Ultrasound-magnetic resonance / CT registration method for dorsal root ganglion localization

Abstract

An ultrasound-magnetic resonance / CT registration method for dorsal root ganglion positioning, which takes ribs as auxiliary markers of auxiliary positioning image sections, fixes the feature of the relative distance between transverse processes and ribs, completes accurate registration and image fusion of ultrasound images and magnetic resonance / CT images, and finally achieves the purpose of accurate positioning of dorsal root ganglion. The method is simple and easy to operate, with high accuracy, which can effectively solve the problem of inaccurate positioning of dorsal root ganglion on ultrasound images and improve the effect of dorsal root ganglion puncture treatment.

Description

Technical Field

[0001] This invention relates to the field of ultrasound diagnostic and therapeutic technology, and in particular to an ultrasound-MRI or CT registration method for locating dorsal root ganglia. Background Technology

[0002] Pulsed radiofrequency ablation of the dorsal root ganglion is an effective neuromodulation therapy for postherpetic neuralgia. It modulates the spinal nerves involved in transmitting pain signals, reduces the transmission of pain signals, and promotes the release of analgesic substances to control pain.

[0003] Currently, several methods are commonly used in clinical practice for locating the dorsal root ganglion, including X-ray guidance, CT guidance, and ultrasound guidance. CT and X-ray guidance can visualize the bony structures surrounding the dorsal root ganglion, but they cannot visualize blood vessels, nerves, or surrounding soft tissues, nor can they display the needle tip in real time, and they involve radiation contamination. Ultrasound-guided puncture, on the other hand, not only has the advantage of no radiation contamination but also allows for real-time dynamic observation of the needle tip and needle insertion path, guiding adjustments to the puncture direction. This avoids radiation exposure for both doctors and patients and significantly improves the safety of the puncture procedure, making it a popular new method among clinicians.

[0004] However, because the thoracic dorsal root ganglion is located within the intervertebral foramen and on the ventral surface of the lamina, the ultrasound beam is blocked by the lamina bone when the ultrasound probe scans from the patient's dorsal side, making it impossible to accurately locate the dorsal root ganglion. Preoperative MRI or CT scans can show the relationship between the dorsal root ganglion and the surrounding vertebral structures. Measurements taken by preoperative MRI or CT can help locate the thoracic dorsal root ganglion and pre-plan the ultrasound puncture path, thereby shortening the ultrasound-guided dorsal root ganglion puncture time and improving puncture accuracy. (See attached image) Figure 1 As shown.

[0005] However, there are some problems with preoperative MRI or CT scan-assisted localization: if there is a distance between the specific location of the ultrasound image section and the location of the MRI or CT measurement section during puncture, the localization of the dorsal root ganglion based on the MRI or CT measurement results will be deviated, causing the preset puncture path and distance to fail to reach the dorsal root ganglion. Summary of the Invention

[0006] This disclosure provides an ultrasound-MRI / CT image registration method for dorsal root ganglion localization, which enables precise auxiliary localization of the dorsal root ganglion by preoperative MRI or CT for real-time ultrasound scanning.

[0007] This method utilizes the fact that the direction of the ribs runs at a certain angle to the vertebral body in each individual, and the distance from the outer edge of the vertebral body to the edge of the rib is unique and relatively fixed at each level (as shown in the attached figure). Figure 2In steps ① to ④, the ribs are used as registration markers for auxiliary positioning image sections. By fixing the relative distance between the spine (lamina or transverse process) and the ribs, and utilizing the relative distance between the vertebral lamina (or transverse process) and the inner (or outer) edge of the rib, the ultrasound image is accurately registered and fused with the MRI or CT image, ultimately achieving the goal of precise localization of the dorsal root ganglion.

[0008] Specifically, the following steps are included:

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

[0010] S2, ultrasound scans along the transverse axis of the patient's thoracic spine, identifies and locates the spinal and rib structures in the scanning plane, and measures the relative distance between the edge of the spine and the edge of the rib in the ultrasound image section of the target segment at a set angle.

[0011] S3, by measuring the relative distance between the spine and the edges of the ribs, locates the corresponding layer of the ultrasound image section of the current target segment on the thoracic MRI or CT, thus achieving alignment between the ultrasound image section and the MRI or CT image layer;

[0012] S4. Locate the coordinates and puncture path of the dorsal root ganglion on the MRI or CT scan plane located in step S3.

[0013] S5 feeds back the coordinates of the dorsal root ganglion and the puncture path to the ultrasound image.

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

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

[0016] During the scanning process, technicians optimized image quality by adjusting machine parameters to ensure 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 the transverse axis of the patient's thoracic spine to obtain transverse cross-sectional images of the lamina or spinous process of any segment. By placing the ultrasound probe along the transverse axis of the thoracic spine, the ultrasound image can display the lamina or transverse process of the vertebral body of that segment, as well as the ribs.

[0020] Along a set angle, use the built-in scale of the ultrasound to measure the distance between the inner (or outer) edge of the rib 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 edge of the rib.

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

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

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

[0024] Locate the coordinates of the dorsal root ganglion on the MRI or CT scan as described in step S3, and design the optimal path for transsurface puncture to the dorsal root ganglion based on the course of the pleura.

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

[0026] Image fusion is used to integrate relevant information from MRI or CT images onto ultrasound images, using the inner or outer edges of the ribs and the vertebral lamina or transverse processes of the vertebral body as landmarks. This process displays the location of the dorsal root ganglion and the pre-defined puncture path.

[0027] Compared with existing technologies, the beneficial effects of this disclosure are: ① By locating the spinous process, lamina, or transverse process of any segment of the thoracic vertebra and measuring the relative distance between its lateral edge and the edge of the rib in the ultrasound section, it is possible to register to the corresponding MRI / CT scan level and locate the coordinates of the dorsal root ganglion on the MRI / CT image, and then feed it back to the ultrasound image to mark the actual location of the dorsal root ganglion, thus solving the problem of the inability to accurately locate the dorsal root ganglion on the ultrasound image; ② It can effectively improve the treatment effect of dorsal root ganglion puncture; ③ The method is simple and easy to perform, and has high accuracy. Attached Figure Description

[0028] The above and other objects, features and advantages of this disclosure will become more apparent from the more detailed description of exemplary embodiments of this disclosure taken in conjunction with the accompanying drawings, in which the same reference numerals generally represent the same components.

[0029] Figure 1 This is a schematic diagram of preoperative MRI scan and measurement of the dorsal root ganglion.

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

[0031] Figure 3 A flowchart illustrating an exemplary embodiment of this disclosure;

[0032] Figure 4 Example of registration for ultrasound and MRI images. Detailed Implementation

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

[0034] This disclosure provides a method for ultrasound-MRI / CT image registration for dorsal root ganglion localization.

[0035] In one exemplary implementation, the process is as follows: Figure 3 As shown, the main steps include:

[0036] Step 1: MRI Image Acquisition: Acquire plain MRI images of the patient's thoracic spine.

[0037] The patient lies supine to ensure the spine is in a naturally relaxed state. During the scan, technicians can adjust machine parameters to optimize image quality, ensuring clear visualization of the anatomical structures of the thoracic spine and dorsal root ganglia. After the scan is completed, the MRI scan file is obtained in DICOM format.

[0038] Step 2: Ultrasonic measurement of the relative distance between the transverse process and the ribs of the target segment: Ultrasonic acquisition of a transverse axial image of the spinous process of any segment, placing the ultrasound probe along the transverse axis of the thoracic vertebra, the ultrasound image can display the transverse process of the vertebral body and the ribs of that segment, at a set fixed angle, using the built-in scale of the ultrasound to measure the distance between the spine and the edge of the ribs, the measurement points are located at the inner edge of the ribs and the outer edge of the transverse process, respectively, and the measured value is the distance A.

[0039] Step 3: Locate the corresponding layer of the target segment on the thoracic MRI by using the relative distance A between the transverse process and the rib: Based on the ultrasound scan, the target segment is initially located on the MRI image, and then the corresponding layer of the target segment on the thoracic MRI is precisely located based on the distance A.

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

[0041] Step 5: Feedback the coordinates of the dorsal root ganglion and the puncture path onto the ultrasound image: Using image fusion technology, with the inner edge of the ribs and the transverse processes of the vertebrae as landmarks, relevant information from the MRI images is fused onto the ultrasound image, as shown in the attached figure. Figure 4 As shown, this allows for accurate location and display of the dorsal root ganglion position, as well as the preset puncture path.

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

Claims

1. A method for ultrasound-MRI / CT registration for dorsal root ganglion localization, characterized in that, Includes the following steps: S1, acquire MRI or CT images of the patient's thoracic spine; S2, ultrasound scans the transverse axis of the patient's thoracic spine, identifies and locates the spinal and rib structures in the scanning plane, and measures the relative distance between the edge of the spine and the edge of the rib in the ultrasound image section of the target segment at a set angle. S3, by measuring the relative distance between the spine and the edges of the ribs, locates the corresponding layer of the ultrasound image section of the current target segment on the thoracic MRI or CT, thus achieving alignment between the ultrasound image section and the MRI or CT image layer; S4. Locate the coordinates and puncture path of the dorsal root ganglion on the MRI or CT scan plane located in step S3. S5 feeds back the coordinates of the dorsal root ganglion and the puncture path to the ultrasound image. The specific method of step S2 includes: Ultrasound scans the transverse axis of the patient's thoracic spine to obtain transverse cross-sectional images of the lamina or spinous process of any segment. By placing the ultrasound probe along the transverse axis of the thoracic spine, the ultrasound image can display the lamina or transverse process of the vertebral body of that segment, as well as the ribs. Along a set angle, the ultrasound built-in ruler is used to measure the distance between the inner or outer edge of the rib 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 edge of the rib. The specific method of step S3 includes: Based on the target segment of the current ultrasound scan, the corresponding segment in the MRI or CT image is initially located. Then, based on the relative distance between the spine and the rib edges in the ultrasound section, the corresponding layer of the target segment of the current ultrasound scan on the thoracic MRI or CT is precisely located.

2. The method according to claim 1, characterized in that, The specific method of step S1 includes: The patient should lie supine to ensure that the spine is in a naturally relaxed state; During the scanning process, technicians optimized image quality by adjusting machine parameters to ensure 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, characterized in that, The specific method of step S4 includes: Locate the coordinates of the dorsal root ganglion on the MRI or CT scan as described in step S3, and design the optimal path for transsurface puncture to the dorsal root ganglion based on the course of the pleura.

4. The method according to claim 1, characterized in that, The specific method of step S5 includes: Image fusion is used to integrate relevant information from MRI or CT images onto ultrasound images, using the inner or outer edges of the ribs and the vertebral lamina or transverse processes of the vertebral body as landmarks. This process displays the location of the dorsal root ganglion and the pre-defined puncture path.

Images