Trigeminal neuralgia percutaneous puncture path planning method and system

Abstract

The invention discloses a trigeminal neuralgia percutaneous puncture path planning method and system. The method comprises the following steps: acquiring skull CT (Computed Tomography) image data and MRI (Magnetic Resonance Imaging) image data of a target, and performing three-dimensional reconstruction to obtain an oval foramen bony model and a McLeod cavity three-dimensional model; determining an anatomical entry point, determining a bony channel constraint point based on an oval foramen bony model, and determining an ideal end point of a puncture path based on a McLeod cavity three-dimensional model; taking the anatomical entry point as a path starting point, taking the ideal end point as a path end point target, taking the bony channel constraint point as a path space constraint condition for path passing, and optimizing a target function to obtain an optimal puncture path; based on the McLeod cavity three-dimensional model space volume, determining an individualized balloon injection amount estimation range of a target; and storing the space coordinate and the direction vector of the optimal puncture path and the individualized balloon injection amount estimation range as a standardized digital file. According to the invention, the certainty and safety of the puncture path can be improved.

Description

Technical Field

[0001] This invention relates to the field of medical and health technology, and more specifically, to a method and system for percutaneous puncture path planning for trigeminal neuralgia. Background Technology

[0002] Primary trigeminal neuralgia is a common cranial nerve disorder, and percutaneous balloon compression is an important treatment method. This procedure involves inserting a needle through a specific point on the face (usually near the corner of the mouth), passing it through the foramen ovale at the base of the skull, and finally delivering the balloon catheter to McBurney's cavum, where the trigeminal ganglion is located within the skull. Precision and safety of the puncture path are crucial to this surgical procedure.

[0003] Currently, the most widely used preoperative planning method in clinical practice is as follows: First, review the patient's head CT and MRI axial and coronal images to roughly understand the location, size, and shape of the foramen ovale. On the patient's face, based on experience, mark an entry point approximately 20mm-30mm lateral to the corner of the mouth on the affected side. Simultaneously, mentally construct a line connecting this entry point to the location of the foramen ovale as seen on the ipsilateral image, serving as the approximate puncture direction. Intraoperative two-dimensional fluoroscopy using a C-arm X-ray machine is often used to adjust the puncture path and position. After the needle tip enters the foramen ovale, it continues to penetrate the cavum McBurney's, usually indirectly judged by cerebrospinal fluid outflow, electrophysiological responses, or the needle tip's proximity to specific anatomical landmarks under X-ray fluoroscopy. Balloon injection relies on the surgeon's accumulated experience and the "pear-shaped" shape of the balloon under intraoperative fluoroscopy for judgment and adjustment, lacking preoperative quantitative basis.

[0004] Analysis reveals the following main shortcomings in existing technologies: (1) The current planning process relies heavily on the surgeon’s spatial imagination and hand-eye coordination. It is an “estimate” rather than a “calculation”, which makes it difficult to ensure that the needle tip is accurately located in the ideal position of McBurney’s cavity, which may result in the balloon not being fully inflated or deviating, affecting the surgical efficacy.

[0005] (2) In the existing technology, “passing through the foramen ovale” is a rather vague concept. Because the foramen ovale is a three-dimensional bony passage, the adjacent structures in different regions such as the anterior medial and posterolateral sides have different risks. The existing technology does not define and constrain the specific target point of the puncture needle in the foramen ovale in three-dimensional space, which poses a potential risk of damaging the meningeal structure.

[0006] (3) Currently, the amount of balloon injected during surgery is not actually related to the volume of McBurney's cavity, which varies from person to person. It is filled by the surgeon based on their sense of feeling and lacks scientific basis with data support. If the injection is insufficient, it may lead to incomplete compression and poor efficacy; if the injection is excessive, it may lead to serious complications such as bradycardia and permanent neurological deficits.

[0007] (4) For the treatment of trigeminal neuralgia, since the planning process is non-quantitative and non-digital, it is difficult to standardize and promote and replicate it among different hospitals and doctors, which is not conducive to the learning, repetition and quality control of the technology.

[0008] In summary, current methods rely on the surgeon's spatial imagination based on two-dimensional images and their experience and tactile judgment for puncture. This results in a path that is difficult to define and reproduce precisely in three-dimensional space, leading to variations in puncture trajectories, entry points, and target locations among different surgeons, and even among the same surgeon at different times. This results in inaccurate path planning and poor repeatability. Furthermore, traditional path planning only requires the puncture path to pass through the foramen ovale, without clearly defining the specific safe area within the foramen ovale. In addition, the current balloon injection volume primarily depends on the surgeon's experience and lacks correlation with individual patient anatomical characteristics (such as the volume of McBurney's lumen). Summary of the Invention

[0009] The purpose of this invention is to overcome the shortcomings of the prior art and provide a method and system for percutaneous puncture path planning for trigeminal neuralgia.

[0010] According to a first aspect of the present invention, a method for percutaneous puncture path planning for trigeminal neuralgia is provided. The method includes the following steps: Acquire the head CT and MRI images of the target and perform three-dimensional reconstruction to obtain the corresponding three-dimensional reconstructed bony model of the foramen ovale and the segmented three-dimensional model of the cavum McBurney's. The anatomical entry point is determined, and the bony channel constraint point is determined based on the foramen ovale bony model. The ideal endpoint of the puncture path is determined based on the McBurney's three-dimensional model. Using the anatomical entry point as the starting point of the path, the ideal endpoint as the target endpoint of the path, and the bony passage constraint point as the spatial constraint condition of the path, the optimal puncture path is obtained by optimizing the set objective function. Based on the spatial volume of the McFarland three-dimensional model, the range of individualized balloon injection volume prediction for the target is determined. The spatial coordinates and direction vector of the optimal puncture path, as well as the estimated range of the individualized balloon injection volume, are stored as standardized digital files.

[0011] In one embodiment, the anatomical entry point is set as follows: on a three-dimensional facial skin model, a point with a preset distance threshold d is selected outward from the corner of the mouth on the affected side as the origin, which is the anatomical entry point.

[0012] In one embodiment, the distance threshold d is set to 20mm to 30mm.

[0013] In one embodiment, the bony channel constraint point is determined according to the following steps: For the foramen ovale bony model, the contour is identified by an edge detection algorithm from the axial view that best displays its elliptical shape, and the anteromedial bony edge point closest to the medial canthus on the contour is selected as the bony channel constraint point.

[0014] In one embodiment, the ideal endpoint is determined according to the following process: Calculate the total volume of the McBurney cavity 3D model and calculate the geometric center point of the McBurney cavity 3D model, defining it as the target point as the ideal endpoint.

[0015] In one embodiment, the objective function minimizes the total length of the puncture path and minimizes the distance between the set point group on the puncture path and the bony channel constraint point.

[0016] In one embodiment, the range of the individualized balloon injection volume is determined based on the following formula: Injection volume = V × k, where V is the total volume of the McBurney cavity in the three-dimensional model of the McBurney cavity, and k is a set coefficient.

[0017] In one embodiment, the set coefficient k ≥ 1.5.

[0018] According to a second aspect of the present invention, a percutaneous puncture path planning system for trigeminal neuralgia is provided. The system includes: Image acquisition and reconstruction module: used to acquire the head CT image data and MRI image data of the target, and perform three-dimensional reconstruction to obtain the corresponding three-dimensional reconstructed bony model of foramen ovale and segmented three-dimensional model of McBurney's cavity, respectively. Key parameter calculation module: used to determine the anatomical entry point, and to determine the bony channel constraint point based on the foramen ovale bony model, and to determine the ideal endpoint of the puncture path based on the McBurney's three-dimensional model; Path optimization module: Used to obtain the optimal puncture path by optimizing the set objective function, with the anatomical entry point as the starting point of the path, the ideal endpoint as the target endpoint of the path, and the bony channel constraint point as the spatial constraint condition of the path. Injection volume estimation module: used to determine the individualized balloon injection volume prediction range of the target based on the spatial volume of the McBurney cavity three-dimensional model; The planning scheme output module is used to store the spatial coordinates and direction vector of the optimal puncture path, as well as the estimated range of the individualized balloon injection volume, as a standardized digital file.

[0019] Compared with existing technologies, the advantages of this invention are as follows: the percutaneous puncture path planning method and system for trigeminal neuralgia can calculate the optimal puncture path based on the patient's preoperative three-dimensional images, reducing reliance on the surgeon's personal experience to a certain extent; the planning defines the puncture path as passing through a specific safe point within the foramen ovale as much as possible, improving the predictability and safety of the path; the planning integrates the function of calculating the McBurney's lumen volume and scientifically predicts the balloon injection volume based on this volume, enabling the differentiation of operational parameters according to individual settings. This invention can form a digital planning scheme that can directly interface with surgical navigation systems or robots, realizing a closed loop from planning to execution, and promoting the standardization and intelligence of surgery.

[0020] Other features and advantages of the invention will become clear from the following detailed description of exemplary embodiments of the invention with reference to the accompanying drawings. Attached Figure Description

[0021] The accompanying drawings, which are incorporated in and form part of this specification, illustrate embodiments of the invention and, together with their description, serve to explain the principles of the invention.

[0022] Figure 1 This is a flowchart of a percutaneous puncture path planning method for trigeminal neuralgia according to an embodiment of the present invention; Figure 2 This is an image processing flowchart according to an embodiment of the present invention. Detailed Implementation

[0023] Various exemplary embodiments of the present invention will now be described in detail with reference to the accompanying drawings. It should be noted that, unless otherwise specifically stated, the relative arrangement, numerical expressions, and values ​​of the components and steps set forth in these embodiments do not limit the scope of the invention.

[0024] The following description of at least one exemplary embodiment is merely illustrative and is in no way intended to limit the invention or its application or use.

[0025] Techniques, methods, and equipment known to those skilled in the art may not be discussed in detail, but where appropriate, such techniques, methods, and equipment should be considered part of the specification.

[0026] In all the examples shown and discussed herein, any specific values ​​should be interpreted as merely exemplary and not as limitations. Therefore, other examples of exemplary embodiments may have different values.

[0027] It should be noted that similar labels and letters in the following figures indicate similar items; therefore, once an item is defined in one figure, it does not need to be discussed further in subsequent figures.

[0028] This invention aims to systematically optimize the preoperative planning and intraoperative puncture aspects of current percutaneous trigeminal neuralgia puncture surgery (balloon compression). For example, it aims to constrain the puncture needle to pass through a safer and more reasonable location within the foramen ovale, reducing the risk of damage to surrounding blood vessels and nerves after balloon inflation. Using this invention, surgical parameters can be scientifically estimated based on the calculable McBurney's lumen volume during the preoperative planning stage, enabling more precise treatment.

[0029] Specifically, see Figure 1 As shown, the provided percutaneous puncture path planning method for trigeminal neuralgia includes the following steps: Step S1: Acquire multimodal images and perform 3D reconstruction.

[0030] For example, multimodal imaging includes a patient's head CT and MRI images. Combined Figure 2 As shown, medical image processing algorithms are used to segment and reconstruct 3D data from CT data to obtain a bony model of the skull base including the foramen ovale. Image segmentation and 3D reconstruction are also performed on MRI data to obtain a 3D model of the location of McBurney's cavity. Furthermore, image registration techniques are used to fuse the two models into a unified 3D coordinate system, and the resulting 3D model is displayed and reconstructed.

[0031] Step S2: Calculate key parameters, including the anatomical entry point, the bony channel constraint point, and the ideal endpoint of the puncture path.

[0032] In one embodiment, calculating key parameters includes: Step S21, determine the dissection entry point For example, on a three-dimensional facial skin model, take the corner of the mouth on the affected side as the origin and measure a preset distance d (preferably 20mm to 30mm) outward. Mark this point as the skin needle entry point, i.e., the anatomical entry point.

[0033] Step S22, determine the bony channel constraint point For example, in a 3D reconstructed model of the foramen ovale, its contour is identified using an edge detection algorithm from the axial viewpoint that best displays its elliptical shape. The anteromedial bony edge point closest to the inner canthus (corner of the eye) on the contour is selected and defined as the bony channel constraint point.

[0034] Step S23: Calculate the volume of the McBurney cavity and the central target point.

[0035] For example, calculate the total volume of the segmented McBurney's cavity 3D model. Simultaneously, calculate the geometric center point of this 3D model and define it as the target point, serving as the ideal endpoint of the puncture path.

[0036] Step S3: Using the anatomical entry point as the starting point of the path, the ideal endpoint as the target endpoint of the path, and the bony passage constraint point as the spatial constraint condition of the path, a multi-constraint optimized path is generated by optimizing the set objective function.

[0037] For example, using the anatomical entry point near the corner of the mouth as the starting point of the path and the central target point of McBurney's cavity as the endpoint, the bony edge point on the inner side of the foramen ovale is introduced as a spatial constraint condition for the path. An optimization algorithm is used to construct an objective function that minimizes the total length of the puncture path while simultaneously minimizing the distances between certain point groups along the path and the bony edge point on the inner side of the foramen ovale. This algorithm iteratively calculates in three-dimensional space to find an optimal puncture path. This path begins at the anatomical entry point, is "attracted," and passes through the aforementioned bony edge point on the inner side of the foramen ovale as much as possible, ultimately pointing to the central target point of McBurney's cavity. The optimized path generated in this way is a straight line that achieves the best balance between geometric shortest distance, anatomical safety, and constraint satisfaction.

[0038] In this invention, the bony edge point at the anterior medial side of the foramen ovale is defined as the bony passage constraint point that the puncture path should pass through as much as possible. This achieves a key anatomical definition for refined safety constraints of the puncture path, thus improving its safety. Furthermore, a multi-objective optimization algorithm is used to generate the path, with the anatomical entry point near the corner of the mouth as the starting point, the center target point of McBurney's cavity as the endpoint, and the bony edge point at the medial side of the foramen ovale as the mid-path constraint. This makes the path planning logic more reasonable and reliable, significantly different from simple two-point connections or rigidly constrained three-point collinearity, and routes that require continuous intraoperative adjustments.

[0039] Step S4: Perform safety verification and dose correlation, and determine the range of individualized balloon injection volume estimates.

[0040] The optimal puncture path generated by the test is kept within a safe distance from other bony structures at the skull base (such as the clivus and carotid canal). Simultaneously, the calculated McBurney's lumen volume V is used to determine the ratio k between the injection volume and McBurney's lumen volume based on clinical experience. For example, injection volume = V × k. This allows for the calculation of an individualized range for estimated balloon injection volume, where k is a definable coefficient; generally, an injection volume ≥ 1.5V requires k ≥ 1.5.

[0041] In summary, by organically integrating the individualized volume calculation of McBurney's lumen with the puncture path planning, this invention can not only plan a more reasonable specific path, but also provide quantitative suggestions on the specific injection volume based on anatomical data.

[0042] Step S5: Store the planning scheme as a standardized digital file for later use.

[0043] To enable the reusability of the planned procedure, the spatial coordinates and direction vector of the final optimal puncture path, along with the estimated range of individualized balloon injection volume, are output as a standardized digital file. This standardized digital file can be directly imported into a surgical navigation system. During the procedure, the navigation system registers and displays the planned path with the real-time tracked puncture needle, guiding the surgeon's execution. Simultaneously, the surgeon can refer to the estimated injection volume displayed on the screen for balloon inflation. By outputting the planned procedure as quantitative content containing quantified path parameters and quantified operational parameters (injection volume estimation), it can be interfaced with surgical navigation systems or robotic systems, thereby expanding its application scope.

[0044] Accordingly, the present invention also provides a percutaneous puncture path planning system for trigeminal neuralgia, used to implement one or more aspects of the above-mentioned method. For example, the system includes: an image acquisition and reconstruction module: used to acquire CT and MRI image data of the target skull, and perform three-dimensional reconstruction to obtain corresponding three-dimensional reconstructed bony models of the foramen ovale and segmented three-dimensional models of the cavum Megwert's cavity; a key parameter calculation module: used to determine the anatomical entry point, and determine the bony channel constraint point based on the foramen ovale bony model, and determine the ideal endpoint of the puncture path based on the cavum Megwert's cavity three-dimensional model; a path optimization module: used to obtain the optimal puncture path by optimizing the set objective function, using the anatomical entry point as the path starting point, the ideal endpoint as the path endpoint target, and the bony channel constraint point as the path spatial constraint condition; an injection volume estimation module: used to determine the individualized balloon injection volume estimation range of the target based on the spatial volume of the cavum Megwert's cavity three-dimensional model; and a planning scheme output module: used to store the spatial coordinates and direction vector of the optimal puncture path, as well as the individualized balloon injection volume estimation range, as a standardized digital file. Each functional module in the system can be implemented using a general-purpose processor, a dedicated processor, an FPGA, or a combination of software.

[0045] In summary, compared with the prior art, the present invention has the following advantages: (1) This invention generates paths through three-dimensional image calculation and optimization algorithms, realizing quantitative design and reducing the error of human estimation. The same patient data can be calculated at different times and by different surgeons to obtain consistent or similar planning results, which improves the standardization and repeatability of the surgery.

[0046] (2) By making the path pass through the relatively safe bony reference point on the inner side of the foramen ovale as much as possible, the present invention actively avoids the problems of potentially damaged vascular and nerve structures when passing through the posterolateral side of the foramen ovale, and the difficulty in achieving optimal filling when entering from other locations, thus reducing the surgical risk from the planning source.

[0047] (3) The present invention estimates the balloon injection volume by calculating the patient’s own McBurney’s cavity volume, so that the surgical parameters are matched with the patient’s unique anatomical features, thereby improving the efficacy and reducing complications caused by improper dosage.

[0048] (4) The planning scheme output by the present invention can connect preoperative planning and intraoperative navigation robot, providing a reference for automated and intelligent surgical execution and improving the overall technological level and efficiency of surgery.

[0049] This invention can be a system, method, and / or computer program product. A computer program product may include a computer-readable storage medium having computer-readable program instructions loaded thereon for causing a processor to implement various aspects of the invention.

[0050] The computer-readable program instructions described herein can be downloaded from computer-readable storage media to various computing / processing devices, or downloaded via a network, such as the Internet, local area network, wide area network, and / or wireless network, to an external computer or external storage device. The network may include copper transmission cables, fiber optic transmission, wireless transmission, routers, firewalls, switches, gateway computers, and / or edge servers. A network adapter card or network interface in each computing / processing device receives the computer-readable program instructions from the network and forwards them to the computer-readable storage media in the respective computing / processing device.

[0051] Various aspects of the present invention are described herein with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the invention. It should be understood that each block of the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer-readable program instructions.

[0052] The flowcharts and block diagrams in the accompanying drawings illustrate the architecture, functionality, and operation of possible implementations of systems, methods, and computer program products according to various embodiments of the present invention. In this regard, each block in a flowchart or block diagram may represent a module, segment, or portion of an instruction containing one or more executable instructions for implementing a specified logical function. In some alternative implementations, the functions marked in the blocks may occur in a different order than those marked in the drawings. For example, two consecutive blocks may actually be executed substantially in parallel, and they may sometimes be executed in reverse order, depending on the functions involved. It should also be noted that each block in the block diagrams and / or flowcharts, and combinations of blocks in the block diagrams and / or flowcharts, can be implemented using a dedicated hardware-based system that performs the specified function or action, or using a combination of dedicated hardware and computer instructions. It will be well known to those skilled in the art that implementation in hardware, implementation in software, and implementation using a combination of software and hardware are equivalent.

[0053] The various embodiments of the present invention have been described above. These descriptions are exemplary and not exhaustive, and are not limited to the disclosed embodiments. Many modifications and variations will be apparent to those skilled in the art without departing from the scope and spirit of the described embodiments. The terminology used herein is chosen to best explain the principles, practical application, or technical improvements to the embodiments in the market, or to enable others skilled in the art to understand the embodiments disclosed herein. The scope of the invention is defined by the appended claims.

Claims

1. A method for percutaneous puncture path planning for trigeminal neuralgia, comprising the following steps: Acquire the head CT and MRI images of the target and perform three-dimensional reconstruction to obtain the corresponding three-dimensional reconstructed bony model of the foramen ovale and the segmented three-dimensional model of the cavum McBurney's. The anatomical entry point is determined, and the bony channel constraint point is determined based on the foramen ovale bony model. The ideal endpoint of the puncture path is determined based on the McBurney's three-dimensional model. Using the anatomical entry point as the starting point of the path, the ideal endpoint as the target endpoint of the path, and the bony passage constraint point as the spatial constraint condition of the path, the optimal puncture path is obtained by optimizing the set objective function. Based on the spatial volume of the McFarland three-dimensional model, the range of individualized balloon injection volume prediction for the target is determined. The spatial coordinates and direction vector of the optimal puncture path, as well as the estimated range of the individualized balloon injection volume, are stored as standardized digital files.

2. The method according to claim 1, characterized in that, The anatomical entry point is set as follows: on the three-dimensional facial skin model, with the corner of the mouth on the affected side as the origin, a point with a preset distance threshold d is selected outward as the anatomical entry point.

3. The method according to claim 1, characterized in that, The bony channel constraint points are determined according to the following steps: For the foramen ovale bony model, the contour is identified by an edge detection algorithm from the axial view that best displays its elliptical shape, and the anteromedial bony edge point closest to the medial canthus on the contour is selected as the bony channel constraint point.

4. The method according to claim 1, characterized in that, The ideal endpoint is determined according to the following process: Calculate the total volume of the McBurney cavity 3D model and calculate the geometric center point of the McBurney cavity 3D model, defining it as the target point as the ideal endpoint.

5. The method according to claim 1, characterized in that, The objective function minimizes the total length of the puncture path and minimizes the distance between the set point group on the puncture path and the bony channel constraint point.

6. The method according to claim 1, characterized in that, The range of individualized balloon injection volume is determined based on the following formula: Injection volume = V × k, where V is the total volume of the McBurney cavity in the three-dimensional model of the McBurney cavity, and k is a set coefficient.

7. The method according to claim 6, characterized in that, The set coefficient k ≥ 1.

5.

8. The method according to claim 2, characterized in that, The distance threshold d is set to 20mm to 30mm.

9. A percutaneous puncture path planning system for trigeminal neuralgia, comprising: Image acquisition and reconstruction module: used to acquire the head CT image data and MRI image data of the target, and perform three-dimensional reconstruction to obtain the corresponding three-dimensional reconstructed bony model of foramen ovale and segmented three-dimensional model of McBurney's cavity, respectively. Key parameter calculation module: used to determine the anatomical entry point, and to determine the bony channel constraint point based on the foramen ovale bony model, and to determine the ideal endpoint of the puncture path based on the McBurney's three-dimensional model; Path optimization module: Used to obtain the optimal puncture path by optimizing the set objective function, with the anatomical entry point as the starting point of the path, the ideal endpoint as the target endpoint of the path, and the bony channel constraint point as the spatial constraint condition of the path. Injection volume estimation module: used to determine the individualized balloon injection volume prediction range of the target based on the spatial volume of the McBurney cavity three-dimensional model; The planning scheme output module is used to store the spatial coordinates and direction vector of the optimal puncture path, as well as the estimated range of the individualized balloon injection volume, as a standardized digital file.

10. A computer-readable storage medium having a computer program stored thereon, characterized in that, When the computer program is executed by a processor, it implements the steps of the method according to any one of claims 1 to 8.

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