A method for locating thoracic dorsal root ganglia based on ultrasound scanning

Abstract

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

Description

[0001] The application is a divisional application, the original application number of which is 202211484052.1, the filing date of which is November 24, 2022, and the invention name of which is "a method for positioning thoracic dorsal root ganglion and presetting puncture path". TECHNICAL FIELD

[0002] The application belongs to the technical field of image recognition, and particularly relates to a thoracic dorsal root ganglion positioning method based on ultrasonic scanning. BACKGROUND

[0003] Thoracic dorsal root ganglion puncture positioning is usually performed under C-arm guidance, however, the process needs to be repeatedly radiated, and the influence of radioactive pollution on the health of doctors and patients cannot be ignored. In addition, the actual needle insertion process of C-arm guidance operation is still blind puncture, and the position of the needle tip is only verified after puncture by using a C-arm, so there is still a risk of damaging the surrounding tissue, especially the pleura, in the puncture process. Ultrasonic real-time guidance puncture has the advantages of no radioactive pollution and can dynamically observe the needle tip and needle body insertion path and guide the adjustment of the puncture direction at all times, that is, the doctors and patients are avoided from being exposed to radioactive pollution, and the safety of the puncture process is obviously improved, so it has become a new method that clinicians prefer. However, since the thoracic dorsal root ganglion is located in the intervertebral foramen and the ventral surface of the lamina, when the ultrasonic probe is scanned through the back of the patient, the ultrasonic beam is blocked by the bone of the lamina, so that the position of the dorsal root ganglion cannot be accurately positioned. Therefore, it is urgent to propose a thoracic dorsal root ganglion positioning method based on ultrasonic scanning. SUMMARY

[0004] The purpose of the present application is to provide a thoracic dorsal root ganglion positioning method based on ultrasonic scanning, which can accurately position the thoracic dorsal root ganglion without radiation.

[0005] To achieve the above-mentioned purpose, the present application provides a thoracic dorsal root ganglion positioning method based on ultrasonic scanning, comprising the following steps:

[0006] Obtaining a magnetic resonance scan image of the target thoracic vertebra segment intervertebral foramen / intervertebral space horizontal cross section and measuring the magnetic resonance scan image to obtain a first distance;

[0007] Based on the first distance, pleural information and rib information, setting a needle insertion scheme and a second distance;

[0008] Through ultrasonic pre-scanning of the target puncture area of the patient, marking the position of the dorsal root ganglion and the position of the ultrasonic probe, and presetting a puncture point based on the second distance, the thoracic dorsal root ganglion positioning is completed.

[0009] Optionally, the measurement of the magnetic resonance scan image specifically comprises:

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

[0011] designing an optimal path from the body surface to the dorsal root ganglion according to the pleura shape, and positioning a puncture point on the body surface according to the optimal path, and measuring a second distance from the puncture point to a vertical line of the spinous process midline.

[0012] Optionally, the nuclear magnetic resonance scan image after measurement is converted, specifically including: converting the first distance into an actual distance A and the second distance into an actual distance B according to the nuclear magnetic resonance image scale.

[0013] Optionally, the designing of the optimal path from the body surface to the dorsal root ganglion according to the pleura shape specifically includes:

[0014] drawing a straight line from the dorsal root ganglion to the outside and upward, one end of the straight line is from the dorsal root ganglion, and the other end is the intersection of the straight line and the ipsilateral body surface skin, and the intersection is the designed needle entry point; the optimal path is gentle and does not contact the pleura.

[0015] Optionally, the pre-scanning of the target puncture area of the patient by ultrasound specifically includes:

[0016] positioning the target spinal segment intervertebral foramen / intervertebral space plane by longitudinal axis scanning of ultrasound, and positioning the target segment vertebral body, lamina, and pleural structure in the ultrasound image of the scanning plane by transverse axis scanning of the ultrasound probe at the target spinal segment intervertebral foramen / intervertebral space plane;

[0017] placing the target line along the lateral side of the lamina in the ultrasound image, and placing the end point of the target line at the position of the dorsal root ganglion, the start point of the target line is the upper edge of the ultrasound image, the running direction is perpendicular to the upper edge of the ultrasound image, the length of the target line is set as A, and a body surface mark C is made at a position point B away from the dorsal midline of the target segment.

[0018] Optionally, the positioning of the target stage intervertebral foramen / intervertebral space by ultrasound and the positioning of the target segment vertebral body, lamina, and pleural structure in the ultrasound image under the condition of transverse axis scanning of the ultrasound probe specifically includes:

[0019] annotating the position of the dorsal root ganglion in the ultrasound image according to the nuclear magnetic image and the depth of distance A, and placing the target line to the inside 1-2 mm of the lateral edge of the lamina acoustic shadow on the body surface perpendicular position.

[0020] Optionally, based on the target puncture area, the needle is punctured from the body surface C point, and the puncture direction points 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 lamina acoustic shadow 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 mark 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 accompanying drawings, which constitute part of this application, are intended to provide a further understanding of this application. The exemplary embodiments and descriptions of this application are intended to explain this application and do not constitute an improper limitation on this application. In the accompanying drawings:

[0024] Figure 1 Schematic diagram of the flow 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 based on the measurement results of an MRI image according to an embodiment of the present invention;

[0027] Among them, * 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 of the embodiments in this 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 image of a horizontal cross section of the intervertebral foramen / intervertebral space of the target thoracic vertebral segment and measure the nuclear magnetic resonance image to obtain 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 patient's target puncture area 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 solution, 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 puncture to the dorsal root ganglion through the body surface was designed according to the pleural shape, and the puncture point was located on the body surface accordingly, and the second distance from the puncture point to the perpendicular line of the spinous process midline was measured.

[0037] A further optimization scheme converts 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 plan, based on the pleural contour, to design the optimal path for transcorporeal puncture to the dorsal root ganglion, specifically includes:

[0039] A straight line is drawn outward and upward 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. 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, specifically including:

[0041] Locating the intervertebral foramen / intervertebral body space plane of the target spinal segment using ultrasound longitudinal scanning, and scanning the intervertebral foramen / intervertebral body space plane of the target spinal segment using ultrasound probe transversely to obtain a scanning plane, and locating the target segment vertebral body, vertebral lamina, and pleural structures 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 position point B on the back midline of the target segment on the patient's body surface is marked as C on the surface of the body.

[0043] Further optimization of the solution involves using ultrasound to locate the intervertebral foramen / intervertebral space at the target level and locating the target segmental vertebral body, lamina, and pleural structures in the ultrasound image while scanning the ultrasound probe transversely. Specifically, the following are included:

[0044] Based on the MRI image and the depth of distance A, the dorsal root ganglion position is marked on 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 of the solution, based on the target puncture area, inserting the needle through point C on the body surface and pointing to the end of the target line specifically includes:

[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 lamina acoustic shadow 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 insertion point according to the position and angle of the pleura and ribs. Measure the distance from the needle insertion point to the midline (distance B). Figure 2 shown.

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

[0049] Step 3: Under real-time ultrasound guidance, puncture is performed through the surface puncture point C, with the needle inserted from the outside to the inside in the plane until the end of the target line is reached. Throughout the 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 lateral edge of the vertebral lamina acoustic shadow and 1-2 mm inside the lateral edge.

[0050] The present invention discloses a method for locating thoracic dorsal root ganglia based on ultrasound scanning. The method uses magnetic resonance imaging (MRI) to calculate the depth of the dorsal root ganglia, which is then used to guide the operator in locating the dorsal root ganglia in the ultrasound image and marking it with a marking line. The method also presets the puncture path and needle insertion point based on the position of the pleura (avoiding the pleura during the puncture process). The method also measures the distance from the needle insertion point to the midline of the spine, and uses this distance to pre-locate the puncture point on the patient's body surface.

[0051] The above description is merely a preferred embodiment of the present application, but the scope of protection of the present application is not limited thereto. Any changes or substitutions that can be easily conceived by a person skilled in the art within the technical scope disclosed in the present application should be included in the scope of protection of the present application. Therefore, the scope of protection of the present application should be based on the scope of protection 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 cross-sectional magnetic resonance imaging image of the target thoracic vertebral segment at the level of the intervertebral foramen / intervertebral space and measure the magnetic resonance imaging image to obtain a first distance; Setting a needle insertion plan and a second distance based on the first distance, pleural information, and rib information; The target puncture area of ​​the patient is pre-scanned by ultrasound, the location of the dorsal root ganglion and 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; 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 puncture through the body surface to the dorsal root ganglion is designed based on the pleural contour, and the puncture point is located on the body surface based on this, and the second distance from the puncture point to the perpendicular line of the spinous process midline is measured; The optimal route for transperitoneal puncture to the dorsal root ganglion based on the pleural contour includes: Draw a straight line from the dorsal root ganglion outward and upward. 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 optimal path is flat and does not touch the pleura.

2. The method for locating thoracic dorsal root ganglia based on ultrasound scanning according to claim 1, characterized in that: The measured MRI 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 MRI 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 is scanned by ultrasound, including: 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, the target segment vertebral body, vertebral lamina, and pleural structures are located in the ultrasound image of the scanning plane; Place the target line along the outside of the vertebral lamina in the ultrasound image, and place the end point of the target line 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 on the back midline of the target segment on the patient's body surface is marked as C on the surface of the body.

4. The method for locating thoracic dorsal root ganglia based on ultrasound scanning according to claim 3, characterized in that: Using ultrasound to locate the intervertebral foramen / intervertebral space at the target level, and locating the target segmental vertebral body, lamina, and pleural structures in the ultrasound image while scanning the ultrasound probe transversely, specifically includes: Based on the MRI image and the depth of distance A, the dorsal root ganglion position is marked on 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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