Chest segment dorsal root ganglion positioning method based on ultrasonic scanning

Abstract

The invention discloses a thoracic segment dorsal root ganglion positioning method based on ultrasonic scanning, and relates to the technical field of image recognition, and the method comprises the following steps: obtaining a nuclear magnetic resonance scanning image of a horizontal cross section of an intervertebral foramen / intervertebral space of a target thoracic vertebra segment, and measuring the nuclear magnetic resonance scanning image to obtain a first distance; setting a needle inserting scheme and a second distance based on the first distance, the pleural information and the rib information; pre-scanning the target puncture area of the patient through ultrasound, marking the position of the dorsal root ganglion and the position of the ultrasonic probe, and presetting a puncture point based on a second distance to complete the positioning of the thoracic segment dorsal root ganglion. A puncture path and a needle insertion point are preset according to the pleura position (pleura is avoided in the puncture process) in a nuclear magnetic resonance scanning image; measuring a vertical distance from a needle inserting point to a spinous process connecting line body surface projection line in a nuclear magnetic resonance image, and positioning a puncture point on the body surface of a patient in advance according to the vertical distance.

Description

[0001] This application is a divisional application. The application number of the original application is 202211484052.1, the application date is November 24, 2022, and the name of the invention is "A method for locating thoracic dorsal root ganglia and presetting puncture paths." Technical Field

[0002] The invention belongs to the technical field of image recognition, and in particular relates to a thoracic dorsal root ganglion positioning method based on ultrasonic scanning. Background Art

[0003] Thoracic dorsal root nerve puncture positioning is mostly performed under the guidance of C-arms. However, this process requires repeated radiation exposure, and the impact of radioactive contamination on the health of doctors and patients cannot be ignored. In addition, the actual needle insertion process under C-arm guidance is still blind, and the needle tip position is only verified by C-arm after puncture. Therefore, the puncture process still has the risk of damaging surrounding tissues, especially the pleura. Ultrasound real-time guided puncture has the advantages of not only no radioactive contamination, but also the advantages of being able to observe the needle tip and needle body in real time and guide the adjustment of the puncture direction, that is, to avoid exposure of doctors and patients to radiation contamination, and at the same time significantly improve the safety of the puncture process, so it has become a new method that clinicians are keen to choose. However, since the thoracic dorsal root ganglion is located in the intervertebral foramen and the ventral side of the lamina, when the ultrasound probe is scanned through the dorsal side of the patient, the ultrasound beam is blocked by the lamina bone, resulting in the inability to accurately locate the dorsal root ganglion position. Therefore, it is urgent to propose a thoracic dorsal root ganglion positioning method based on ultrasound scanning. Summary of the invention

[0004] The purpose of the present invention is to provide a thoracic dorsal root ganglion positioning method based on ultrasound scanning, which can accurately position the thoracic dorsal root ganglion in the absence of radiation.

[0005] To achieve the above object, the present invention provides a method for locating thoracic dorsal root ganglia based on ultrasound scanning, comprising the following steps:

[0006] Acquire a nuclear magnetic resonance scan image of a horizontal cross section of the intervertebral foramen / intervertebral space of the target thoracic vertebral segment and measure the nuclear magnetic resonance scan image to acquire a first distance;

[0007] Setting a needle insertion plan and a second distance based on the first distance, pleural information and rib information;

[0008] The target puncture area of ​​the patient is pre-scanned by ultrasound, the position of the dorsal root ganglion and the position of the ultrasound probe are marked, and the puncture point is preset based on the second distance to complete the positioning of the thoracic dorsal root ganglion.

[0009] Optionally, measuring the nuclear magnetic resonance scan image specifically includes:

[0010] Measuring a first distance from the body surface to the dorsal root ganglion based on the nuclear magnetic resonance scan image;

[0011] The optimal path for puncturing the dorsal root ganglion through the body surface is designed according to the shape of the pleura, and the puncture point is located on the body surface accordingly, and the second distance from the puncture point to the perpendicular line of the spinous process midline is measured.

[0012] Optionally, converting the measured nuclear magnetic resonance scan image specifically includes: converting the first distance into an actual distance A and converting the second distance into an actual distance B according to a scale of the nuclear magnetic resonance image.

[0013] Optionally, the optimal route for puncturing the dorsal root ganglion through the body surface can be designed based on the pleural shape, including:

[0014] A straight line is drawn upward and outward from the dorsal root ganglion, with one end of the straight line starting from the dorsal root ganglion and the other end being the intersection of the straight line and the skin on the same side of the body. The intersection is the designed needle insertion site; the optimal path is flat and does not touch the pleura.

[0015] Optionally, the target puncture area of ​​the patient may be pre-scanned by ultrasound, specifically including:

[0016] Using ultrasound longitudinal scanning to locate the intervertebral foramen / intervertebral body space plane of the target spinal segment, and using ultrasound probe transverse scanning at the intervertebral foramen / intervertebral body space plane of the target spinal segment to obtain a scanning plane, and locating the target segment vertebral body, vertebral plate, and pleural structure in the ultrasound image of the scanning plane;

[0017] The target line is placed along the outside of the vertebral plate in the ultrasound image, and the end point of the target line is placed at the location of the dorsal root ganglion. The starting point of the target line is the upper edge of the ultrasound image, and the running direction is perpendicular to the upper edge of the ultrasound image. The length of the target line is set to A, and the point at the back midline of the target segment on the patient's body surface is marked as C on the body surface.

[0018] Optionally, using ultrasound to locate the intervertebral foramen / intervertebral space of the target stage, and locating the target segment vertebral body, vertebral plate, and pleural structure in the ultrasound image when the ultrasound probe is scanned in the transverse axis, specifically includes:

[0019] Based on the MRI image and the depth of distance A, the position of the dorsal root ganglion is marked in the ultrasound image. Using the built-in target line function of the ultrasound instrument, the target line is placed at a vertical position on the body surface 1 to 2 mm inward from the lateral edge of the acoustic shadow of the vertebral plate.

[0020] Optionally, based on the target puncture area, puncturing through point C on the body surface, and inserting the needle in a direction pointing to the end of the target line specifically includes:

[0021] The position of the target line in the ultrasound image is consistent with that in the pre-scan, parallel to the lateral edge of the acoustic shadow of the vertebral lamina, and 1 to 2 mm inside the lateral edge.

[0022] Technical effect of the present invention: The present invention discloses a method for locating thoracic dorsal root ganglia based on ultrasound scanning, which uses magnetic resonance imaging to calculate the depth of the dorsal root ganglia, and guides the operator to locate the position of the dorsal root ganglia in the ultrasound image, and marks it with a marking line; the puncture path and needle insertion point are preset according to the position of the pleura (avoiding the pleura during the puncture process); the distance from the needle insertion point to the midline of the spine is measured, and the puncture point is located in advance on the patient's body surface based on this. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] The drawings constituting a part of the present application are used to provide a further understanding of the present application. The illustrative embodiments and descriptions of the present application are used to explain the present application and do not constitute an improper limitation on the present application. In the drawings:

[0024] Figure 1 It is a schematic flow chart of a method for locating thoracic dorsal root ganglia based on ultrasound scanning according to an embodiment of the present invention;

[0025] Figure 2 A schematic diagram of measuring a nuclear magnetic resonance image and obtaining a first distance and a second distance according to an embodiment of the present invention;

[0026] Figure 3 A schematic diagram of locating the dorsal root ganglion position in an ultrasound image and presetting the puncture path according to the measurement results of a nuclear magnetic resonance image according to an embodiment of the present invention;

[0027] Among them, the * is the lateral edge of the lamina, the dotted line is the target line of the ultrasound instrument, and the end cross line is the end of the target line. DETAILED DESCRIPTION

[0028] It should be noted that, in the absence of conflict, the embodiments and features in the embodiments of the present application can be combined with each other. The present application will be described in detail below with reference to the accompanying drawings and in combination with the embodiments.

[0029] It should be noted that the steps shown in the flowcharts of the accompanying drawings can be executed in a computer system such as a set of computer executable instructions, and that, although a logical order is shown in the flowcharts, in some cases, the steps shown or described can be executed in an order different from that shown here.

[0030] like Figure 1-3 As shown, this embodiment provides a method for locating thoracic dorsal root ganglia based on ultrasound scanning, comprising the following steps:

[0031] Acquire a nuclear magnetic resonance scan image of a horizontal cross section of the intervertebral foramen / intervertebral space of the target thoracic vertebral segment and measure the nuclear magnetic resonance scan image to acquire a first distance;

[0032] Setting a needle insertion plan and a second distance based on the first distance, pleural information and rib information;

[0033] The target puncture area of ​​the patient is pre-scanned by ultrasound, the position of the dorsal root ganglion and the position of the ultrasound probe are marked, and the puncture point is preset based on the second distance to complete the positioning of the thoracic dorsal root ganglion.

[0034] Further optimizing the scheme, measuring the nuclear magnetic resonance scan image specifically includes:

[0035] Measuring a first distance from the body surface to the dorsal root ganglion based on the nuclear magnetic resonance scan image;

[0036] The optimal path for puncturing the dorsal root ganglion through the body surface is designed according to the shape of the pleura, and the puncture point is located on the body surface accordingly, and the second distance from the puncture point to the perpendicular line of the spinous process midline is measured.

[0037] A further optimization scheme is to convert the measured MRI scan image, specifically including: converting the first distance into the actual distance A and converting the second distance into the actual distance B according to the scale of the MRI image.

[0038] Further optimization of the scheme, based on the shape of the pleura, the optimal path for puncturing through the body surface to the dorsal root ganglion is designed, including:

[0039] A straight line is drawn upward and outward from the dorsal root ganglion, with one end of the straight line starting from the dorsal root ganglion and the other end being the intersection of the straight line and the skin on the same side of the body. The intersection is the designed needle insertion site; the optimal path is flat and does not touch the pleura.

[0040] To further optimize the solution, ultrasound pre-scans the patient's target puncture area, including:

[0041] Using ultrasound longitudinal scanning to locate the intervertebral foramen / intervertebral body space plane of the target spinal segment, and using ultrasound probe transverse scanning at the intervertebral foramen / intervertebral body space plane of the target spinal segment to obtain a scanning plane, and locating the target segment vertebral body, vertebral plate, and pleural structure in the ultrasound image of the scanning plane;

[0042] The target line is placed along the outside of the vertebral plate in the ultrasound image, and the end point of the target line is placed at the location of the dorsal root ganglion. The starting point of the target line is the upper edge of the ultrasound image, and the running direction is perpendicular to the upper edge of the ultrasound image. The length of the target line is set to A, and the point at the back midline of the target segment on the patient's body surface is marked as C on the body surface.

[0043] Further optimization scheme, using ultrasound to locate the target stage intervertebral foramen / vertebral body space, and locating the target segment vertebral body, lamina, and pleural structure in the ultrasound image when the ultrasound probe is scanned in the transverse axis, specifically including:

[0044] Based on the MRI image and the depth of distance A, the position of the dorsal root ganglion is marked in the ultrasound image. Using the built-in target line function of the ultrasound instrument, the target line is placed at a vertical position on the body surface 1 to 2 mm inward from the lateral edge of the acoustic shadow of the vertebral plate.

[0045] Further optimization scheme, based on the target puncture area, punctures the needle through point C on the body surface, and the needle insertion direction points to the end of the target line, specifically including:

[0046] The position of the target line in the ultrasound image is consistent with that in the pre-scan, parallel to the lateral edge of the acoustic shadow of the vertebral lamina, and 1 to 2 mm inside the lateral edge.

[0047] Step 1: Before the operation, perform a plain MRI scan of the thoracic intervertebral foramen / intervertebral space on the patient to obtain the MRI image of the segment. Measure the vertical distance from the dorsal root ganglion to the skin in the image (distance A), and preset the optimal needle insertion path (the needle insertion path should be as smooth as possible and avoid the pleura) and the needle insertion point according to the position and angle of the pleura and ribs, and measure the distance from the needle insertion point to the midline (distance B). Figure 2 shown.

[0048] Step 2: The patient lies prone, and ultrasound is used to pre-scan the target puncture area. Based on the MRI image and the depth of distance A, the dorsal root ganglion position is marked in the ultrasound image. Using the built-in target line function of the ultrasound instrument, the starting end of the target line is placed at a vertical position on the body surface 1-2 mm inward from the outer edge of the lamina acoustic shadow (referring to the position in the ultrasound image); the end of the target line is placed at the depth of A from the body surface, and the position of the ultrasound probe is recorded on the body surface. Based on the predicted distance B, the preset puncture site C is marked on the body surface at a distance equal to B from the midline (the midline of the back of the human body, i.e., the position of the line connecting the spinous processes) in the target intervertebral space.

[0049] Step 3: Under the guidance of real-time ultrasound, puncture is performed through the surface puncture point C, and the needle is inserted from the outside to the inside in the plane until it reaches the end of the target line. During the whole process, ensure that the position of the target line in the ultrasound image is consistent with the position during the pre-scan, that is, parallel to the outer edge of the acoustic shadow of the vertebral lamina and 1-2 mm inside the outer edge.

[0050] The present invention discloses a method for locating thoracic dorsal root ganglia based on ultrasound scanning. The method uses magnetic resonance imaging to calculate the depth of the dorsal root ganglia, and guides the operator to locate the dorsal root ganglia in the ultrasound image and mark it with a marking line. The puncture path and the needle insertion point are preset according to the position of the pleura (avoiding the pleura during the puncture process). The distance from the needle insertion point to the midline of the spine is measured, and the puncture point is located in advance on the patient's body surface based on the calculation.

[0051] The above is only a preferred specific implementation of the present application, but the protection scope of the present application is not limited thereto. Any changes or substitutions that can be easily thought of by a person skilled in the art within the technical scope disclosed in the present application should be included in the protection scope of the present application. Therefore, the protection scope of the present application should be based on the protection scope of the claims.

Claims

1. A method for locating thoracic dorsal root ganglia based on ultrasound scanning, characterized in that: The following steps are involved: Acquire a nuclear magnetic resonance scan image of a horizontal cross section of the intervertebral foramen / intervertebral space of the target thoracic vertebral segment and measure the nuclear magnetic resonance scan image to acquire a first distance; Setting a needle insertion plan and a second distance based on the first distance, pleural information, and rib information; Pre-scan the patient's target puncture area with ultrasound, mark the dorsal root ganglion position and the ultrasound probe position, and preset the puncture point based on the second distance to complete the positioning of the thoracic dorsal root ganglion; The measurement of the nuclear magnetic resonance scan image specifically includes: The first distance from the body surface to the dorsal root ganglion is measured based on the MRI scan image; the optimal path for puncturing the dorsal root ganglion through the body surface is designed according to the pleural shape, and the puncture point is located on the body surface accordingly, and the second distance from the puncture point to the vertical line of the spinous process midline is measured; The best route for puncturing the dorsal root ganglion through the body surface according to the pleural shape includes: Draw a straight line from the dorsal root ganglion to the outside and above. One end of the straight line starts from the dorsal root ganglion, and the other end is the intersection of the straight line and the skin on the same side. The intersection is the designed needle insertion site. The best path is flat and does not touch the pleura.

2. A method for locating thoracic dorsal root ganglia based on ultrasound scanning as claimed in claim 1, characterized in that: The measured nuclear magnetic resonance scan image is converted, specifically including: converting the first distance into the actual distance A and converting the second distance into the actual distance B according to the scale of the nuclear magnetic resonance image.

3. The method for locating thoracic dorsal root ganglia based on ultrasound scanning according to claim 1, characterized in that: The target puncture area of ​​the patient through ultrasound pre-scanning specifically includes: Using ultrasound longitudinal scanning to locate the intervertebral foramen / intervertebral space plane of the target spinal segment, and using ultrasound probe transverse scanning to obtain the scanning plane at the intervertebral foramen / intervertebral space plane of the target spinal segment, and locating the vertebral body, lamina, and pleural structure of the target segment in the ultrasound image of the scanning plane; The target line is placed along the outside of the vertebral lamina in the ultrasound image, and the end point of the target line is placed at the location of the dorsal root ganglion. The starting point of the target line is the upper edge of the ultrasound image, and the running direction is perpendicular to the upper edge of the ultrasound image. The length of the target line is set to A, and the point B beside the midline of the back of the target segment on the patient's body surface is marked as C on the body surface.

4. A method for locating thoracic dorsal root ganglia based on ultrasound scanning as claimed in claim 3, characterized in that: Use ultrasound to locate the intervertebral foramen / intervertebral space of the target stage, and locate the target segment vertebral body, vertebral plate, and pleural structure in the ultrasound image when the ultrasound probe is scanned in the transverse axis. Specifically include: Based on the MRI image and the depth of distance A, the position of the dorsal root ganglion is marked in the ultrasound image. Using the built-in target line function of the ultrasound instrument, the target line is placed at a vertical position on the body surface 1 to 2 mm inward from the lateral edge of the acoustic shadow of the vertebral plate.

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