architecture

基于视频跟踪的ACL重建导航与评估系统


摘要:

在前交叉韧带(ACL)重建手术中,移植物的入点位置至关重要。然而,对于外科医生而言,确定这一入点位置往往十分困难。方法:本文基于视频追踪技术,构建了一套导航与评估系统。该系统能够利用膝关节侧位X光图像,依据股骨象限法(Quadrant Method)和胫骨Staubli法,对移植物的入点位置进行规划与仿真评估。同时,文中详细介绍了图像校正、图像配准、C臂校准、视频追踪、骨表面重建、图像融合以及虚拟仿真等关键技术的实现过程。最后,我们利用8个塑料骨模型(Sawbone,瑞士产)和10个山羊骨标本,对该系统的骨隧道规划方法及手术器械的实时追踪功能进行了实验验证。在实验过程中,外科医生通过操作使胫骨相对于股骨进行旋转,进而利用系统内置的虚拟仿真与评估模块,对预先规划的入点位置进行效果评估。结果:经对30个空间目标点进行分析,测得该系统的定位误差为1.59 mm。系统虚拟重建的ACL在“最佳等长性”以及“移植物与股骨髁间窝表面之间的无碰撞性”这两项关键指标上,均达到了理想的要求。实验结果表明,该系统在实际手术应用中具有良好的可行性与有效性。结论:该系统能够显著提高移植物入点定位的精确度,从而提升ACL重建手术的整体质量。其极低的定位误差完全满足临床手术的精度要求,且系统的各项性能已通过实验得到了充分验证。此外,由于该系统能够实时、有效地确保入点位置的准确性,不仅减轻了患者因反复调整入点而遭受的额外痛苦,同时也降低了外科医生及患者在手术过程中所受到的放射线照射剂量。



An ACL reconstruction navigation and evaluation system based on the video tracking


Abstract:

Entry position of the graft is very important in anterior cruciate ligament (ACL) reconstruction. However the determination of entry position is very difficult to the surgeon. Methods: In this paper, a navigation and evaluation system based on the video tracking is implemented for the simulation evaluation and planning insertion points based on quadrant method for the femur and Staublis method for the tibia on the lateral X-ray image of knee joint. Meanwhile, the implementation of the key technologies such as image correction, image registration, C-arm calibration, video tracking, bone surface reconstruction, image fusion, and virtual simulation are introduced. Finally, Experiments about the tunnel planning method and real time tracking of surgical apparatus are implemented on 8 bone of plastic models (Sawbone, Swiss) and 10 bones of the goat ones. In the experiment, the tibia rotates around the femur under the surgeon's implementation to evaluate the planning result with the virtual simulation and evaluation module. Result: The positioning error is 1.59mm from analysis on 30 space targets. The virtual reconstruction ACL is satisfied with two important criteria of the best isometry and collision detection between graft and intercondylar surface of femur. The results are well accepted in operations. Conclusions: It can improve precision of the entry placement and quality of ACL reconstruction operation. Low position error satisfies the requirement of operations, and system performance has been verified by the experiment. Because the position can be assured effectively in time, it not only reduces the patient's additional pain, but also decreases the surgeon and patient's radiation.