Registration method and system for intraoperative real-time registration

Abstract

The invention discloses an intraoperative real-time registration method, which comprises the following steps of: fixedly arranging a tracer I with a rotating working head on an image system, selecting one or more known shooting positions of the image system, and tracking three-dimensional coordinates of the tracer I at the selected known shooting positions by a navigation system, wherein the position relation between the three-dimensional coordinates of the first tracer with the known shooting position and the center of the image system is known, and image data shot by the image system, a three-dimensional image of the surgical site and the three-dimensional coordinates of the first tracer are obtained; then the relation between the image system and the navigation system calibrated and registered before the operation, the recorded position of the first tracer and the image data condition are used for fitting calculation, and the relation of three-dimensional images obtained by the second tracer fixed to the body of the patient, the navigation system and the image system is registered, so that real-time tracking and observation in the operation are achieved; and the overall real-time registration precision is improved through the preoperative calibration structure of which a plurality of recognized structures II recognized by the image system are arranged on a plurality of surfaces.

Description

Technical Field

[0001] The present invention belongs to the field of surgical navigation technology, and in particular to the field of intraoperative real-time registration technology where a sufficient surgical area cannot be exposed, and specifically is a registration method and system for intraoperative real-time registration. Background Art

[0002] In the field of surgical navigation robots, an intraoperative real-time registration step is included during the operation to ensure that the patient's surgical position and the images of the navigation system and imaging system can be registered together, so as to ensure that the subsequent surgical navigation process can be tracked in real time.

[0003] At present, the commonly used method is to expose the surgical area, and the surgical area must meet the requirements of having a registration space for constructing a point cloud. Then, the probe is used to point multiple times, usually 30 to 40 times, to construct a point cloud and register it with the preoperative image to complete the real-time registration during the operation. However, for bone tumor surgery, irregular osteotomy, minimally invasive surgery, and tumor growth in the registration space, it is impossible to expose or provide an effective registration space for the probe to construct a point cloud. In addition, this point-to-point cloud method needs to consider the effectiveness of the registration of the constructed point cloud due to the large number of points. There is also the problem of point selection, which leads to a long registration time for the entire point cloud method.

[0004] Therefore, a technology is needed to complete intraoperative real-time registration without using point cloud to solve the above-mentioned technical problems of high dependence on registration space and long registration time. The present invention provides a registration method and system for intraoperative real-time registration. Summary of the invention

[0005] Since it is impossible to use point cloud to complete the real-time registration during surgery for bone tumor surgery, irregular osteotomy, minimally invasive surgery and tumor growth in the registration space, it is necessary to find a new technology for real-time registration during surgery. The present invention sets tracer one on the imaging device and tracer two on the patient, and uses the navigation system to track the three-dimensional coordinates of tracer one and tracer two at the same shooting position of the imaging system, and records at least the three-dimensional coordinates of tracer one and tracer two at the shooting positions of the two imaging systems; based on the correspondence between the registration of the coordinate systems of the imaging system and the navigation system calibrated and registered before surgery, and the three-dimensional coordinates of tracer one and tracer two, the changes in the image data of the corresponding positions captured are calculated. Through fitting calculation, the relationship between the tracer 2, the navigation system and the image during the operation is registered to ensure that the three-dimensional image corresponding to the patient's actual surgical site can be effectively displayed on the display structure, and the changes in the patient's surgical site are represented by the changes in the tracer 2, and the position of the operating instrument at the actual surgical site is known through the third tracer set on the operating instrument tracked by the navigation system, so that the virtual image of the operating instrument can be displayed on the display structure by tracking the changes of the third tracer on the operating instrument at the actual surgical position, and the real-time tracking of the subsequent surgical navigation system is completed by observing the virtual image of the operating instrument at the surgical site. And the registration is the positional relationship between the three-dimensional image of the patient's actual surgical site and the virtual image of the surgical instrument. The tracking after registration is a way to display the operation path in real time, rather than a way to cooperate with the preoperative planning path. This method can solve the problem of difficulty in tracking the operation path of irregular osteotomy or complex surgery.

[0006] By setting a tracer 1 on the imaging system and a tracer 2 on the patient, by 1-a plurality of known image shooting positions of the three-dimensional coordinate relationship between the tracer 1 and the tracer 2, by continuously shooting the patient's real image data, and the three-dimensional coordinate relationship between the tracer 1 and the tracer 2 at a plurality of selected image shooting positions to complete the intraoperative real-time registration action, the essence is to replace the point cloud constructed by the probe with the tracer by setting the tracer 1 on the imaging system and combining multiple groups of shooting. This method does not require the registration space in the surgical area, and the entire registration time is the time for the shooting process to achieve the complete shooting of the surgical CT machine, and the entire time is short. It is best to track the three-dimensional coordinate relationship between the tracer 1 and the tracer 2 in the effective stop state at the termination shooting position, and the relationship between the termination shooting position and the center position of the navigation system, and perform registration in combination with the image data changes at the corresponding position, so as to avoid the error caused by the deformation or shaking of the imaging instrument during the movement process during continuous tracking and registration.

[0007] Specifically, it is a system for real-time intraoperative registration, which includes an imaging system, a navigation system, a tracer 1 and a tracer 2. The imaging system obtains imaging data of patients in different positions by rotating in one plane; the navigation system is used to track the three-dimensional coordinates of the tracer; the tracer 1 is fixedly set on the working head of the imaging system and changes its position with the working head; the tracer 2 is fixedly set on the patient;

[0008] One or more known shooting positions of the imaging system are selected, and the navigation system simultaneously tracks the three-dimensional coordinates of the tracer 1 and the tracer 2 when selecting the shooting position of at least one known imaging system, wherein the positional relationship between the three-dimensional coordinates of the tracer 1 at the selected known shooting position and the center of the imaging system is known, and all the image data shot by the imaging system are obtained, and the three-dimensional coordinates of the first tracer 1 and the tracer 2 are obtained, and the position is equivalent to the three-dimensional coordinates; then, the registration relationship between the imaging system and the navigation system calibrated and registered before the operation, and the three-dimensional coordinates of the tracer 1 and the tracer 2 at the shooting position of at least one imaging system, and the image data captured by the imaging system are used to register the relationship between the tracer 2, the navigation system and the three-dimensional image of the surgical site obtained by the imaging system through fitting calculation. After registration in this way, subsequent real-time tracking can be performed, and this registration method does not require the surgical site to be exposed in advance, and there is no requirement for the exposure of the surgical site, which greatly shortens the difficulty of real-time registration during the operation.

[0009] Furthermore, for irregular osteotomy or bone tumor resection surgery, the difficulty in the surgery is that it is impossible to clearly know the positional relationship between the surgical instrument and the surgical area. In long bone navigation surgery and other related surgeries, the surgical path is usually planned before the operation and then performed according to the specific path. However, the operation path for irregular osteotomy or bone tumor resection surgery is very complicated, and traditional surgical methods cannot meet the tracking needs of complex surgical paths. The above-mentioned system tracks the position changes of the tracer three connected to the operating instrument, and displays the relative changes of the virtual image of the operating instrument in real time on the three-dimensional image corresponding to the surgical site. The operating path of the operating instrument can be observed in real time, and the actual positional relationship between the operating instrument and the surgical site can be understood. In this way, the complex surgical sites and complex surgical paths that cannot be seen can be intuitively displayed through the display structure of the navigation system, thereby ensuring the effectiveness of subsequent real-time tracking. The registration accuracy meets the accuracy of the tracking position, thereby ensuring the results of the surgery. It is a real-time tracking method under a precise registration state.

[0010] Furthermore, in order to obtain accurate three-dimensional images and improve the accuracy of registration, 300-500 images from different angles are obtained by rotating the surgical CT during the operation, and then fitted through an algorithm to obtain a three-dimensional image with higher registration accuracy with the patient's actual surgical site.

[0011] Furthermore, the imaging system is a surgical CT, and the tracer 1 is fixedly arranged on the working head of the surgical CT and fixed on a plane 1 parallel to the C-shaped ring. This arrangement ensures that the navigation system can always identify the three-dimensional coordinates of the tracer 1 when the image is taken.

[0012] Furthermore, the known shooting position selected is the position where the shooting of the C-shaped ring of the surgical CT is terminated when the working head moves. This position is a fixed known position, and its relationship with the center position of the imaging system is known. The relationship between the plane represented by the last tracked tracer and the known imaging system shooting center can be used to fit the center of the image data, and then the relationship between the image data and the patient's actual surgical area can be combined with its known data. This method of fitting the entire image data center by tracking a single position is more accurate and reliable than the image data center obtained by tracking the entire process to obtain a dynamic data, because the entire process tracking is prone to center instability due to deformation and shaking of the instrument structure, and fitting through a final position greatly reduces this possibility.

[0013] Furthermore, the relationship between the end position of the shooting and the center of the semicircle of the C-shaped ring is used to fit the relationship between the tracer 1 and the C-shaped ring.

[0014] Furthermore, the tracer 1 is fixed on the working head of the surgical CT by pasting, and once fixed, the position cannot change during the entire operation. However, because it is pasted, a suitable plane 1 can be selected according to the setting position of the navigation system and the surgical position of the patient before the operation, and the tracer 1 can be fixed on the plane 1.

[0015] Furthermore, the tracer 1 is a plate-shaped structure, and the shape of the plate-shaped structure is an asymmetric polygonal shape, on which no less than three identified structures 1 are arranged, and the identified structures 1 can be NDI balls.

[0016] Furthermore, the NDI ball is embedded in the plate-shaped structure, and 6 identified structures 1 are set. The plate-shaped structure includes a long side structure and a short side structure. More identified structures 1 are set on the long side structure than on the short side structure. In this way, it can be ensured that the shape of the tracer 2 can be distinguished, and the stability of the tracking effect can be guaranteed.

[0017] Furthermore, the long side structure and the short board structure are connected by arc-shaped side structures on both sides, and the arrangement of the arc-shaped side structures can increase the ease of operation of the entire device.

[0018] Furthermore, the plate-shaped structure also includes an intermediate structure arranged in parallel between the long side structure and the short side structure. The thickness of the intermediate structure is greater than that of the plate-shaped structure. The portion of the intermediate structure that exceeds the plate-shaped structure constructs a platform structure. A fixing structure is arranged on the side wall from the long side structure to the intermediate structure and on the platform structure. The fixing structure may be an adhesive layer. The quadrilateral structure as a whole is fixed parallel to plane one through the fixing structure from the long side structure to the side wall of the intermediate structure. The platform structure extends to plane two perpendicular to plane one and is fixed on plane two. By fixing on two perpendicular planes, the stability of the tracer one after being fixed is greatly increased.

[0019] Furthermore, in order to improve the accuracy of real-time intraoperative registration, a preoperative calibration tool that can improve the registration accuracy is set up, which is an irregular hollow polyhedron structure. An identifiable structure 2 that can be recognized by the imaging system is set on multiple surfaces of the irregular hollow polyhedron structure, and an identifiable structure 1 that can be recognized by the navigation system is set on a non-bottom surface of the polyhedron; by setting multiple groups of identifiable structures 1 in multiple different three-dimensional spaces, the recognition accuracy of the imaging system can be improved, and then the degree of registration of the spatial coordinate system of the imaging system and the navigation system can be improved.

[0020] Furthermore, the preoperative calibration tooling is an irregular polyhedron structure, each face is not parallel to each other, and multiple identified structures 2 are set on each face, any three identified structures 1 are not set on the same straight line, and multiple groups of planes constructed by any three points on different faces are not parallel to each other. This setting can ensure that more identification planes can be constructed, effectively improving the alignment accuracy.

[0021] Furthermore, in order to better improve the registration accuracy, in addition to the bottom surface, no less than 6 identified structures 2 are set on the planes of other polyhedrons, wherein preferably 8 identified structures 2 are set on each plane, and the identified structures 1 are small steel balls. The small steel balls are embedded in the planar structure where each plane of each polyhedron is located. This setting method can greatly improve the registration accuracy of the imaging system and the navigation system, provide better accuracy conditions for subsequent intraoperative real-time registration, and ensure that the surgical accuracy reaches the sub-millimeter level.

[0022] Furthermore, the polyhedron is an irregular hexahedron, and eight identified structures 2 are embedded in the planar structures of the five planes except the bottom surface. Connecting columns are extended from the planar structure corresponding to the upper surface opposite to the bottom surface, and the identified structure 1 is arranged on the connecting columns. Four identified structures 1 constructed into irregular trapezoids are arranged.

[0023] Furthermore, during preoperative calibration, the calibration tooling tracked by the navigation system and the tooling image data collected by the imaging system are automatically fitted and calculated. By automatically extracting 40 highlight feature points of the CT image and aligning them with the tooling, the time of the alignment process can be greatly shortened and the alignment efficiency can be improved.

[0024] A method for intraoperative real-time registration, comprising:

[0025] 4) One or more known shooting positions of the imaging system are selected, and the navigation system simultaneously tracks the three-dimensional coordinates of the tracer 1 and the tracer 2 at the selected shooting position of at least one known imaging system, wherein the positional relationship between the three-dimensional coordinates of the tracer 1 at the selected known shooting position and the center of the imaging system is known,

[0026] 5) Obtain all image data captured by the imaging system, and obtain the three-dimensional coordinates of the first tracer 1 and the tracer 2, the positions are equivalent to the three-dimensional coordinates;

[0027] 6) Using the registration relationship between the imaging system and the navigation system calibrated and registered before the operation, the three-dimensional coordinates of tracer one and tracer two at the shooting position of at least one imaging system, and the image data captured by the imaging system, the relationship between tracer two, the navigation system and the three-dimensional image of the surgical site obtained by the imaging system during the operation is registered through fitting calculation.

[0028] The beneficial effects of the present invention are:

[0029] By using the imaging system and the tracer 1 on the imaging system, and the tracer 2 on the patient, and cooperating with the navigation system, the three-dimensional coordinate relationship between the tracer 1 and the tracer 2 and the corresponding image data are recorded at a specific 2-3 shooting position, and the change data of the three-dimensional coordinate relationship between the tracer 1 and the tracer 2 and the change data of the image data obtained by the imaging system are obtained. Combined with the registration coordinate system of the imaging system and the navigation system registered before surgery, the three-dimensional image data obtained by the imaging system, the tracer 2 representing the patient's position and the navigation system are registered during surgery, ensuring that the tracer 2 and the tracer 3 connected to the operating instrument are subsequently tracked in real time by the navigation system, and the position of the virtual image of the operating instrument in the three-dimensional image is displayed in real time on the display structure. This intraoperative real-time registration method does not require the probe to construct a point cloud in the intraoperative surgical area. The entire registration time is the time to complete the rotation of the surgical CT to shoot the three-dimensional image, the time period, the operation is simple, and there are no special requirements for the operator.

[0030] By respectively setting a plurality of identifiable structures on the plurality of faces of the polyhedral structure, the calibration and registration accuracy of the imaging system and the navigation system before surgery can be improved, the registration time can be reduced, and the accuracy of the intraoperative registration can be ensured.

[0031] Automatic fitting calculation is performed on the calibration tooling tracked by the navigation system and the tooling image data collected by the imaging system, thereby improving the accuracy and efficiency of the calibration results.

[0032] This intraoperative real-time registration method ensures the accuracy of surgical tracking. There is no need to plan the surgical path in advance. The operator can intuitively track the relative position of the operating instrument and the surgical site during the operation. This tracking method also solves the surgical risks caused by the inability to observe the relationship between the surgical instrument and the patient's surgical site in complex osteotomies or complex surgical environments.

[0033] Simplifying the operation process and providing an intuitive user interface reduces the doctor's operation difficulty and time cost and improves the efficiency of the operation. At the same time, due to the improvement of surgical accuracy and the reduction of surgical risks, doctors can focus more on the operation itself, further improving the efficiency and quality of the operation.

[0034] By constructing a registration system in this way, there is no need for multiple scans during the operation. The navigation system tracks tracer 2 and can intuitively display the actual position relationship between the operating instrument and the three-dimensional image corresponding to the patient's actual part on the display structure, avoiding unnecessary repeated scanning during the operation, thereby reducing the patient's radiation exposure and discomfort. BRIEF DESCRIPTION OF THE DRAWINGS

[0035] Figure 1 This is a flow chart of the operation of the real-time registration system of the present invention;

[0036] Figure 2 It is a schematic diagram of the structure of a tracer of the present invention from the front side;

[0037] Figure 3 It is a schematic diagram of the structure of a tracer of the present invention from the rear side;

[0038] Figure 4 This is a schematic diagram of the calibration tooling structure of the present invention;

[0039] Figure 5 This is a flow chart of the intraoperative real-time registration system of the present invention;

[0040] Description of main reference numerals

[0041] 1. Imaging system; 2. Navigation system; 3. Tracer 1; 31. Long side structure; 32. Short side structure; 33. Middle structure; 4. Tracer 2; 5. Tracer 3; 6. NDI ball; 7. Small steel ball; 8. Calibration tooling. DETAILED DESCRIPTION

[0042] Example 1

[0043] 1).Reference Figure 1 and Figure 5 , a system for intraoperative real-time registration, including a navigation system including an optical tracker: as the "eyes" of surgical navigation, the optical tracker tracks the position and trajectory of surgical instruments in the surgical space in real time through an optical camera and triangulation technology;

[0044] The imaging system includes surgical CT, which can collect three-dimensional images during surgery and quickly generate cross-sectional, sagittal, and coronal tomographic images and three-dimensional stereo images, providing a comprehensive observation angle for surgery;

[0045] The system also includes a control and display system that integrates the data collected by the optical tracking system and the 3D C-arm machine to achieve real-time registration and synchronous display of surgical instruments and intraoperative 3D images;

[0046] It also includes a tracer 1 3 fixed on the imaging system and a tracer 2 4 fixed on the patient.

[0047] 2). A registration method for an intraoperative real-time registration system

[0048] Step 1. Initial calibration before surgery

[0049] Place the calibration tool 8 near the surgical area, ensuring that it is within the field of view of the C-arm and the optical tracking system.

[0050] The C-arm machine is started to collect projection images of the calibration tool 8 at multiple angles.

[0051] An optical tracker is used to track the marking points on the calibration tool 8 and record their three-dimensional coordinates.

[0052] By using image processing technology, the characteristic points of the calibration tool 8 in the projection image are extracted and matched with the three-dimensional coordinates recorded by the optical tracking system.

[0053] According to the matching results, the internal and external parameters of the C-arm machine are calculated to complete the initial calibration.

[0054] The calibration tool 8 is an irregular hollow polyhedron structure, wherein a second identified structure that can be identified by the imaging system is arranged on multiple faces of the irregular hollow polyhedron structure, and a first identified structure that can be identified by the navigation system is arranged on a non-bottom face of the polyhedron; by arranging multiple groups of the first identified structure in multiple different three-dimensional spaces, the recognition accuracy of the imaging system can be improved, and thus the registration degree of the spatial coordinate system of the imaging system and the navigation system can be improved. The points of the second identified structure on the projection are automatically extracted feature points.

[0055] The preoperative calibration tool 8 is an irregular polyhedron structure, each face is not parallel to each other, and multiple identified structures 2 are set on each face. Any three identified structures 1 are not set on the same straight line, and multiple groups of planes constructed by any three points on different faces are not parallel to each other. This setting can ensure that more identification planes can be constructed, effectively improving the alignment accuracy.

[0056] In addition to the bottom surface, no less than 6 identified structures 2 are set on the planes of other polyhedrons, wherein preferably 8 identified structures 2 are set on each plane, and the identified structure 1 is a small steel ball 7. The small steel ball 7 is embedded in the planar structure where each plane of each polyhedron is located. This setting method can well improve the registration accuracy of the imaging system and the navigation system, provide better accuracy conditions for subsequent intraoperative real-time registration, and ensure that the surgical accuracy reaches the sub-millimeter level.

[0057] The polyhedron is an irregular hexahedron, and eight identified structures 2 are embedded in the plane structures of the five planes except the bottom surface. A connecting column is extended from the plane structure corresponding to the upper surface opposite to the bottom surface, and an identified structure 1 is arranged on the connecting column. Four identified structures 1 constructed into irregular trapezoids are arranged. The identified structure 1 is a marking point on the calibration tool 8 tracked by the optical tracker.

[0058] During preoperative calibration, the calibration tool 8 tracked by the navigation system and the tool image data collected by the imaging system are automatically fitted and calculated.

[0059] By accurately calibrating the coordinate systems of the navigation system and the imaging system before surgery, the accuracy of real-time tracking during surgery can be guaranteed.

[0060] Step 2. Intraoperative Registration

[0061] After the patient enters the operating room, the doctor dissects the surgical site and installs a tracking target at the anatomical site;

[0062] An optical tracker is used to track the tracer 1 3 set on the surgical CT and the tracer 2 4 on the patient;

[0063] The surgical CT machine rotates 180° to collect the patient's three-dimensional image;

[0064] One or more known shooting positions of the imaging system are selected, and the navigation system simultaneously tracks the three-dimensional coordinates of the tracer 1 3 and the tracer 2 4 when selecting the shooting position of at least one known imaging system, and obtains all the image data shot by the imaging system; wherein the position relationship between the position of the tracer 1 3 at the selected known shooting position and the center of the imaging system is known, and then the registration relationship between the imaging system and the navigation system calibrated and registered before the operation, and the three-dimensional coordinate data of the tracer 1 3 and the tracer 2 4 at the shooting position of at least one imaging system, and the image data of the imaging system are used to register the relationship between the tracer 2 4, the navigation system and the three-dimensional image of the surgical site obtained by the imaging system through fitting calculation. After registration in this way, subsequent real-time tracking can be performed, and this registration method does not require the surgical site to be exposed in advance, and there is no requirement for the exposure of the surgical site, which greatly shortens the difficulty of real-time registration during the operation.

[0065] In order to obtain accurate three-dimensional images and improve the accuracy of registration, 300-500 images from different angles are obtained by rotating the surgical CT during the operation, and then fitted through an algorithm to obtain a three-dimensional image with higher registration accuracy with the patient's actual surgical site.

[0066] The imaging system is a surgical CT, and the tracer 3 is fixedly set on the working head of the surgical CT and fixed on a plane 1 parallel to the C-shaped ring. This setting can ensure that the navigation system can always identify the position of the tracer 3 when the image is taken. The selected known shooting position is the position where the shooting ends when the working head moves to the C-shaped ring of the surgical CT. This position is a fixed known position, and the relationship with the center position of the imaging system shooting is known. The relationship between the plane represented by the last tracked tracer and the known imaging system shooting center can be used to fit the center of the image data, and then combined with its known data to align the relationship between the image data and the patient's actual surgical area. This method of fitting the entire image data center by tracking a single position is more accurate and reliable than the image data center obtained by tracking the entire process to obtain a dynamic data, because the entire process tracking is prone to the problem of unstable center due to deformation and shaking of the instrument structure, and fitting through a final position greatly reduces this possibility.

[0067] The relationship between the end position of the shooting and the center of the semicircle of the C-shaped ring is used to fit the relationship between the tracer 3 and the C-shaped ring.

[0068] The tracer 3 is fixed on the working head of the surgical CT by pasting. Once fixed, the position cannot change during the whole operation. However, because it is pasted, a suitable plane 1 can be selected according to the setting position of the navigation system and the surgical position of the patient before the operation, and the tracer 3 can be fixed on the plane 1. The tracer 3 is a plate-shaped structure. The shape of the plate-shaped structure is an asymmetric polygonal shape. No less than 3 identified structures 1 are set on it. The identified structure 1 can be an NDI ball 6. The NDI ball 6 is embedded in the plate-shaped structure, and 6 identified structures 1 are set. The plate-shaped structure includes a long side structure 31 and a short side structure 32. More identified structures 1 are set on the long side structure 31 than on the short side structure 32. In this way, it can be distinguished from the shape of the tracer 2 4, and the stability of the tracking effect can be guaranteed. The long side structure 31 and the short plate structure are connected by the arc-shaped side structure on both sides. The setting of the arc-shaped side structure can increase the operation of the entire instrument during operation. The plate-shaped structure also includes an intermediate structure 33 arranged in parallel between the long side structure 31 and the short side structure 32. The thickness of the intermediate structure 33 is greater than that of the plate-shaped structure. The portion of the intermediate structure 33 that exceeds the plate-shaped structure constructs a platform structure. A fixing structure is arranged on the side walls from the long side structure 31 to the intermediate structure 33 and on the platform structure. The fixing structure may be an adhesive layer. The entire quadrilateral structure is fixed parallel to plane one through the fixing structure from the long side structure 31 to the side walls of the intermediate structure 33. The platform structure extends to plane two perpendicular to plane one and is fixed on plane two. By fixing on two perpendicular planes, the stability of tracer 3 after fixation is greatly increased.

[0069] Step 3. Real-time tracking during surgery

[0070] By real-time tracking of the position changes of the tracer 35 connected to the operating instrument, and at the same time displaying the changes of the virtual image of the operating instrument corresponding to the operating instrument in real time on the three-dimensional image corresponding to the surgical site, the operating path of the operating instrument can be observed in real time, and the real position relationship between the operating instrument and the surgical site can be understood. On the screen of the surgical navigation system, the doctor can see the relative position relationship between the surgical instrument and the anatomical structure of the surgical site of the patient in real time, so as to perform the surgical operation accurately. In this way, the complex surgical sites and complex surgical paths that cannot be seen can be intuitively displayed through the display structure of the navigation system, ensuring the effectiveness of subsequent real-time tracking, and the registration accuracy meets the accuracy of the tracking position, ensuring the success of the surgery.

[0071] For surgical methods with irregular operation paths such as bone tumor surgery and irregular osteotomy, the user can intuitively understand the positional relationship between the operation path and the surgical site.

[0072] Example 2

[0073] refer to Figure 2-3A tracer 3 fixed on the imaging system, the tracer 3 is fixedly arranged on a plane 1 parallel to the C-shaped ring and the working head of the surgical CT. This arrangement ensures that the navigation system can always identify the position of the tracer 3 when the image is taken.

[0074] A more preferred embodiment is that the tracer 3 is fixed on the working head of the surgical CT by gluing. Once fixed, the position cannot change during the entire operation. However, because it is gluing, a suitable plane 1 can be selected before the operation according to the setting position of the navigation system and the surgical position of the patient, and the tracer 3 can be fixed on the plane 1.

[0075] In a more preferred embodiment, the tracer 3 is a plate-shaped structure, the shape of the plate-shaped structure is an asymmetric polygonal shape, and no less than three identified structures 1 are arranged thereon, and the identified structure 1 can be an NDI ball 6.

[0076] A more preferred implementation is that the NDI ball 6 is embedded in a plate-shaped structure, and six identified structures 1 are set. The plate-shaped structure includes a long side structure 31 and a short side structure 32. More identified structures 1 are set on the long side structure 31 than on the short side structure 32. In this way, it can be ensured that the shape of the tracer 2 4 can be distinguished, and the stability of the tracking effect can be guaranteed.

[0077] In a more preferred embodiment, the long side structure 31 and the short plate structure are connected via arc-shaped side structures on both sides. The arrangement of the arc-shaped side structures can increase the ease of operation of the entire device.

[0078] A more preferred embodiment is that the plate-shaped structure also includes an intermediate structure 33 arranged in parallel between the long side structure 31 and the short side structure 32. The thickness of the intermediate structure 33 is greater than that of the plate-shaped structure. The portion of the intermediate structure 33 that exceeds the plate-shaped structure constructs a platform structure. A fixing structure is arranged on the side walls from the long side structure 31 to the intermediate structure 33 and on the platform structure. The fixing structure may be an adhesive layer. The entire quadrilateral structure is fixed parallel to plane one through the fixing structure from the long side structure 31 to the side walls of the intermediate structure 33. The platform structure extends to plane two perpendicular to plane one and is fixed on plane two. By fixing on two perpendicular planes, the stability of tracer 3 after fixation is greatly increased.

[0079] Example 3

[0080] refer to Figure 4A calibration tool 8 for improving the accuracy of preoperative calibration, which is an irregular hollow polyhedron structure, wherein a second identifiable structure that can be recognized by an imaging system is arranged on multiple faces of the irregular hollow polyhedron structure, and a first identifiable structure that can be recognized by a navigation system is arranged on a non-bottom face of the polyhedron; by arranging multiple groups of the first identifiable structure in multiple different three-dimensional spaces, the recognition accuracy of the imaging system can be improved, thereby improving the degree of alignment of the spatial coordinate systems of the imaging system and the navigation system.

[0081] A more preferred implementation is that the preoperative calibration tool 8 is an irregular polyhedron structure, each face is not parallel to each other, and multiple identified structures 2 are arranged on each face, any three identified structures 1 are not arranged on the same straight line, and multiple groups of planes constructed by any three points on different faces are not parallel to each other. This arrangement can ensure that more identification planes can be constructed, effectively improving the alignment accuracy.

[0082] A more preferred implementation is that, in order to better improve the registration accuracy, in addition to the bottom surface, no less than 6 identified structures 2 are set on the planes of other polyhedrons, wherein preferably 8 identified structures 2 are set on each plane, and the identified structure 1 is a small steel ball 7. The small steel ball 7 is embedded in the planar structure where each plane of each polyhedron is located. This setting method can well improve the registration accuracy of the imaging system and the navigation system, provide better accuracy conditions for subsequent intraoperative real-time registration, and ensure that the surgical accuracy reaches the sub-millimeter level.

[0083] A more preferred embodiment is that the polyhedron is an irregular hexahedron, and eight identified structures 2 are embedded in the planar structures of the five planes except the bottom surface, and connecting columns are extended from the planar structure corresponding to the upper surface opposite to the bottom surface, and the identified structure 1 is arranged on the connecting columns, and four identified structures 1 constructed into an irregular trapezoid are arranged.

[0084] The technical solutions in the embodiments of the present invention are clearly and completely described above through specific embodiments. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Those skilled in the art can easily understand other advantages and effects of the present invention from the contents disclosed in this specification. The present invention can also be implemented or applied through other different specific implementation methods. In the absence of conflict, the above embodiments and features in the embodiments can be combined with each other. Based on the embodiments in the present invention, all other embodiments obtained by ordinary technicians in this field without making creative work are within the scope of protection of the present invention.

Claims

1. A system for intraoperative real-time registration, comprising: The imaging system obtains imaging data of patients in different positions by rotating in one plane; Tracer 1 is fixedly mounted on the working head of the imaging system, and its relative position to the working head does not change, but moves or rotates with the working head; a navigation system for tracking the three-dimensional coordinates of tracer one and also tracking tracer two fixedly disposed on the patient; One or more known shooting positions of the imaging system are selected, and the navigation system simultaneously tracks the three-dimensional coordinates of tracer one and tracer two when selecting the shooting position of at least one known imaging system, wherein the positional relationship between the three-dimensional coordinates of the tracer one at the selected known shooting position and the center of the imaging system is known, and all the imaging data and the three-dimensional image of the surgical site captured by the imaging system are acquired, and the three-dimensional coordinates of tracer one and tracer two are acquired; then, by utilizing the registration relationship between the imaging system and the navigation system calibrated and registered before the operation, the three-dimensional coordinates of tracer one and tracer two at the shooting position of at least one imaging system, and the image data captured by the imaging system, the relationship between tracer two, the navigation system and the three-dimensional image of the surgical site obtained by the imaging system is registered through fitting calculation, so as to realize real-time tracking and observation during the operation.

2. The system for intraoperative real-time registration according to claim 1, characterized in that: The navigation system tracks the position changes of the tracer three connected to the operating instrument, and at the same time displays the three-dimensional image position corresponding to the surgical site and the corresponding changes of the virtual image of the operating instrument in real time on the display structure, and observes the changing operation path of the operating instrument through the display structure in real time.

3. The system for intraoperative real-time registration according to claim 1, characterized in that: During the operation, the imaging system is rotated to obtain 300-500 images from different angles, and the images are fitted through algorithms to obtain a three-dimensional image that is aligned with the patient's actual surgical site. The imaging system is a surgical CT, and a tracer 1 is fixedly arranged on a working head of the surgical CT and fixed on a plane 1 which is parallel to the C-shaped ring.

4. The system for intraoperative real-time registration according to claim 1, characterized in that: The selected known shooting position is the position where the shooting ends when the working head moves to the C-shaped ring of the surgical CT; The relationship between the shooting end position and the center of the semicircle of the C-shaped ring is used to fit the relationship between tracer 1 and the C-shaped ring.

5. The system for intraoperative real-time registration according to claim 1, characterized in that: The tracer 1 is a plate-shaped structure, which is an asymmetric polygonal shape, and has no less than 3 identified structures 1 arranged thereon; The plate-shaped structure includes a long side structure and a short side structure, and more identified structures are arranged on the long side structure than on the short side structure; The plate-shaped structure also includes an intermediate structure arranged in parallel between the long side structure and the short side structure. The thickness of the intermediate structure is greater than that of the plate-shaped structure. The portion of the intermediate structure that exceeds the plate-shaped structure constructs a platform structure. A fixing structure is arranged on the side wall from the long side structure to the intermediate structure and on the platform structure. The quadrilateral structure is fixed as a whole in parallel on plane one through the fixing structure from the long side structure to the side wall of the intermediate structure. The platform structure extends to plane two perpendicular to plane one and is fixed on plane two. Tracer one is fixed to the working head of the imaging system on two perpendicular planes.

6. The system for intraoperative real-time registration according to claim 1, characterized in that: The system also includes a preoperative calibration tool capable of improving the registration accuracy, which is an irregular hollow polyhedron structure, wherein a second identified structure capable of being identified by the imaging system is arranged on multiple faces of the irregular hollow polyhedron structure, and a first identified structure capable of being identified by the navigation system is arranged on a non-bottom face of the polyhedron; Each face of the hollow polyhedron structure is not parallel to each other, and multiple identified structures 2 are set on each face, any three identified structures 1 are not set on the same straight line, and multiple groups of planes constructed by any three points on different faces are not parallel to each other; During preoperative calibration, the three-dimensional coordinates of the calibration tool tracked by the navigation system and the feature points corresponding to the identified structure 2 in the tool image data collected by the imaging system are automatically fitted and calculated for registration.

7. A method for intraoperative real-time registration, which is performed using the system of claim 1, comprising: S1: One or more known shooting positions of the imaging system are selected, and the navigation system simultaneously tracks the three-dimensional coordinates of the tracer 1 and the tracer 2 at the selected known shooting position of at least one imaging system, wherein the positional relationship between the three-dimensional coordinates of the tracer 1 at the selected known shooting position and the center of the imaging system is known; S2: Acquire all image data captured by the imaging system, and obtain the three-dimensional coordinates of the first tracer 1 and the tracer 2; S3: Using the registration relationship between the imaging system and the navigation system calibrated and registered before the operation, the three-dimensional coordinates of tracer one and tracer two at the shooting position of at least one imaging system, and the image data captured by the imaging system, the relationship between tracer two, the navigation system and the three-dimensional image of the surgical site obtained by the imaging system is registered through fitting calculation.

8. The method for intraoperative real-time registration according to claim 7, characterized in that: By improving the accuracy of preoperative registration calibration, improving the accuracy of real-time registration, and setting up preoperative calibration tools to improve registration accuracy, The preoperative calibration work is an irregular hollow polyhedron structure, and a second identifiable structure that can be identified by the imaging system is set on multiple faces of the irregular hollow polyhedron structure, and a first identifiable structure that can be identified by the navigation system is set on a non-bottom face of the polyhedron; Each face of the hollow polyhedron structure is not parallel to each other, and multiple identified structures 2 are set on each face, any three identified structures 1 are not set on the same straight line, and multiple groups of planes constructed by any three points on different faces are not parallel to each other; During preoperative calibration, the three-dimensional coordinates of the calibration tool tracked by the navigation system and the feature points corresponding to the identified structure 2 in the tool image data collected by the imaging system are automatically fitted and calculated for registration.

9. A tracer fixed to an imaging system, which is a tracer 1 involved in the system of claim 1, characterized in that: The tracer 1 is fixedly arranged on the working head of the surgical CT and fixed on a plane 1 parallel to the C-shaped ring. The tracer 1 is a plate-shaped structure. The shape of the plate-shaped structure is an asymmetric polygonal shape, and no less than 3 identified structures 1 are arranged on it; the plate-shaped structure includes a long side structure and a short side structure, and the plate-shaped structure also includes an intermediate structure arranged in parallel between the long side structure and the short side structure. The thickness of the intermediate structure is greater than that of the plate-shaped structure, and the part of the intermediate structure exceeding the plate-shaped structure constructs a platform structure. A fixed structure is arranged on the side wall from the long side structure to the intermediate structure and on the platform structure. The quadrilateral structure is fixed as a whole in parallel on the plane 1 through the fixed structure from the long side structure to the side wall of the intermediate structure. The platform structure extends to a plane 2 perpendicular to the plane 1 and is fixed on the plane 2. The tracer 1 is fixed to the working head of the imaging system on two perpendicular planes.

10. A preoperative calibration tool for improving registration accuracy, which is used to improve the real-time registration accuracy of the system of claim 1, characterized in that: The preoperative calibration tool is an irregular hollow polyhedron structure. An identifiable structure 2 that can be recognized by the imaging system is set on multiple faces of the irregular hollow polyhedron structure, and an identifiable structure 1 that can be recognized by the navigation system is set on a non-bottom face of the polyhedron; each face of the hollow polyhedron structure is not parallel to each other, and multiple identifiable structures 2 are set on each face, any three identifiable structures 1 are not set on the same straight line, and multiple groups of planes constructed by any three points on different faces are not parallel to each other.

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