MPG pulse is applied, the signal will drop, and if there is a part spreading in the slice plane, the signal at that part will be relatively high, This is a technique for rendering nerve fibers traveling in the slice plane with a relatively high signal. In diffusion tensor imaging, the MPG pulse application direction is changed and images are taken a plurality of times, and then mathematical tensor analysis is performed to image nerve fiber running.
JP 2003-79637 A

  There is a system that uses an open MRI system as a system that can perform MRI imaging during the operation, but the static magnetic field strength is about 0.3T, which is a low magnetic field strength, and a high magnetic field device of about 1.5T that is used in normal examinations. The signal to noise ratio (hereinafter referred to as SNR) of the image is inferior. Furthermore, in diffusion-weighted imaging that can depict the running of nerve fibers, the SNR of the image is lower than in normal imaging methods. Therefore, in conventional surgical navigation, spatial recognition was possible using anatomical images and preoperative nerve fiber images, but nerve fiber images corresponding to organ movement and deformation during surgery were acquired and It was difficult to navigate.

Therefore, the first object of the present invention is to provide easy-to-understand surgical navigation by simultaneously providing an anatomical image and an image that can confirm the running state of nerve fibers corresponding to the movement and deformation of an organ during surgery. is there.
A second object is to acquire a nerve fiber image with a relatively high SNR while having a relatively small (effective) slice interval.

In order to achieve the above object, the present invention is configured as follows. That is,
Measuring means for measuring an anatomical image of the subject and a nerve fiber image depicting the running state of nerve fibers, a display means for displaying the anatomical image and the nerve fiber image, and indicating the subject In the magnetic resonance imaging apparatus, comprising: an indicator for detecting an indication point; and a detector for detecting an indication point and an indication direction of the indicator. The display means displays the detected indication point and the indication direction in the anatomical image. And displayed on the nerve fiber image.
As a result, an anatomical image and a nerve fiber image can be captured and displayed corresponding to the point and direction indicated by the indicator, and the indication point and the indication direction can be displayed on the image. . As a result, the first object can be achieved.

In a preferred embodiment, the measurement unit shifts the slice position so that a part of the slice thickness overlaps between different imagings when the nerve fiber image is imaged multiple times by multi-slices.
Accordingly, the effective slice thickness can be reduced while increasing the slice thickness of the nerve fiber image, and thus the SNR of the nerve fiber image can be improved without reducing the resolution. As a result, the second object can be achieved.

  According to the present invention, it is possible for a surgeon in a neurosurgery or the like to spatially recognize the running of nerve fibers together with the anatomical structure of the imaging site during the operation, and by confirming the surgical operation site on these images, Surgical navigation corresponding to organ movement / deformation is possible. As a result, it is possible to remove tumors and the like more safely without damaging nerve fibers related to important brain functions.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. Note that components having the same function are denoted by the same reference symbols throughout the drawings for describing the embodiment of the invention, and the repetitive description thereof is omitted.
First, an MRI apparatus to which the present invention is applied will be described. FIG. 4 is a block diagram showing the overall configuration of an embodiment of a magnetic resonance imaging (hereinafter referred to as MRI) apparatus to which the present invention is applied. This MRI apparatus uses a nuclear magnetic resonance (NMR) phenomenon to obtain a tomographic image of a subject. As shown in FIG. 4, the MRI apparatus includes a static magnetic field generation system 2, a gradient magnetic field generation system 3, A transmission system 5, a reception system 6, a data processing system 7, a sequencer 4, a central processing unit (CPU) 8, and an operation system 25 are configured.

  The static magnetic field generation system 2 generates a uniform static magnetic field in the space around the subject 1 in the direction of the body axis (horizontal magnetic field method) or in the direction perpendicular to the body axis (vertical magnetic field method). A normal magnetic field generation system, a superconductivity system, or a permanent magnet system static magnetic field generation source is arranged around the space.

  The gradient magnetic field generating system 3 includes a gradient magnetic field coil 9 wound in three axial directions of X, Y, and Z, and a gradient magnetic field power source 10 for driving each gradient magnetic field coil 9. By driving the gradient magnetic field power supply 10 of each coil in accordance with the above command, gradient magnetic fields Gx, Gy, and Gz in three axial directions of X, Y, and Z are applied to the subject 1. More specifically, a slice direction gradient magnetic field pulse (Gs) is applied in one of X, Y, and Z to set the slice plane for the subject 1, and the phase encode direction gradient magnetic field is applied to the remaining two directions. A pulse (Gp) and a frequency encoding direction gradient magnetic field pulse (Gf) are applied, and position information in each direction is encoded in the echo signal.

  The sequencer 4 is a control means that repeatedly applies a high-frequency magnetic field pulse (hereinafter referred to as “RF pulse”) and a gradient magnetic field pulse in a predetermined pulse sequence, and operates under the control of the CPU 8 to collect tomographic image data of the subject 1. Various commands necessary for the transmission are sent to the transmission system 5, the gradient magnetic field generation system 3, and the reception system 6.

  The transmission system 5 irradiates an RF pulse to cause nuclear magnetic resonance to the nuclear spins of atoms constituting the biological tissue of the subject 1, and includes a high frequency oscillator 11, a modulator 12, a high frequency amplifier 13, and a transmission side And a high-frequency coil 14a. The high-frequency pulse output from the high-frequency oscillator 11 is amplitude-modulated by the modulator 12 at a timing according to a command from the sequencer 4, and the amplitude-modulated high-frequency pulse is amplified by the high-frequency amplifier 13 and then placed close to the subject 1. By supplying to the high frequency coil 14a, the subject 1 is irradiated with the RF pulse.

  The receiving system 6 detects an echo signal (NMR signal) emitted by nuclear magnetic resonance of nuclear spins constituting the biological tissue of the subject 1, and receives a high-frequency coil 14b on the receiving side, a signal amplifier 15, and quadrature detection. And an A / D converter 17. After the echo signal of the response of the subject 1 induced by the RF pulse irradiated from the high frequency coil 14a on the transmission side is detected by the high frequency coil 14b arranged close to the subject 1 and amplified by the signal amplifier 15 The signal is divided into two orthogonal signals by the quadrature phase detector 16 at the timing according to the command from the sequencer 4, and each signal is converted into a digital quantity by the A / D converter 17 and sent to the data processing system 7 as echo data. .

  The data processing system 7 stores an external storage device such as an optical disk 19 and a magnetic disk 18, a display 20 such as a CRT, a program for performing image analysis processing and measurement over time, invariant parameters used in the execution, and the like. ROM (read-only memory) 21 and measurement parameters obtained in the previous measurement, echo data detected by the receiving system 4 and images used for region of interest setting are temporarily stored and parameters for setting the region of interest are stored. When the echo data from the receiving system 6 is input to the CPU 8, the CPU 8 executes processing such as signal processing and image reconstruction, and the result is the subject. One tomographic image is displayed on the display 20 and recorded on the magnetic disk 18 of the external storage device.

  The operation system 25 includes a trackball 23 and a keyboard 24, and inputs control information for processing performed by the data processing system 7. The operation unit 25 is disposed in the vicinity of the display 20, and the operator interactively controls the processing of the MRI apparatus through the operation unit 25 while looking at the display 20.

In FIG. 4, the high-frequency coil 14a and the gradient magnetic field coil 9 on the transmission side are placed facing the subject 1 in the static magnetic field space of the static magnetic field generation system 2 into which the subject 1 is inserted. The high-frequency coil 14b on the receiving side is installed so as to face or surround the subject 1.
Currently, the radionuclide to be imaged by the MRI apparatus is a hydrogen nucleus (proton) which is a main constituent material of the subject as widely used in clinical practice. By imaging information on the spatial distribution of proton density and the spatial distribution of relaxation time in the excited state, the form or function of the human head, abdomen, limbs, etc. is imaged two-dimensionally or three-dimensionally.

Hereinafter, embodiments of the present invention will be described. FIG. 1 shows a configuration of a surgical navigation apparatus according to this embodiment. As shown in the figure, this surgical navigation device includes an imaging device 80 such as an MRI device that measures an anatomical image and nerve fiber image of the subject 1, an indicator 81, a position detector 82, and a processing device 90. And the display device 100.
In particular, the processing device 90 includes an imaging data storage unit 91, a position detection processing unit 92, a tomographic image reconstruction unit 93, a volume rendering processing unit 94, a display processing unit 95, and a main control unit 96. Then, the subject 1 is placed in the imaging apparatus 80, the marker 51 is fixed to the subject 1, and the position of the marker 51 is detected by the position detector 82.

  In the present embodiment, the surgical navigation device is configured independently of the imaging device 80, but the components of the surgical navigation device that can be shared with the components of the imaging device 80 may be shared. For example, when the aforementioned MRI apparatus is used as the imaging apparatus 80, the processing apparatus 90 can be included in the data processing system 7 and the display apparatus 100 can be the display 20. The imaging data storage unit 91 can be the magnetic disk 18 or the optical disk 19, and the tomographic image reconstruction unit 93 and the volume rendering processing unit 94 can be the CPU 8.

  Hereinafter, the operation of such a surgical navigation apparatus will be described by taking as an example the case where the aforementioned MRI apparatus is an imaging apparatus 90. First, the subject 1 to which the plurality of markers 51 are fixed is imaged by the imaging device 80 before and after the start of surgery. Shooting data shot by the shooting device 80 is transferred to the processing device 90 and stored in the shooting data storage unit 91.

  After the surgery starts, the processing apparatus 90 performs the following registration. That is, when the surgeon instructs the marker 51 fixed to the subject 1 at the tip of the indicator 81 and registration is instructed from the input device 97, the position detection is received via the main control unit 96. The processing unit 92 calculates the coordinates in the real space at the tip of the indicator 81.

  As the position detector 82 for detecting the coordinates of the indicator 81, there is an optical method or the like. The optical type attaches a marker (light source such as a light emitting diode) to the indicator 81 and detects the position of the tip of the indicator 81 from the position of each marker calculated from images taken by a plurality of cameras having parallax, Alternatively, the reflected infrared reflected light is photographed by a plurality of cameras having parallax, and the position of the tip of the indicator 81 is detected from the photographed images.

Next, the position detection processing unit 92 calculates each of the imaging data stored in the imaging data storage unit 91 from the real space coordinates of the tip of the indicator 81 calculated for the state in which each object marker 51 is indicated. A relational expression between coordinates and coordinates in the real space, that is, a relational expression that associates a position of a part of the current subject in the real space with a position where the part of the subject 1 in the photographing data is imaged, This is stored as a registration result. As a specific example, coordinate conversion is performed from the spatial coordinates when the subject marker 51 is pointed at the tip of the indicator 81 to the coordinates of the designated subject marker in the imaging data.
Alternatively, a coordinate conversion formula for performing the reverse conversion is obtained and stored as a registration result.

  When the registration is completed as described above, the processing device 90 performs the following navigation operation. That is, the position detection processing unit 92 detects the position of the tip of the indicator 81 and its pointing direction, and converts them into a position and direction in the space where the shooting data exists according to the relational expression of the registration result obtained earlier. To do.

The tomographic image reconstruction unit 93 calculates a tomographic image including the operation position for three orthogonal planes in a predetermined direction from the imaging data stored in the imaging data storage unit 91. At this time, a cursor indicating the operation position is displayed on each tomographic image.
The volume rendering processing unit performs volume rendering on the imaging data of the nerve image stored in the imaging data storage unit to generate a 3D image. A cursor indicating the operation position is displayed on this 3D image.

The display processing unit 95 displays the tomographic image calculated in each of the three directions orthogonal to each other by the tomographic image reconstruction unit 93 and the 3D image generated by the volume rendering processing unit on the display device.
Display examples of the display device 100 are shown in FIGS. The monitor of the display device 100 has a cross-sectional tomographic image 110, 120, 130 and its display parameter 140 in a format as shown in FIG. 2, and a volume rendering (3D) display 150 of the nerve fiber image and its display. The parameter 160 is displayed. FIG. 3 is a specific example displayed in the format of FIG. In Fig. 3, the first, second, and third screens (upper left, center, lower left) of the Anatomical View on the left are TRS (Transaxial), SAG (Sagittal), and COR (Coronal) images. The setting value is indicated by enclosing the setting value with □ to indicate that it can be changed. In other words, the display parameters in Fig. 3 are RL (Right-Left) for the horizontal direction on the first screen, AP (Anterior-Posterior) for the vertical direction, and HF (Head-Foot), Vertical direction for the second screen. In the third screen, the horizontal direction is RL and the vertical direction is HF. Further, on the right side of FIG. 3, a 3D nerve fiber image obtained by cutting out a COR (Coronal) image and its display parameters are displayed. The operation position is displayed (ON) with a (cross) cursor (Cursor) on each image. Load is a button for reading image data, and Link is a button for starting / stopping linkage with the indicator.
When changing each display method, the value is changed for each item to be changed. For example, the display setting value may be changed as RL → LR in order to horizontally flip the horizontal direction.

  The nerve fiber image can be displayed by cutting out the cross section designated by the indicator 81. For example, when observing a pyramidal path that is an important nerve path, the COR section is usually set by the display parameter. At this time, according to the position pointed to by the tip of the indicator 81, the COR section including the tip is immediately displayed. In this way, the intraoperative image is updated by performing MRI imaging when necessary during the operation, and the operator performs the anatomical structure corresponding to the movement / deformation of the organ during the operation, the running of the nerve fiber, and the surgical operation site. Surgery can be performed while spatially recognizing.

  Here, when performing imaging during surgery, there are cases where imaging and surgery are performed at the same position, and patients are inserted into the MRI gantry only at the time of imaging, and are taken out of the gantry after imaging and surgery is performed. is there. The surgical navigation device displays the position of the operator's surgical tool tip on the anatomical image and nerve fiber image on the room monitor, and indicates where the operator is actually operating in the organ. By visually showing, the surgeon's surgical operation is supported. When an operator operates a position hidden in an organ such as the deep part of the brain, or when it is difficult to confirm with the naked eye and the field of view is limited even using a microscope, the operator can view the navigation image. It is possible to grasp three-dimensionally what is around. In either case, the operation is navigated by displaying the image at the position indicated by the indicator 81.

  One method of acquiring a nerve fiber image is a method of performing diffusion weighted imaging by applying at least one MPG pulse orthogonal to a target nerve fiber in an MRI apparatus. Details of applying this imaging method to the EPI method are described on page 46 of [Non-patent Document 1]. For example, when depicting a pyramidal tract that is an important nerve fiber, a slice plane containing the pyramidal tract is set based on the anatomical structure in the positioning image, and an MPG pulse is applied in a direction perpendicular to the slice plane. Apply diffusion-weighted imaging. Such nerve fiber images are acquired during the operation, and surgical navigation corresponding to the movement / deformation of the organ is performed.

As another method for acquiring a nerve fiber image, there is a method of performing diffusion tensor imaging in an MRI apparatus. Details of diffusion tensor imaging are described on pages 80 to 103 of [Non-Patent Document 1]. Such nerve fiber images are acquired during the operation, and surgical navigation corresponding to the movement / deformation of the organ is performed.
Shigeki Aoki and Osamu Abe, “Diffusion MRI understood by this”

  When nerve fiber images are taken by diffusion-weighted imaging with intraoperative MRI, slices are overlapped in order to improve the SNR of the image while reducing the slice interval (hereinafter referred to as slice overlap method). In the slice overlap method, as shown in Fig. 3, the slice position is shifted and multi-slice shooting is performed multiple times (three times in the figure), and a part of the thick slice thickness is overlapped between multiple shootings. Let The data photographed multiple times after measurement is rearranged using the slice position as an index. In the case of FIG. 4, the slices are rearranged in the order of slice start positions from the left side, such as 401-1, 402-1, 403-1, 401-2, 402-2, 403-2,.

  Usually, the effective slice interval is made constant by making the amount of shifting the slice position constant. For example, if the slice thickness is 8 mm and the gap is 1 mm, the slice interval in one imaging in this case is 9 mm. On the other hand, if the slice overlap method is used three times, the slice position is shifted by 3 mm and the effective slice interval is 3 mm. When viewing the captured image, it is necessary to pay attention to the resolution in the slice direction, but during operation, nerve fiber images corresponding to organ movement / deformation have a relatively high SNR with a relatively small (effective) slice interval. It becomes possible to see with image quality.

The block diagram which shows the structure of the surgery navigation apparatus which concerns on embodiment of this invention. The figure which shows the display format of the surgery navigation which concerns on embodiment of this invention. The figure which shows the specific example of FIG. The figure which shows the slice overlap method which concerns on embodiment of this invention. The block diagram showing the whole structure of one Example of an MRI apparatus.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Subject, 2 ... Static magnetic field generation system, 3 ... Gradient magnetic field generation system, 4 ... Sequencer, 5 ... Transmission system, 6 ... Reception system, 7 ... Signal processing system, 8 ... Central processing unit (CPU), 9 ... Gradient magnetic field coil, 10 Gradient magnetic field power source, 11 High frequency transmitter, 12 Modulator, 13 High frequency amplifier, 14 a High frequency coil (transmitting coil), 14 b High frequency coil (receiving coil), 15 Signal amplifier, 16 ... Quadrature phase detector, 17 ... A / D converter, 18 ... Magnetic disk, 19 ... Optical disk, 20 ... Display, 51 ... Marker fixed to object, 80 ... Imaging device, 81 ... Indicator, 82 ... Position detection 90 ... processing device 91 ... imaging data storage unit 92 ... position detection processing unit 93 ... tomographic image reconstruction unit 94 ... volume rendering processing unit 95 ... display processing unit 100 ... display device 110 ... tomography Image TRS, 20 ... tomographic image SAG, 130 ... tomographic image COR, 140 ... tomographic image display parameters, 150 ... nerve fibers image, 160 ... nerve fibers image display parameters

Claims (2)

Measuring means for measuring an anatomical image of the subject and a nerve fiber image depicting the running state of nerve fibers, a display means for displaying the anatomical image and the nerve fiber image, and indicating the subject In a magnetic resonance imaging apparatus, comprising: an indicator for detecting, and a detector for detecting an indication point and an indication direction of the indicator,
The display means displays the detected pointing point and pointing direction on the anatomical image and the nerve fiber image.   2. The magnetic resonance imaging apparatus according to claim 1, wherein when the nerve fiber image is imaged a plurality of times by multi-slice, the measurement unit sets the slice position so that a part of the slice thickness overlaps between different imaging operations. A magnetic resonance imaging apparatus characterized by shifting.

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