技术领域technical field
本发明涉及图像处理技术领域，具体涉及一种基于虚拟现实的经皮椎间孔镜手术精准规划系统，及其采用该系统进行手术精准规划的方法。The invention relates to the technical field of image processing, in particular to a virtual reality-based precise planning system for percutaneous transforaminal endoscopic surgery, and a method for using the system for precise surgical planning.
背景技术Background technique
在传统椎间孔镜手术规划中，采用二维规划：基于MR、CT横断面规划，术中需依据C臂进行调整，准度较差。对椎间盘、神经等软组织三维立体结构显影不清。对上关节突、椎弓根磨除范围无指导作用，术中需依据术者经验，标准化程度低。对游离型椎间盘突出，术前规划不能准确评估是否适合椎间孔镜手术及确切手术入路。In traditional transforaminal surgery planning, two-dimensional planning is adopted: based on MR and CT cross-sectional planning, the operation needs to be adjusted according to the C-arm, and the accuracy is poor. The three-dimensional structure of soft tissues such as intervertebral discs and nerves cannot be clearly developed. It has no guiding effect on the grinding range of the superior articular process and pedicle, and the operation needs to be based on the experience of the surgeon, with a low degree of standardization. For free intervertebral disc herniation, the preoperative planning cannot accurately evaluate whether it is suitable for endoscopic transforaminal surgery and the exact surgical approach.
同时传统规划方法导致手术定位过程耗时长，使得术中X线的曝光次数增多和照射时间延长，增加X线辐射对病人、手术医师的伤害且增加医源性损伤及手术并发症的发生概率，致使椎间孔镜技术学习麻烦，影响椎间孔镜技术的学习和推广应用。At the same time, the traditional planning method leads to a long time-consuming surgical positioning process, which increases the number of X-ray exposures and prolongs the exposure time during the operation, increases the harm of X-ray radiation to patients and surgeons, and increases the probability of iatrogenic injury and surgical complications. Cause the intervertebral foramina technique to study trouble, influence the study and popularization and application of the intervertebral foramina technique.
发明内容Contents of the invention
针对上述技术问题，本发明所要解决的技术问题是提供一种经皮椎间孔镜手术精准规划系统，及其使用该系统的方法，运用的三维重建技术，采用计算机技术对二维医学图像进行边界识别，重新还原出被检组织或器官的三维图像。用户可多角度、清晰观察关注的部位以及其与周围结构之间的关系，多方位查看局部解剖结构，并模拟手术器械如穿刺针、工作管道等的置入过程，便捷地控制工作管道在虚拟平台中的位置，精确模拟术中穿刺过程并生成相应3D测量数据，最终可应用于真实手术中，用户根据得到的相关数据进行手术规划，规划结果可直接用于手术过程，提高穿刺针穿刺的成功率。In view of the above technical problems, the technical problem to be solved by the present invention is to provide a precise planning system for percutaneous transforaminal endoscopic surgery, and a method for using the system. Boundary recognition to restore the 3D image of the inspected tissue or organ. The user can clearly observe the concerned part and the relationship between it and the surrounding structures from multiple angles, view the local anatomical structure in multiple directions, and simulate the insertion process of surgical instruments such as puncture needles and working pipelines, and conveniently control the working pipeline in the virtual The position in the platform accurately simulates the puncture process in the operation and generates corresponding 3D measurement data, which can finally be applied to real operations. Users can plan operations according to the relevant data obtained. The planning results can be directly used in the operation process to improve the puncture efficiency of the puncture needle. Success rate.
本发明解决上述技术问题的技术方案如下：The technical scheme that the present invention solves the problems of the technologies described above is as follows:
一种经皮椎间孔镜手术精准规划方法，其特征在于，按如下步骤：A precise planning method for percutaneous transforaminal endoscopic surgery, characterized in that, the steps are as follows:
S1：读取DICOM数据，重建为体数据；S1: Read DICOM data and reconstruct it as volume data;
S2：分割选取原始图像所需区域，对所需区域三维重建，获取三维模型面数据信息，分割出椎间盘、神经根和皮肤；选择骨组织阈值，分割出骨组织；S2: Segment and select the required area of the original image, reconstruct the required area in 3D, obtain the data information of the 3D model surface, segment the intervertebral disc, nerve root and skin; select the bone tissue threshold, and segment the bone tissue;
S3：进行孔镜规划，定位穿刺针目标靶点；S3: Carry out borescope planning and locate the target point of the puncture needle;
S4：规划穿刺针的入针角度；S4: Planning the needle entry angle of the puncture needle;
S5：入针后，查看不同方位下穿刺针的放置情况；S5: After the needle is inserted, check the placement of the puncture needle in different directions;
S6：显示或隐藏皮肤，查看皮肤上穿刺针的入针点；S6: Show or hide the skin, check the entry point of the puncture needle on the skin;
S7：规划和测量，得到皮肤交点距离人体中线的距离，皮肤交点距离病椎上缘面的距离以及入针深度；S7: Planning and measurement, to obtain the distance between the skin intersection point and the midline of the human body, the distance between the skin intersection point and the upper edge of the diseased vertebra, and the needle insertion depth;
S8：建立工作管道，将穿刺针显示为工作管道；S8: establishing a working pipeline, displaying the puncture needle as a working pipeline;
S9：通过对体数据进行蒙特卡罗物理模拟方法，生成模拟X光片；S9: Generate a simulated X-ray film by performing a Monte Carlo physical simulation method on the volume data;
S10：获取和查看报告。S10: Obtain and view a report.
有益效果：本发明主要运用的三维重建技术，采用计算机技术对二维医学图像进行边界识别，重新还原出被检组织或器官的三维图像。用户可多角度、清晰观察关注的部位以及其与周围结构之间的关系，多方位查看局部解剖结构，并模拟手术器械如穿刺针、工作管道等的置入过程，便捷地控制工作管道在虚拟平台中的位置，精确模拟术中穿刺过程并生成相应3D测量数据，最终可应用于真实手术中。相比传统二维测量，在距离测量、角度测量等方面更能准确体现真实状况，体现不同解剖结构及内置物(工作管道、穿刺针等)之间的关系，实现手术操作的精准规划。Beneficial effects: the three-dimensional reconstruction technology mainly used in the present invention uses computer technology to recognize the boundary of two-dimensional medical images, and restores the three-dimensional images of the examined tissues or organs. The user can clearly observe the concerned part and the relationship between it and the surrounding structures from multiple angles, view the local anatomical structure in multiple directions, and simulate the insertion process of surgical instruments such as puncture needles and working pipelines, and conveniently control the working pipeline in the virtual The position in the platform accurately simulates the puncture process in the operation and generates corresponding 3D measurement data, which can finally be applied in real operations. Compared with traditional two-dimensional measurement, it can more accurately reflect the real situation in terms of distance measurement and angle measurement, reflect the relationship between different anatomical structures and built-in objects (working pipelines, puncture needles, etc.), and realize precise planning of surgical operations.
进一步，重建为体数据的方法为采用光线投射算法和三维重建技术，将传统的二维医学图像渲染成三维图像，并通过虚拟现实医学图像渲染模块，呈像于所有的虚拟现实设备。Further, the method of reconstructing volume data is to use ray-casting algorithm and 3D reconstruction technology to render traditional 2D medical images into 3D images, and present them on all virtual reality devices through the virtual reality medical image rendering module.
采用进一步技术方案的有益效果：采用光线投射算法，光线投射算法从图像的每一个像素，沿固定方向(通常是视线方向)发射一条光线，光线穿越整个图像序列，并在这个过程中，对图像序列进行采样获取颜色信息，同时依据光线吸收模型将颜色值进行累加，直至光线穿越整个图像序列，最后得到的颜色值就是渲染图像的颜色，采样点颜色采用从前往后的方式混合，将混合后的颜色作为该像素的最终颜色值，从而实现三维重建。Beneficial effects of adopting a further technical solution: using a ray-casting algorithm, the ray-casting algorithm emits a ray from each pixel of the image along a fixed direction (usually the line of sight), the ray traverses the entire image sequence, and in the process, the image is The sequence is sampled to obtain color information, and the color value is accumulated according to the light absorption model until the light passes through the entire image sequence, and the final color value is the color of the rendered image. The color of the sampling point is mixed from front to back. The color of the pixel is used as the final color value of the pixel, thus realizing three-dimensional reconstruction.
进一步，通过多态医学图像融合技术，把同一病人的CT和MRI数据进行人工智能化的区域识别，分割出椎间盘、神经根和皮肤的方法为：采用移动立方体算法，对不同的区域进行模型重建、颜色标注，输出三维医学网格模型。Further, through the polymorphic medical image fusion technology, the CT and MRI data of the same patient are recognized by artificial intelligence, and the method of segmenting the intervertebral disc, nerve root and skin is: using the moving cube algorithm to reconstruct the model of different regions , color labeling, and output the 3D medical grid model.
采用进一步技术方案的有益效果：移动立方体法算法是面绘制算法中的经典算法，它是W.Lorensen等人于1987年提出来的一种体素级重建方法。这算法实际上是一个分而治之的方法，因为其将等值面的抽取分布于每一个体素(voxel)中进行。对于每个被处理的体素(voxel)，以三角面片来逼近其内部的等值面。每个体素是一个小立方体(cube)，在构造三角面片的处理过程中对每个体素都“扫描”一遍。算法的基本思想是逐个处理数据场中的立方体，找出与等值面相交的立方体，采用线性插值计算出等值面与立方体边的交点。根据立方体每一顶点与等值面的相对位置，将等值面与立方体边上的交点按一定方式连接生成等值面，作为等值面在该立方体内的一个逼近表示。采用该移动立方体法算法分割选取原始图像感兴趣区域，一键三维重建，获取到三维模型面数据信息，分割出椎间盘、神经根、皮肤。Beneficial effects of adopting a further technical solution: the moving cube method algorithm is a classic algorithm in surface rendering algorithms, and it is a voxel-level reconstruction method proposed by W.Lorensen et al. in 1987. This algorithm is actually a divide-and-conquer method because it distributes the extraction of isosurfaces to each voxel. For each processed voxel, the internal isosurface is approximated by a triangular patch. Each voxel is a small cube (cube), and each voxel is "scanned" once during the process of constructing a triangular patch. The basic idea of the algorithm is to process the cubes in the data field one by one, find out the cubes that intersect with the isosurface, and use linear interpolation to calculate the intersection points between the isosurface and the sides of the cube. According to the relative position of each vertex of the cube and the isosurface, the intersection points of the isosurface and the side of the cube are connected in a certain way to generate an isosurface, which is an approximate representation of the isosurface in the cube. The moving cube method algorithm is used to segment and select the region of interest in the original image, and one-click 3D reconstruction to obtain the 3D model surface data information, and segment the intervertebral disc, nerve root, and skin.
进一步，所述分割出骨组织的方法为采用大津阈值分割算法，将图像灰度进行自适应的阈值分割，按照图像上灰度值的分布，将图像分成背景和前景两部分看待，前景就是我们要按照阈值分割出来的部分，背景和前景的分界值就是我们要求出的阈值，通过对图像灰度值信息进行统计，根据最大类间方差判断准则，可自适应得到将背景和前景尽可能分开的阈值，最终完成图像分割，从而分割出骨组织。Further, the method for segmenting bone tissue is to use the Otsu threshold segmentation algorithm to perform adaptive threshold segmentation on the gray scale of the image, and divide the image into two parts, the background and the foreground, according to the distribution of gray values on the image. The foreground is our For the part to be segmented according to the threshold, the cut-off value of the background and the foreground is the threshold we require. By counting the gray value information of the image, and according to the maximum inter-class variance judgment criterion, the background and the foreground can be adaptively separated as much as possible. Finally, the image segmentation is completed, and the bone tissue is segmented.
采用进一步技术方案的有益效果：大津阈值分割算法是一种图像灰度自适应的阈值分割算法，1979年由日本学者大津提出。大津法按照图像上灰度值的分布，将图像分成背景和前景两部分看待，前景就是我们要按照阈值分割出来的部分。背景和前景的分界值就是我们要求出的阈值。通过对图像灰度值信息进行统计，根据最大类间方差判断准则，可自适应得到将背景和前景尽可能分开的阈值，最终完成图像分割，一键分割出骨组织。Beneficial effects of adopting further technical solutions: Otsu threshold segmentation algorithm is a threshold segmentation algorithm adaptive to image grayscale, which was proposed by Japanese scholar Otsu in 1979. According to the distribution of gray values on the image, the Otsu method divides the image into two parts, the background and the foreground. The foreground is the part we want to segment out according to the threshold. The cutoff value between the background and the foreground is the threshold we require. By counting the gray value information of the image, according to the maximum inter-class variance judgment criterion, the threshold that separates the background and the foreground as much as possible can be adaptively obtained, and finally the image segmentation is completed, and the bone tissue can be segmented with one key.
进一步，所述定位穿刺针目标靶点的方法为：利用二维灰度图和定位功能，直接在二维图上定位，虚拟现实平台上的穿刺针实时同步于相应位置，精准确定目标靶点。Further, the method for locating the target point of the puncture needle is: use the two-dimensional grayscale image and the positioning function to directly locate on the two-dimensional image, and the puncture needle on the virtual reality platform is synchronized with the corresponding position in real time to accurately determine the target point .
采用进一步技术方案的有益效果：直接在二维图上鼠标点击定位，虚拟现实平台上的穿刺针实时同步于相应位置，精准确定手术的目标靶点，定位精准，操作简单方便。The beneficial effect of adopting the further technical solution: directly click the mouse on the two-dimensional map to locate, the puncture needle on the virtual reality platform is synchronized to the corresponding position in real time, accurately determine the target point of the operation, the positioning is accurate, and the operation is simple and convenient.
进一步，查看不同方位下穿刺针的放置情况的方法为：通过复位、操控缩放、操控移动和控制选中一种或几种结合的方式查看不同方位下穿刺针的放置情况。Further, the method for checking the placement of the puncture needles in different orientations is: checking the placement of the puncture needles in different orientations by means of resetting, manipulating scaling, manipulating movement, and controlling selection of one or more combinations.
采用进一步技术方案的有益效果：设置多种方式查看不同部位下的穿刺，比如复位、缩放等，操作简便。The beneficial effect of adopting the further technical solution: multiple ways are set to view the punctures in different parts, such as reset, zoom, etc., and the operation is simple.
进一步，所述工作管道是模拟实际手术过程中与实际放置的管道大小一致，直观显示工作管道与人体各部位之间的关系。Furthermore, the size of the working pipeline is the same as that of the pipeline placed in the simulated actual operation process, and the relationship between the working pipeline and various parts of the human body is visually displayed.
采用进一步技术方案的有益效果：工作管道是一个模拟椎间孔镜手术通道的一直径7mm、金属、笔直的空心圆柱管道，椎间孔镜镜头及各种抓钳、射频刀头、镜下磨钻等各种器械通过其到达目标靶点。采用穿刺针定位完成后，采用逐级扩张方式置入扩张器械，最后置入工作管道，通过工作管道可以看见目标突出椎间盘与周围神经等软组织的关系，保证手术的顺利进行。Beneficial effects of adopting a further technical solution: the working pipeline is a 7 mm in diameter, metal, straight hollow cylindrical pipeline simulating the transforaminal endoscopic surgery channel, the intervertebral foramen mirror lens and various grasping forceps, radio frequency cutter heads, and grinding under the mirror Various instruments such as drills reach the target target through it. After the positioning with the puncture needle is completed, the expansion device is placed in a step-by-step expansion method, and finally the working channel is inserted. Through the working channel, the relationship between the target herniated intervertebral disc and soft tissues such as peripheral nerves can be seen to ensure the smooth progress of the operation.
一种经皮椎间孔镜手术精准规划系统，其特征在于，包括A precise planning system for percutaneous transforaminal surgery, characterized in that it includes
体数据重建模块，用于读取DICOM数据，重建为体数据；The volume data reconstruction module is used to read DICOM data and reconstruct it as volume data;
虚拟现实医学图像渲染模块，用于把医学的体数据呈像在虚拟现实设备以及裸眼三维显示设备系统上；The virtual reality medical image rendering module is used to present the medical volumetric data on the virtual reality equipment and the naked-eye three-dimensional display equipment system;
分割模块，用于分割选取原始图像所需区域，对所需区域三维重建，获取三维模型面数据信息，分割出椎间盘、神经根和皮肤；选择骨组织阈值，分割出骨组织；The segmentation module is used to segment and select the required area of the original image, reconstruct the required area in 3D, obtain the data information of the 3D model surface, and segment the intervertebral disc, nerve root and skin; select the bone tissue threshold to segment the bone tissue;
孔镜规划模块，用于孔镜规划，定位穿刺针目标靶点；The borescope planning module is used for borescope planning and positioning of the target point of the puncture needle;
穿刺针入针规划模块，用于规划穿刺针的入针角度；The puncture needle insertion planning module is used to plan the insertion angle of the puncture needle;
入针查看模块，用于入针后查看不同方位下穿刺针的放置情况；The needle insertion viewing module is used to check the placement of the puncture needle in different directions after the needle is inserted;
显示或隐藏模块，用于显示皮肤后查看皮肤上穿刺针的入针点；Show or hide the module, which is used to view the entry point of the puncture needle on the skin after displaying the skin;
规划测量模块，用于得到皮肤交点距离人体中线的距离，皮肤交点距离病椎上缘面的距离以及入针深度；The planning measurement module is used to obtain the distance between the skin intersection point and the midline of the human body, the distance between the skin intersection point and the upper edge of the diseased vertebra, and the needle insertion depth;
工作管道建立模块，用于将穿刺针显示为工作管道；A working pipeline establishment module is used for displaying the puncture needle as a working pipeline;
蒙特卡罗物理模拟X光片生成模块，对体数据进行蒙特卡罗物理模拟方法，计算出不同角度的仿真二维X光片，以便用户在手术中进行对比应用；Monte Carlo physical simulation X-ray film generation module, which performs Monte Carlo physical simulation method on volume data, and calculates simulated two-dimensional X-ray films from different angles, so that users can compare and apply them in surgery;
报告查看模块，用于获取和查看穿刺针与横断面、矢状面、冠状面的角度；皮肤交点距离人体中线的距离、皮肤交点距离病椎上缘面的距离、入针深度；正位、侧位X光片，3D体正侧位。The report viewing module is used to obtain and view the angle between the puncture needle and the transverse plane, sagittal plane, and coronal plane; the distance between the skin intersection point and the midline of the human body, the distance between the skin intersection point and the upper edge of the diseased vertebra, and the needle insertion depth; Lateral X-ray film, 3D body positive and lateral.
进一步，控制模块，用于通过复位、操控缩放、操控移动和控制选中一种或几种结合的方式查看不同方位下穿刺针的放置情况。Further, the control module is used to check the placement of the puncture needle in different orientations by means of resetting, manipulating scaling, manipulating movement and controlling selection of one or more combinations.
进一步，还包括控制笔，用于直接控制和操作虚拟现实平台上的图像，使用操控笔过程中，操控笔笔尖会形成一条虚拟可视的直线，当碰到任一操作对象时，操控笔会产生震动，同时直线变色，表示当前碰到的对象可操作。Further, it also includes a control pen, which is used to directly control and operate the images on the virtual reality platform. During the use of the manipulation pen, the tip of the manipulation pen will form a virtual and visible straight line. When touching any operation object, the manipulation pen will generate Vibrates, and the color of the line changes at the same time, indicating that the object currently encountered can be operated.
操控笔是系统的硬件组成部分之一，用于直接控制和操作虚拟现实平台上的图像，控制的主要对象有：骨组织、椎间盘、神经根、皮肤、穿刺针、工作管道。使用操控笔过程中，操控笔笔尖会形成一条虚拟可视的绿色直线，当碰到任一操作对象时，操控笔会产生震动，同时绿色直线变成红色，表示当前碰到的对象可操作。操作方式有两种，一种是直接长按笔上的按键，另一种是使用笔选择功能菜单界面上的按钮即可完成操作。The control pen is one of the hardware components of the system. It is used to directly control and operate the images on the virtual reality platform. The main objects to be controlled are: bone tissue, intervertebral disc, nerve root, skin, puncture needle, and working pipeline. During the use of the manipulation pen, the pen tip of the manipulation pen will form a virtual and visible green straight line. When touching any operation object, the manipulation pen will vibrate, and the green straight line will turn red at the same time, indicating that the currently touched object can be operated. There are two operation methods, one is to directly press and hold the button on the pen, and the other is to use the pen to select the button on the function menu interface to complete the operation.
附图说明Description of drawings
图1为经皮椎间孔镜手术精准规划方法的步骤流程图。Figure 1 is a flow chart of the steps of the precise planning method for percutaneous transforaminal surgery.
具体实施方式Detailed ways
以下结合附图对本发明的原理和特征进行描述，所举实例只用于解释本发明，并非用于限定本发明的范围。The principles and features of the present invention are described below in conjunction with the accompanying drawings, and the examples given are only used to explain the present invention, and are not intended to limit the scope of the present invention.
一种经皮椎间孔镜手术精准规划方法，基于经皮椎间孔镜手术精准规划系统。A precise planning method for percutaneous transforaminal surgery, based on a precise planning system for percutaneous transforaminal surgery.
经皮椎间孔镜手术精准规划系统包括：Precise planning system for percutaneous transforaminal surgery includes:
体数据重建模块，用于读取DICOM数据，重建为体数据；DICOM(Digital lmagingand Communications in Medicine)数据即医学数字成像和通信数据，是医学图像和相关信息的国际标准(IS012052)。它定义了质量能满足临床需要的可用于数据交换的医学图像格式。DICOM被广泛应用于放射医疗，心血管成像以及放射诊疗诊断设备(X射线，CT，核磁共振，超声等)，并且在眼科和牙科等其它医学领域得到越来越深入广泛的应用。The volume data reconstruction module is used to read DICOM data and reconstruct it into volume data; DICOM (Digital Imaging and Communications in Medicine) data is medical digital imaging and communication data, which is an international standard for medical images and related information (IS012052). It defines a medical image format that can be used for data exchange with a quality that meets clinical needs. DICOM is widely used in medical radiology, cardiovascular imaging, and radiological diagnostic equipment (X-ray, CT, nuclear magnetic resonance, ultrasound, etc.), and has been increasingly used in other medical fields such as ophthalmology and dentistry.
虚拟现实医学图像渲染模块，用于把医学的体数据呈像在虚拟现实设备以及裸眼三维显示设备系统上；The virtual reality medical image rendering module is used to present the medical volumetric data on the virtual reality equipment and the naked-eye three-dimensional display equipment system;
分割模块，用于分割选取原始图像所需区域，对所需区域三维重建，获取三维模型面数据信息，分割出椎间盘、神经根和皮肤；选择骨组织阈值，分割出骨组织；The segmentation module is used to segment and select the required area of the original image, reconstruct the required area in 3D, obtain the data information of the 3D model surface, and segment the intervertebral disc, nerve root and skin; select the bone tissue threshold to segment the bone tissue;
孔镜规划模块，用于孔镜规划，定位穿刺针目标靶点；The borescope planning module is used for borescope planning and positioning of the target point of the puncture needle;
穿刺针入针规划模块，用于规划穿刺针的入针角度；The puncture needle insertion planning module is used to plan the insertion angle of the puncture needle;
入针查看模块，用于入针后查看不同方位下穿刺针的放置情况；The needle insertion viewing module is used to check the placement of the puncture needle in different directions after the needle is inserted;
显示或隐藏模块，用于显示皮肤后查看皮肤上穿刺针的入针点；Show or hide the module, which is used to view the entry point of the puncture needle on the skin after displaying the skin;
规划测量模块，用于得到皮肤交点距离人体中线的距离，皮肤交点距离病椎上缘面的距离以及入针深度；The planning measurement module is used to obtain the distance between the skin intersection point and the midline of the human body, the distance between the skin intersection point and the upper edge of the diseased vertebra, and the needle insertion depth;
工作管道建立模块，用于将穿刺针显示为工作管道；A working pipeline establishment module is used for displaying the puncture needle as a working pipeline;
蒙特卡罗物理模拟X光片生成模块，对体数据进行蒙特卡罗物理模拟方法，计算出不同角度的仿真二维X光片，以便用户在手术中进行对比应用；Monte Carlo physical simulation X-ray film generation module, which performs Monte Carlo physical simulation method on volume data, and calculates simulated two-dimensional X-ray films from different angles, so that users can compare and apply them in surgery;
报告查看模块，用于获取和查看穿刺针与横断面、矢状面、冠状面的角度；皮肤交点距离人体中线的距离、皮肤交点距离病椎上缘面的距离、入针深度；正位、侧位X光片，3D体正侧位。The report viewing module is used to obtain and view the angle between the puncture needle and the transverse plane, sagittal plane, and coronal plane; the distance between the skin intersection point and the midline of the human body, the distance between the skin intersection point and the upper edge of the diseased vertebra, and the needle insertion depth; Lateral X-ray film, 3D body positive and lateral.
还包括控制笔，用于直接控制和操作虚拟现实平台上的图像，使用操控笔过程中，操控笔笔尖会形成一条虚拟可视的直线，当碰到任一操作对象时，操控笔会产生震动，同时直线变色，表示当前碰到的对象可操作It also includes a control pen, which is used to directly control and operate the images on the virtual reality platform. During the use of the control pen, the tip of the control pen will form a virtual and visible straight line. When touching any operation object, the control pen will vibrate. At the same time, the line changes color, indicating that the object currently encountered can be operated
经皮椎间孔镜手术精准规划方法，如图1所示，按如下步骤：The precise planning method for percutaneous transforaminal endoscopic surgery is shown in Figure 1, and the steps are as follows:
步骤1：读取DICOM数据，重建为体数据；Step 1: Read DICOM data and reconstruct it as volume data;
步骤2：分割选取原始图像所需区域，对所需区域三维重建，获取三维模型面数据信息，分割出椎间盘、神经根和皮肤；选择骨组织阈值，分割出骨组织；Step 2: Segment and select the required area of the original image, reconstruct the required area in 3D, obtain the data information of the 3D model surface, segment the intervertebral disc, nerve root and skin; select the bone tissue threshold, and segment the bone tissue;
步骤3：进行孔镜规划，定位穿刺针目标靶点；Step 3: Carry out borescope planning and locate the target point of the puncture needle;
步骤4：规划穿刺针的入针角度；Step 4: Plan the needle entry angle of the puncture needle;
步骤5：入针后，查看不同方位下穿刺针的放置情况；Step 5: After the needle is inserted, check the placement of the puncture needle in different directions;
步骤6：显示或隐藏皮肤，查看皮肤上穿刺针的入针点；Step 6: Show or hide the skin, and check the entry point of the puncture needle on the skin;
步骤7：规划和测量，得到皮肤交点距离人体中线的距离，皮肤交点距离病椎上缘面的距离以及入针深度；Step 7: Plan and measure to obtain the distance between the skin intersection point and the midline of the human body, the distance between the skin intersection point and the upper edge of the diseased vertebra, and the needle insertion depth;
步骤8：建立工作管道，将穿刺针显示为工作管道；Step 8: Establish a working pipeline, and display the puncture needle as a working pipeline;
步骤9：通过对体数据进行蒙特卡罗物理模拟方法，生成模拟X光片；Step 9: Generate a simulated X-ray film by performing a Monte Carlo physical simulation method on the volume data;
步骤10：获取和查看报告。Step 10: Get and view reports.
其中，为体数据的方法为采用光线投射算法和三维重建技术，将传统的二维医学图像渲染成三维图像，并通过虚拟现实医学图像渲染模块，呈像于所有的虚拟现实设备。Among them, the method for volumetric data is to use ray-casting algorithm and 3D reconstruction technology to render traditional 2D medical images into 3D images, and use the virtual reality medical image rendering module to present images on all virtual reality devices.
其中，通过多态医学图像融合技术，把同一病人的CT和MRI数据进行人工智能化的区域识别，分割出椎间盘、神经根和皮肤的方法为：采用移动立方体算法，对不同的区域进行模型重建、颜色标注，输出三维医学网格模型。Among them, through polymorphic medical image fusion technology, the CT and MRI data of the same patient are recognized by artificial intelligence, and the method of segmenting the intervertebral disc, nerve root and skin is: using the moving cube algorithm to reconstruct the model of different regions , color labeling, and output the 3D medical grid model.
其中，分割出骨组织的方法为采用大津阈值分割算法，将图像灰度进行自适应的阈值分割，按照图像上灰度值的分布，将图像分成背景和前景两部分看待，前景就是我们要按照阈值分割出来的部分，背景和前景的分界值就是我们要求出的阈值，通过对图像灰度值信息进行统计，根据最大类间方差判断准则，可自适应得到将背景和前景尽可能分开的阈值，最终完成图像分割，从而分割出骨组织。Among them, the method of segmenting bone tissue is to use the Otsu threshold segmentation algorithm to perform adaptive threshold segmentation on the image grayscale. According to the distribution of grayscale values on the image, the image is divided into two parts, the background and the foreground. The foreground is what we need to follow. The cut-off value of the background and the foreground is the threshold value we require for the part separated by the threshold value. By counting the gray value information of the image and according to the maximum inter-class variance judgment criterion, the threshold value that separates the background and the foreground as much as possible can be adaptively obtained. , and finally complete the image segmentation, thereby segmenting the bone tissue.
定位穿刺针目标靶点的方法为：利用二维灰度图和定位功能，直接在二维图上定位，虚拟现实平台上的穿刺针实时同步于相应位置，精准确定目标靶点。The method of locating the target point of the puncture needle is: use the two-dimensional grayscale image and the positioning function to locate directly on the two-dimensional image, and the puncture needle on the virtual reality platform is synchronized with the corresponding position in real time to accurately determine the target point.
查看不同方位下穿刺针的放置情况的方法为：通过复位、操控缩放、操控移动和控制选中一种或几种结合的方式查看不同方位下穿刺针的放置情况。The method for viewing the placement of the puncture needles in different orientations is: to check the placement of the puncture needles in different orientations by means of resetting, manipulating zoom, manipulating movement, and controlling to select one or more combinations.
工作管道是模拟实际手术过程中与实际放置的管道大小一致，直观显示工作管道与人体各部位之间的关系。The size of the working pipeline is the same as that of the actual pipeline in the simulation of the actual operation process, and the relationship between the working pipeline and various parts of the human body is intuitively displayed.
本发明主要结合了传统二维医学图片、一键式虚拟现实重建、手势操控等优点，将病人医学影像进行虚拟重建显示，并进行一系列手术前准备工作。通过查看三维立体医学影像、定位穿刺针、工作管道目标位置、模拟手术过程、测量规划、手术培训等操作，用户可以直观地观察到工作管道与各关键部位(如神经根、上关节突、椎间盘等)之间的关系，并得到用户所需的病人手术相关数据，例如皮肤入针点距离人体中线的长度，皮肤入针点距离病椎上缘的距离，入针深度等，用户根据得到的相关数据进行手术规划，规划结果可直接用于手术过程，提高穿刺针穿刺的成功率。The present invention mainly combines the advantages of traditional two-dimensional medical pictures, one-button virtual reality reconstruction, gesture control, etc., performs virtual reconstruction and display of patient medical images, and performs a series of preoperative preparations. By viewing three-dimensional medical images, locating puncture needles, target positions of working pipelines, simulating surgical procedures, measurement planning, and surgical training, users can intuitively observe the working pipelines and key parts (such as nerve roots, superior articular processes, and intervertebral discs) etc.), and obtain the patient’s surgery-related data required by the user, such as the length of the skin needle entry point from the midline of the human body, the distance between the skin needle entry point and the upper edge of the diseased vertebra, and the needle entry depth. Relevant data are used for surgical planning, and the planning results can be directly used in the surgical process to improve the success rate of puncture needle puncture.
最后，以上仅为本发明的较佳实施例，并不用以限制本发明，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。Finally, the above are only preferred embodiments of the present invention, and are not intended to limit the present invention. Any modifications, equivalent replacements, improvements, etc. made within the spirit and principles of the present invention shall be included in the protection of the present invention. within range.
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