CN-122004939-A - Comprehensive quantitative evaluation method and device for spinal surgery based on multi-mode ultrasonic parameters

CN122004939ACN 122004939 ACN122004939 ACN 122004939ACN-122004939-A

Abstract

The invention discloses a comprehensive quantitative evaluation method and device for spinal surgery based on multi-mode ultrasonic parameters, and relates to the technical field of medical ultrasonic imaging. Aiming at the problems that the prior operation decompression assessment depends on subjective experience and has an optical blind zone, the invention respectively calculates the change characteristic quantities of morphology, tissue mechanics and hemodynamic dimensions by acquiring ultrasonic data such as B ultrasonic, shear wave elasticity, ultramicro blood flow and the like of nerve roots before and after decompression in a liquid coupling medium, and generates a comprehensive decompression score representing physical state improvement by substituting the change characteristic quantities into a weighting model constructed by an entropy weight method after normalization. The invention converts subjective qualitative judgment into objective quantitative evaluation, and cooperatively verifies the anatomic restoration and deep function restoration, assists blind area hidden piezometric detection, and improves the objectivity and accuracy of operation end point judgment.

Inventors

NING GUANGZHI
WANG JIAN
ZHU RUSEN
Ban Dexiang
GAO SHIJIE
WU QIULI
ZHAO YABING
LI BO
GUO JUNRUI
ZHANG SHUHAO

Assignees

天津医科大学总医院

Dates

Publication Date: 20260512
Application Date: 20260414

Claims (9)

1. A multi-modal ultrasound based comprehensive quantitative assessment method for spinal surgery, characterized in that the method is applied to data processing equipment and comprises the following steps: The method comprises the steps of acquiring multi-mode ultrasonic data of a target object at a first time sequence and a second time sequence, wherein the multi-mode ultrasonic data are acquired in a liquid acoustic coupling medium through an ultrasonic acquisition device and comprise B-type ultrasonic image data, shear wave elastography data and ultramicro blood flow imaging data; based on the multi-mode ultrasonic data of the first time sequence and the second time sequence, respectively calculating characteristic values of the target object in morphological dimension, tissue mechanics dimension and hemodynamic dimension, and acquiring variation characteristic values of the characteristic values of each dimension in the second time sequence relative to the first time sequence; Normalizing the change characteristic quantity of each dimension to obtain a dimensionless change characteristic quantity, substituting the dimensionless change characteristic quantity of each dimension into a preset first weighted evaluation model for weighted fusion, and generating and outputting a comprehensive decompression scoring signal representing the improvement degree of the physical state of the target object; The first weighted evaluation model is: Wherein, the method comprises the steps of, For the comprehensive decompression score, 、、 The weight coefficients corresponding to the morphological dimension, the tissue mechanical dimension and the hemodynamic dimension are satisfied and the sum is 1, 、、 The dimensionless variation characteristic quantities of the cross-sectional area dimension, the elastic modulus dimension and the blood flow state dimension after normalization treatment are respectively obtained.
2. The multi-modal ultrasound-based comprehensive quantitative assessment method for spinal surgery of claim 1, wherein the weight coefficients 、、 The method is determined by an entropy weight method based on a target data set, and the calculation process of the entropy weight method comprises the following steps: Calculating the specific gravity of the sample of each dimensionless variation characteristic quantity; Calculating information entropy of each dimensionless variation characteristic quantity based on the specific gravity of the sample; calculating a corresponding information utility value according to the information entropy; And carrying out normalization processing on each information utility value to obtain the weight coefficient corresponding to each dimensionless variation characteristic quantity.
3. The multi-modal ultrasound-based comprehensive quantitative assessment method for spinal surgery according to claim 1, wherein the calculating of the characteristic values of the target object in the morphological dimension, the tissue mechanical dimension, and the hemodynamic dimension, respectively, includes: Extracting a closed boundary contour by applying an edge detection algorithm to the B-type ultrasonic image data, and calculating a cross-sectional area as a characteristic value of morphological dimension; Extracting shear wave velocity in a preset region of interest from the shear wave elastography data, and calculating an average Young modulus value based on soft tissue density to be used as a characteristic value of tissue mechanics dimension; And applying tissue motion artifact inhibition processing to the ultramicro blood flow imaging data, calculating the proportion of color blood flow pixels in a preset region of interest to all pixels to obtain a blood vessel index, or carrying out hierarchical quantization based on the power intensity distribution characteristics of blood flow signals to serve as characteristic values of hemodynamic dimensions.
4. The method for quantitative evaluation of multi-modal ultrasound-based spinal surgery according to any one of claims 1-3, further comprising the step of quantitative evaluation of the intervertebral disc: acquiring multi-mode ultrasonic data of an intervertebral disc region; Based on the acquired multi-mode ultrasonic data of the intervertebral disc region, respectively extracting characteristic parameters of three dimensions of structural form, tissue mechanics and biological physicochemical, and obtaining dimensionless characteristic quantities of all dimensions after normalization treatment; Substituting dimensionless characteristic quantities of all dimensions into a preset second weighted evaluation model to generate and output an intervertebral disc health scoring signal, wherein the second weighted evaluation model is as follows: Wherein, the method comprises the steps of, The health score for the intervertebral disc is given, 、、 The dimensionless characteristic quantities of structural form dimension, tissue mechanics dimension and biological physical and chemical dimension after normalization treatment are respectively adopted, 、、 The corresponding weight coefficients are respectively and the sum is 1.
5. The multi-modal ultrasound-based comprehensive quantitative assessment method for spinal surgery according to claim 4, wherein the extraction of the characteristic parameters of structural morphology dimensions comprises the calculation of the structural integrity scoring parameters of the annulus fibrosus, comprising the specific steps of: Performing polar coordinate transformation processing on a region of interest of the fibrous ring in the B-type ultrasonic image data, converting the region of interest into a linearly-unfolded texture image, and applying tubular structure filtering enhancement processing; extracting texture continuity index from enhanced linear texture image And abnormal echo ratio Wherein the texture continuity index Averaging the ratio of the continuous segment length to the total length of each layer of fiber texture along the fiber running direction, and passing the texture continuity index and the abnormal echo ratio through a formula Weighting and fusing to obtain normalized fiber ring structural integrity scoring parameters as the components Wherein And (3) with As the internal weight coefficient of the model, the model is a model, The coefficients are adjusted for sensitivity.
6. The multi-modal ultrasound-based spinal surgery integrated quantitative assessment method of claim 4, further comprising generating and outputting integrated guidance information based on a dual-rail assessment strategy, specifically comprising: The first rail is used for comparing the generated comprehensive decompression scoring signal with a preset effective decompression threshold value, and generating prompt information for maintaining a real-time navigation state and a residual compression area if the comprehensive decompression scoring signal is lower than the threshold value; a second rail, comparing the generated intervertebral disc health scoring signal with a preset safety threshold, and if the generated intervertebral disc health scoring signal is lower than the safety threshold, generating a prognosis risk label representing high recurrence risk; And synchronously integrating the signals of the first rail and the second rail, and outputting comprehensive guidance information including operation end point confirmation and postoperative rehabilitation management advice.
7. The multi-modal ultrasound-based comprehensive quantitative assessment method for spinal surgery according to claim 1, further comprising a blind area auxiliary identification step of: Receiving ultrasonic scan data for a field of view blind zone; Sequentially applying a contrast limited self-adaptive histogram equalization technology, speckle suppression filtering and edge sharpening to the ultrasonic scanning data to carry out image enhancement processing; and (3) carrying out feature detection on the enhanced image based on a gray threshold segmentation algorithm or a pre-trained deep learning model, identifying abnormal echo areas such as a high echo lump, a low echo shadow area or an irregular boundary structure and the like, and superposing a visual tag for prompting a hidden pressobject on the original B-type ultrasonic image.
8. The method for comprehensive quantitative assessment of multi-modal ultrasound-based spinal surgery of claim 1, further comprising, prior to acquiring the first time series of multi-modal ultrasound data: acquiring preliminary ultrasonic scanning data of an operation area; Based on the B-type ultrasonic morphological data in the preliminary ultrasonic scanning data, extracting a continuously and linearly distributed hyperecho strip structure through an edge detection algorithm, and establishing a local coordinate system to acquire space parameters so as to establish a nerve root positioning model; fusing the shear wave elastography data and the B-type ultrasonic data, and judging the anatomical variation condition of the target object through a branching point curvature calculation algorithm and a local curvature gradient analysis; fusing the B-type ultrasonic data and the hemodynamic data, and calculating an adhesion index based on the continuous echo pixel proportion of the target boundary; and calculating a safe avoiding distance and a safe exposing path by integrating the positioning model, the anatomical variation condition and the adhesion index so as to output planning information for prompting adjustment of the window expansion parameters.
9. A multi-modal ultrasound based spinal surgery comprehensive quantitative assessment device, comprising: at least one processor, and A memory communicatively coupled to the at least one processor; The memory stores a computer program executable by the at least one processor, which, when executed by the at least one processor, enables the at least one processor to implement the method of any one of claims 1 to 8.

Description

Comprehensive quantitative evaluation method and device for spinal surgery based on multi-mode ultrasonic parameters Technical Field The invention relates to the technical field of medical ultrasonic imaging, in particular to a comprehensive quantitative evaluation method and device for spinal surgery based on multi-mode ultrasonic parameters. Background Spinal degenerative diseases are common causes of pain in the waist and legs, and lumbar spinal stenosis and lumbar disc herniation are typical clinical manifestations thereof. The application of effective physical decompression to the pressurized nerve is a central principle in the surgical treatment of such diseases. Along with the continuous evolution of surgical techniques, clinical procedures have evolved from traditional open spinal decompression endoprosthesis to single-sided two-channel endoscopic procedures, percutaneous transluminal foramenal procedures, and the like. Although surgical approaches and instruments are continually innovated, thoroughly relieving nerve compression is always the key to determine success or failure of surgery. However, in existing clinical practice, the intra-operative judgment of the operator on the core problem of "whether nerve decompression is sufficient" still relies largely on subjective experience. In open surgery, an operator usually surveys the looseness of nerve roots by means of a nerve stripper to obtain tactile feedback or observes the pulse recovery condition of an epidural sac to obtain visual feedback, and in endoscopic minimally invasive surgery, the evaluation mode mainly depends on the surface tension change, color change and pulse recovery condition of the nerve roots presented by an endoscope monitor. This qualitative assessment model, which is dominated by the personal experience of the operator, inherently lacks a uniform, objective quantitative standard, and the consistency of judgment among operators of different annual capital, different experience levels is poor, which may lead to problems of under-or over-decompression. Meanwhile, the physical boundaries limited by the optical visual field are difficult for the operator to directly observe the regions such as ventral nerve root, deep side crypt and opposite nerve root canal, and the hidden pressers possibly existing in the blind sight areas are often difficult to be found in time. More importantly, the information obtained by vision or touch is simply remained on the external form level of the nerve root, the change of functional indexes such as microcirculation perfusion state and tissue elastic modulus in the nerve root cannot be reflected, and the microcosmic physical parameters are just early sensitive indexes for judging the decompression effect. Various intraoperative auxiliary examination means applied in clinic at present cannot effectively fill the defects. The X-ray or CT scanning in the operation is mainly suitable for positioning and confirming bone structures, has limited resolving power to soft tissues such as nerves and the like and risks of ionizing radiation exposure, has higher soft tissue resolution in the operation, has high equipment cost and long time consumption in single scanning, has strict electromagnetic shielding requirements on an operation field, and is difficult to realize real-time continuous evaluation in the conventional spine operation. Although the traditional body surface ultrasonic examination does not involve ionizing radiation, the acoustic wave needs to pass through multiple layers of tissues such as skin, muscle and bone, attenuation is serious, imaging signal to noise ratio of a deep structure of a vertebral canal is insufficient, and the design of the traditional body surface probe does not consider the special liquid perfusion environment of the minimally invasive spine surgery, so that the traditional body surface ultrasonic examination cannot be directly adapted to the scenes in the surgery. As another widely used means, the intraoperative neurophysiologic monitoring is essentially a damage early warning system rather than a curative effect evaluation system. Electrophysiological signals usually exhibit abnormal changes after the nerve function is substantially damaged, have obvious hysteresis, and are difficult to reflect the dynamic process of nerve function recovery after decompression operation in an immediate and forward way. The accuracy of the technique is also easily affected by factors such as anesthesia depth, electric knife interference, body temperature fluctuation and the like, and false positive or false negative results are generated. In addition, macroscopic electrophysiological indexes cannot reach microscopic information such as improvement of local microcirculation blood supply of nerve roots and resolution of tissue edema. In recent years, multi-modal ultrasound techniques such as shear wave elastography, ultramicro-blood flow imaging, etc. have demonstrated the ability to pro