Pelvic organ prolapse degree evaluation method and system based on MRI three-dimensional reconstruction pelvis

Abstract

The invention provides a pelvic organ prolapse degree assessment method, system, medium and device based on MRI three-dimensional reconstruction pelvis, and the method comprises the following steps: obtaining MRI data of a pelvic organ of a to-be-assessed object, and constructing a pelvic organ complex model with anatomical features based on the MRI data; constructing a three-dimensional reference plane based on the pelvic three-dimensional model of the pelvic organ complex model; marking point positions of prolapse measuring points based on the pelvic organ complex model, constructing a vertical line of the shortest distance from the prolapse measuring points to the three-dimensional reference plane, marking intersection points of the vertical line and the three-dimensional reference plane as foot points, and calculating the distance from the prolapse measuring points to the foot points to obtain a prolapse quantity value; and implementing POP-Q check based on the same object to be evaluated to obtain a POP-Q scoring result, and comparing the POP-Q scoring result with the prolapse quantity value to obtain a prolapse degree evaluation result. By means of the method, POP-Q evaluation deviation caused by different hospitals and doctors can be eliminated, and pelvic floor reconstruction operation approach selection is guided.

Description

Technical Field

[0001] The present invention relates to the technical field of medical diagnosis, and in particular, to a method, system, medium and device for evaluating the degree of pelvic organ prolapse based on three-dimensional reconstruction of the pelvis by MRI. Background Art

[0002] Female pelvic organ prolapse (FPOP) refers to the downward displacement of one or more of the anterior vaginal wall, posterior vaginal wall, uterus or vaginal apex, and is a common pelvic floor dysfunction disease that affects the quality of life of middle-aged and elderly women.

[0003] Accurate diagnosis and early intervention are the keys to reducing the negative impacts of female pelvic floor diseases on health and economy. For the grading evaluation of FPOP, the Pelvic Organ Prolapse Quantification (POP-Q) system is mostly used. However, non-specialist gynecological urologists still lack professional training and diagnosis experience in the interpretation of POP-Q scores. Moreover, the POP-Q score only indicates the distance between the prolapsed organ and the hymen in the longitudinal axis direction to express the degree of prolapse. Inaccurate judgment of the degree of prolapse directly affects the treatment effect and the quality of life of patients.

[0004] Although currently B-ultrasound and two-dimensional MRI (magnetic resonance imaging) are used for imaging judgment of the degree of prolapse, they can only show the anatomical defect information of the local pelvic floor in one plane. For example, on the two-dimensional sagittal plane of MRI, the pubococcygeal line (PCL), midpubic line (MPL), and HMO grading system, perineal line, H line, etc. are used for the imaging diagnosis of FPOP. However, there is no grading system in the existing MRI evaluation system that has good consistency with clinical POP-Q. Because the current imaging evaluation method only relies on the sagittal plane and does not comprehensively analyze from a three-dimensional perspective. Moreover, in the process of using the POP-Q scoring system by gynecological urology experts, it mainly relies on experience and manual measurement. After measuring 9 distances, interpretation and diagnosis are carried out. However, experience and manual measurement are highly subjective. Therefore, the measurement results of POP-Q scores may vary among different hospitals (including non-specialist hospitals) and doctors, resulting in diagnostic errors, thus affecting the selection of surgical methods and increasing the recurrence rate of patients after surgery. Summary of the Invention

[0005] The purpose of the present invention is to provide a method, system, medium and device for evaluating the degree of pelvic organ prolapse based on three-dimensional reconstruction of the pelvis by MRI, effectively solving the technical problem that the existing evaluation of FPOP diagnosis grading mainly relies on manual measurement, which easily leads to diagnostic errors and a high recurrence rate of patients after surgery.

[0006] To solve the above technical problems, in a first aspect, the present invention provides a method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis, including the following steps:

[0007] Obtain MRI data of the pelvic organs of the object to be evaluated, and construct a pelvic organ complex model with anatomical features based on the MRI data; wherein, the pelvic organ complex model includes a three-dimensional pelvis model, a three-dimensional uterus model, a three-dimensional bladder model, a three-dimensional vagina model, and a three-dimensional rectum model;

[0008] Construct a three-dimensional reference plane based on the three-dimensional pelvis model of the pelvic organ complex model;

[0009] Mark the positions of the prolapse measurement points based on the pelvic organ complex model; wherein, the prolapse measurement points include the lowest point of the anterior vaginal wall, the lowest point of the uterus, and the lowest point of the posterior vaginal wall;

[0010] Construct a perpendicular line from the prolapse measurement point to the shortest distance of the three-dimensional reference plane based on the pelvic organ complex model, mark the intersection point of the perpendicular line and the three-dimensional reference plane as the foot of the perpendicular point, and calculate the distance from the prolapse measurement point to the foot of the perpendicular point to obtain the prolapse value; wherein, the foot of the perpendicular points include the foot of the perpendicular point of the anterior vaginal wall, the foot of the perpendicular point of the uterus, and the foot of the perpendicular point of the posterior vaginal wall;

[0011] Perform POP-Q examination on the same object to be evaluated to obtain the POP-Q score result, and compare the POP-Q score result with the prolapse value to obtain the prolapse degree evaluation result.

[0012] Preferably, obtaining MRI data of the pelvic organs of the patient and constructing a pelvic organ complex model with anatomical features based on the MRI data specifically includes the following sub-steps:

[0013] Perform mask construction, threshold segmentation, region growing, multi-layer editing, and mask smoothing processing on the MRI data in sequence to obtain a pelvic organ point cloud shell structure; wherein, the pelvic organ point cloud shell structure includes a pelvic bone point cloud shell structure, a bladder point cloud shell structure, a uterine point cloud shell structure, a vaginal point cloud shell structure, and a rectal point cloud shell structure;

[0014] Perform three-dimensional modeling based on the pelvic organ point cloud shell structure to obtain a three-dimensional pelvis model, a three-dimensional bladder model, a three-dimensional uterus model, a three-dimensional vagina model, and a three-dimensional rectum model;

[0015] Perform origin assembly on the three-dimensional pelvis model, the three-dimensional bladder model, the three-dimensional uterus model, the three-dimensional vagina model, and the three-dimensional rectum model to obtain a pelvic organ complex model.

[0016] Preferably, in the step of obtaining the pelvic organ point cloud shell structure by sequentially performing mask construction, threshold segmentation, region growing, multi-layer editing, and mask smoothing based on MRI data, the mask construction includes the following steps:

[0017] Based on the gray histogram distribution characteristics of the MRI image, respectively outline the initial contours of the pelvis, uterus, bladder, vagina, and rectum, and strengthen the gray threshold boundaries between the bladder wall, vaginal wall, and rectal wall and the surrounding tissues to improve the recognition of anatomical structures.

[0018] Preferably, a three-dimensional reference plane is constructed based on the three-dimensional model of the pelvis of the pelvic organ complex model, which specifically includes the following sub-steps:

[0019] Based on the three-dimensional model of the pelvis, sequentially mark the most protruding point on the lower edge of the left pubic symphysis, the most protruding point on the lower edge of the right pubic symphysis, the upper edge point of the starting point of the left sacrotuberous ligament, and the upper edge point of the starting point of the right sacrotuberous ligament, and calculate the midpoint between the most protruding point on the lower edge of the left pubic symphysis and the most protruding point on the lower edge of the right pubic symphysis to obtain the midpoint of the lower edge of the pubic symphysis;

[0020] Construct a three-dimensional reference plane based on the upper edge point of the starting point of the left sacrotuberous ligament, the upper edge point of the starting point of the right sacrotuberous ligament, and the midpoint of the lower edge of the pubic symphysis.

[0021] Preferably, the marking of the prolapse measurement points is performed based on the pelvic organ complex model, which specifically includes the following sub-steps:

[0022] Based on the three-dimensional model of the vagina, respectively take the point located 3 cm from the hymenal margin on the midline of the anterior vaginal wall and the lowest point on the midline of the posterior vaginal wall at the level of the rectal ampulla, and mark them as the lowest point of the anterior vaginal wall and the lowest point of the posterior vaginal wall respectively;

[0023] Based on the three-dimensional model of the uterus, mark the lowest point of the external os of the cervix as the lowest point of the uterus.

[0024] Preferably, based on the empirical value of the pelvic anatomical dimensions, the dimension length of the vertical line is set to 140 - 160 mm so that the vertical line penetrates the three-dimensional reference plane.

[0025] In a second aspect, the present invention also provides a pelvic organ prolapse degree evaluation system based on MRI three-dimensional reconstruction of the pelvis, including an MRI data acquisition module, a three-dimensional reference plane construction module, a prolapse measurement point marking module, a prolapse magnitude calculation module, a POP-Q score data acquisition module, and a consistency and correlation verification module; wherein,

[0026] An MRI data acquisition module, configured to acquire MRI data of a patient's pelvic organs and construct a pelvic organ complex model with anatomical features based on the MRI data; wherein, the pelvic organ complex model includes a three-dimensional pelvic model, a three-dimensional uterine model, a three-dimensional bladder model, a three-dimensional vaginal model, and a three-dimensional rectal model;

[0027] A three-dimensional reference plane construction module, configured to construct a three-dimensional reference plane based on the three-dimensional pelvic model of the pelvic organ complex model;

[0028] A prolapse measurement point marking module, configured to mark the positions of prolapse measurement points based on the pelvic organ complex model; wherein, the prolapse measurement points include the lowest point of the anterior vaginal wall, the lowest point of the uterus, and the lowest point of the posterior vaginal wall;

[0029] A prolapse magnitude calculation module, configured to construct a perpendicular line from the prolapse measurement point to the shortest distance from the prolapse measurement point to the three-dimensional reference plane based on the pelvic organ complex model, mark the intersection point of the perpendicular line and the three-dimensional reference plane as the foot of the perpendicular point, and calculate the distance from the prolapse measurement point to the foot of the perpendicular point to obtain the prolapse magnitude; wherein, the foot of the perpendicular points include the foot of the perpendicular point of the anterior vaginal wall, the foot of the perpendicular point of the uterus, and the foot of the perpendicular point of the posterior vaginal wall;

[0030] A POP-Q score data acquisition module, configured to perform a POP-Q examination on the same patient to obtain a POP-Q score result;

[0031] A comparison module, configured to verify the consistency and correlation between the POP-Q score result and the prolapse magnitude to obtain a prolapse degree evaluation result.

[0032] In a third aspect, the present invention further provides a computer storage medium, which stores a computer program. The computer program includes program instructions, and when the program instructions are executed by a processor, the processor is caused to execute the pelvic organ prolapse degree evaluation method based on MRI three-dimensional reconstruction of the pelvis as described in the first aspect.

[0033] In a fourth aspect, the present invention further provides a computing device, including a processor and a memory for storing processor-executable programs. When the processor executes the programs stored in the memory, the pelvic organ prolapse degree evaluation method based on MRI three-dimensional reconstruction of the pelvis as described in the first aspect is implemented.

[0034] Adopting the technical solution provided by the present invention, compared with the prior art, it has the following advantages:

[0035] A method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis provided by the present invention. By obtaining MRI data of pelvic organs of an object to be evaluated and constructing a pelvic organ complex model with anatomical features based on the MRI data, it provides a high-fidelity anatomical model for quantitative analysis and surgical simulation of pelvic floor dysfunction diseases. By constructing a three-dimensional reference plane to solve the subjectivity of the hymenal margin positioning and insufficient imaging development in the POP-Q score, it can effectively avoid the influence of soft tissue imaging differences on the measurement results, form an anatomical correspondence with the POP-Q scoring system, and enhance the objectivity of clinical evaluation. By marking the positions of prolapse measurement points, constructing perpendicular lines from the prolapse measurement points to the shortest distance of the three-dimensional reference plane, and automatically calculating the distance from the prolapse measurement points to the foot points on the three-dimensional reference plane, the obtained prolapse value is a direct quantitative index of the clinical prolapse degree, which can effectively eliminate the influence of body position changes on the measurement results, realize the three-dimensional space mapping of the POP-Q scoring system, and improve the objectivity of prolapse evaluation. By verifying the consistency and correlation between the POP-Q score results and the prolapse values, it can be seen that the method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis has good consistency and correlation with the POP-Q score. Based on this, a standardized measurement process based on the three-dimensional reference plane can be established, which is compatible with multi-modal data of imaging examinations, eliminates the POP classification evaluation deviation caused by different medical institutions and different doctors, generates a three-dimensional prolapse vector map, guides the selection of individualized pelvic floor reconstruction surgical approaches, and quantitatively predicts the biomechanical stability after FPOP repair. Description of the Drawings

[0036] In order to more clearly illustrate the technical solutions of the prior art and the embodiments of the present application, the following will briefly introduce the drawings required for the description of the prior art and the embodiments of the present application. Obviously, the drawings described below are only some embodiments recorded in the present application. For those of ordinary skill in the art, without creative efforts, other drawings can also be obtained based on these drawings.

[0037] Figure 1 It is a schematic diagram of the overall process of a method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis in Embodiment 1 of the present application.

[0038] Figure 2 It is a schematic diagram of the process of constructing a pelvic organ complex model in Embodiment 1 of the present application.

[0039] Figure 3 It is a three-dimensional structure schematic diagram of the pelvic organ complex model and the three-dimensional reference plane in Embodiment 1 of the present application.

[0040] Figure 4This is a schematic three-dimensional structure diagram of constructing a three-dimensional reference plane on the pelvic three-dimensional model in the first embodiment of the present application.

[0041] Figure 5 This is a schematic three-dimensional structure diagram of constructing a perpendicular line from the lowest point of the uterus to the three-dimensional reference plane in the first embodiment of the present application. Detailed implementation manners

[0042] In order to better understand the purpose, structure and function of the present invention, the following further describes in detail a method, system, medium and device for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis provided by the present invention with reference to the accompanying drawings, so that those skilled in the art can better understand the present invention and implement it, but the examples given are not intended to limit the present invention.

[0043] Embodiment 1

[0044] Please refer to Figures 1 to 5 As shown, this embodiment provides a method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis, including the following steps:

[0045] Step S1: Obtain MRI data of the pelvic organs of the object to be evaluated, and construct a pelvic organ complex model with anatomical features based on the MRI data; wherein, the pelvic organ complex model includes a pelvic three-dimensional model, a uterine three-dimensional model, a bladder three-dimensional model, a vaginal three-dimensional model and a rectal three-dimensional model.

[0046] Specifically, first obtain the MRI data of the pelvic organs of the object to be evaluated under the Valsalva maneuver, export the original data file that conforms to the Digital Imaging and Communications in Medicine (DICOM) standard from the MRI scanning device, and then import the DICOM data into the medical imaging control system Mimics (Materialise's interactive medical image control system) for image processing. Among them, in the sequence selection stage, according to the anatomical features and imaging parameter requirements, select the diagnostically valuable T2-weighted fast spin echo axial sequence (T2WTSE-ax sequence) or the standard T2WTSE sequence scan images. After the Mimics system performs automatic image registration and preprocessing, a multi-planar reformation view interface is generated: including three mutually related coronal, transverse and sagittal view windows. Among them, the transverse window is used as the basic operation plane, which completely retains the spatial resolution and gray level information of the original MRI scan data. Constructing a pelvic organ complex model with anatomical features based on the MRI data specifically includes the following sub-steps:

[0047] Step S11: Based on the MRI data, perform mask construction, threshold segmentation, region growing, multi-layer editing, and mask smoothing processing in sequence to obtain the pelvic organ point cloud shell structure. Among them, the pelvic organ point cloud shell structure includes the pelvic bone point cloud shell structure, bladder point cloud shell structure, uterus point cloud shell structure, vagina point cloud shell structure, and rectum point cloud shell structure.

[0048] Specifically, establish the initial region of interest through mask construction, and apply threshold segmentation to distinguish different tissue types based on signal intensity differences. All segmentation operations follow the anatomical landmark points confirmed by radiologists to ensure the clinical applicability of the model. Use the region growing algorithm to achieve continuous expansion of adjacent voxels, and then perform manual correction through multi-layer editing to eliminate artifact interference. Finally, optimize the tissue boundary topology through mask smoothing. After the above processing flow, a high-precision point cloud data set is generated, that is, the pelvic organ point cloud shell structure is obtained. The pelvic organ point cloud shell structure is composed of discrete point clouds to form a non-entity shell structure, with the spatial geometric shape of the real anatomical structure. Further, according to the morphological characteristics of different pelvic organs, adopt a hierarchical progressive segmentation strategy. In the cross-sectional window, based on the gray histogram distribution characteristics of the MRI image, manually draw the initial contours of each target organ (pelvic bone, uterus, bladder, vagina, rectum), and apply the window width and window level adjustment technology to dynamically adjust the image display parameters to enhance the gray threshold boundaries between the bladder wall, vagina wall, and rectum wall and the surrounding tissues, and improve the recognition of anatomical structures.

[0049] Step S12: Perform 3D modeling based on the pelvic organ point cloud shell structure to obtain the 3D model of the pelvic bone, 3D model of the bladder, 3D model of the uterus, 3D model of the vagina, and 3D model of the rectum.

[0050] Specifically, the Mimics medical imaging processing system is used to achieve the refined three-dimensional reconstruction of pelvic organs (pelvis, bladder including urethra, anterior and posterior vaginal walls, uterus including cervix, rectum). Through the synchronous linkage function of the three views, the anatomical boundaries of the pelvis, bladder (including urethra), anterior / posterior vaginal walls, uterus (including cervix) and rectum are located layer by layer to ensure the accuracy of three-dimensional spatial positioning. Through the multi-plane reconstruction view updated in real time, the morphological continuity and spatial consistency of the organ contours in the sagittal plane and the coronal plane are synchronously verified, the artifact interference caused by the partial volume effect is eliminated, and the discrete mask is converted into a continuous surface model through the triangular meshing algorithm to obtain the three-dimensional model of the pelvis, the three-dimensional model of the bladder, the three-dimensional model of the uterus, the three-dimensional model of the vagina and the three-dimensional model of the rectum. In addition, it should be noted that when constructing the three-dimensional model of the uterus containing the cervix, the anatomical landmark points of the internal os and the external os of the cervix are accurately defined in the sagittal plane window, and the corpus-cervix continuous structure is constructed along the long axis of the uterus through the region growing algorithm, so that the constructed three-dimensional model of the uterus completely contains the corpus, the fundus and the cervical structure, and accurately restores the anatomical morphology of the internal os-external os of the cervix, which can effectively avoid the distortion problem of the corpus-cervix junction caused by the cervical flexion in the traditional method. When constructing the three-dimensional model of the vagina, the vaginal wall is stratified, that is, the mucosal-myometrial interface of the anterior and posterior vaginal walls is outlined by combining the axial and sagittal plane images, and a lumen structure with anatomical thickness is generated through mask Boolean operation. When constructing the three-dimensional model of the bladder containing the urethra, the transitional region from the bladder neck to the proximal end of the urethra is traced using the coronal plane view, and the dynamic threshold segmentation is used to maintain the morphological continuity of the urinary tract lumen.

[0051] Step S13: Perform origin assembly on the three-dimensional models of the pelvis, bladder, uterus, vagina and rectum to obtain a pelvic organ complex model.

[0052] Specifically, by performing origin assembly on the three-dimensional models of the pelvis, bladder, uterus, vagina and rectum, a pelvic organ complex model is obtained to accurately reproduce the spatial topological relationship of the pelvis-organ complex, providing a high-fidelity anatomical model for the quantitative analysis and surgical simulation of pelvic floor dysfunction diseases. Moreover, this pelvic organ complex model can be evaluated repeatedly to avoid the trouble caused by multiple physical examinations of patients.

[0053] Step S2: Construct a three-dimensional reference plane based on the three-dimensional model of the pelvis in the pelvic organ complex model.

[0054] Specifically, the purpose of this step is to establish a pelvic standardized reference plane through the all-osseous landmark localization method, aiming to solve the problems of subjectivity in the localization of the hymenal margin and insufficient imaging development in the POP-Q score, that is, the traditional POP-Q scoring system uses the hymenal margin as the horizontal reference line. However, in the MRI sagittal plane imaging, this structure often appears blurred or missing due to the limitation of soft tissue resolution. The situation of unclear imaging in special populations such as obesity during examination can be better improved. It has been confirmed by anatomical research that the spatial relationship formed by the lower edge of the pubic symphysis and the upper edge of the sacrotuberous ligament has high stability. Based on this, the most prominent point on the lower edge of the left pubic symphysis, the most prominent point on the lower edge of the right pubic symphysis, and the upper edge point of the origin of the sacrotuberous ligament (i.e., the cranial edge vertex of the bilateral osseous attachment points of the sacrotuberous ligament) are selected as osseous landmarks to construct a three-dimensional reference plane, which specifically includes the following steps:

[0055] Step S21: Based on the three-dimensional pelvic model, mark the most prominent point on the lower edge of the left pubic symphysis, the most prominent point on the lower edge of the right pubic symphysis, the upper edge point of the origin of the left sacrotuberous ligament, and the upper edge point of the origin of the right sacrotuberous ligament in sequence, and calculate the midpoint between the most prominent point on the lower edge of the left pubic symphysis and the most prominent point on the lower edge of the right pubic symphysis to obtain the midpoint of the lower edge of the pubic symphysis.

[0056] Step S22: Construct a three-dimensional reference plane based on the upper edge point of the origin of the left sacrotuberous ligament, the upper edge point of the origin of the right sacrotuberous ligament, and the midpoint of the lower edge of the pubic symphysis.

[0057] Specifically, the repeatability of plane construction is improved by bilateral symmetric point localization, and the influence of soft tissue imaging differences on the measurement results is avoided by constructing the plane with osseous landmarks, so as to form an anatomical correspondence with the POP-Q scoring system and enhance the objectivity of clinical evaluation. In addition, the three-dimensional reference plane is three-dimensionally verified by using the Mimics system to check the spatial conformity of the three-dimensional reference plane with the pelvic osseous structure, and the anatomical correspondence between the three-dimensional reference plane and the pubic symphysis and the upper edge of the origin of the sacrotuberous ligament is confirmed in the sagittal plane window.

[0058] Step S3: Mark the positions of the prolapse measurement points based on the pelvic organ complex model; among them, the prolapse measurement points include the lowest point of the anterior vaginal wall, the lowest point of the uterus, and the lowest point of the posterior vaginal wall.

[0059] Specifically, the purpose of this step is to establish an objective pelvic organ prolapse measurement system based on the pelvic organ complex model and strictly follow the definition of anatomical landmarks in the POP-Q scoring system, which specifically includes the following sub-steps:

[0060] Step S31: Based on the three-dimensional vaginal model, take the points located 3 cm from the hymenal margin on the midline of the anterior vaginal wall and the lowest point on the midline of the posterior vaginal wall at the level of the ampulla of the rectum, and mark them as the lowest point of the anterior vaginal wall and the lowest point of the posterior vaginal wall respectively.

[0061] Step S32: Based on the three-dimensional uterine model, mark the lowest point of the external os of the cervix as the lowest point of the uterus.

[0062] Specifically, load the three-dimensional reconstructed pelvic organ complex model in the Mimics system, and define the key measurement points according to the International Federation of Gynecology and Obstetrics POP-Q scoring standard, namely the lowest point of the anterior vaginal wall, the lowest point of the uterus, and the lowest point of the posterior vaginal wall. Among them, the lowest point of the anterior vaginal wall corresponds to Point Ba, which is located 3 cm from the hymenal margin on the midline of the anterior vaginal wall. The lowest point of the uterus corresponds to Point C, which is defined as the lowest point of the external os of the cervix and marked as the lowest point of the uterus. The lowest point of the posterior vaginal wall corresponds to Point Bp, which is defined as the lowest point on the midline of the posterior vaginal wall at the level of the ampulla of the rectum.

[0063] Step S4: Construct a perpendicular line from the prolapse measurement point to the shortest distance of the three-dimensional reference plane based on the pelvic organ complex model, mark the intersection point of the perpendicular line and the three-dimensional reference plane as the foot of the perpendicular point, and calculate the distance from the prolapse measurement point to the foot of the perpendicular point to obtain the prolapse value; among them, the foot of the perpendicular point includes the foot of the perpendicular point of the anterior vaginal wall, the foot of the perpendicular point of the uterus, and the foot of the perpendicular point of the posterior vaginal wall.

[0064] Specifically, select the marked prolapse measurement points, that is, mark the Ba / C / Bp points. If the prolapse measurement point is located caudal to the three-dimensional reference plane, set the perpendicular line direction to cephalad; if the prolapse measurement point is located cranial to the three-dimensional reference plane, set the perpendicular line direction to caudal. According to the empirical value of pelvic anatomical dimensions, set the length of the perpendicular line to 140 - 160 mm to ensure that the perpendicular line penetrates the reference plane. In this embodiment, the length of the perpendicular line is set to 150 mm. The perpendicular line includes the perpendicular line of the anterior vaginal wall, the perpendicular line of the uterus, and the perpendicular line of the posterior vaginal wall. Use Mimics to automatically measure the spatial distance from the lowest point of pelvic organ prolapse to the three-dimensional reference plane, eliminating the inter-observer differences in manual measurement, that is, calculate the straight-line distance from Point Ba to the foot of the perpendicular point of the anterior vaginal wall, the straight-line distance from Point C to its foot of the perpendicular point of the uterus, and the straight-line distance from Point Bp to the foot of the perpendicular point of the posterior vaginal wall respectively, and obtain the prolapse value of the anterior vaginal wall, the prolapse value of the uterus, and the prolapse value of the posterior vaginal wall, which are used to represent the degree of anterior vaginal wall prolapse, the degree of uterine prolapse, and the degree of posterior vaginal wall prolapse respectively. By constructing a perpendicular line from the prolapse measurement point to the shortest distance of the three-dimensional reference plane to eliminate the influence of body position changes on the measurement results, realize the three-dimensional space mapping of the POP-Q scoring system, and improve the objectivity of prolapse assessment. In addition, to break through the perspective limitation of traditional two-dimensional measurement and accurately reflect the spatial vector characteristics of organ prolapse, the perpendicular line and the three-dimensional model are synchronously colored and displayed.

[0065] Furthermore, by using the principle of the two-point linear equation in Euclidean geometry, the shortest path segment between the lowest point of pelvic organ prolapse and the foot point is established in a three-dimensional coordinate system, and the length of this segment is the direct quantitative index of the clinical prolapse degree. In the three-dimensional coordinate system, the coordinates of the prolapse measurement point (the lowest point of the anterior vaginal wall, the lowest point of the uterus, or the lowest point of the posterior vaginal wall) are set as A(x A , y A , z A ), and the coordinates of the foot point corresponding to the prolapse measurement point (the foot point of the anterior vaginal wall, the foot point of the uterus, or the foot point of the posterior vaginal wall) are B(x B , y B , z B ). The Euclidean distance formula is applied to calculate the length d of the shortest path segment, and the calculation formula is as follows:

[0066]

[0067] The distance value with positive and negative values is obtained through the above formula. If d is positive, it indicates that the prolapse measurement point is located caudal to the three-dimensional reference plane, suggesting pelvic organ prolapse; if d is negative, it indicates that the prolapse measurement point is located cranial to the three-dimensional reference plane, suggesting normal anatomical position.

[0068] Step S5: Perform a POP-Q examination on the same object to be evaluated, obtain the POP-Q score result, and compare the POP-Q score result with the prolapse magnitude value to obtain the prolapse degree evaluation result.

[0069] Specifically, the purpose of this step is to establish the mapping relationship between the imaging evaluation system and the clinical POP-Q scoring system, and realize the quantitative multimodal evaluation of pelvic organ prolapse, which specifically includes the following sub-steps:

[0070] Step S51: Perform data standardization processing to unify the symbol rules.

[0071] Specifically, the three-dimensional reference plane is set as the anatomical zero plane, and the cranial space and caudal space of the three-dimensional reference plane are respectively defined as the negative value area and the positive value area, so that the negative value area and the positive value area respectively correspond to the upper and lower parts of the reference plane in the POP-Q score, realizing the three-dimensional space mapping of the POP-Q scoring system and establishing the mathematical correspondence between the three-dimensional reference plane and the clinical POP-Q scoring system. The four-level classification method is adopted: normal, mild, moderate, and severe, and 15 normal control groups and 71 POP patient experimental groups are included to form a research cohort.

[0072] Step S52: Perform K-means clustering analysis.

[0073] Specifically, the implementation process of K-means Clustering analysis is as follows:

[0074] Using the prolapse magnitude as the input parameter, preset the number of categories K = 4, corresponding to the four clinical degrees of classification, and perform the following steps:

[0075] Step S52-1: Randomly generate the initial cluster centers.

[0076] Step S52-2: Calculate the Euclidean Distance between the sample points and the cluster centers.

[0077] Step S52-3: Iteratively update the cluster centers until convergence (convergence threshold Δ < 0.01).

[0078] Step S53: Perform data cleaning and optimization.

[0079] Specifically, detect and eliminate the extreme value samples with Mahalanobis Distance > 3σ; repeat step S52 until a stable classification result is obtained (Cluster Stability ≥ 95%).

[0080] Step S54: Conduct data visualization verification.

[0081] Specifically, generate a two-dimensional scatter plot, with the horizontal and vertical axes representing the POP-Q score measurement values and the prolapse magnitude respectively. Use color coding to distinguish the four levels of classification (blue: normal; green: mild; orange: moderate; red: severe), and mark the classification boundaries with dotted lines to verify the spatial mapping relationship between the imaging evaluation system and the clinical POP-Q score system.

[0082] Step S55: Conduct the Kappa consistency test. The calculation formula for the Kappa coefficient is as follows:

[0083]

[0084] Among them, the Kappa consistency test is mainly used to measure the degree of consistency when two evaluation methods classify the same object. In the above formula, P o is the observed agreement rate, P eLet \(k\) be the expected consistency rate, and the grading criteria are as follows: if \(0.61\leq k\leq0.80\), it indicates that there is a high consistency between the imaging evaluation system and the clinical POP-Q scoring system in the grading of pelvic organ prolapse; if \(0.41\leq k\leq0.60\), it indicates that the imaging evaluation system and the clinical POP-Q scoring system can reach a certain degree of agreement in the grading of pelvic organ prolapse; if \(k\leq0.40\), it indicates that there is only a low consistency between the imaging evaluation system and the clinical POP-Q scoring system in the grading of pelvic organ prolapse. In this embodiment, the consistency test results between the imaging evaluation system and the clinical POP-Q scoring system are as follows: for the middle pelvis (uterine prolapse), \(k = 0.713\), indicating a high consistency between the imaging evaluation system and the clinical POP-Q scoring system in the grading of uterine prolapse; for the anterior pelvis (anterior vaginal wall prolapse), \(k = 0.427\), indicating that the imaging evaluation system and the clinical POP-Q scoring system can reach a certain degree of agreement in the grading of anterior vaginal wall prolapse; for the posterior pelvis (posterior vaginal wall prolapse), \(k = 0.261\), indicating that there is only a low consistency between the imaging evaluation system and the clinical POP-Q scoring system in the grading of posterior vaginal wall prolapse.

[0085] Step S56: Perform Spearman rank correlation analysis to evaluate the correlation strength between the grading results of the imaging evaluation system and the clinical POP-Q scoring system.

[0086] Specifically, the Spearman rank correlation analysis is a non-parametric correlation metric used to measure the monotonic correlation between two variables. The calculation formula of the Spearman rank correlation coefficient is as follows:

[0087]

[0088] where \(r\) in the above formula is the rank correlation coefficient, and \(D\) iLet \(d\) be the difference in ranks for each pair of samples of the two variables, and \(n\) be the sample size. Grading criteria: If \(0.7\leq r\leq1.0\), it indicates a strong correlation between the imaging evaluation system and the clinical POP-Q scoring system in the grading of pelvic organ prolapse; if \(0.5\leq r\lt0.7\), it indicates a moderate positive correlation between the imaging evaluation system and the clinical POP-Q scoring system in the grading of pelvic organ prolapse; if \(r\lt0.5\), it indicates a weak correlation between the imaging evaluation system and the clinical POP-Q scoring system in the grading of pelvic organ prolapse. In this embodiment, the results of the correlation analysis between the imaging evaluation system and the clinical POP-Q scoring system are as follows: for the middle pelvis (uterine prolapse), \(r = 0.864\), indicating a strong correlation between the imaging evaluation system and the clinical POP-Q scoring system in the grading of uterine prolapse; for the posterior pelvis (posterior vaginal wall prolapse), \(r = 0.710\), indicating a strong correlation between the imaging evaluation system and the clinical POP-Q scoring system in the grading of posterior vaginal wall prolapse; for the anterior pelvis (anterior vaginal wall prolapse), \(r = 0.586\), indicating a moderate positive correlation between the imaging evaluation system and the clinical POP-Q scoring system in the grading of anterior vaginal wall prolapse.

[0089] From the above steps, it can be seen that a method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis provided in this embodiment obtains the MRI data of the pelvic organs of the object to be evaluated, and constructs a pelvic organ complex model with anatomical features based on the MRI data, which is used to provide a high-fidelity anatomical model for the quantitative analysis and surgical simulation of pelvic floor dysfunction diseases. By constructing a three-dimensional reference plane to solve the subjectivity of the hymenal margin positioning and the insufficient imaging in the POP-Q scoring, it can effectively avoid the influence of soft tissue imaging differences on the measurement results, and form an anatomical correspondence with the POP-Q scoring system, enhancing the objectivity of clinical evaluation. By marking the positions of the prolapse measurement points, constructing a perpendicular line from the prolapse measurement point to the shortest distance of the three-dimensional reference plane, and automatically calculating the distance from the prolapse measurement point to the foot point on the three-dimensional reference plane, the obtained prolapse value is the direct quantitative index of the clinical prolapse degree, which can effectively eliminate the influence of body position changes on the measurement results, realize the three-dimensional space mapping of the POP-Q scoring system, and improve the objectivity of prolapse evaluation. By verifying the consistency and correlation between the POP-Q scoring results and the prolapse values, it can be seen that the method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis has good consistency and correlation with the POP-Q scoring. Based on this, a standardized measurement process based on the three-dimensional reference plane can be established, which is compatible with the multi-modal data of imaging examinations, eliminates the POP classification evaluation deviation caused by different medical institutions and different doctors, and generates a three-dimensional prolapse vector map to guide the selection of individualized pelvic floor reconstruction surgical approaches and quantitatively predict the biomechanical stability after FPOP repair.

[0090] Example Two

[0091] This embodiment provides a pelvic organ prolapse degree evaluation system based on MRI three-dimensional reconstruction of the pelvis, which is characterized by including an MRI data acquisition module, a three-dimensional reference plane construction module, a prolapse measurement point marking module, a prolapse value calculation module, a POP-Q score data acquisition module, and a consistency and correlation verification module; wherein,

[0092] The MRI data acquisition module is used to acquire the MRI data of the patient's pelvic organs and construct a pelvic organ complex model with anatomical features based on the MRI data; wherein, the pelvic organ complex model includes a three-dimensional pelvis model, a three-dimensional uterine model, a three-dimensional bladder model, a three-dimensional vaginal model, and a three-dimensional rectal model;

[0093] The three-dimensional reference plane construction module is used to construct a three-dimensional reference plane based on the three-dimensional pelvis model of the pelvic organ complex model;

[0094] The prolapse measurement point marking module is used to mark the positions of the prolapse measurement points based on the pelvic organ complex model; wherein, the prolapse measurement points include the lowest point of the anterior vaginal wall, the lowest point of the uterus, and the lowest point of the posterior vaginal wall;

[0095] The prolapse value calculation module is used to construct a perpendicular line from the prolapse measurement point to the shortest distance from the prolapse measurement point to the three-dimensional reference plane based on the pelvic organ complex model, mark the intersection point of the perpendicular line and the three-dimensional reference plane as the foot of the perpendicular point, and calculate the distance from the prolapse measurement point to the foot of the perpendicular point to obtain the prolapse value; wherein, the foot of the perpendicular points include the foot of the perpendicular point of the anterior vaginal wall, the foot of the perpendicular point of the uterus, and the foot of the perpendicular point of the posterior vaginal wall;

[0096] The POP-Q score data acquisition module is used to perform a POP-Q examination on the same patient to obtain the POP-Q score result;

[0097] The comparison module is used to verify the consistency and correlation between the POP-Q score result and the prolapse value to obtain the prolapse degree evaluation result.

[0098] Embodiment Three

[0099] This embodiment provides a computer storage medium, and the computer storage medium stores a computer program. The computer program includes program instructions, and when the program instructions are executed by a processor, the processor is caused to execute a method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis as described in Embodiment One.

[0100] Embodiment Four

[0101] This embodiment provides a computing device, including a processor and a memory for storing the executable program of the processor. When the processor executes the program stored in the memory, it implements a method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis as described in Embodiment One.

[0102] It should be noted here that the steps involved in the above second, third, and fourth embodiments correspond to those in the first embodiment. For the specific implementation manners, reference may be made to the relevant description part of the first embodiment, which will not be elaborated here.

[0103] It can be understood that the present invention is described by means of some embodiments. Those skilled in the art will know that, without departing from the spirit and scope of the present invention, various changes or equivalent replacements can be made to these features and embodiments. Additionally, under the teaching of the present invention, these features and embodiments can be modified to adapt to specific situations and materials without departing from the spirit and scope of the present invention. Therefore, the present invention is not limited by the specific embodiments disclosed herein, and all embodiments falling within the scope of the claims of this application belong to the scope protected by the present invention.

Claims

1. A method for evaluating the degree of pelvic organ prolapse based on three-dimensional reconstruction of the pelvis by MRI, characterized in that, The steps are as follows: Obtain the MRI data of the pelvic organs of the object to be evaluated, and construct a pelvic organ complex model with anatomical features based on the MRI data; wherein, the pelvic organ complex model includes a three-dimensional pelvic model, a three-dimensional uterine model, a three-dimensional bladder model, a three-dimensional vaginal model, and a three-dimensional rectal model; Construct a three-dimensional reference plane based on the three-dimensional pelvic model of the pelvic organ complex model; Mark the positions of the prolapse measurement points based on the pelvic organ complex model; wherein, the prolapse measurement points include the lowest point of the anterior vaginal wall, the lowest point of the uterus, and the lowest point of the posterior vaginal wall; Construct a perpendicular line from the prolapse measurement point to the shortest distance from the prolapse measurement point to the three-dimensional reference plane based on the pelvic organ complex model, mark the intersection point of the perpendicular line and the three-dimensional reference plane as the foot of the perpendicular point, and calculate the distance from the prolapse measurement point to the foot of the perpendicular point to obtain the prolapse value; wherein, the foot of the perpendicular points include the foot of the perpendicular point of the anterior vaginal wall, the foot of the perpendicular point of the uterus, and the foot of the perpendicular point of the posterior vaginal wall; Perform a POP-Q examination on the same object to be evaluated to obtain the POP-Q score result, and compare the POP-Q score result with the prolapse value to obtain the prolapse degree evaluation result.

2. The method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis according to claim 1, wherein The step of obtaining the MRI data of the patient's pelvic organs and constructing a pelvic organ complex model with anatomical features based on the MRI data specifically includes the following sub-steps: Successively perform mask construction, threshold segmentation, region growing, multi-layer editing, and mask smoothing processing based on the MRI data to obtain a pelvic organ point cloud shell structure; wherein, the pelvic organ point cloud shell structure includes a pelvic point cloud shell structure, a bladder point cloud shell structure, a uterine point cloud shell structure, a vaginal point cloud shell structure, and a rectal point cloud shell structure; Perform three-dimensional modeling based on the pelvic organ point cloud shell structure to obtain a three-dimensional pelvic model, a three-dimensional bladder model, a three-dimensional uterine model, a three-dimensional vaginal model, and a three-dimensional rectal model; Perform origin assembly on the three-dimensional pelvic model, the three-dimensional bladder model, the three-dimensional uterine model, the three-dimensional vaginal model, and the three-dimensional rectal model to obtain a pelvic organ complex model.

3. The method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis according to claim 2, wherein In the step of successively performing mask construction, threshold segmentation, region growing, multi-layer editing, and mask smoothing processing based on the MRI data to obtain a pelvic organ point cloud shell structure, the mask construction includes the following steps: Based on the gray histogram distribution characteristics of the MRI image, respectively outline the initial contours of the pelvis, uterus, bladder, vagina, and rectum, and strengthen the gray threshold boundaries between the bladder wall, vaginal wall, and rectal wall and the surrounding tissues to improve the recognition of anatomical structures.

4. The method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis according to claim 1, wherein The step of constructing a three-dimensional reference plane based on the three-dimensional pelvic model of the pelvic organ complex model specifically includes the following sub-steps: Based on the three-dimensional pelvic model, successively mark the most protruding point on the lower edge of the left pubic symphysis, the most protruding point on the lower edge of the right pubic symphysis, the upper edge point of the starting point of the left sacrotuberous ligament, and the upper edge point of the starting point of the right sacrotuberous ligament, and calculate the midpoint between the most protruding point on the lower edge of the left pubic symphysis and the most protruding point on the lower edge of the right pubic symphysis to obtain the midpoint of the lower edge of the pubic symphysis; A three-dimensional reference plane is constructed based on the upper edge point of the starting point of the left sacrotuberous ligament, the upper edge point of the starting point of the right sacrotuberous ligament, and the midpoint of the lower edge of the pubic symphysis.

5. The method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis according to claim 1, wherein The marking of the prolapse measurement point positions based on the pelvic organ complex model specifically includes the following sub-steps: Based on the three-dimensional vaginal model, a position 3 cm from the hymenal margin on the midline of the anterior vaginal wall and the lowest point on the midline of the posterior vaginal wall at the level of the rectosigmoid ampulla are respectively taken and marked as the lowest point of the anterior vaginal wall and the lowest point of the posterior vaginal wall. Based on the three-dimensional uterine model, the lowest point of the external os of the cervix is marked as the lowest point of the uterus.

6. The pelvic organ prolapse degree evaluation method based on MRI three-dimensional reconstruction of the pelvis according to claim 1, wherein, Based on the empirical values of pelvic anatomical dimensions, the dimension length of the vertical line is set to 140 - 160 mm so that the vertical line passes through the three-dimensional reference plane.

7. A pelvic organ prolapse degree evaluation system based on MRI three-dimensional reconstruction of the pelvis, characterized in that, It includes an MRI data acquisition module, a three-dimensional reference plane construction module, a prolapse measurement point position marking module, a prolapse magnitude calculation module, a POP-Q score data acquisition module, and a consistency and correlation verification module; among them, The MRI data acquisition module is used to acquire the MRI data of the patient's pelvic organs and construct a pelvic organ complex model with anatomical features based on the MRI data; among them, the pelvic organ complex model includes a three-dimensional pelvic model, a three-dimensional uterine model, a three-dimensional bladder model, a three-dimensional vaginal model, and a three-dimensional rectal model. The three-dimensional reference plane construction module is used to construct a three-dimensional reference plane based on the three-dimensional pelvic model of the pelvic organ complex model. The prolapse measurement point position marking module is used to mark the prolapse measurement point positions based on the pelvic organ complex model; among them, the prolapse measurement points include the lowest point of the anterior vaginal wall, the lowest point of the uterus, and the lowest point of the posterior vaginal wall. The prolapse magnitude calculation module is used to construct a vertical line from the prolapse measurement point to the shortest distance from the three-dimensional reference plane based on the pelvic organ complex model, mark the intersection point of the vertical line and the three-dimensional reference plane as the foot of the perpendicular point, and calculate the distance from the prolapse measurement point to the foot of the perpendicular point to obtain the prolapse magnitude; among them, the foot of the perpendicular points include the foot of the perpendicular point of the anterior vaginal wall, the foot of the perpendicular point of the uterus, and the foot of the perpendicular point of the posterior vaginal wall. The POP-Q score data acquisition module is used to perform a POP-Q examination on the same patient to obtain the POP-Q score result. The comparison module is used to verify the consistency and correlation between the POP-Q score result and the prolapse magnitude to obtain the prolapse degree evaluation result.

8. A computer storage medium, characterized in that, The computer storage medium stores a computer program, and the computer program includes program instructions. When the program instructions are executed by the processor, the processor executes the method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis according to any one of claims 1 to 6.

9. A computing device, comprising a processor and a memory for storing processor-executable programs, characterized in that, When the processor executes the program stored in the memory, it implements the method for evaluating the degree of pelvic organ prolapse based on MRI three-dimensional reconstruction of the pelvis according to any one of claims 1 to 6.

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