Ureter navigation device and method

Abstract

The ureter navigation method comprises the steps that a contrast agent is injected into a human body through an intravenous injection method, and the contrast agent comprises a fluorescence contrast reagent and a solvent; the position features of the ureter are collected through the endoscope fluorescence camera, and a fluorescence image of the ureter is formed. The fluorescent contrast agent in the contrast agent can be discharged through the ureter through human body circulation after intravenous injection, when the fluorescent contrast agent passes through the ureter, the position characteristics of the ureter can be collected by means of an endoscope fluorescent camera, and the contour image of the ureter is formed. Noninvasive recognition and positioning of the ureter in the operation can be achieved, the accuracy and reliability of ureter recognition are improved, particularly under the condition of poor visual conditions, recognition and imaging of the ureter can be achieved by means of fluorescence imaging, and the safety and accuracy of the operation are improved.

Description

Technical Field

[0001] The invention belongs to the field of fluorescence imaging, and in particular relates to a ureteral navigation device and method. Background Art

[0002] Iatrogenic ureteral injury refers to ureteral injury caused by surgical operations, such as ureteral mucosal injury, ureteral perforation, ureteral tear and ureteral rupture. Iatrogenic ureteral injury is the most common complication of pelvic surgery. In traditional surgery, the identification of the ureter depends on the surgeon's experience and visual judgment. In difficult surgeries such as massive intraoperative bleeding, tumor compression, and extensive pelvic adhesions, the ureter is more difficult to identify and locate, and the resection range is not accurately controlled. In systematic lymph node dissection surgery for malignant tumor lymph node metastasis, the proximity of lymph nodes to the ureter also greatly increases the risk of ureteral injury.

[0003] In clinical practice, ureteral stents or luminous ureteral guidewires are often placed through ureteral catheterization. The ureters are identified and located by touch or observation during surgery, or dyes or fluorescent contrast agents are injected into the urinary system for tracing through retrograde pyelourerography. However, the inserted ureteral stents or guidewires are exogenously inserted and are invasive, which will increase the patient's pain and operation time. In addition to being invasive, retrograde pyelourerography may also cause leakage of dyes or fluorescent agents due to improper surgical operation, which can contaminate the surgical field and lead to positioning failure, increasing the difficulty of the operation.

[0004] Methylene blue (MB) is a near-infrared fluorescent contrast agent approved by the FDA. It has been widely used in lymph node staining, lung nodule localization, insulinoma localization, and intraoperative navigation for breast cancer. Some scholars have applied it to ureteral angiography, but there are still many shortcomings in terms of stable fluorescence angiography and continuity, such as inconsistent drug dosage, discontinuous imaging time, and the ureter can only be detected when urine containing MB contrast agent passes through the ureter. Once the urine in the ureter is emptied, it is necessary to wait for the next urine flow to detect the ureteral fluorescence imaging again. These existing problems are not conducive to the application of continuous navigation during surgery. The present invention proposes an intelligent ureteral navigation system based on near-infrared fluorescence imaging to at least solve one of the technical problems that may exist in the prior art. Summary of the invention

[0005] One of the purposes of the present invention is to provide a ureteral navigation method, which realizes non-invasive ureteral near-infrared fluorescence continuous development through contrast agent and endoscopic fluorescent camera, thereby improving the accuracy of non-invasive identification and positioning during ureteral surgery.

[0006] In order to achieve the above-mentioned purpose, the present application adopts the following technical solution: a ureteral navigation method, comprising:

[0007] Injecting a contrast agent into a human body by intravenous injection, wherein the contrast agent comprises a fluorescent contrast agent and a solvent;

[0008] The positional features of the ureter are collected by an endoscopic fluorescent camera, and a fluorescent image of the ureter is formed.

[0009] Furthermore, the fluorescent contrast agent is methylene blue, and the solvent is 0.9% sodium chloride injection.

[0010] Furthermore, the contrast agent injection dose is 0.25 mg / kg-1.0 mg / kg.

[0011] Furthermore, the intravenous injection time is 15-30 minutes.

[0012] Furthermore, the position characteristics of the ureter are collected by an endoscopic fluorescent camera within 10-60 minutes after the intravenous injection is completed.

[0013] Furthermore, the method also includes: collecting position features of the ureter through an endoscopic white light camera to form a visible light image of the ureter.

[0014] Furthermore, it also includes: using image registration technology to spatially align the visible light image of the ureter and the fluorescent image of the ureter, and extracting the fluorescent feature contour of the ureter from the fluorescent image of the ureter, extracting feature points of the ureter and surrounding tissues from the visible light image of the ureter, and generating a three-dimensional model of the ureter through three-dimensional reconstruction technology.

[0015] The present application provides a ureteral navigation device, comprising an endoscopic fluorescent camera, an endoscopic white light camera, and a signal processing module. The endoscopic fluorescent camera photographs the fluorescent contrast agent in the ureter to form a fluorescent image of the ureter; the endoscopic white light camera collects the position characteristics of the ureter to form a visible light image of the ureter; the signal processing module uses image registration technology to spatially align the visible light image of the ureter and the fluorescent image of the ureter, and extracts the fluorescent feature contour of the ureter from the fluorescent image of the ureter, extracts the feature points of the ureter and the surrounding tissues from the visible light image of the ureter, and generates a three-dimensional model of the ureter through three-dimensional reconstruction technology.

[0016] Furthermore, it also includes a display, which is connected to the signal processing module, and the three-dimensional model is displayed through the display.

[0017] Furthermore, it also includes an operator, the display is connected to the operator, and the operator can adjust the position, angle, and transparency of the three-dimensional model in the display.

[0018] The beneficial effects of the present invention are:

[0019] The ureteral navigation method provided by the present application includes: injecting a contrast agent into the human body by intravenous injection, wherein the contrast agent includes a fluorescent contrast agent and a solvent; collecting the position characteristics of the ureter by an endoscopic fluorescent camera, and forming a fluorescent image of the ureter. Among them, the fluorescent contrast agent in the contrast agent can be discharged through the ureter through the human body circulation after intravenous injection. When the fluorescent contrast agent passes through the ureter, the position characteristics of the ureter can be collected with the help of an endoscopic fluorescent camera, and a contour image of the ureter can be formed. The present application can realize non-invasive identification and positioning of the ureter during surgery: improve the accuracy and reliability of ureteral identification, especially under poor visual conditions, with the help of fluorescent imaging, the ureter can be identified and imaged, and the safety and accuracy of the operation can be improved. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1 A schematic diagram of the ureteral navigation method for this application;

[0021] Figure 2 A schematic diagram of a ureteral navigation device for this application;

[0022] Figure 3 This is a fluorescent image of the ureter generated in Example 2. DETAILED DESCRIPTION

[0023] The specific implementation of the present invention is further described below in conjunction with specific embodiments:

[0024] like Figure 1 As shown, the present application provides a ureteral navigation method, comprising:

[0025] S1: Injecting a contrast agent into a human body by intravenous injection, wherein the contrast agent comprises a fluorescent contrast agent and a solvent.

[0026] The fluorescent contrast agent is methylene blue, and the solvent is 0.9% sodium chloride injection. When preparing the contrast agent, methylene blue is diluted into 250 mL of medical sodium chloride injection and mixed evenly.

[0027] The contrast agent injection dose is 0.25mg / kg-1.0mg / kg. The injection of methylene blue into the body will cause a pseudo-transient decrease in the reading of the blood oxygen detector. This is because the blood oxygen detector is based on the principle of reflectance spectrophotometry to analyze the blood oxygen saturation. After intravenous injection of methylene blue, part of the emitted light is absorbed by methylene blue, and the reflected light is reduced, which will cause the reading error of the blood oxygen detector, but the patient's actual blood oxygen remains at a normal level. When the injection dose is controlled to be 0.25mg / kg-1.0mg / kg, the present application can ensure clear imaging effects and reduce the interference of methylene blue on the blood oxygen detector. The contrast agent is introduced into the human body by intravenous injection or drip. During the intravenous injection process, it is necessary to pay close attention to the blood oxygen saturation to avoid a pseudo-transient decrease in the reading of the blood oxygen detector. The faster the injection speed, the greater the impact on the blood oxygen meter reading. Therefore, it is necessary to control the injection time to minimize the misjudgment effect of the contrast agent on the blood oxygen meter. The injection time selected in this application is 15-30 minutes, which can not only ensure the imaging effect, but also reduce the interference of methylene blue on the blood oxygen detector.

[0028] S2: The positional features of the ureter are captured by an endoscopic fluorescent camera, and a fluorescent image of the ureter is formed.

[0029] The position characteristics of the ureter are collected by an endoscopic fluorescent camera within 10-60 minutes after the intravenous injection is completed; preferably, the position characteristics of the ureter are collected by an endoscopic fluorescent camera 10 minutes after the intravenous injection is completed.

[0030] If bluish urine has appeared in the catheter or urine bag during the operation but has not been observed, the above operation can be repeated with an equal dose of methylene blue solution dripped intravenously.

[0031] The endoscopic fluorescent camera in the present application includes an infrared fluorescent camera and an image processing and analysis unit, wherein the fluorescent image of the ureter in the surgical area is captured in real time by a highly sensitive near-infrared fluorescent camera. The near-infrared fluorescent camera can move along a predetermined path in the surgical area, capture fluorescent points from different angles, and transmit these fluorescent points to the image processing and analysis unit. The image processing and analysis unit is combined through stereo vision technology or a three-dimensional reconstruction algorithm to form a fluorescent three-dimensional image of the ureter.

[0032] The fluorescent points collected in this application can be used to determine the outline of the ureter. Not only the outline of the ureter, but also the relationship between the ureter and the surrounding tissues. Specifically, while generating the outline of the ureter, the image processing and analysis unit can associate the ureter with the surrounding tissues by analyzing the contrast, texture and other features of the fluorescent points and the surrounding tissues; specifically, the association between the ureter and the surrounding tissues can be achieved through techniques such as image segmentation, feature extraction and pattern recognition. The image processing and analysis unit combines the characteristics of the fluorescent points with the surrounding tissues through image processing technology to generate a more complete fluorescent three-dimensional image of the ureter.

[0033] The fluorescent contrast agent in the contrast agent of the present application can be discharged through the ureter through the human body circulation after intravenous injection. When the fluorescent contrast agent passes through the ureter, the position characteristics of the ureter can be collected with the help of an endoscopic fluorescent camera, and a contour image of the ureter can be formed. The present application can realize non-invasive identification and positioning of the ureter during surgery: improve the accuracy and reliability of ureter identification, especially in poor visual conditions, with the help of fluorescent imaging, the ureter can be identified and imaged, improving the safety and accuracy of the operation.

[0034] Furthermore, the present application can further form a three-dimensional model of the ureter based on the generated fluorescence image of the ureter. The specific method includes:

[0035] S3: The positional features of the ureter are collected by an endoscopic white light camera to form a visible light image of the ureter.

[0036] S4: Through image registration technology, the visible light image of the ureter and the fluorescence image of the ureter are spatially aligned, and the fluorescence feature contour of the ureter is extracted from the fluorescence image of the ureter. The feature points of the ureter and surrounding tissues are extracted from the visible light image of the ureter, and a three-dimensional model of the ureter is generated through three-dimensional reconstruction technology.

[0037] In the present application, the endoscopic fluorescent camera and the endoscopic fluorescent camera are simultaneously connected to a signal processing module, and the signal processing module is used to perform fusion processing on the fluorescent image of the ureter and the visible light image of the ureter.

[0038] Specifically, the signal processing module uses image registration technology to ensure that the visible light image and the fluorescent image of the ureter are aligned in space; the fluorescent feature contour of the ureter is extracted from the fluorescent image of the ureter, and the feature points of the ureter and surrounding tissues are extracted from the visible light image of the ureter. The extracted fluorescent feature contour and feature points are used to generate a three-dimensional model of the ureter through three-dimensional reconstruction technology, and the three-dimensional model is displayed on a monitor through an image fusion algorithm, and presented to the doctor in real time.

[0039] The feature points in the visible light image in this step refer to significant visual landmarks used to assist in locating and identifying the ureter and its surrounding structures. These feature points can be specific landmarks of the ureter itself or feature points in the tissues surrounding the ureter. Specific parts of the ureter itself: such as the starting point of the ureter, the bend, the connection point with the surrounding structures, etc. These feature points help to accurately locate the position and shape of the ureter in three-dimensional space; significant landmarks in the tissues surrounding the ureter, such as blood vessels, fat pads, and other anatomical structures. These feature points help to provide relative position information of the ureter relative to the surrounding tissues, thereby providing more accurate and comprehensive information in three-dimensional reconstruction.

[0040] In the present application, the display is connected to the signal processing module and the operator at the same time, the three-dimensional model is displayed through the display, and the operator can adjust the position, angle, and model transparency of the three-dimensional model in the display.

[0041] The operator is specifically a mouse and keyboard connected to the monitor. The doctor uses the mouse and keyboard to manually adjust the model, including translation, angle rotation, scaling, model transparency adjustment, etc., and displays the adjusted effect on the monitor.

[0042] During the operation, the unit model generated by this application can be used as a real-time navigation tool to help doctors accurately locate the ureter and avoid accidental injury to the ureter and surrounding important structures. The system also supports screen recording for teaching and surgical training.

[0043] This application combines the fluorescent image and the visible light image to automatically extract feature points to generate a feature model of the ureter, thereby improving the accuracy of ureter positioning. The fluorescent image of the ureter is fused with the visible light image to continue to identify the ureter in the absence of fluorescence, ensuring the continuity of navigation and improving the safety of the operation.

[0044] like Figure 2 As shown, the present application also provides a ureteral navigation device, including an endoscopic fluorescent camera, an endoscopic white light camera, and a signal processing module, wherein the endoscopic fluorescent camera photographs the fluorescent contrast agent in the ureter to form a fluorescent image of the ureter; the endoscopic white light camera collects the position characteristics of the ureter to form a visible light image of the ureter; the signal processing module uses image registration technology to spatially align the visible light image of the ureter and the fluorescent image of the ureter, and extracts the fluorescent feature contour of the ureter from the fluorescent image of the ureter, extracts the feature points of the ureter and the surrounding tissues from the visible light image of the ureter, and generates a three-dimensional model of the ureter through three-dimensional reconstruction technology.

[0045] Specifically, the endoscopic fluorescent camera includes an infrared fluorescent camera and an image processing and analysis unit. The near-infrared fluorescent camera can move along a predetermined path in the surgical area, capture fluorescent points from different angles, and transmit these fluorescent points to the image processing and analysis unit. The image processing and analysis unit is combined through stereo vision technology or three-dimensional reconstruction algorithm to form a fluorescent three-dimensional image of the ureter.

[0046] The endoscope fluorescence camera and the endoscope fluorescence camera are simultaneously connected to the signal processing module, which is used to fuse the fluorescence image of the ureter and the visible light image of the ureter. Specifically, the signal processing module uses image registration technology to ensure that the visible light image of the ureter and the fluorescence image of the ureter are aligned in space; extract the fluorescence feature contour of the ureter from the fluorescence image of the ureter, extract the feature points of the ureter and surrounding tissues from the visible light image of the ureter, use the extracted fluorescence feature contour and feature points, generate a 3D model of the ureter through 3D reconstruction technology, and display the 3D model on the display through image fusion algorithm, so as to show it to the doctor in real time.

[0047] The device of the present application also includes a display, which is connected to the signal processing module and the operator at the same time. The three-dimensional model is displayed through the display, and the operator can adjust the position, angle, and model transparency of the three-dimensional model in the display. The operator is specifically a mouse, keyboard, etc. connected to the display. The doctor manually adjusts the model through the mouse and keyboard, including translation, angle rotation, scaling, model transparency adjustment, etc. of the model, and displays the adjusted effect on the display. During the operation, the unit model generated by the present application can be used as a real-time navigation tool to help doctors accurately locate the position of the ureter and avoid accidental injury to the ureter and surrounding important structures. At the same time, the system also supports screen recording function for teaching and surgical training.

[0048] The present application scheme is further explained below through specific embodiments:

[0049] Example 1

[0050] like Figure 1 As shown, this embodiment provides a ureteral navigation method, comprising:

[0051] S1: Injecting a contrast agent into a human body by intravenous injection, wherein the contrast agent includes a fluorescent contrast agent and a solvent. Specifically, it includes:

[0052] S11: Prepare contrast agent: dilute methylene blue into 250 mL of medical sodium chloride injection and mix well.

[0053] S12: Determine the injection dose of contrast agent according to the patient's weight, and the injection dose of contrast agent is 0.25 mg / kg-1.0 mg / kg.

[0054] S13: After the patient is anesthetized for surgery, observe for 30 minutes, and then slowly drip through the peripheral vein. During the intravenous injection, it is necessary to pay close attention to the blood oxygen saturation to avoid a significant drop in the blood oxygen monitor reading. The time for intravenous injection or drip is 15-30 minutes.

[0055] S2: The position characteristics of the ureter are collected through an endoscopic fluorescent camera, and a fluorescent image of the ureter is formed. Specifically, it includes:

[0056] S21: 10 minutes after the intravenous injection, the position characteristics of the ureter are collected by an endoscopic fluorescent camera. If the urinary catheter and urine bag have already shown blue urine phenomenon during the operation but it is not observed, step S1 can be repeated to drip the same dose of methylene blue solution intravenously.

[0057] S22: The fluorescent image of the ureter in the surgical area is captured in real time by a highly sensitive near-infrared fluorescent camera. The near-infrared fluorescent camera can move along a predetermined path in the surgical area, capture fluorescent points from different angles, and transmit these fluorescent points to the image processing and analysis unit. The image processing and analysis unit is combined with stereo vision technology or a three-dimensional reconstruction algorithm to form a fluorescent three-dimensional image of the ureter.

[0058] S3: The positional features of the ureter are collected by an endoscopic white light camera to form a visible light image of the ureter.

[0059] S4: The signal processing module uses image registration technology to spatially align the visible light image of the ureter and the fluorescent image of the ureter, extracts the fluorescent feature contour of the ureter from the fluorescent image of the ureter, extracts the feature points of the ureter and surrounding tissues from the visible light image of the ureter, and generates a three-dimensional model of the ureter through three-dimensional reconstruction technology.

[0060] The three-dimensional model is displayed on a display, and the operator can adjust the position, angle, and transparency of the three-dimensional model on the display.

[0061] Time of intravenous injection or drip

[0062] The fluorescent contrast agent in the contrast agent of the present application can be discharged through the ureter through the human body circulation after intravenous injection. When the fluorescent contrast agent passes through the ureter, the position characteristics of the ureter can be collected with the help of an endoscopic fluorescent camera, and a contour image of the ureter can be formed. The present application can realize non-invasive identification and positioning of the ureter during surgery: improve the accuracy and reliability of ureter identification, especially in poor visual conditions, with the help of fluorescent imaging, the ureter can be identified and imaged, improving the safety and accuracy of the operation.

[0063] This application combines the fluorescent image and the visible light image to automatically extract feature points to generate a feature model of the ureter, thereby improving the accuracy of ureter positioning. The fluorescent image of the ureter is fused with the visible light image to continue to identify the ureter in the absence of fluorescence, ensuring the continuity of navigation and improving the safety of the operation.

[0064] According to the disclosure and teaching of the above description, those skilled in the art to which the present invention belongs may also make changes and modifications to the above embodiments. Therefore, the present invention is not limited to the specific embodiments disclosed and described above, and some modifications and changes to the invention should also fall within the scope of protection of the claims of the present invention. In addition, although some specific terms are used in this specification, these terms are only for the convenience of description and do not constitute any limitation to the present invention.

Claims

1. A ureteral navigation method, characterized in that: include: Injecting a contrast agent into a human body by intravenous injection, wherein the contrast agent comprises a fluorescent contrast agent and a solvent; The positional features of the ureter are collected by an endoscopic fluorescent camera, and a fluorescent image of the ureter is formed.

2. A ureteral navigation method according to claim 1, characterized in that: The fluorescent contrast agent is methylene blue, and the solvent is 0.9% sodium chloride injection.

3. A ureteral navigation method according to claim 1, characterized in that: The contrast agent injection dose is 0.25 mg / kg-1.0 mg / kg.

4. A ureteral navigation method according to claim 1, characterized in that: The intravenous injection time is 15-30 minutes.

5. A ureteral navigation method according to claim 1, characterized in that: The position characteristics of the ureter were collected by an endoscopic fluorescent camera within 10-60 minutes after the intravenous injection was completed.

6. A ureteral navigation method according to claim 5, characterized in that: Also includes: The positional features of the ureter are collected by an endoscopic white light camera to form a visible light image of the ureter.

7. A ureteral navigation method according to claim 6, characterized in that: Also includes: Through image registration technology, the visible light image and the fluorescent image of the ureter are spatially aligned, and the fluorescent feature contour of the ureter is extracted from the fluorescent image of the ureter. The feature points of the ureter and surrounding tissues are extracted from the visible light image of the ureter, and a three-dimensional model of the ureter is generated through three-dimensional reconstruction technology.

8. A ureteral navigation device, characterized in that: The system comprises an endoscopic fluorescent camera, an endoscopic white light camera and a signal processing module. The endoscopic fluorescent camera photographs the fluorescent contrast agent in the ureter to form a fluorescent image of the ureter; the endoscopic white light camera collects the position characteristics of the ureter to form a visible light image of the ureter; the signal processing module uses the image registration technology to spatially align the visible light image of the ureter and the fluorescent image of the ureter, extracts the fluorescent feature contour of the ureter from the fluorescent image of the ureter, extracts the feature points of the ureter and the surrounding tissues from the visible light image of the ureter, and generates a three-dimensional model of the ureter through three-dimensional reconstruction technology.

9. A ureteral navigation device according to claim 8, characterized in that: It also includes a display, which is connected to the signal processing module, and the three-dimensional model is displayed through the display.

10. The ureteral navigation device according to claim 9, characterized in that: It also includes an operator, the display is connected to the operator, and the operator can adjust the position, angle, and model transparency of the three-dimensional model in the display.

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