CN120436787A - A magnetic resonance breast interventional system combining software and hardware to locate lesions - Google Patents

Abstract

The present invention relates to a magnetic resonance breast intervention system for jointly locating lesions with hardware and software, and relates to magnetic resonance imaging technology; it includes a C-type magnetic resonance imaging system, a breast intervention device installed on its examination bed, and lesion positioning software on the computer side. The breast intervention device is internally integrated with an open breast coil to scan the breast tissue within the imaging area. The doctor determines a plane based on the MR images of three reference points on the outer splint of the splint assembly of the breast intervention device, and calculates the coordinate position of the lesion on the plane through the positioning software, thereby accurately determining the needle insertion position on the outer splint. The present invention is based on a C-type open low-field magnetic resonance imaging platform, allowing doctors to perform interventional operations directly from the side without the need for the patient to move throughout the process, ensuring the stability of the needle insertion and the accuracy of the relative position; in addition, by designing a special breast intervention device combined with positioning software for rapid positioning, the interventional surgery process is simplified, and accurate positioning also reduces additional damage.

Description

Magnetic resonance mammary gland intervention system for positioning focus by combining software and hardware

Technical Field

The invention relates to the technical field of magnetic resonance imaging, in particular to a magnetic resonance mammary gland interventional system for locating focus by combining software and hardware.

Background

According to data statistics, breast cancer has become the most common cancer worldwide over lung cancer, magnetic Resonance Imaging (MRI) is reliable and effective in detecting breast cancer with clinical significance and directly locating lesions in biopsies, and has increasingly highlighted roles in minimally invasive (local) treatment of breast cancer, interventional therapy research under MRI guidance has improved diagnosis and treatment of breast diseases from morphological level to diagnosis and treatment at tissue, cell and molecular level, MRI has higher sensitivity to breast cancer than ultrasound or mammography, and does not expose patients to harmful ionizing radiation;

MRI guided breast biopsies are currently performed mainly in closed magnet systems by the provision of dedicated open coils, which are mostly performed in high field strength magnetic resonance systems (1.5T and above) due to their excellent resolution and soft tissue contrast. However, the high cost makes high field MR I a difficult screening tool for widespread use by the general population, which is also why commercial MRI guided biopsy and interventional systems are currently lacking in the market. Traditional MR I-guided minimally invasive breast intervention is performed by inserting a biopsy needle from outside the breast, with limited routing, which must be performed after the patient has left the magnet. The low field MR I can provide typical MRI contrast at a lower cost than a high field MRI system with a large aperture. There are studies showing that the sensitivity of low-field and high-field MRI is the same, and that the specificity and accuracy of low-field is higher. Open MRI scanners also have lower prices, no maintenance, low specific absorption and gradient transfer rates, facilitate continuous monitoring of patient condition by the physician, and perform interventional procedures such as breast biopsies and minimally invasive interventional procedures under image guidance. Therefore, a magnetic resonance mammary gland interventional system for locating a focus by combining software and hardware is provided.

Disclosure of Invention

The invention aims to provide a magnetic resonance mammary gland interventional system for locating a focus by combining software and hardware.

The technical problems solved by the invention are as follows:

(1) How to utilize a C-type open low-field magnetic resonance imaging platform to directly perform interventional operation from the side, and solve the problems of poor needle insertion accuracy and limited path selection caused by repeated access under a high-field magnetic resonance system in the prior art;

(2) How to set image reference points by designing a special mammary gland interventional device, the grid, the needle guide position and the needle insertion depth of the needle are rapidly calculated according to the MR image, and the problems of positioning and complex operation flow by relying on subjective experience of doctors in the prior art are solved.

The invention can be realized by the following technical scheme that the magnetic resonance mammary gland interventional system for positioning focuses by combining software and hardware comprises a C-type MR I system and a mammary gland interventional device arranged on an examination bed thereof, wherein the mammary gland interventional device comprises a bottom plate fixed with the examination bed, a chest support component which accords with human engineering and is used for bearing the chest of a patient is fixed on the top of the bottom plate, the bottom plate is divided into two chambers, an open mammary gland coil is integrated in each chamber to scan mammary gland tissues in an imaging area, and a splint component used for fixing mammary gland soft tissues is arranged in each chamber;

The calculating end of the C-shaped MR I system is also provided with positioning software, and a plane is determined according to three reference point MR images on an outer splint in a splint assembly of the mammary gland interventional device, so that the needle inserting position on the outer splint is accurately determined.

The invention further technically improves that the chest support component comprises a chest support arranged at the top of the bottom plate, a sternum cushion is fixed at the middle part of the chest support, and a chest circumference cushion is arranged on the top surface of the chest support in a covering manner.

A further technical improvement of the invention is that the splint assembly comprises an inner splint fixed on one side of the sternum cushion, the inner splint is arranged in parallel relative to the outer splint, and the distance between the outer splint and the inner splint is adjustable.

The invention further technically improves that a pair of sliding rails are horizontally and symmetrically fixed on one side of the outer clamping plate far away from the inner clamping plate, the sliding rails are slidably arranged on the bottom plate, and a detachable handle is jointly fixed on one side of the pair of sliding rails far away from the outer clamping plate;

one side of the bottom plate is rotatably provided with a buckle, and the buckle is matched with a limit groove arranged on the side edge of the sliding rail.

The invention further technically improves that the outer clamping plate is uniformly provided with grids, when focus projection is positioned in the corresponding grids, needle guides are arranged in the grids so as to further determine the needle insertion position, and the specification of the needle guides is selected according to the focus position and the instrument size.

The invention further technically improves that 1, 3 and 4 hollow cylinders filled with the imitation body solution are respectively arranged on the outer clamping plate, and the three reference points are determined in the following ways:

The first reference point is the center of an equilateral triangle formed by connecting the center lines of the three hollow cylinders, and the third reference point is the center of a square formed by connecting the four hollow cylinders.

The invention further technically improves that the two sides of the mammary gland interventional device are respectively provided with a patient head support and an abdomen supporting cushion, the patient head support comprises a head support base arranged on an examination bed, and the top of the head support base is provided with the head support cushion.

The invention further technically improves that the interventional operation process by using the system mainly comprises the following steps:

Cleaning related equipment and checking equipment, and fixing breast tissues of a patient by adjusting the gap between the clamping plates;

acquiring MR images for lesion localization by MR I scanning;

selecting a reference point by using positioning software, constructing a plane coordinate system, calculating focus projection coordinates and matching a corresponding grid position and a needle insertion position;

the puncture needle is used for reaching and fixing the focus position, then scanning is carried out again to obtain an MR image,

Verifying puncture positioning accuracy;

Finally, tissue extraction is carried out by using the biopsy needle, and the operation ending work is completed.

Compared with the prior art, the invention has the following beneficial effects:

1. Based on the C-shaped open type low-field magnetic resonance imaging platform, doctors can directly perform interventional operations such as puncturing, tissue extraction and the like from the side, patients do not need to move in the whole process, the step of repeatedly entering and exiting under a high-field magnetic resonance system is omitted, and the stability of needle insertion and the accuracy of relative positions are ensured;

2. The interventional system is provided with the magnetic compatible display in the magnet, so that images scanned by a computer end and positioning results can be shared in real time, and an operator can communicate with an image scanning doctor through a voice communication system;

3. By designing a special mammary gland interventional device, setting an image reference point, using focus positioning software can rapidly calculate the grid, the needle guide position and the needle insertion depth of the needle according to the MR image, greatly reducing the dependence on the experience of doctors, simplifying the mammary gland interventional operation flow guided by magnetic resonance, and reducing the extra injury caused by repeated adjustment in accurate positioning.

Drawings

The present invention is further described below with reference to the accompanying drawings for the convenience of understanding by those skilled in the art.

FIG. 1 is a schematic diagram of the surgical configuration used in the magnetic resonance breast interventional system of the present invention;

FIG. 2 is a schematic view of the whole perspective structure of the mammary gland interventional device of the present invention;

FIG. 3 is a schematic view of two sets of splint mounting connection structures of the breast interventional device of the present invention;

FIG. 4 is a schematic view showing the connection of the external splint and the locking structure of the mammary gland interventional device according to the present invention;

FIG. 5 is a side view of the outer splint of the present invention in a simulated condition after fixing the soft tissue;

FIG. 6 is a graphical interface diagram of a process of locating a lesion in accordance with the present invention in combination with locating software and an interventional device;

FIG. 7 is a diagram of a positioning pin penetration actual scenario of the present invention;

FIG. 8 is a schematic view showing the state of the post-puncture scan image according to the present invention;

Fig. 9 is a schematic view of a biopsy procedure according to the present invention.

In the figure, 1, C-shaped MR I system, 2, mammary gland interventional device, 3, head support of patient, 4, human body model of patient, 5, display, 8, abdomen supporting cushion, 201, chest cushion, 202, chest support, 203, bottom plate, 204, coil cabin, 205, outer splint, 206, inner splint, 207, slide rail, 208, buckle, 209, detachable handle, 210, sternum cushion, 211, wire harness box, 301, head support base, 302, head support cushion, 901, simulated focus, 902, reference point one, 903, reference point two, 904, reference point three, 905, needle guide, 906 and image focus.

Detailed Description

In order to further describe the technical means and effects adopted by the invention for achieving the preset aim, the following detailed description is given below of the specific implementation, structure, characteristics and effects according to the invention with reference to the attached drawings and the preferred embodiment.

Referring to fig. 1-2, a magnetic resonance breast interventional system with a focus located by combining software and hardware is disclosed, wherein a main body part of the magnetic resonance breast interventional system comprises a C-type MR I system 1 and a breast interventional device 2, the breast interventional device 2 is arranged on an examination bed of the C-type MR I system 1, a human body treatment state is simulated through a patient human body model 4, a patient head support 3 and an abdomen support cushion 8 are respectively arranged at two side positions of the breast interventional device 2 and correspond to the head and abdomen positions of the patient human body model 4, the magnetic resonance guided breast interventional operation is ensured to be carried out on a human body under the prone position condition, the patient is always in a more comfortable state in the operation process, the position is ensured not to be moved due to external reasons, so that errors between an actual position and an image position are avoided, the accuracy of the operation is influenced, an angle-adjustable display 5 is further fixed at one side position of the C-type MR I system 1, so that a doctor can directly see a synchronously switched breast magnetic resonance image and focus locating result, and the left side position from top to bottom in fig. 1 is a side view of a breast interventional device entity, a side view of the breast interventional device entity, and a breast interventional device entity side view.

The structural details of the breast interventional device 2 shown in fig. 2-4 comprise a bottom plate 203 fixed on an examination bed of the C-type MR I system 1, an ergonomic breast support 202 is fixed at the top of the bottom plate 203, a breast cushion 210 is fixed at the middle part of the breast support 202, and a perithoracic cushion 201 is arranged on the top surface of the breast support 202 in a covering manner, so that discomfort brought to a patient due to a long-time lying posture is reduced to the greatest extent;

Two coil bins 204 are symmetrically arranged at the opening position of the bottom plate 203, and an open breast coil is integrated in each coil bin 204 to perform magnetic resonance scanning imaging on the breast of a patient;

Because the operation of puncturing and the like is needed to be carried out on the mammary gland of a patient through medical machinery (such as a puncture needle, a biopsy needle, an ablation needle, scissors and the like) in the interventional operation, and the mammary gland is soft tissue, in order to ensure the accuracy of the operation, clamping plate assemblies are symmetrically arranged at two sides of a sternum cushion 210 and used for fixing the soft tissue, each clamping plate assembly comprises an inner clamping plate 206 and an outer clamping plate 205, wherein the inner clamping plate 206 is fixed at one side of the sternum cushion 210, the outer clamping plate 205 is arranged at one side of the corresponding inner clamping plate 206 in parallel, the distance between the inner clamping plate 206 and the outer clamping plate 205 is adjustable, a plurality of grids are arranged on the outer clamping plate 205, and the interventional operation of needle entering into the grids at the corresponding position of the vertical projection of the focus on the outer clamping plate 205 can be carried out according to the grids of the focus;

Further, a pair of slide rails 207 are horizontally and symmetrically fixed on one side of each outer clamping plate 205 far away from the inner clamping plates, the slide rails 207 penetrate through and are arranged on one side of the bottom plate 203 in a sliding manner, and a detachable handle 209 is jointly fixed on one side of the pair of slide rails 207 far away from the outer clamping plates 205;

The breast coil in the coil bin 204 transmits signals through outgoing lines, a wire harness box 211 is fixedly arranged on the side wall of the bottom plate 203, and the outgoing line end of the breast coil is accommodated in the wire harness box 211;

Further, the patient's head rest 3 includes a head rest base 301 mounted on the examination bed, and a head rest cushion 302 is mounted on top of the head rest base 301.

In order to accurately determine the location of the target lesion in cooperation with the positioning software, as shown in fig. 5, a side view of the external splint 205 after fixing the soft tissue, the method for determining the location of the target lesion by using the patient manikin 4 specifically includes:

assuming that there is a simulated lesion 901 inside the breast of the patient phantom 4, it is necessary to precisely locate the vertical projection position of the simulated lesion 901 on the external splint 205 and the depth from the external splint 205;

Three reference points which are not on the same straight line are arranged on the outer clamping plate 205 and are respectively marked as a first reference point 902, a second reference point 903 and a third reference point 904, a plane is determined by the three reference points, and the projected coordinates of the simulated focus 901 on the plane can be calculated, so that the corresponding grid position is positioned, the needle insertion position on the needle guide 905 is determined deeper, and the needle guide 905 such as 2 multiplied by 2, 3 multiplied by 3, 4 multiplied by 4 and the like can be selected according to the differences of the focus position, the instrument size and the like, so that the operation can be performed more accurately;

Further, the first reference point 902, the second reference point 903 and the third reference point 904 are respectively set to be 1,3 and 4 hollow cylinders filled with the imitation body solution, the first reference point 902 is specifically a center of an equilateral triangle formed by connecting the centers of the three hollow cylinders, the second reference point 903 is specifically a center of a square formed by connecting the four hollow cylinders; it should be noted that, when the reference point is selected, the doctor operates the mouse to select on the positioning software, and the selection mode of the second reference point 903 and the third reference point 904 has a plurality of circles, compared with the direct selection of the first reference point 902, the circle center operation has self-comparison and reference, the vision error is smaller, the selection precision is higher, the construction precision of the coordinate system is further improved, and the obtained needle position is also more accurate;

As shown in fig. 6, three reference points are selected by positioning software, and the position of focus projection relative to the three reference points is determined after scanning, so that the position coordinates of the focus in the projection plane are obtained, the grid and the needle guide position of the needle are determined, and support is provided for a doctor to perform positioning contact pin puncture. Fig. 7 is a view of a scene of a positioning pin puncture from a magnetic resonance image and positioning software, with the lower left corner of the view illustrating the puncture in detail.

In the embodiment, the breast biopsy operation flow and focus positioning verification based on the magnetic resonance guidance are performed, the biopsy operation flow is shown in fig. 9, and the operation flow and focus positioning verification process is as follows:

Step one, preoperative preparation

Breast biopsy is a minimally invasive procedure performed by extracting focal tissue for pathological examination when the benign or malignant lesions cannot be determined after the suspicious lesions are detected by imaging. Because it belongs to invasive surgery, it is necessary to clean and disinfect the mammary gland interventional device 2, medical instruments, etc. at medical level before surgery, and check that the inter-magnet display 5 and the inter-magnet internal and external voice communication system are normal, surgical supplies and doctors are in place.

Step two, surgical positioning

Accurately placing the mammary gland interventional device 2, requesting the patient to go to a magnetic resonance examination bed, adjusting to a more comfortable prone position, placing the patient in a wrapping range of a mammary gland coil after local anesthesia of the mammary gland on the biopsy side, extruding and fixing soft tissues by adjusting the position of an outer clamping plate 205, ensuring that the imaged tissues are positioned in the center of the examination bed, and transmitting the imaged tissues to the center of a magnet by laser positioning.

Step three, MR I scanning

After the positioning is finished, the position of the focus on the image is confirmed through scanning the positioning image and the breast magnetic resonance image, the position is to be reached to the sagittal plane scanning magnetic resonance image of the breast, the scanning is to encompass the plane where the positioning point is located and the whole breast tissue, and proper sequence parameters such as layer thickness, layer spacing and the like are set to obtain the MR image for focus positioning.

Taking the silica gel phantom as an example, the scan image is shown in the left diagram of fig. 6, which is the slice MR image of the reference point and the slice MR image of the imaging focus 906 (the whole sequence images about 10 slices, only the target slice is shown here).

Step four, focus positioning

After the MR image is scanned, entering focus positioning software through a right click corresponding sequence, and automatically importing the image by the software, wherein the image is shown as a right image of the figure 6 in the third step;

According to the prompt, three reference points and a target focus are selected, and a needle inserting grid, a needle guiding position and a needle inserting depth reaching the target focus are obtained;

In the embodiment shown in fig. 6, the simulated in vivo lesion 901 is located in the grid of the fourth row and the needle guide is located in the grid of the second row, the needle insertion depth is about 35mm from the surface of the outer splint 205, and the positioning process is operated by the doctor at the computer end of the C-type MR I system 1 and synchronously displayed on the display 5 in the magnet room.

Step five, positioning puncture

The doctor in the magnet room performs interventional operation according to the positioning result displayed by the display 5, the breast biopsy is performed by using the puncture needle to reach the focus position and fixing the position, the state after the needle insertion is shown in fig. 7, and the needle insertion needs to have certain experience and special doctor operation due to certain elasticity of breast tissue and extrusion fixation.

Step six, scanning and confirming

Scanning the MR image again after the puncture needle enters, and confirming that the needle tip reaches the focus of the target, if the needle tip is deviated, a doctor is required to finely adjust according to experience or in the third step until the puncture needle reaches the focus position;

According to the simulation experiment, the matching positioning precision of software and hardware designed by the system can be controlled within 2mm, the damage to mammary tissue caused by repeatedly adjusting the needle position is reduced, a puncture confirmation image is shown in fig. 8, the track of a puncture needle can be obviously seen, and the interventional instruments are all made of the compatible material due to the special requirement of magnetic resonance.

Seventh, tissue extraction

After confirming the focus position, the puncture needle core is withdrawn from the needle sleeve, the needle sleeve is left, the biopsy needle is replaced to be inserted into the same depth to withdraw focus tissue, the biopsy needle and the needle sleeve are withdrawn repeatedly for a small amount, the needle hole is stopped, and at the moment, the breast MR image after tissue extraction can be scanned again to observe focus change.

Step eight, ending the operation

After the biopsy tissue is extracted, hemostatic treatment is performed on the puncture needle hole, scanning is finished, the patient leaves the space between the magnets, the mammary gland interventional device and the examination bed are cleaned, and the magnetic resonance system is restored.

Related technical terms are that a doctor judges the position of a focus according to magnetic resonance breast imaging, obtains tissues from the position of a target focus by using a puncture needle or performs operation of ablation treatment on the target focus by using ablation.

The magnetic resonance radio frequency coil is an electronic device composed of a plurality of groups of wires, and when the induced current in the wires changes, the (vibration) change of the magnetic field is found.

The mammary gland magnetic resonance interventional coil is used for performing magnetic resonance guided mammary gland interventional operation, needs to have an open structure, is convenient for doctors to perform interventional operation, and can fix mammary gland soft tissues by using clamping plates, so that the deviation of interventional operation caused by tissue sliding in the operation process is prevented.

The present invention is not limited in any way by the above-described preferred embodiments, but is not limited to the above-described preferred embodiments, and any person skilled in the art will appreciate that the present invention can be embodied in the form of a program for carrying out the method of the present invention, while the above disclosure is directed to various equivalent embodiments, which are capable of being modified or altered in some ways, any simple modification, equivalent variations and alterations made to the above embodiments according to the technical principles of the present invention will still fall within the scope of the technical aspects of the present invention.

Claims (8)

1. The magnetic resonance mammary gland interventional system for locating the focus by combining software and hardware comprises a C-type MR I system (1) and a mammary gland interventional device (2) arranged on an examination bed, and is characterized in that the mammary gland interventional device (2) comprises a bottom plate (203) fixed with the examination bed, a chest support component which accords with the ergonomics and is used for bearing the chest of a patient is fixed on the top of the bottom plate (203), the bottom plate (203) is divided into two chambers, an open mammary gland coil is integrated in each chamber, and mammary gland tissues entering an imaging area are scanned;

the computing end of the C-type MR I system (1) is also provided with positioning software, and a plane is determined according to three reference point MR images on an outer splint (205) in a splint assembly of the mammary gland interventional device, so that the needle insertion position on the outer splint (205) is accurately determined.

2. The magnetic resonance breast interventional system for combining software and hardware to locate lesions according to claim 1, wherein the breast support assembly comprises a breast support (202) arranged at the top of a bottom plate (203), a breast cushion (210) is fixed at the middle part of the breast support (202), and a chest cushion (201) is arranged on the top surface of the breast support (202) in a covering manner.

3. The system of claim 1, wherein the splint assembly comprises an inner splint (206) fixed to one side of the sternum cushion (210), the inner splint (206) is disposed in parallel with respect to the outer splint (205), and the distance between the outer splint (205) and the inner splint (206) is adjustable.

4. A magnetic resonance breast interventional system for locating lesions by combining software and hardware according to claim 3, wherein a pair of sliding rails (207) are horizontally and symmetrically fixed on one side of the outer clamping plate (205) far away from the inner clamping plate, the sliding rails (207) are slidably mounted on the bottom plate (203), and a detachable handle (209) is jointly fixed on one side of the pair of sliding rails (207) far away from the outer clamping plate (205);

one side of the bottom plate (203) is rotatably provided with a buckle (208), and the buckle (208) is matched with a limit groove arranged on the side edge of the sliding rail (207).

5. The magnetic resonance breast interventional system for locating lesions by combining software and hardware according to claim 1, wherein grids are uniformly arranged on the outer clamping plate (205), needle guides (905) are arranged in the grids so as to further determine the needle insertion positions when the lesion projections are positioned in the corresponding grids, and the specifications of the needle guides (905) are selected according to the lesion positions and the instrument sizes.

6. The magnetic resonance mammary gland interventional system for locating lesions by combining software and hardware according to claim 1, wherein 1, 3 and 4 hollow cylinders filled with a body-imitated solution are respectively arranged on the outer splint (205), and the three reference points are determined in the following ways:

The reference point I (902) corresponds to the center of the hollow cylinder, the reference point II (903) corresponds to the center of an equilateral triangle formed by connecting lines of the centers of the three hollow cylinders, and the reference point III (904) corresponds to the center of a square formed by connecting lines of the four hollow cylinders.

7. The magnetic resonance breast interventional system for positioning focuses by combining software and hardware according to claim 1, wherein a patient head rest (3) and an abdomen supporting cushion (8) are respectively arranged at two side positions of the breast interventional device (2), the patient head rest (3) comprises a head rest base (301) arranged on an examination bed, and a head rest cushion (302) is arranged at the top of the head rest base (301).

8. The magnetic resonance breast interventional system for locating lesions by combining software and hardware according to claim 1, wherein the interventional procedure using the system mainly comprises the following steps:

Cleaning related equipment and checking equipment, and fixing breast tissues of a patient by adjusting the gap between the clamping plates;

acquiring MR images for lesion localization by MR I scanning;

selecting a reference point by using positioning software, constructing a plane coordinate system, calculating focus projection coordinates and matching a corresponding grid position and a needle insertion position;

using a puncture needle to reach the focus position and fix, then scanning again to obtain an MR image, and verifying the puncture positioning accuracy;

Finally, tissue extraction is carried out by using the biopsy needle, and the operation ending work is completed.