CN-121337464-B - Puncture path planning method for severe acute pancreatitis abdominal cavity puncture drainage

CN121337464BCN 121337464 BCN121337464 BCN 121337464BCN-121337464-B

Abstract

The invention relates to the technical field of puncture path planning, in particular to a puncture path planning method for severe acute pancreatitis abdominal cavity puncture drainage. The method comprises the steps of firstly, constructing an abdominal cavity three-dimensional model by fusing CT images and MRI images, segmenting the abdominal cavity three-dimensional model to obtain tissue areas (organ areas, blood vessel areas and focus areas), generating candidate paths based on target positions and preset body access points, then, calculating risk coefficients based on geometric features (included angles, lengths and proximity to the tissue areas) of the candidate paths, screening preliminary preferred paths, further determining puncture positions and gravity component directions by combining sagittal/coronal plane position relations, analyzing tissue density distribution, quantifying tissue deformation interference indexes, finally fusing the risk coefficients and deformation indexes, realizing rescreening of the paths, and determining optimal and alternative paths, so that key tissue structures can be effectively avoided, shifting risks in operation can be reduced, and puncture accuracy and stability are improved.

Inventors

SHI QIAO
ZHANG XIAOYI
RONG YUPING
LIU LEI
ZHU KONGFAN
Lan Jianan

Assignees

武汉大学人民医院（湖北省人民医院）

Dates

Publication Date: 20260508
Application Date: 20251217

Claims (8)

1. A puncture path planning method for severe acute pancreatitis abdominal puncture drainage, the method comprising: Acquiring CT images and MRI images of the abdominal cavity of a patient, dividing the CT images and the MRI images, determining a tissue area and constructing an abdominal cavity three-dimensional model of the patient; Analyzing the position relation between the candidate puncture path and the tangent plane of the patient body, the length of the candidate puncture path and the distribution characteristics of the puncture path and the tissue area, and determining risk factors for screening a plurality of preliminary preferred paths from all the candidate puncture paths; Determining a puncture body position and a path gravity component direction under the puncture body position based on the position relation between the initial preferred path and the sagittal plane and the coronal plane of the abdominal cavity three-dimensional model; combining the tissue deformation interference index of the preliminary preferred paths with the risk coefficient so as to determine the optimal puncture path and the alternative puncture path in all the preliminary preferred paths; Determining the puncture body position and the direction of a path gravity component under the puncture body position, wherein the puncture body position comprises the steps of taking a preliminary preferred path with the smallest risk coefficient as a target puncture path in all preliminary preferred paths, taking the intersecting line of the sagittal plane and the coronal plane of an abdominal cavity three-dimensional model as a central axis, taking the vertical line of the central axis passing through a preset body surface access point corresponding to the target puncture path, taking the included angle between the vertical line and the sagittal plane as an angle deviation factor, taking the puncture body position of a patient as supine or prone position when the angle deviation factor is smaller than a preset deviation angle, taking the direction of the path gravity component of the patient as a vertical downward direction, taking the normalized value of the difference between the angle deviation factor and the preset deviation angle as a puncture body position rotation coefficient when the angle deviation factor is larger than the preset deviation angle, taking the product of the included angle between the vertical line and the coronal plane and the body position rotation coefficient as a rotation estimation angle, taking the rotation estimation angle of the patient to the affected side or the healthy side, and taking the direction of the vertical downward direction offset by the rotation estimation angle as the direction of the path gravity component of the patient under the puncture body position; The method for acquiring the tissue deformation interference index comprises the steps of selecting a tissue region as a region to be detected, acquiring the largest two-dimensional cross section of the region to be detected in the path gravity component direction, analyzing the density characteristics of the tissue region through which the largest two-dimensional cross section passes, determining the gravity compression coefficient of the region to be detected, analyzing the distribution characteristics of the tissue region in the adjacent range of the region to be detected, determining the local space density of the region to be detected, normalizing the product of the gravity compression coefficient corresponding to the region to be detected and the local space density to obtain a tissue deformation coefficient of the region to be detected, and normalizing the sum of the tissue deformation coefficients of the tissue regions of each voxel point on any one preliminary preferred path to obtain the tissue deformation interference index of the preliminary preferred path.
2. The puncture path planning method for abdominal puncture drainage for severe acute pancreatitis according to claim 1, wherein the candidate puncture path acquisition method comprises: Taking a connecting line between each preset body entry point and the target puncture point as an initial puncture path; For any initial puncture path, performing space intersection detection on the initial puncture path and all tissue areas in the abdominal cavity three-dimensional model, and if an intersection point exists, determining that the initial puncture path is a forbidden area path; Among all the initial puncture paths, the initial puncture paths of all the non-forbidden zone paths are taken as candidate puncture paths.
3. The puncture path planning method for abdominal puncture drainage of severe acute pancreatitis according to claim 1, wherein the risk factor obtaining method comprises the following steps: Taking the cosine value of the included angle between each candidate puncture path and the tangent plane of the body surface of the patient as a puncture included angle risk factor; taking the length of each candidate puncture path as a puncture distance risk factor; On each candidate puncture path, taking the space Euclidean distance between each voxel point and the voxel point of the nearest tissue region as a distance factor, and taking the sum value of the distance factors corresponding to all the voxel points on each candidate puncture path as a puncture structure risk factor of each candidate puncture path after carrying out negative correlation mapping and normalization; and taking the normalized value of the product of the puncture angle risk factor, the puncture distance risk factor and the puncture structure risk factor of each candidate puncture path as the risk coefficient of each candidate puncture path.
4. The puncture path planning method for abdominal puncture drainage of severe acute pancreatitis according to claim 1, characterized in that the method for acquiring the gravitational compression coefficient comprises: taking the average value of HU values of all voxel points in each tissue area as a density coefficient of each tissue area, and taking the normalized value of the product of the number of the voxel points in each tissue area and the density coefficient as a quality coefficient of each tissue area; The method comprises the steps of obtaining the maximum two-dimensional cross section of a region to be measured in the direction of the path gravity component, taking all tissue regions passing through the maximum two-dimensional cross section in the direction opposite to the path gravity component as target regions, and taking the sum of the mass coefficients of all the target regions as the gravity compression coefficient of the region to be measured after normalization.
5. The puncture path planning method for abdominal puncture drainage for severe acute pancreatitis according to claim 1, wherein the local spatial density obtaining method comprises: And carrying out negative correlation mapping on the volume of the region to be detected and the minimum bounding volumes of all tissue regions intersected with the region to be detected and normalizing the volume to obtain the local space density of the region to be detected.
6. A puncture path planning method for abdominal puncture drainage for severe acute pancreatitis according to claim 1, characterized in that the determination of the optimal puncture path and the alternative puncture path among all the preliminary preferred paths comprises: taking the normalized value of the product of the tissue deformation interference index and the risk coefficient of each preliminary preferred path as a puncture risk index of each preliminary preferred path; taking the preliminary preferred path corresponding to the minimum puncture risk index as an optimal puncture path, and taking the remaining preliminary preferred path as an alternative puncture path.
7. The puncture path planning method for abdominal puncture drainage for severe acute pancreatitis according to claim 1, wherein the tissue region acquisition method comprises: The CT image and the MRI image of the abdominal cavity of the patient are used as inputs of a pre-trained neural network, so that a tissue region is output, wherein the tissue region at least comprises an organ region, a blood vessel region and a focus region.
8. The puncture path planning method for abdominal puncture drainage of severe acute pancreatitis according to claim 1, characterized in that the preliminary preferred path acquisition method comprises: And taking the candidate puncture paths with risk coefficients smaller than a preset risk threshold value as preliminary optimal paths in all the candidate puncture paths.

Description

Puncture path planning method for severe acute pancreatitis abdominal cavity puncture drainage Technical Field The invention relates to the technical field of puncture path planning, in particular to a puncture path planning method for severe acute pancreatitis abdominal cavity puncture drainage. Background Severe acute pancreatitis (Severe acute pancreatitis, SAP) is an acute abdomen with rapid onset, rapid progress, many complications and high death rate, and patients often have cases of necrosis of pancreas and surrounding tissues, fluid retention, abdominal infection, abdominal abscess, etc. The abdominal cavity puncture drainage is one of the clinically important treatment means at present, can effectively reduce abdominal cavity pressure, drain abdominal cavity effusion and abdominal cavity necrosis, and relieve abdominal cavity infection, thereby improving the prognosis of patients, so how to quickly, accurately and safely determine the puncture path, avoid damaging large blood vessels, intestinal tracts and important viscera, and simultaneously ensure the puncture effect, thus being an important problem facing the current clinic. In the prior art, a doctor is guided to perform puncturing operation based on ultrasonic or CT images, namely, a clinician acquires focus in the abdominal cavity of a patient and structural information of an adjacent important tissue area through ultrasonic examination or CT scanning, and the method is combined with image data to assist in selecting a puncturing path, but the method is more dependent on empirical puncturing of anatomical structures, in the practical application process, the adjustment of the puncturing body position of the patient can change the distribution of tissues in the abdominal cavity and the gravity acting direction, so that the tissues on the puncturing path can be mutually pushed and extruded to deform, and if the influence caused by the factors is ignored when the puncturing path is selected, the position between the puncturing path and the actual tissue position is offset, the accuracy of path planning is reduced, and the puncturing effect is seriously influenced. Disclosure of Invention In order to solve the technical problems that in the practical application process, the adjustment of the puncture body position of a patient can change the distribution of tissues in abdominal cavity and the action direction of gravity, so that the tissues on the puncture path can generate mutual pushing and other deformations, if the influence of the factors is ignored in the process of selecting the puncture path, the position between the puncture path and the actual tissue position can be offset, the accuracy of path planning is reduced, and the puncture effect is seriously influenced, the invention aims to provide a puncture path planning method for the abdominal cavity puncture drainage of severe acute pancreatitis, which adopts the following technical scheme: Acquiring CT images and MRI images of the abdominal cavity of a patient, dividing the CT images and the MRI images, determining a tissue area and constructing an abdominal cavity three-dimensional model of the patient; Analyzing the position relation between the candidate puncture path and the tangent plane of the patient body, the length of the candidate puncture path and the distribution characteristics of the puncture path and the tissue area, and determining risk factors for screening a plurality of preliminary preferred paths from all the candidate puncture paths; Determining a puncture body position and a path gravity component direction under the puncture body position based on the position relation between the initial preferred path and the sagittal plane and the coronal plane of the abdominal cavity three-dimensional model; Combining the tissue deformation interference index of the preliminary preferred path with the risk coefficient, so as to determine the optimal puncture path and the alternative puncture path in all the preliminary preferred paths. Further, the method for acquiring the candidate puncture path comprises the following steps: Taking a connecting line between each preset body entry point and the target puncture point as an initial puncture path; For any initial puncture path, performing space intersection detection on the initial puncture path and all tissue areas in the abdominal cavity three-dimensional model, and if an intersection point exists, determining that the initial puncture path is a forbidden area path; Among all the initial puncture paths, the initial puncture paths of all the non-forbidden zone paths are taken as candidate puncture paths. Further, the risk coefficient obtaining method includes: Taking the cosine value of the included angle between each candidate puncture path and the tangent plane of the body surface of the patient as a puncture included angle risk factor; taking the length of each candidate puncture path as a puncture distance risk factor; On