影像引导血管内精准介入诊疗

Image-guided Endovascular Interventional Diagnosis and Treatment

血管类疾病作为全球头号死因,其诊断与治疗已受到越来越多的关注。由于创伤小、恢复时间短及术后并发症少等原因,微创介入诊疗成为血管内疾病治疗的新趋势。而血管内介入诊疗需要借助于术中影像的引导,如术中2D X线透视图。但是X线透视图引导的方式存在以下问题:术前影像的定量分析不足;缺少对介入装置及组织的三维实时影像且影像显示方式不直观;术中依赖重复的X线照射会带来安全隐患。针对这些问题,本文从基于影像分析的术前先验、术前术中影像结合及引导、直观的影像显示3方面展开,提出了术中无辐射的影像引导血管内介入诊疗方法,为医生提供3D定量、显示直观的影像引导信息,辅助血管内诊疗。

As the leading cause of death in the world, the diagnosis and treatment of vascular diseases has received more and more attention. The minimally invasive endovascular procedures which require effective intraoperative guidance, such as 2D X ray fluoroscopy, become the preferred option for patients because the patient trauma, risk of complications and recovery times can be reduced. The 2D-fluoroscopyguided endovascular navigation, however, is limited by a number of factors： insufficient analysis of the preoperative images; lacking of 3D real-time images of instruments and surrounding anatomy and exposure to repeated doses of X-ray radiation. To solve these problems, an intraoperative fluoroscopyfree endovascular navigation method is introduced in this paper from three aspects： the preoperative prior information based on image analysis, the fusion of preoperative and intraoperative images and the intuitive navigation images. The proposed intraoperative fluoroscopy-free navigation method can provide 3D quantitative and intuitive navigation information for doctors to assist endovascular interventional therapy.