Method of 3D contrast visualization with formation of volumetric mapping and navigation of soft and hard tissue formations in humans based on ultrasound examination data

Abstract

FIELD: surgery.SUBSTANCE: invention can be used for 3D contrast visualization with the formation of volumetric mapping and navigation of soft and hard tissue formations in humans based on ultrasound examination data. An ultrasound scan of the area of the formation and surrounding tissues is performed with a 5 MHz or higher sensor to clarify the location, nature, and boundaries of the pathological process. Scan data are loaded into 3D modelling software. A spatial map of the location of formations with a coordinate system is formed, their sizes, quantity and relative positions are determined. The distances from the skin surface to the formations are measured. Maps in digital video and photo formats are saved.EFFECT: increased efficiency and accuracy of surgical interventions, isolation and removal of tumours, stones, vascular anatomical and pathological formations by obtaining a detailed three-dimensional model of anatomical structures with precise reference to real spatial coordinates and the possibility of interactive planning of surgical access.2 cl, 3 ex

Description

[0001] The invention relates to medicine, namely to surgery, and can be used to perform 3D contrast visualization with the formation of volumetric mapping and navigation of soft and hard tissue formations of a person based on ultrasound examination data - scanning of a person for performing surgical operations and other manipulations.

[0002] A method of 3D ultrasound scanning of the uterus is known for differentiating the saddle-shaped intrauterine septum and determining vascular blood flow for the purpose of surgical treatment [Patent RU 2707865 C1, 04 / 25 / 2019].

[0003] The disadvantage of this method is that there are no 3D reformats of intra-tissue structures: nerves, vessels, soft and hard tissue formations, only the uterine cavity and structures of the uterine cavity.

[0004] A method for obtaining 3D ultrasound tomographic images and a device for implementing it are known [Patent EA 036092 dated 07 / 18 / 2018].

[0005] The disadvantage of this method is that it requires a special ultrasound tomograph – 3D ultrasound scanner equipment.

[0006] A method of intraoperative contrast ultrasound diagnostics of uterine diseases is known [Patent RU 2188580 C1 dated 04 / 18 / 2001].

[0007] This method is an invasive surgical method using multiple sensors simultaneously without obtaining a single 3D volumetric image, navigation and mapping, and is only applicable to the uterus.

[0008] The objective of the proposed invention is to develop a method for obtaining a fundamentally new technology for planning and designing treatment for a patient by constructing a spatial three-dimensional navigation map with orientation coordinate points and spatial anatomotopic contrasting - highlighting anatomical formations (peripheral nerves, vessels, tumor formations, tissue infiltrates, stones) by ultrasound scanning of the patient and converting the scanning data into three-dimensional images with subsequent contrasting anatomotopic highlighting of anatomical and pathological formations with their mapping and the introduction of a coordinate system and dimensional indicators.

[0009] The proposed method uses the construction of a spatial, contrasting three-dimensional model of the shape and structure of soft and hard tissue anatomical structures of a person - their 3D isolated high-resolution reformats based on ultrasound (ultrasound) data and sections with their contrast highlighting (using additional software) of anatomical formations.

[0010] The proposed method allows to determine the personalized volume, structure, shape, density of each tissue element of the formation, their spatial relationship and mutual orientation - to form a volumetric three-dimensional image with mapping of the tissue (solid, including stones or soft tissue formations) structure along its entire length and to create a three-dimensional spatial map - to measure the distance in relation to reference surfaces and points for navigation of surgical manipulations and operations.

[0011] The proposed method significantly increases the efficiency and accuracy of surgical operations and manipulations for the introduction of medicinal and cosmetic substances, the isolation and removal of tumor formations, stones, vascular anatomical and pathological formations, reducing the likelihood of damage to peripheral nerves, vessels, including small ones, starting from 2 mm in diameter, due to a complete spatially oriented calculation of the volume of vascular formations, their interrelationships and interrelations with each other, as well as detailed navigation of the ultrasound sensor taking into account the obtained 3D spatial reformats of vascular formations.

[0012] The technical result of the proposed invention is an increase in the efficiency and accuracy of surgical interventions for the introduction of medicinal and cosmetic substances, the isolation and removal of tumor formations, stones, vascular anatomical and pathological formations, and a reduction in the likelihood of damage to peripheral nerves.

[0013] The technical result is achieved by a method of 3D contrast visualization with the formation of volumetric mapping and navigation of soft and hard tissue formations of a person based on ultrasound examination data - scanning of a person, characterized by the sequential implementation of the following stages:

[0014] At the first stage, to clarify the localization, nature and boundaries of the pathological process, a preliminary ultrasound scan of the anatomical area of ​​the formation and surrounding tissues is carried out using an ultrasound sensor with a frequency of 5 MHz or higher;

[0015] In the second stage, to obtain 3D models of the required anatomical structures, the ultrasound scanning data is loaded into programs to obtain 3D reformats with digital selection and reformation;

[0016] at the third stage, using a program for obtaining 3D reformats, a spatial map of the formations is formed with the corresponding coordinate system and boundaries of the pathological process - the sizes of the formations and the total number of elements of the formations, while measurements of the distance are taken in relation to reference surfaces and reference points;

[0017] at the fourth stage, based on the obtained 3D reformats, taking into account their complete spatial map and coordinate system, as well as reference points: the size of the formations, the total number of formations, an accurate calculation of the formations is carried out - the location of anatomical and pathological formations from spatial reference points - from the surface of the skin;

[0018] At the fifth stage, the data from the spatial navigation map with anatomical and topographic contrasting of the identified anatomical and pathological elements - formations in digital video and photo formats are transferred to the operating surgeon, on the basis of which the anatomical elements are identified and pathological formations are removed.

[0019] A spatial navigation map of formations with their 3D reformats is used as an addition to an ultrasound sensor during biopsy of formations and manipulation of a puncture needle.

[0020] The invention works as follows.

[0021] To clarify the localization, nature and boundaries of the pathological process, a preliminary ultrasound scan of the anatomical area of ​​the formation and surrounding tissues is performed with an ultrasound sensor with a frequency of 5 MHz or higher, depending on the anatomical or pathological formation.

[0022] Then, to obtain 3D models of the required anatomical structures, the ultrasound scan data is loaded into programs for generating 3D reformats with digital extraction and reformatting. Applications with digital augmentation are used.

[0023] The program generates a spatial map of lesions (3D reformats) with a corresponding coordinate system and the boundaries of the pathological process (lesion sizes and the total number of elements in the lesions). The map of lesions is created by measuring the distance relative to reference surfaces and points.

[0024] Then, using the obtained 3D reformats, taking into account their complete spatial map and coordinate system, reference points (size of formations, total number of formation elements), an accurate calculation of formations is carried out - the location of anatomical and pathological formations from spatial reference points - from the skin surface.

[0025] Then the data from the spatial navigation map with anatomical and topographic contrasting of the identified anatomical and pathological elements in digital video and photo formats is transmitted to the operating surgeon, on the basis of which the anatomical structures are identified and pathological structures are removed.

[0026] A spatial navigation map of formations with their 3D reformats is used as an addition to an ultrasound sensor during biopsy of formations and manipulation of a puncture needle.

[0027] The proposed method is confirmed by clinical examples.

[0028] Clinical Example No. 1

[0029] Patient B.M.A., 23 years old.

[0030] Diagnosis: soft tissue formation in the right parotid-masticatory region.

[0031] The patient underwent: preliminary ultrasound scanning of the soft tissue formation area and surrounding tissues with a 20 MHz ultrasound transducer, the scan data files were copied, after which the data was loaded into the program to obtain 3D reformats with selection and reformation - obtaining a 3D model of the soft tissue formation - a precision calculation of the formations was carried out in the software application based on the obtained 3D reformats, taking into account their connections to each other - anastomosis and a complete picture of the formation - the total number of elements of the formations, as well as visualization and orthotopic contrasting with spatial selection and formation of mapping of the branches of the facial nerve passing under the soft tissue formation.

[0032] As a result of which it was revealed:

[0033] 2 voluminous soft tissue formations with a diameter of 2.5 and 3 mm, respectively, located at a depth from the skin surface of 4 mm, 8 mm, 5 mm, 7 mm along their length from the posterior-dorsal to the anterior ventral pole.

[0034] The branches of the facial nerve were located under the formation at a depth of 15 mm, 13 mm, 14 mm, 11 mm, respectively, from the posterior-dorsal to the anterior ventral pole of the formation.

[0035] The patient successfully underwent a puncture biopsy of the formation, targeted cytological material was obtained, no deficit in facial nerve function was observed, and there was no tissue edema.

[0036] A 3D navigation map of the formations with their 3D reformats was also used as an addition to the ultrasound sensor during formation biopsy and puncture needle manipulation.

[0037] By volumetric indicators – irregular geometric multilayer shape.

[0038] Clinical Example No. 2

[0039] Patient I.L.I., 34 years old.

[0040] Diagnosis: venous malformation of the parotid-buccal region on the right.

[0041] During preliminary ultrasound scanning and obtaining 3D reformats and mapping of vascular neoplasms, malformations were detected.

[0042] For treatment according to the proposed method, a 3D navigation map of formations with their 3D reformats was used as an addition to the ultrasound sensor during the introduction of a sclerosant with the calculation of the location of the elements of vascular formations - malformations in relation to each other and other anatomical landmarks.

[0043] It was detected:

[0044] Volumetric Calculation Data

[0045] Formation No. 1 - 250 mm cu.

[0046] Formation No. 2 – 170 mm cu.

[0047] Formation No. 3 – 78 mm cu.

[0048] Location of formations

[0049] Formation No. 1– 250 mm3 – 3 mm, 2.7 mm, 3.2 mm from the skin surface in the dorsal-ventral direction from the skin surface.

[0050] Location of the facial nerve and its branches in this area: 11 mm, 12.1 mm, 10.0 mm, respectively.

[0051] From the lower wall of the formation: 2.8 mm, 2.0 mm, 1.8 mm, respectively, in the dorsal-ventral direction

[0052] Formation No. 2– 170 mm3 – 3.7 mm, 3.1 mm, 2.9 mm from the skin surface in the dorsal-ventral direction from the skin surface.

[0053] Formation No. 3– 78 mm cu. – 4.2 mm, 3.7 mm, 2.5 mm from the skin surface in the dorsal-ventral direction from the skin surface.

[0054] General anastomoses in the horizontal transverse plane:

[0055] Formation No. 1 - 250 mm cu.

[0056] Formation No. 2 – 170 mm cu.

[0057] General anastomoses in the vertical plane:

[0058] Formation No. 1 - 250 mm cu.

[0059] Formation No. 8 – 80 mm cu.

[0060] Isolated vascular lesions:

[0061] Formation No. 3 – 75 mm cu.

[0062] Treatment was performed according to the stated method, taking into account the calculations of the volume - the total anastomosing volume, was introduced

[0063] Serving No. 1

[0064] General anastomoses in the horizontal transverse plane:

[0065] Formation No. 1 - 250 mm cu.

[0066] Formation No. 2 – 170 mm cu.

[0067] General anastomoses in the vertical plane:

[0068] Formation No. 1 - 250 mm cu.

[0069] 0.672 cm3 – 0.672 ml + 0.11 ml taking into account filling according to ultrasound control data.

[0070] Isolated vascular lesions:

[0071] Formation No. 3 – 75 mm cu.

[0072] Serving No. 2

[0073] Education No. 3

[0074] 0.075 cm3 + 0.01 ml (additionally according to ultrasound monitoring data).

[0075] Serving No. 3

[0076] Education No. 4

[0077] 0.03 cm3 + 0.02 ml (additionally according to ultrasound monitoring data).

[0078] A 3D navigation map of formations with their 3D reformats was used as an addition to the ultrasound sensor during the introduction of a sclerosant with the calculation of the location of the elements of vascular formations - malformations in relation to each other and other anatomical landmarks of the branches of the facial nerve.

[0079] In the early postoperative period (1-5 days), the patient experienced slight swelling on the right side, which did not cause any discomfort, except for temporary aesthetic concerns. The swelling completely resolved spontaneously within 6 days after the procedure. On the 28th day after surgery, the patient returned for a follow-up examination. Pale pink, intact skin surfaces were visible at the site of the previously located venous malformation. There were no clinical manifestations of the disease. One session of sclerotherapy was required to achieve recovery.

[0080] No evidence of facial nerve dysfunction was detected throughout the treatment period.

[0081] Clinical Example No. 3

[0082] Patient S.A.V., 29 years old.

[0083] Diagnosis: age-related changes in facial soft tissues, condition after COVID-19.

[0084] The patient was treated using the proposed method.

[0085] Preliminary ultrasound scanning of the anatomical area and surrounding tissues was carried out with a 22 MHz ultrasound sensor, the scan data files were copied, after which the data was loaded into programs to obtain 3D reformats with the selection and reformation of a 3D model of the necessary anatomical formations - branches of the facial nerve in the area of ​​​​the proposed introduction of a revitalizant solution (vitamin-collagen composition) is carried out. An accurate calculation of the formations in the software application is carried out based on the obtained 3D reformats, taking into account their complete spatial map and coordinate system and reference points - the size of the formations - the total number of elements of the formations - branches of the facial nerve on both sides.

[0086] Right:

[0087] Location – the boundaries of the dermal layer in the area of ​​drug administration from the skin surface

[0088] According to the designated points:

[0089] 1. 2.3 mm,

[0090] 2. 2.1 mm,

[0091] 3. 0.98 mm,

[0092] 4. 0.96 mm,

[0093] 5. 1.98 mm.

[0094] Location – boundaries of the branches of the facial nerve in the area of ​​drug administration from the skin surface:

[0095] 1. 11 mm,

[0096] 2. 12.2 mm,

[0097] 3. 89.7 mm,

[0098] 4. 89.8 mm,

[0099] 5. 11.2 mm.

[0100] Video and photo images of the volumetric anatomical location of the anatomical structures were transferred to the surgeon for the introduction of a revitalizing cosmetic mixture of the drug with additional ultrasound control of the introduction.

[0101] The effect after the procedure is positive.

[0102] No evidence of facial nerve dysfunction, minimal swelling.

[0103] Thus, the use of the proposed method significantly increases the effectiveness of surgical interventions and manipulations, reduces their trauma, and also introduces controllability of surgical manipulations and operations and the likelihood of damage to nerve and vascular structures.

Claims

1. A method of 3D contrast visualization with the formation of volumetric mapping and navigation of soft and hard tissue formations in humans based on ultrasound examination data, characterized by the sequential implementation of the following stages: At the first stage, to clarify the localization, nature and boundaries of the pathological process, a preliminary ultrasound scan of the anatomical area of ​​the formation and surrounding tissues is carried out using an ultrasound sensor with a frequency of 5 MHz or higher; At the second stage, to obtain 3D models of the anatomical structures being studied, the ultrasound scanning data is loaded into programs for obtaining 3D reformats with digital selection and reforming; At the third stage, using a program for obtaining 3D reformats, a spatial map of the location of pathological formations is formed with the corresponding coordinate system; the size of the formations and the total number of elements of the formations are determined, the location of pathological formations in relation to each other and to anatomical formations is determined; at the fourth stage, the distance from the skin surface to the identified anatomical and pathological formations is determined; At the fifth stage, the spatial navigation map data with anatomical and pathological contrasting of the identified anatomical and pathological formations is saved in digital video and photo formats.

2. The method according to paragraph 1, characterized in that the spatial navigation map of formations with their 3D reformats is used as an addition to the ultrasound sensor during biopsy of formations and manipulation of a puncture needle.