3D Image Guided Endovascular Surgery

描述（由申请人提供）：我们的长期目标是将联合收割机 最先进的三维（3D）图像引导， 血管分割和描述，以提高速度和减少 血管内手术困难的风险。的具体示例 困难的手术是经颈静脉肝内门体分流形成 （TIPS），在此期间，临床医生将针插入患者的肝脏 以连接静脉循环。目标不可能是 在肝穿刺过程中观察到，因此导致多次穿刺和高 患者风险。我们的目标是为临床医生提供准确的3D图像引导 以提高速度并降低手术风险。 方法包括：1）从血管和肝脏的分割 术前采集的MR或CT数据，2）术中3D-2D配准 使用术中采集的双平面数字图像分割3D血管 减影血管造影（DSA），3）开发快速、实时跟踪 检测目标门静脉位置变化的方法 在手术过程中由于患者呼吸或针对肝脏的压力， 4)从双平面视图对TIPS针进行3D重建，从而将 5）在3D脉管系统的坐标系内整合 通过立体、头部跟踪显示的信息和可视化，以及6） 四个阶段的评估过程。 根据这一建议制定的方法应立即有利于 提示.此外，这些方法通常适用于各种各样的应用。 血管内手术，因此与数百名 成千上万的肿瘤或血管疾病患者接受血管内治疗， 每年治疗。事实上，根据这一建议制定的方法 有可能改变血管内手术的执行方式 在整个身体。

DESCRIPTION (provided by applicant): Our long-term goal is to combine state-of-the-art, three-dimensional (3D) image guidance with a new method of vascular segmentation and description in order to increase the speed and reduce the risk of difficult endovascular procedures. A specific example of a difficult procedure is transjugular intrahepatic portosystemic shunt formation (TIPS), during which the clinician inserts a needle through a patient's liver in order to connect one venous circulation with another. The target cannot be seen during liver puncture, thus leading to multiple needle passes and high patient risk. Our goal is to provide the clinician accurate, 3D image guidance in order to increase the speed and to decrease the risks of the procedure. Methods include: 1) Segmentation of the vasculature and liver from preoperatively acquired MR or CT data, 2) Intraoperative 3D-2D registration of the segmented 3D vessels with intraoperatively acquired biplane digital subtraction angiograms (DSA), 3) Development of fast, real-time tracking methods to detect changes in the position of the target portal vein resulting from patient respiration or needle pressure on the liver during the procedure, 4) 3D reconstruction of the TIPS needle from biplane views, thus placing the needle within the coordinate system of the 3D vasculature, 5) Integration of information and visualization by means of stereo, head-tracked display, and 6) A four-phase evaluation process. The methods developed under this proposal should be of immediate benefit to TIPS. Moreover, these methods are generally applicable to a wide variety of endovascular procedures, and are thus immediately relevant to the hundreds of thousands of patients with tumors or vascular disease that undergo endovascular treatment each year. Indeed, the methods to be developed under this proposal have the potential to change how endovascular procedures are performed throughout the body.