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WO2018214807A1 - 一种前列腺穿刺术活检取出方法及装置 - Google Patents

一种前列腺穿刺术活检取出方法及装置 Download PDF

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Publication number
WO2018214807A1
WO2018214807A1 PCT/CN2018/087396 CN2018087396W WO2018214807A1 WO 2018214807 A1 WO2018214807 A1 WO 2018214807A1 CN 2018087396 W CN2018087396 W CN 2018087396W WO 2018214807 A1 WO2018214807 A1 WO 2018214807A1
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puncture
coordinate system
point
target
prostate
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PCT/CN2018/087396
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English (en)
French (fr)
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叶慧
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北京龙慧珩医疗科技发展有限公司
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Publication of WO2018214807A1 publication Critical patent/WO2018214807A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/0241—Pointed or sharp biopsy instruments for prostate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A61B2017/3413—Needle locating or guiding means guided by ultrasound

Definitions

  • the invention belongs to the field of medical instruments, and particularly relates to a local puncture method for prostate lesion tissue and a calculation method for the spatial position of the preoperative puncture needle.
  • Prostate cancer is one of the most common cancers in the male population, and its mortality rate ranks second in non-skin cancer.
  • the most popular prostate cancer screening method is serum prostate specific antigen screening, followed by six or more biopsies performed in real-time 2D transrectal ultrasound guidance. As part of this procedure, the prostate is typically divided into six equal volume regions. One or more biopsies are taken from each of these six regions in a systematic, but essentially non-directional manner. This procedure is called a sextant biopsy.
  • the sextant biopsy is low cost and relatively simple compared to other methods of detecting prostate cancer, it is widely used.
  • the sextant biopsy has shown a severe false negative rate and may be inaccurate with regard to the true location of the biopsy.
  • the results of the sextant biopsy are usually reported using the original standard map of the prostate, and the pathologist manually annotates the biopsy results on the original standard map of the prostate. This picture is intrinsically inaccurate because the pathologist who annotated does not know the real part of the biopsy.
  • Transrectal ultrasound (TRUS)-guided systemic biopsy seems to solve the above technical problems. Because of its real-time performance, imaging without radiation, low cost and simple operation, it has become an important indicator for the diagnosis and diagnosis of prostate cancer.
  • ultrasound imaging is fast, although it can be imaged in real time during surgery.
  • the discrimination between soft tissues in the image is not high.
  • the position of the sampling catheter can be tracked in real time, the lesion cannot be imaged. Accurate positioning of the tissue results in a pure ultrasound-based sampling method that is not sensitive to cancer detection, only 60% to 85%.
  • prostate interventional surgery is performed under 2D transrectal ultrasound guidance, only the prostate tissue contour can be seen without soft tissue. It is not sensitive to chronic prostatitis, prostatic hypertrophy, and early prostate cancer, so the sextant biopsy usually The average sample was taken from the top, middle and bottom of the prostate, and the left and right sides, and the representative samples were taken out. This random biopsy was predicted without accurately grasping the cancer location, and the high detection rate of cancer could not be guaranteed. Most cancers occur in the top region of the prostate. Although the biopsy is guided by the TURS, the needle may not reach the target area accurately. Only the doctor's skill and experience locate the needle, and it is impossible to accurately determine whether it is accurate.
  • a method comprising the steps of:
  • the puncture set having an outer sheath, a puncture needle embedded in the outer sheath, and a hose, the outer edge of the outer sheath being connected to the first edge a position sensor having a handle tail end for the operator to hold and a remote front end contacting the examined portion; a contact force sensor at the remote front end portion, a transmitter, a receiver, and an ultrasound at the remote front end portion a transducer, and a second position sensor located at a rear side of the remote front end;
  • Puncture point delineation pre-acquisition of the medical imaging modality of the subject before surgery, path planning operation according to the imaging modality, and
  • the iterative threshold segmentation combined with morphological operation is used to segment the image of the detected part.
  • the target feature morphology is extracted by the double threshold method in the segmented part of the segment, and then the surface rendering method is used for 3D visualization. Finally, the visual image is imported into 3D.
  • the Slicer selects the first target entry point to the sixth target entry point based on the spatial anatomical positional relationship of the target feature form, thereby taking out the examined tissue A2, A3, A4, A5, A6.
  • the medical imaging modality is one of the following, medical resonance (MR) imaging; computed tomography (CT) imaging; positron emission tomography (PET) imaging; or single photon emission computed tomography (SPECT) imaging.
  • MR medical resonance
  • CT computed tomography
  • PET positron emission tomography
  • SPECT single photon emission computed tomography
  • the medical imaging modal device has a custom coordinate system, which is recorded as the tracking system coordinate system C T in the method , according to the voxel position parameter and the voxel size parameter in the DICOM file of the medical imaging modal image.
  • the layer spacing parameter obtains the coordinate information of the reference point;
  • the calibration container is filled with water or a coupling agent, and the puncture kit is placed on the fixing bracket, attached to one side of the container and fixed, and the ultrasonic image in the calibration container is collected in real time, and the second position sensor is recorded at this time.
  • the metal probe locator is fixed on the probe clamping bracket, and the spatial position of the metal probe locator is moved.
  • the movement stops, and the metal probe locator is fixed, and the metal probe is fixed.
  • the needle tip is located in the ultrasound imaging area, and the coordinate P i of the metal probe locator in the tracking system coordinate system C T is recorded, and the coordinate I i of the bright spot on the ultrasonic image coordinate system Cus is recorded on the ultrasonic image;
  • ICP Iterative Closest
  • CPR coherent point drift
  • RP robust point match
  • an apparatus comprising: a puncture kit, a moving unit, a calibration container, and an information processing unit,
  • the puncture set has an outer sheath, a puncture needle and a hose embedded in the outer sheath, and an outer edge of the outer end of the outer sheath is connected to the first position sensor, and the puncture needle has a handle end end for the operator to hold And a remote front end contacting the examined portion; a contact force sensor at the remote front end portion, a transmitter at the remote front end portion, a receiver and an ultrasonic transducer, and a second side at a rear side of the remote front end portion position sensor;
  • An information processing unit that establishes an ultrasound image in response to the processor and the ultrasound transducer echo signal
  • the moving unit moves the holder in real time in a three-dimensional direction
  • the calibration container is a container that is open at the top.
  • the outer edge of the outer end of the outer sheath is further connected with an angle indicating dial, the angle indicating that the dial is arranged counterclockwise, and the direction of the 0 scale in the dial coincides with the sagittal axis of the human coordinate system.
  • the metal probe locator is composed of a handle, a needle and a positioning sensor, and the tracking system can display the real-time coordinates of the positioning sensor in the tracking system coordinate system in real time.
  • the moving unit is composed of a base and a plurality of rods and a gripper.
  • the rods are connected by a sliding rail, and the slidable and fixed gripper clamps the metal probe locator and can be moved to the target position and fixed. To keep the metal probe positioner down vertical.
  • Figure 1 is a schematic diagram of a six-point sampling of the present invention.
  • FIG. 2 is a schematic view of the schematic device of the angle dial of the present invention.
  • FIG. 3 is a flow chart of a calibration scheme for an ultrasound image and tracking system coordinate system calibration according to the present invention.
  • the invention mainly includes two aspects:
  • the interventional physician passes the rectal puncture kit through the rectum into the prostate, and the ultrasound enters the prostate from the prostate side through the rectal wall, prostate, and rectal interface.
  • the working frequency is usually At around 6.5MHz, because the preoperative doctor has obtained the position of the lesion in the medical imaging modal device, the interventional doctor selects the region of interest for the needle by experience, and divides the traditional whole prostate into six parts (the top of the prostate, The middle and bottom, left and right sides are improved to select punctures only for the lesions of the above-mentioned regions of interest, and select the points in the upper-lower, left-right, anterior-posterior directions of the diseased tissue, as shown in Fig.
  • the puncture needle can only be performed in the rectum, and the puncture kit can only move up and down the rectum. Therefore, if it is necessary to reduce the number of puncture needles entering the prostate and the depth as much as possible, the puncture needs to be performed.
  • the needle advances in the direction of adjustment, that is, the tail end of the hand-held puncture needle handle rotates around the axis of the handle itself, so that The puncture needle achieves six-point sampling by in and out and rotation in the case of a needle insertion to the diseased tissue.
  • the puncture needle handle end of the puncture kit contains a position sensor that provides a signal to a processor located in the console.
  • the processor can perform several processing functions as described below, introducing a contact force sensor and a position sensor in the puncture kit, and an angle indicating dial on the outer edge of the outer end of the outer sheath of the puncture kit.
  • the angle dial design is shown in Figure 2: the direction of the 0 scale in the dial coincides with the sagittal axis of the human coordinate system; the direction of the angle increase is counterclockwise; the hole in the center is the reserved hole for nesting in the puncture kit On the outer sheath.
  • the medical imaging modal device has a custom coordinate system, which is recorded as the tracking system coordinate system C T in the method , according to the voxel position parameter and the voxel size parameter in the DICOM file of the medical imaging modal image.
  • the layer spacing parameter obtains the coordinate information of the reference point;
  • the calibration container (4) is filled with water or a coupling agent, and the puncture kit (9) is placed on the fixing bracket (11), attached to one side of the container (4) and fixed, and the calibration container is collected in real time (4).
  • the ultrasonic image (6) inside, recording the conversion matrix T2 given by the second position sensor (10) at this time;
  • the metal probe positioner 5 (composed of the handle 5-1 and the needle 5-2) is fixed on the probe holding bracket, and the spatial position of the metal probe positioner (5) is moved when the ultrasonic image appears. When the bright spot is stopped, the movement is stopped. At this time, the metal probe positioner is fixed, and the metal probe tip (5-2) is located in the ultrasonic imaging area, and the metal probe positioner (5) is recorded in the tracking system coordinate system C T at this time.
  • ICP Iterative Closest
  • CPR coherent point drift
  • RP robust point match
  • the purpose of the probe holding bracket (1) is to hold the metal probe positioner (5) and to move the metal probe positioner (5) to the target position and fix it.
  • the probe clamping bracket is composed of a base and a bracket rod (1), a crossbar (2), and a longitudinal rod (3).
  • the bracket rod (1), the crossbar (2), and the longitudinal rod (3) are connected by a slide rail. , can be slid and fixed.
  • a clamp is mounted on the longitudinal rod (3) to hold the shank 5-1 of the metal probe positioner (5) so that the needle 5-2 remains vertically downward.

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Abstract

一种能够精确地操作前列腺穿刺针进行活检的取出方法及装置，对传统的六分仪活检进行改进，即将以往对前列腺整体进行六部分均分(前列腺顶部、中部和底部、左右两侧)改进为只对感兴趣区域选点穿刺，通过术前影像信息完全能提供给医生清晰地、立体的前列腺病变区域，通过添加一个角度调整指示刻度盘辅助装置，并在术前规划的基础上计算出针点位置、规划路径以及所需的穿刺旋转角，使得改进后的穿刺套件（9）能够实现精准的旋转操作，具有较高的精度，以及高度的个体特异性，实现精确穿刺。

Description

一种前列腺穿刺术活检取出方法及装置 技术领域
本发明属于医疗仪器领域，具体的涉及一种用于前列腺病变组织的局部穿刺方法，及术前穿刺针空间位置的计算方法。
背景技术
前列腺癌是男性人群中最常见的癌症之一，并且其致死率在非皮肤癌中排行第二。目前，最为流行的前列腺癌筛查方法是血清前列腺特异性抗原筛查，其次是在实时2D经直肠超声引导下进行的六次或更多次活检。作为这一程序的部分，通常将前列腺分为6个等体积的区域。以系统的、但本质上无方向性的方式从这六个区域中的每个获取一次或多次活检。这一程序称为六分仪活检。
由于六分仪活检成本低并且相对于检测前列腺癌的其他方法较为简单而被广泛使用。然而，六分仪活检已经表现出具有严重的假阴性率，并且可能关于活检的真实位置不准确。通常使用前列腺的原始标准图报告六分仪活检的结果，在前列腺的原始标准图上，病理医师手动地注解活检结果。这张图本质上是不准确的，因为进行注解的病理医师不知道活检的真实部位。经直肠超声(TRUS)引导的系统性穿刺活检似乎解决了上述的技术难题，因其实时性，成像无辐射，低成本和操作简单等性能已成为检查诊断前列腺癌的重要指标。但是，超声成像速度快，虽然可以在术中实时成像，但由于超声波图像的分辨率有限，图像中软组织间的区分度也不高，虽能实时追踪采样导管的位置，却无法通过图像对病变组织进行精确定位，导致单纯基于超声的采样方法，对癌症检测的灵敏度不高，只有60％至85％。
发明内容
本发明的目的是提供一种用于前列腺穿刺术的穿刺套件结构改进及术前穿刺针空间位置的计算方法，使得术中旋转穿刺针成为可能，且其操作角度提示更精确，并给出一种个性化的术前穿刺针空间位置的计算方法，实现精准的六分仪活检操作。该方法主要针对现有技术中存在的以下技术问题：
(1)旋转操作的角度提示不精确
因为仅通过与穿刺针针尖共面的尾标来感观地提示旋转角度，没有对旋转操作进行量化，随着精准化手术时代的到来，必然要求量化的操作提示，所以带精准刻度的手术套件成为必然。
(2)六分仪活检位置的确定完全凭经验
因为前列腺介入手术在2D经直肠超声引导下进行的，只能看到前列腺组织轮廓而看不到软组织，则对慢性前列腺炎、前列腺肥大、与早期前列腺癌不能敏感区分，所以六分仪活检通 常分别从前列腺顶部、中部和底部、左右两侧平均分成六部分，进行代表性样品取出，这种随机的活检是在没有准确掌握癌症位置时所进行的预测，无法保证癌症的高检出率，大多数的癌症发生在前列腺的顶部区域，虽然活检经由TURS导引，但是穿刺针可能无法准确地到达目标区域，仅医生技能和经验对穿刺针定位，无法准确确定是否准确。
本发明就是给医生提供一种能够精确地操作前列腺穿刺针进行活检取出方法，并给出术前穿刺针空间位置的计算方法。通过对传统的六分仪活检进行改进，即将以往对前列腺整体进行六部分均分(前列腺顶部、中部和底部、左右两侧)改进为只对感兴趣区域选点穿刺，通过术前影像信息完全能提供给医生清晰地、立体的前列腺病变区域，通过添加一个角度调整指示刻度盘辅助装置，并在术前规划的基础上计算出针点位置、规划路径以及所需的穿刺旋转角，使得改进后的穿刺套件能够实现精准的旋转操作，具有较高的精度，以及高度的个体特异性，实现精确穿刺。
本发明的技术方案是：
一种方法，其特征在于包括以下步骤：
将穿刺套件插入到位于受检者的身体中的腔中，所述穿刺套件具有外鞘、嵌在所述外鞘内的穿刺针及软管，所述外鞘的尾端外缘接第一位置传感器，所述穿刺针有供操作者手持的手柄尾端和接触受检部位的远程前端；位于所述远程前端部的接触力传感器、位于所述远程前端部的发射器、接收器和超声换能器，以及位于所述远程前端部后侧的第二位置传感器；
将所述穿刺针操纵成与位于所述腔的壁中的目标检测点接触；
响应于所述接触力传感器的读数来建立所述穿刺针远程前端前部和所述目标出针点之间的期望的接触力；以及
根据所述期望的接触力调整穿刺针手柄尾端空间姿态，直至到达期望的第一目标入针点，通过所述软管取出受检组织物A1；
继续调整穿刺针手柄尾端的空间姿态，到达预先规划的第二、第三、第四、第五、第六目标入针点；通过所述软管取出受检组织物A2、A3、A4、A5、A6。
进一步地，所述外鞘的尾端外缘还接一个角度提示刻度盘，所述角度提示刻度盘为逆时针方向布置，刻度盘中0刻度的方向与人体坐标系的矢状轴重合。
进一步地，包括：
穿刺点勾画，对受检者在术前预先获取医学成像模态，根据所述成像模态上进行路径规划操作，以及
采用迭代阈值分割结合形态学操作进行受检部位图像分割，在分割后的受检部位区域内采用双阈值法进行目标特征形态的提取，然后采用面绘制方法进行三维可视化，最后将可视化影 像导入3D Slicer由操作者基于目标特征形态的空间解剖位置关系选取第一目标入针点至第六目标入针点，从而取出受检组织物A2、A3、A4、A5、A6。
进一步地，包括，
所述医学成像模态是下列之一，医学共振(MR)成像；计算机断层摄影(CT)成像；正电子发射光谱(PET)成像；或单光子发射计算机断层摄影(SPECT)成像。
进一步地，包括，超声图像与跟踪系统坐标系校准的计算，
第一步，医学成像模态设备有自定义的坐标系，记为所述方法中的跟踪系统坐标系C T，根据医学成像模态图像DICOM文件中的体素位置参数、体素大小参数、层距参数，获得参考点的坐标信息；
第二步，将校准容器内注入水或耦合剂，将穿刺套件放于固定支架上，贴于容器一侧并固定，实时采集校准容器内的超声图像，记录此时第二位置传感器给出的转换矩阵T2；
第三步，将金属探针定位器固定于探针夹持支架上，移动金属探针定位器空间位置，当超声图像上出现亮点时，停止移动，此时金属探针定位器固定，金属探针针尖位于超声成像区域内，记录此时金属探针定位器在跟踪系统坐标系C T中的坐标P i，并记录超声图像上此亮点在超声图像坐标系Cus上的坐标I i；
第四步，重复上述操作n次，得到跟踪系统坐标系C T中的点集P i(i＝1,2,…,n)，这n个点的坐标均不相同，并得到与这n个点对应的超声图像坐标系Cus中的点集I i(i＝1,2,…,n)；由坐标关系，P i＝T2·T1·I i，其中P i、I i、T2均为已知，T1待求。
进一步地，包括，
令US坐标系(Cus)与跟踪系统坐标系(C T)之间的转换矩阵T＝T2·T1，那么Pi＝T·Ii；求解T采用下列刚性点集配准方法之一，ICP(Iterative Closest Points)算法、CPR(coherent point drift)算法、RP(robust point match)算法；求出T后，T1＝(T2)-1·T。
作为本发明的一个实施例，还提供一种设备，其特征在于包括：穿刺套件、移动单元、校准容器和信息处理单元，
所述穿刺套件具有外鞘、嵌在所述外鞘内的穿刺针及软管，所述外鞘的尾端外缘接第一位置传感器，所述穿刺针有供操作者手持的手柄尾端和接触受检部位的远程前端；位于所述远程前端部的接触力传感器、位于所述远程前端部的发射器、接收器和超声换能器，以及位于所述远程前端部后侧的第二位置传感器；
响应于所述接触力传感器的读数来建立所述穿刺针远程前端前部和所述目标出针点之间的期望的接触力的处理器；以及
响应于所述处理器和所述超声换能器回波信号建立超声图像的信息处理单元，
所述移动单元在三维方向上对夹持物实时移动；
所述校准容器为一顶端开口的容器。
进一步地，包括，
所述外鞘的尾端外缘还接一个角度提示刻度盘，所述角度提示刻度盘为逆时针方向布置，刻度盘中0刻度的方向与人体坐标系的矢状轴重合。
进一步地，包括，
金属探针定位器，所述金属探针定位器由手柄、针、定位传感器组成，跟踪系统可实时显示定位传感器在跟踪系统坐标系中的实时坐标。
进一步地，包括，
所述移动单元由底座和若干杆件以及夹持器组成，杆件之间由滑轨连接，可滑动并固定夹持器夹持金属探针定位器，并可使之移动到目标位置并固定，使金属探针定位器保持向下垂直。
附图说明
此处所说明的附图用来提供对本发明的进一步理解，构成本申请的一部分，本发明的示意性实施例及其说明用于解释本发明，并不构成对本发明的不当限定。在附图中：
图1为本发明的六点取样示意图。
图2为本发明的角度刻度盘示意图装置的示意图。
图3为本发明的超声图像与跟踪系统坐标系校准计算方案流程图。
图4为本发明的US与跟踪系统坐标系校准装置。
具体实施方式
下面将参考附图并结合实施例，来详细说明本发明。
本发明主要包括两个方面：
一个是穿刺套件结构改进使得在术中操作时精确提示旋转角度；另一个是配套地给出一种个性化的旋转角度计算方法。
1)穿刺套件结构改进
手术操作过程分析：
手术时，病人平躺，介入医师将经直肠的穿刺套件经过直肠进入前列腺，超声波经过直肠壁、前列腺、和直肠交界面从前列腺一侧进入前列腺，为了保证超声信号的穿透能力，工作频率通常在6.5MHz左右，由于术前医生已经获得病变区域在医学成像模态设备中的位置，介入医生凭经验选取感兴趣区域进行给针，将传统的对前列腺整体进行六部分均分(前列腺顶部、中部和底部、左右两侧)改进为只对上述感兴趣区域的病变组织选点穿刺，分别对所述病变 组织的上-下、左-右、前-后六个方向选点，如图1；由于直肠与前列腺为不连通器官，穿刺针只能在直肠内进行，穿刺套件只能在直肠上下移动，因此如果需要尽可能减少穿刺针进入前列腺的刺点数以及深度的情况下，需对穿刺针前进方向进行调整，即手持穿刺针手柄尾端进行绕手柄所在轴自身旋转，使得穿刺针在对病变组织一次进针的情况下通过进出和旋转实现六点取样。
穿刺套件改进：
为了协助医生操作，穿刺套件的穿刺针手柄尾端包含向位于控制台中的处理器提供信号的位置传感器。处理器可履行如下描述的若干处理功能，在穿刺套件中引入接触力传感器和位置传感器，在穿刺套件外鞘的尾端外缘接一个角度提示刻度盘。角度刻度盘设计如图2：刻度盘中0刻度的方向与人体坐标系的矢状轴重合；角度增大的方向为逆时针方向；中央的孔洞为留出孔，用于嵌套在穿刺套件的外鞘上。手术前建立好受检部位的空间位置，并且根据接触力传感器的读数来建立穿刺针远程前端前部和目标出针点之间的期望的接触力，通常情况不同的受检部位(例如前列腺、直肠、子宫等)的受力值不同，对于个性化手术导航而言，有经验的医生提前会建立起力值和空间位置之间的关系作为辅助，手术时将带刻度盘的外鞘固定，穿刺针及软管嵌在外鞘内进出直肠或旋转操作，穿刺针尾端的箭头留出在外鞘外，通过读箭头在刻度盘的指示和处理器给出的受力参数来实时读取操作时的旋转角。
2)个性化的超声图像与跟踪系统坐标系校准的计算
配套的超声图像与跟踪系统坐标系校准计算方案流程图如图3：
第一步，医学成像模态设备有自定义的坐标系，记为所述方法中的跟踪系统坐标系C T，根据医学成像模态图像DICOM文件中的体素位置参数、体素大小参数、层距参数，获得参考点的坐标信息；
第二步，将校准容器(4)内注入水或耦合剂，将穿刺套件(9)放于固定支架(11)上，贴于容器(4)一侧并固定，实时采集校准容器(4)内的超声图像(6)，记录此时第二位置传感器(10)给出的转换矩阵T2；
第三步，将金属探针定位器5(由柄5-1和针5-2组成)固定于探针夹持支架上，移动金属探针定位器(5)空间位置，当超声图像上出现亮点时，停止移动，此时金属探针定位器固定，金属探针针尖(5-2)位于超声成像区域内，记录此时金属探针定位器(5)在跟踪系统坐标系C T中的坐标(7)P i，并记录超声图像上此亮点在超声图像坐标系Cus上的坐标(8)I i；第四步，重复上述操作n次，得到跟踪系统坐标系C T中的点集P i(i＝1,2,…,n)，这n个点的坐标均不相同，并得到与这n个点对应的超声图像坐标系Cus中的点集I i(i＝1,2,…,n)；由坐标关系，P i＝T2·T1·I i，其中P i、I i、T2均为已知，T1待求。
令US坐标系(Cus)与跟踪系统坐标系(C T)之间的转换矩阵T＝T2·T1，那么Pi＝T·Ii；求解T采用下列刚性点集配准方法之一，ICP(Iterative Closest Points)算法、CPR(coherent point drift)算法、RP(robust point match)算法；求出T后，T1＝(T2)-1·T。
如图4所示，探针夹持支架(1)的目的是夹持金属探针定位器(5)，并可使金属探针定位器(5)移动到目标位置并固定。探针夹持支架由底座和支架杆(1)、横杆(2)、纵杆(3)组成，支架杆(1)、横杆(2)、纵杆(3)之间由滑轨连接，可滑动并固定。纵杆(3)上装有夹持器，可夹持金属探针定位器(5)的柄5-1，使针5-2保持向下垂直。
以上所述仅为本发明的优选实施例而已，并不用于限制本发明，对于本领域的技术人员来说，本发明可以有各种更改和变化。凡在本发明的精神和原则之内，所作的任何修改、等同替换、改进等，均应包含在本发明的保护范围之内。

Claims (10)

  1. 一种方法，其特征在于包括以下步骤：
    将穿刺套件插入到位于受检者的身体中的腔中，所述穿刺套件具有外鞘、嵌在所述外鞘内的穿刺针及软管，所述外鞘的尾端外缘接第一位置传感器，所述穿刺针有供操作者手持的手柄尾端和接触受检部位的远程前端；位于所述远程前端部的接触力传感器、位于所述远程前端部的发射器、接收器和超声换能器，以及位于所述远程前端部后侧的第二位置传感器；
    将所述穿刺针操纵成与位于所述腔的壁中的目标检测点接触；
    响应于所述接触力传感器的读数来建立所述穿刺针远程前端前部和所述目标出针点之间的期望的接触力；以及
    根据所述期望的接触力调整穿刺针手柄尾端空间姿态，直至到达期望的第一目标入针点，通过所述软管取出受检组织物A1；
    继续调整穿刺针手柄尾端的空间姿态，到达预先规划的第二、第三、第四、第五、第六目标入针点；通过所述软管取出受检组织物A2、A3、A4、A5、A6。
  2. 根据权利要求1所述的方法，其特征在于所述外鞘的尾端外缘还接一个角度提示刻度盘，所述角度提示刻度盘为逆时针方向布置，刻度盘中0刻度的方向与人体坐标系的矢状轴重合。
  3. 根据权利要求2所述的方法，其特征在于包括：
    穿刺点勾画，对受检者在术前预先获取医学成像模态，根据所述成像模态上进行路径规划操作，以及
    采用迭代阈值分割结合形态学操作进行受检部位图像分割，在分割后的受检部位区域内采用双阈值法进行目标特征形态的提取，然后采用面绘制方法进行三维可视化，最后将可视化影像导入3D Slicer由操作者基于目标特征形态的空间解剖位置关系选取第一目标入针点至第六目标入针点，从而取出受检组织物A2、A3、A4、A5、A6。
  4. 根据权利要求3所述的方法，其特征在于包括，
    所述医学成像模态是下列之一，医学共振(MR)成像；计算机断层摄影(CT)成像；正电子发射光谱(PET)成像；或单光子发射计算机断层摄影(SPECT)成像。
  5. 根据权利要求4所述的方法，其特征在于包括，超声图像与跟踪系统坐标系校准的计算，
    第一步，医学成像模态设备有自定义的坐标系，记为所述方法中的跟踪系统坐标系C T，根据医学成像模态图像DICOM文件中的体素位置参数、体素大小参数、层距参数，获得参考点的坐标信息；
    第二步，将校准容器内注入水或耦合剂，将穿刺套件放于固定支架上，贴于容器一侧并固定，实时采集校准容器内的超声图像，记录此时第二位置传感器给出的转换矩阵T2；
    第三步，将金属探针定位器固定于探针夹持支架上，移动金属探针定位器空间位置，当超声 图像上出现亮点时，停止移动，此时金属探针定位器固定，金属探针针尖位于超声成像区域内，记录此时金属探针定位器在跟踪系统坐标系C T中的坐标P i，并记录超声图像上此亮点在超声图像坐标系Cus上的坐标I i；
    第四步，重复上述操作n次，得到跟踪系统坐标系C T中的点集P i(i＝1,2,…,n)，这n个点的坐标均不相同，并得到与这n个点对应的超声图像坐标系Cus中的点集I i(i＝1,2,…,n)；由坐标关系，P i＝T2·T1·I i，其中P i、I i、T2均为已知，T1待求。
  6. 根据权利要求5所述的方法，其特征在于包括，
    令US坐标系(Cus)与跟踪系统坐标系(C T)之间的转换矩阵T＝T2·T1，那么Pi＝T·Ii；求解T采用下列刚性点集配准方法之一，ICP(Iterative Closest Points)算法、CPR(coherent point drift)算法、RP(robust point match)算法；求出T后，T1＝(T2)-1·T。
  7. 一种设备，其特征在于包括：穿刺套件、移动单元、校准容器和信息处理单元，
    所述穿刺套件具有外鞘、嵌在所述外鞘内的穿刺针及软管，所述外鞘的尾端外缘接第一位置传感器，所述穿刺针有供操作者手持的手柄尾端和接触受检部位的远程前端；位于所述远程前端部的接触力传感器、位于所述远程前端部的发射器、接收器和超声换能器，以及位于所述远程前端部后侧的第二位置传感器；
    响应于所述接触力传感器的读数来建立所述穿刺针远程前端前部和所述目标出针点之间的期望的接触力的处理器；以及
    响应于所述处理器和所述超声换能器回波信号建立超声图像的信息处理单元，
    所述移动单元在三维方向上对夹持物实时移动；
    所述校准容器为一顶端开口的容器。
  8. 根据权利要求7所述的设备，其特征在于包括，
    所述外鞘的尾端外缘还接一个角度提示刻度盘，所述角度提示刻度盘为逆时针方向布置，刻度盘中0刻度的方向与人体坐标系的矢状轴重合。
  9. 根据权利要求8所述的设备，其特征在于包括，
    金属探针定位器，所述金属探针定位器由手柄、针、定位传感器组成，跟踪系统可实时显示定位传感器在跟踪系统坐标系中的实时坐标。
  10. 根据权利要求9所述的设备，其特征在于包括，
    所述移动单元由底座和若干杆件以及夹持器组成，杆件之间由滑轨连接，可滑动并固定夹持器夹持金属探针定位器，并可使之移动到目标位置并固定，使金属探针定位器保持向下垂直。
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