CN-122004949-A - Monitoring system for lymph node biopsy puncture and biopsy puncture sampling method

CN122004949ACN 122004949 ACN122004949 ACN 122004949ACN-122004949-A

Abstract

The invention relates to the technical field of medical image navigation puncture, in particular to a monitoring system for lymph node biopsy puncture and a biopsy puncture sampling method, comprising the following steps: the method comprises the steps of obtaining real-time ultrasonic, elastography and color Doppler image data streams of a lymph node area, and performing fusion processing to generate a comprehensive feature map integrating lymph node boundary outline, internal hardness distribution and vascular running paths. And calculating a safe puncture path and a target point which avoid the blood vessel and pass through the target hardness region based on the characteristic diagram. In the puncture process, the needle insertion track is tracked in real time and is dynamically compared with a preset path, and deviation warning and correction guidance are automatically generated. Triggering sampling after the needle tip reaches the target point, and continuously monitoring the sampling area. The method improves the accuracy and the operation safety of puncture sampling through multisource information fusion and real-time navigation deviation correction.

Inventors

JIN YINGMING
Qian Suying
ZHANG CHAOYING
LIU TIANJIAO
FANG ZHI

Assignees

宁波市第二医院

Dates

Publication Date: 20260512
Application Date: 20260228

Claims (10)

1. A method of sampling a biopsy puncture of a lymph node, comprising the steps of: acquiring a real-time multi-mode image data stream of a lymph node area, wherein the real-time multi-mode image data stream comprises an ultrasonic image sequence, elastography data and color Doppler blood flow signals; Performing fusion processing on the real-time multi-mode image data stream to generate a lymph node structural feature map, wherein the lymph node structural feature map comprises the outline of a lymph node boundary, the hardness distribution area of internal tissues and the space running path of a main blood vessel; According to the lymph node structural feature diagram, calculating and determining a safe puncture path and a target point position, wherein the safe puncture path avoids a space running path of the main blood vessel and passes through a target sampling area in the hardness distribution area of the internal tissue; Tracking the actual needle insertion track of the puncture instrument in real time, and dynamically comparing the actual needle insertion track with the safe puncture path to generate track deviation warning information and correction advice; When the tip of the actual needle insertion track reaches the target position, triggering a biopsy sampling device to perform tissue sampling operation, and continuously monitoring real-time image change of a sampling area in the sampling process.
2. The method for sampling a lymph node biopsy puncture according to claim 1, wherein the fusing the real-time multi-mode image data stream to generate a lymph node structural feature map comprises: Extracting morphological boundary information of the lymph node from the ultrasonic image sequence, and constructing an initial geometric model of the lymph node through an edge detection and contour tracking algorithm; analyzing the elastography data, mapping the hardness values of different areas into pseudo colors or gray scales, and overlapping the pseudo colors or gray scales on the initial geometric model to form a lymph node enhancement model containing hardness distribution; Analyzing the color Doppler blood flow signals, identifying and positioning blood vessel structures in and around the lymph nodes, and marking the space running path of the main blood vessel and the diameter information thereof in the lymph node enhancement model; And carrying out three-dimensional registration and fusion on the morphological boundary information, the hardness distribution and the space running path of the main blood vessel under a unified space coordinate system, and outputting the lymph node structural feature map with the multidimensional structural attribute.
3. The method for sampling a lymph node biopsy puncture according to claim 2, wherein calculating and determining a safe puncture path and a target location based on the lymph node structural feature map comprises: Taking a target sampling area in the lymph node structural feature map as a center, wherein the target sampling area is determined according to a preset hardness threshold range in the hardness distribution area or manual labeling of a user; Reversely planning a space straight line or curve reaching a preset skin puncture point by taking the target sampling area as a starting point; virtually probing along the spatial line or curve, checking whether it spatially intersects the spatial travel path of the main vessel and passes through a specific region inside the lymph node causing excessive injury; if crossing or passing through a specific area exists, dynamically adjusting the angle and the depth of the space straight line or curve until a path which meets the requirement of a preset safety distance and has the shortest path length is found, and determining the path as the safety puncture path; And determining the geometric center point of the target sampling area or the characteristic point designated by the user as the target point position.
4. The method of sampling a biopsy puncture of a lymph node of claim 1, wherein said real time tracking of an actual needle penetration trajectory of a puncture instrument and dynamically comparing said actual needle penetration trajectory with said safe penetration path comprises: Acquiring the space coordinates and the attitude angle of a positioning probe arranged on a puncture instrument in real time through an electromagnetic positioning sensor or an optical navigation system; according to the space coordinates and the attitude angle of the positioning probe, the real-time space position of the tip of the puncture instrument and the pointing direction of the long axis of the instrument are calculated by combining the known physical size of the puncture instrument, the actual needle insertion track is formed, and the actual needle insertion track is drawn and updated in real time in the same space coordinate system where the lymph node structural feature map is located; Calculating the space distance between the tip of the actual needle inserting track and the corresponding depth point on the safe puncture path as a transverse deviation value; When the lateral deviation value or the angle deviation value exceeds respective set allowable thresholds, the track deviation warning information and correction advice including a deviation value and a deviation direction are generated immediately.
5. The method for sampling a lymph node biopsy puncture of claim 4, wherein generating the trajectory deviation alert information and correction advice comprises: Comparing the transverse deviation value and the angle deviation value with a preset multi-level alarm threshold value to determine an alarm level; Selecting a corresponding alarm mode according to the alarm level, wherein the alarm mode comprises color change of a visual prompt, figure flickering and frequency and tone change of an audio prompt; calculating a theoretical correction motion vector based on the vector synthesis result of the lateral deviation value and the angle deviation value; The correction motion vector is converted into a guide instruction for an operator, the guide instruction is displayed on a real-time image in a superimposed mode through a graphic arrow or expressed through a voice prompt, and the correction suggestion is formed and comprises a needle inserting angle and an adjusted rough amplitude in which direction the correction suggestion is adjusted.
6. The method of claim 1, wherein triggering the biopsy sampling device to perform a tissue sampling operation and continuously monitoring real-time image changes of the region of interest during sampling comprises: When the system detects that the space distance between the tip coordinate of the actual needle insertion track and the target point position coordinate is smaller than a trigger threshold, automatically or waiting for confirmation of a user, sending a firing instruction to the biopsy sampling device; the biopsy sampling device drives the internal cutting sleeve and the sampling needle to finish rapid advancing, cutting and withdrawing actions according to the firing instruction, and a cylindrical tissue sample is obtained; Continuously acquiring and analyzing the ultrasonic image sequence and the color Doppler blood flow signal in a short time before, during and after the triggering action is executed; echo changes, morphological shifts, and the presence of new blood flow signals in the target sampling region and its surrounding tissue are monitored to assess whether the sampling procedure has caused unexpected bleeding or tissue damage.
7. The method for sampling a lymph node biopsy puncture according to claim 2, wherein the extracting morphological boundary information of the lymph node from the ultrasound image sequence, constructing an initial geometric model of the lymph node by an edge detection and contour tracing algorithm, comprises: Preprocessing each frame of image in the ultrasonic image sequence, wherein the preprocessing comprises noise reduction filtering and contrast enhancement; applying an active contour model algorithm to the preprocessed image to initialize a closed curve surrounding the lymph node area; driving the closed curve to evolve towards the real boundary of the lymph node under the combined action of the image gradient field and the internal constraint force; when the evolution of the closed curve tends to be stable, namely the energy function of the curve reaches the minimum value, locking the curve form at the moment; Tracking and three-dimensionally reconstructing the locked closed curve in continuous frame images to obtain a continuous three-dimensional point cloud or grid model representing the outer surface of the lymph node, and taking the continuous three-dimensional point cloud or grid model as the initial geometric model.
8. The method of claim 6, wherein monitoring the target sampling area and surrounding tissue for echo changes, morphological shifts, and the presence or absence of new blood flow signals to assess whether the sampling procedure has caused unexpected bleeding or tissue damage comprises: Before the triggering action is executed, recording a baseline echo characteristic and a baseline blood flow distribution map of a target sampling area; after the firing action is executed, continuously acquiring images in a preset time period, and analyzing whether a new anechoic zone or a low-echo zone appears in a target sampling zone and a needle track along the line zone, wherein the new anechoic zone or the low-echo zone represents fresh hematoma; Meanwhile, monitoring the color Doppler blood flow signal, and checking whether abnormal punctiform or lamellar blood flow signals appear outside the original blood vessel structure, wherein the abnormal punctiform or lamellar blood flow signals prompt active bleeding; And generating a sampling safety evaluation report by combining the appearance of the new anechoic region or the anechoic region and the appearance of the abnormal punctiform or sheet blood flow signal.
9. The method for sampling a lymph node biopsy puncture of claim 1, further comprising a sample quality pre-evaluation step of: Immediately performing in-situ optical imaging on the acquired tissue sample after the biopsy sampling device completes tissue sampling operation and exits the body; Preliminary analyzing macroscopic morphology, color, length and diameter of the tissue sample through the in-situ optical imaging, and rapidly comparing the macroscopic morphology, color, length and diameter with a prestored normal lymph node tissue sample database; calculating a representative score of the sample based on the integrity, size, and whether the sample contains a characteristic structure of the lymph nodes according to the comparison result; if the representative score is lower than the qualification threshold, generating prompt information for suggesting resampling, and recording the prompt information and the current operation parameters into a case log.
10. A monitoring system for lymph node biopsy puncture comprising a memory, a processor and a computer program stored in the memory and running on the processor, characterized in that the processor, when executing the computer program, realizes the steps of a sampling method for lymph node biopsy puncture according to any of the preceding claims 1 to 9.

Description

Monitoring system for lymph node biopsy puncture and biopsy puncture sampling method Technical Field The invention relates to the technical field of medical image navigation puncture, in particular to a monitoring system for lymph node biopsy puncture and a biopsy puncture sampling method. Background In clinical lymph node aspiration biopsy, ultrasound imaging is a core guide for its practical nature. To fully evaluate lesions, it is often necessary to combine multiple imaging modalities, such as color doppler to identify blood flow distribution to avoid blood vessels, and elastography to assess tissue stiffness to locate suspicious regions. The prior standard technical proposal relies on the doctor to synchronously observe or switch the B ultrasonic image, the elastic diagram and the color blood flow diagram displayed on the independent screen when in operation. These images from different modalities are spatially non-accurately registered, and there is a temporal non-synchronism in that the physician must comprehensively interpret discrete information in the brain to form an overall judgment of the target structure, stiffness properties and vessel location, and plan the approximate puncture route accordingly. This way of integrating multi-source information, which relies on subjective experience, has a solid drawback. The separation display and processing of the multi-mode information increase the cognitive burden of an operator, and the omission or misjudgment of key fine information is easily caused under a real-time dynamic environment, so that the objectivity and accuracy of target area selection are affected. Meanwhile, path planning under non-fusion images lacks accurate quantitative spatial relation support, whether paths effectively avoid all important blood vessels and accurately pass through a target hardness zone or not mainly depends on personal experience of doctors, and uncertainty and difference among operators exist. Furthermore, the prior art lacks continuous, automated monitoring and feedback of deviations between the instrument trajectory and the predetermined path during the lancing performance phase. The doctor can only rely on visual observation of the real-time ultrasonic image to estimate the needle position, and when tissue displacement or needle deflection occurs, the deviation is difficult to be recognized immediately and quantitatively and the specific correction direction is known, so that the success rate and the safety of puncture are affected. Disclosure of Invention The invention aims to solve the defects in the prior art, and provides a monitoring system for lymph node biopsy puncture and a biopsy puncture sampling method. In order to achieve the purpose, the invention adopts the following technical scheme that the sampling method for lymph node biopsy puncture comprises the following steps: acquiring a real-time multi-mode image data stream of a lymph node area, wherein the real-time multi-mode image data stream comprises an ultrasonic image sequence, elastography data and color Doppler blood flow signals; Performing fusion processing on the real-time multi-mode image data stream to generate a lymph node structural feature map, wherein the lymph node structural feature map comprises the outline of a lymph node boundary, the hardness distribution area of internal tissues and the space running path of a main blood vessel; According to the lymph node structural feature diagram, calculating and determining a safe puncture path and a target point position, wherein the safe puncture path avoids a space running path of the main blood vessel and passes through a target sampling area in the hardness distribution area of the internal tissue; Tracking the actual needle insertion track of the puncture instrument in real time, and dynamically comparing the actual needle insertion track with the safe puncture path to generate track deviation warning information and correction advice; When the tip of the actual needle insertion track reaches the target position, triggering a biopsy sampling device to perform tissue sampling operation, and continuously monitoring real-time image change of a sampling area in the sampling process. As a further aspect of the present invention, the fusing the real-time multi-mode image data stream to generate a lymph node structural feature map includes: Extracting morphological boundary information of the lymph node from the ultrasonic image sequence, and constructing an initial geometric model of the lymph node through an edge detection and contour tracking algorithm; analyzing the elastography data, mapping the hardness values of different areas into pseudo colors or gray scales, and overlapping the pseudo colors or gray scales on the initial geometric model to form a lymph node enhancement model containing hardness distribution; Analyzing the color Doppler blood flow signals, identifying and positioning blood vessel structures in and around the lymph no