Ultrasound-nuclear magnetism / CT registration method for positioning dorsal root ganglion

Abstract

An ultrasound-nuclear magnetism / CT registration method for dorsal root ganglion positioning is characterized in that a rib is used as an auxiliary mark of an auxiliary positioning image section, and accurate registration and image fusion of an ultrasound image and a nuclear magnetism / CT image are completed through the characteristic that the relative distance between a transverse process and the rib is fixed. And finally, the purpose of accurately positioning the dorsal root ganglion is achieved. The method is simple and easy to implement, high in accuracy and capable of effectively solving the problem that the dorsal root ganglion cannot be accurately positioned on the ultrasonic image, and the puncture treatment effect of the dorsal root ganglion is improved.

Description

Technical Field

[0001] The present invention relates to the technical field of ultrasonic diagnosis and treatment, and in particular to an ultrasound-nuclear magnetic resonance or CT registration method for dorsal root ganglion positioning. Background Art

[0002] Dorsal root ganglion pulsed radiofrequency therapy is an effective neuromodulatory treatment for postherpetic neuralgia. It can modulate the spinal nerves involved in transmitting pain signals, reduce the transmission of pain signals, and promote the release of analgesic substances to achieve the effect of controlling pain.

[0003] Currently, there are several commonly used methods for locating dorsal root ganglia in clinical practice, including X-ray guidance, CT guidance, and ultrasound guidance. CT and X-ray guidance can display the bony structures surrounding the dorsal root ganglia, but cannot display blood vessels, nerves, or surrounding soft tissues, nor can they display the needle tip in real time, and they are subject to radiation contamination. Ultrasound real-time guided puncture not only has the advantage of being free of radiation contamination, but also allows for dynamic observation of the needle tip and needle path throughout the entire procedure, guiding the adjustment of the puncture direction. This avoids exposure of doctors and patients to radiation contamination while significantly improving the safety of the puncture process, making it a new method favored by clinicians.

[0004] However, since the thoracic dorsal root ganglia are located in the intervertebral foramen and on the ventral side of the vertebral lamina, when the ultrasound probe is scanned through the patient's dorsal side, the ultrasound beam is blocked by the vertebral lamina bone, making it impossible to accurately locate the dorsal root ganglia. Preoperative MRI or CT scans can show the relationship between the dorsal root ganglia and the surrounding vertebral structures. Preoperative MRI or CT measurements can assist in locating the thoracic dorsal root ganglia and presetting the ultrasound puncture path, thereby shortening the ultrasound-guided dorsal root ganglia puncture time and improving the accuracy of the puncture. As shown in the attached figure Figure 1 shown.

[0005] However, there are some problems with preoperative MRI or CT scanning-assisted positioning: during puncture, if there is a distance between the specific position of the ultrasound image section and the position of the MRI or CT measurement section, then the positioning of the affected root ganglion based on the MRI or CT measurement results will be deviated, resulting in the problem that the preset puncture path and distance cannot reach the dorsal root ganglion. Summary of the Invention

[0006] The present disclosure provides an ultrasound-MRI / CT image registration method for dorsal root ganglion positioning, which can achieve accurate auxiliary positioning of dorsal root ganglia by preoperative MRI or CT for real-time ultrasound scanning.

[0007] This method uses the fact that the direction of each person's ribs forms a certain angle with the vertebral body, and the distance from the outer edge of the vertebral body to the edge of the ribs at each level is unique and relatively fixed (see attached figure). Figure 2In ① to ④), the ribs are used as registration landmarks to assist in positioning the image sections. By taking advantage of the fixed relative distance between the spine (lamina or transverse process) and the ribs, and utilizing the relative distance between the spinal lamina (or transverse process) and the inner (or outer) edge of the ribs, precise registration and image fusion of ultrasound images and MRI or CT images are achieved, ultimately achieving the goal of precise positioning of the dorsal root ganglia.

[0008] The specific steps include:

[0009] S1, obtain MRI or CT plain scan images of the patient's thoracic spine;

[0010] S2: Ultrasound scan along the transverse axis of the patient's thoracic spine to identify and locate the spinal column and rib structures in the scanning plane, and measure the relative distance between the spinal column edge and the rib edge in the ultrasound image section of the target segment along the set angle;

[0011] S3, locates the corresponding level of the ultrasound image section of the current target segment on the thoracic spine MRI or CT image based on the relative distance between the spine and the rib edge, and achieves alignment between the ultrasound image section and the MRI or CT image level;

[0012] S4, locating the coordinate position and puncture path of the dorsal root ganglion on the MRI or CT layer located in step S3;

[0013] S5, the coordinate position of the dorsal root ganglion and the puncture path are fed back to the ultrasound image.

[0014] Furthermore, the specific method of step S1 includes:

[0015] The patient lies in a supine position to ensure that the spine is in a naturally relaxed state;

[0016] During the scanning process, technicians optimized the image quality by adjusting the machine parameters to ensure a clear display of the anatomical structure of the thoracic spine and the dorsal root ganglia;

[0017] After the scan is completed, obtain the DICOM format file of the MRI or CT scan.

[0018] Furthermore, the specific method of step S2 includes:

[0019] Ultrasound scans are performed along the transverse axis of the patient's thoracic spine to obtain transverse section images of the vertebral lamina or spinous process at any segment. The ultrasound probe is placed along the transverse axis of the thoracic spine. The ultrasound image can show the vertebral lamina or transverse process of the vertebral body, as well as the ribs at that segment.

[0020] The ultrasound ruler is used to measure along the set angle. The measuring points are located at: the inner edge (or outer edge) of the rib edge, the outer edge of the spinous process, lamina or transverse process of the spine; the measured value is used as the relative distance between the spine and the rib edge.

[0021] Furthermore, the specific method of step S3 includes:

[0022] The target segment of the current ultrasound scan is preliminarily located on the corresponding segment of the MRI or CT image. Then, based on the relative distance between the spine and the rib edge in the ultrasound section, the target segment of the current ultrasound scan is accurately located on the corresponding layer of the thoracic spine MRI or CT.

[0023] Furthermore, the specific method of step S4 includes:

[0024] The coordinate position of the dorsal root ganglion is located on the MRI or CT plane located in step S3, and the optimal path for puncturing the dorsal root ganglion through the body surface is designed based on the course of the pleura.

[0025] Furthermore, the specific method of step S5 includes:

[0026] Through image fusion, the inner or outer edge of the ribs, and the spinal lamina or vertebral transverse process are used as landmarks to fuse the relevant information of the MRI or CT image onto the ultrasound image, and display the location of the dorsal root ganglion and the preset puncture path.

[0027] Compared with the existing technology, the beneficial effects of the present invention are: ① As long as the spinous process, lamina or transverse process of the thoracic vertebra of any segment is located and the relative distance between its outer edge and the edge of the rib in the ultrasound section is measured, it can be aligned to the corresponding MRI / CT scanning level, and the coordinates of the dorsal root ganglion can be located on the MRI / CT image, and then the actual position of the dorsal root ganglion can be identified on the ultrasound image, which solves the problem that the dorsal root ganglion cannot be accurately located on the ultrasound image; ② It can effectively improve the therapeutic effect of dorsal root ganglion puncture; ③ The method is simple and easy to use with high accuracy. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] The above and other objects, features and advantages of the present disclosure will become more apparent through a more detailed description of exemplary embodiments of the present disclosure in conjunction with the accompanying drawings, wherein like reference numerals generally represent like components throughout the exemplary embodiments of the present disclosure.

[0029] Figure 1 Schematic diagram of preoperative MRI scan and dorsal root ganglion measurement;

[0030] Figure 2 This is a schematic diagram of the distance from the spinous process, vertebral body, transverse process edge to the rib edge in the sagittal cross section;

[0031] Figure 3 is a flow chart of an exemplary embodiment according to the present disclosure;

[0032] Figure 4 An example of registration of ultrasound and MRI images. DETAILED DESCRIPTION

[0033] The preferred embodiments of the present disclosure will be described in more detail below with reference to the accompanying drawings. Although preferred embodiments of the present disclosure are shown in the accompanying drawings, it should be understood that the present disclosure can be implemented in various forms and should not be limited by the embodiments set forth herein. Rather, these embodiments are provided to make the present disclosure more thorough and complete, and to fully convey the scope of the present disclosure to those skilled in the art.

[0034] The present disclosure provides an ultrasound-MRI / CT image registration method for dorsal root ganglion positioning.

[0035] In an exemplary embodiment, the process is as shown in the attached Figure 3 As shown, it mainly includes the following steps:

[0036] Step 1: MRI image acquisition: Obtain a plain scan image of the patient's thoracic spine

[0037] The patient lies supine, ensuring a naturally relaxed spine. During the scan, technicians adjust machine parameters to optimize image quality, ensuring a clear view of the thoracic spinal anatomy and dorsal root ganglia. Upon completion of the scan, a DICOM file of the MRI scan is obtained.

[0038] Step 2: Ultrasound measurement of the relative distance between the transverse process and ribs of the target segment: Ultrasound is used to obtain a transverse section image of the spinous process of any segment. The ultrasound probe is placed along the transverse axis of the thoracic spine. The transverse process and ribs of the vertebral body of the segment can be displayed on the ultrasound image. At a set fixed angle, along this angle, the distance between the spine and the edge of the ribs is measured using the ultrasound's built-in ruler. The measurement points are located at the inner edge of the rib and the outer edge of the transverse process. The measured value is the distance A.

[0039] Step 3: Locate the corresponding level of the target segment on the thoracic spine MRI by the relative distance A between the transverse process and the ribs: Preliminarily locate the corresponding segment of the MRI image based on the ultrasound scan of the target segment, and then accurately locate the corresponding level of the target segment on the thoracic spine MRI based on the distance A.

[0040] Step 4: Locate the coordinates of the dorsal root ganglion on the MRI plane: Locate the coordinates of the dorsal root ganglion on the MRI plane, and design the best path for surface puncture to the dorsal root ganglion based on the course of the pleura (as smooth as possible, avoiding the pleura).

[0041] Step 5: Feedback the coordinate position and puncture path of the dorsal root ganglion to the ultrasound image: Using image fusion technology, with the inner edge of the ribs and the transverse process of the vertebra as the landmarks, the relevant information of the MRI image is fused to the ultrasound image, as shown in the attached figure. Figure 4 As shown, the dorsal root ganglion position can be accurately located and displayed, and the puncture path can be preset.

[0042] The above technical solutions are only exemplary embodiments of the present invention. For those skilled in the art, it is easy to make various types of improvements or modifications based on the application methods and principles disclosed in the present invention, and are not limited to the methods described in the above specific embodiments of the present invention. Therefore, the methods described above are only preferred and do not have a restrictive meaning.

Claims

1. An ultrasound-MRI / CT registration method for dorsal root ganglion localization, comprising the following steps: S1, obtain MRI or CT plain scan images of the patient's thoracic spine; S2: Ultrasound scan along the transverse axis of the patient's thoracic spine to identify and locate the spinal column and rib structures in the scanning plane, and measure the relative distance between the spinal column edge and the rib edge in the ultrasound image section of the target segment along the set angle; S3, locates the corresponding level of the ultrasound image section of the current target segment on the thoracic spine MRI or CT image based on the relative distance between the spine and the rib edge, and achieves alignment between the ultrasound image section and the MRI or CT image level; S4, locating the coordinate position and puncture path of the dorsal root ganglion on the MRI or CT layer located in step S3; S5, the coordinate position of the dorsal root ganglion and the puncture path are fed back to the ultrasound image.

2. The method according to claim 1, characterized in that The specific method of step S1 includes: The patient lies in a supine position to ensure that the spine is in a naturally relaxed state; During the scanning process, technicians optimized the image quality by adjusting the machine parameters to ensure a clear display of the anatomical structure of the thoracic spine and the dorsal root ganglia; After the scan is completed, obtain the DICOM format file of the MRI or CT scan.

3. The method according to claim 1 or 2, characterized in that The specific method of step S2 includes: Ultrasound scans are performed along the transverse axis of the patient's thoracic spine to obtain transverse section images of the vertebral lamina or spinous process at any segment. The ultrasound probe is placed along the transverse axis of the thoracic spine. The ultrasound image can show the vertebral lamina or transverse process of the vertebral body, as well as the ribs at that segment. The ultrasound built-in ruler is used to measure along the set angle. The measuring points are located at the inner or outer edge of the rib edge, and the outer edge of the spinous process, lamina or transverse process of the spine. The measured value is used as the relative distance between the spine and the rib edge.

4. The method according to claim 1, wherein The specific method of step S3 includes: The target segment of the current ultrasound scan is preliminarily located on the corresponding segment of the MRI or CT image. Then, based on the relative distance between the spine and the rib edge in the ultrasound section, the target segment of the current ultrasound scan is accurately located on the corresponding layer of the thoracic spine MRI or CT.

5. The method according to claim 1, wherein The specific method of step S4 includes: The coordinate position of the dorsal root ganglion is located on the MRI or CT plane located in step S3, and the optimal path for puncturing the dorsal root ganglion through the body surface is designed based on the course of the pleura.

6. The method according to claim 1, wherein The specific method of step S5 includes: Through image fusion, the inner or outer edge of the ribs, and the spinal lamina or vertebral transverse process are used as landmarks to fuse the relevant information of the MRI or CT image onto the ultrasound image, and display the location of the dorsal root ganglion and the preset puncture path.

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