阅读说明：本技术 一种ct引导下经皮肺穿刺定位方法 (Percutaneous lung puncture positioning method under CT guidance ) 是由 张厚云 周清华 伍龙军 于 2018-06-13 设计创作，主要内容包括：本发明公开了一种CT引导下经皮肺穿刺定位方法,具体操作是：作CT扫描,在CT工作站确定最佳的穿刺层面,移动检查床至最佳穿刺层面所对应的位置,确定该层面视野的中垂线为参考线,建立二维坐标,在最佳穿刺层面取材点沿Y轴方向在皮肤上的投影点P点为最佳穿刺点,测出P点距I点的距离L1,P点距肿块边缘的距离L2,即进针深度,经P点,使同轴套管针与机架X轴激光定位线重合,根据预设进针深度L2穿刺到肿块边缘,本发明的CT引导下经皮肺穿刺定位方法,操作时间短,误差小,此技术执行方便易掌握,常规CT即可,不需另行配置设备,临床应用推广前景好。(The invention discloses a percutaneous lung puncture positioning method under the guidance of CT, which comprises the following specific operations: the method comprises the steps of performing CT scanning, determining an optimal puncture layer at a CT workstation, moving an examining table to a position corresponding to the optimal puncture layer, determining a perpendicular bisector of a view field of the layer as a reference line, establishing a two-dimensional coordinate, taking a projection point P on skin at a material taking point of the optimal puncture layer along a Y-axis direction as an optimal puncture point, measuring a distance L1 between the P point and a point I, and a distance L2 between the P point and the edge of a tumor mass, namely a needle insertion depth, enabling a coaxial trocar to coincide with an X-axis laser positioning line of a rack through the P point, and puncturing the edge of the tumor mass according to a preset needle insertion depth L2.)

1. A percutaneous lung puncture positioning method under CT guidance is characterized in that: the method comprises the following steps:

step 1: performing CT scanning;

step 2: determining a puncture layer plane at a CT workstation;

and step 3: moving the examining bed to the position corresponding to the puncture layer;

and 4, step 4: determining a perpendicular bisector of the visual field of the puncture layer as a reference line, establishing a two-dimensional coordinate, enabling a Y axis of the two-dimensional coordinate to coincide with the perpendicular bisector, and enabling an intersection point of the perpendicular bisector on the X axis to be a point I;

and 5: determining a projection point P on the skin along the Y-axis direction of a sampling point on a puncture layer as a puncture point;

step 6: measuring the distance L1 between the point P and the point I, namely the distance between the actual puncture point of the human body and the Y-axis laser positioning projection line of the machine frame;

and 7: measuring the distance L2 between the point P and the edge of the tumor, namely the depth of the needle insertion;

and 8: according to L1, puncture is carried out from point P along the X-axis laser positioning line on the skin by using a coaxial trocar;

and step 9: and (4) making the coaxial trocar coincide with the X-axis laser positioning line of the frame through a point P, and puncturing the edge of the tumor according to the preset needle insertion depth L2.

2. The method for percutaneous lung puncture positioning under CT guidance according to claim 1, wherein: and 3, enabling the laser positioning line of the frame to be on the layer surface projected by the short axis of the human body.

3. The method for percutaneous lung puncture positioning under CT guidance according to claim 1, wherein: and 4, taking the point I as a projection point of the laser positioning line in the CT frame on the long axis of the human body.

Technical Field

The invention relates to a percutaneous lung puncture positioning method under the guidance of CT.

Background

Percutaneous lung tissue puncture is an important method for clinically identifying lung lesion and pathological properties, at present, the percutaneous lung tissue puncture mainly comprises B-ultrasonic positioning and conventional CT guided positioning, and when the B-ultrasonic guided lung puncture is carried out, if a lesion position is tightly attached to the chest wall, the lesion position can be clearly displayed under B-ultrasonic. The B-ultrasonic real-time guide needle insertion and cutting can reduce the needle insertion time, sometimes can distinguish lumps, atelectasis and inflammation, and has low cost. However, the ultrasonic wave can not penetrate through gas, so that the ultrasonic wave is suitable for the tumor tightly attached to the chest wall, and for the tumor with a certain depth in the lung, the B ultrasonic positioning for guiding the lung puncture positioning has great limitation.

Disclosure of Invention

Aiming at the defects in the prior art, the invention provides a percutaneous lung puncture positioning method under the guidance of CT, which has the advantages of short operation time, small error, convenient and easily-mastered execution, no need of additional equipment for conventional CT, and good clinical application and popularization prospect.

The invention discloses a percutaneous lung puncture positioning method under the guidance of CT, which comprises the following steps:

step 1: performing CT scanning;

step 2: determining a puncture layer plane at a CT workstation;

and step 3: moving the examining bed to the position corresponding to the puncture layer;

and 4, step 4: determining a perpendicular bisector of the visual field of the puncture layer as a reference line, establishing a two-dimensional coordinate, enabling a Y axis of the two-dimensional coordinate to coincide with the perpendicular bisector, and enabling an intersection point of the perpendicular bisector on the X axis to be a point I;

and 5: determining a projection point P on the skin along the Y-axis direction of a sampling point on a puncture layer as a puncture point;

step 6: measuring the distance L1 between the point P and the point I, namely the distance between the actual puncture point of the human body and the Y-axis laser positioning projection line of the machine frame;

and 7: measuring the distance L2 between the point P and the edge of the tumor, namely the depth of the needle insertion;

and 8: according to L1, puncture is carried out from point P along the X-axis laser positioning line on the skin by using a coaxial trocar;

and step 9: the coaxial trocar is superposed with the X-axis laser positioning line of the frame through a point P, and the edge of the tumor is punctured according to the preset needle insertion depth L2;

the whole process from the beginning of scanning to the end of puncture material drawing is completed within 12 +/-3 minutes averagely, no mark is needed on the body surface of a patient, lead wire positioning is not needed, the work flow is obviously reduced, the psychological burden of the patient is relieved, the number of times of positioning and scanning is reduced, the operation time is obviously shortened, the puncture error is less than 2mm, the technology is convenient and easy to master, equipment is not needed to be additionally configured in the conventional CT, and the clinical application and popularization prospect is good.

Furthermore, in step 3, the laser positioning line of the machine frame is positioned on the layer projected by the short axis of the human body, so as to determine the optimal puncture layer, thereby facilitating the measurement and puncture operation.

Further, in the step 4, the point I is taken as a projection point of the laser positioning line in the CT frame on the long axis of the human body, so that the percutaneous lung puncture positioning method under CT guidance is further standardized and normalized.

The invention has the beneficial effects that: the percutaneous lung puncture positioning method under CT guidance has the advantages of short operation time, small error, convenient and easily-mastered execution, no need of additional equipment for conventional CT, and good clinical application and popularization prospects.

Drawings

In order to more clearly illustrate the detailed description of the invention or the technical solutions in the prior art, the drawings that are needed in the detailed description of the invention or the prior art will be briefly described below. In the drawings, like elements or portions are generally identified by like reference numerals. In the drawings, elements or portions are not necessarily drawn to scale.

FIG. 1 is a schematic view of the workstation field of view during positioning in accordance with the present invention.

Detailed Description

Embodiments of the present invention will be described in detail below with reference to the accompanying drawings. The following examples are only for illustrating the technical solutions of the present invention more clearly, and therefore are only examples, and the protection scope of the present invention is not limited thereby.

It is to be noted that, unless otherwise specified, technical or scientific terms used herein shall have the ordinary meaning as understood by those skilled in the art to which the invention pertains.

As shown in fig. 1: the percutaneous lung puncture positioning method under the guidance of CT of the embodiment comprises the following steps:

step 1: performing CT scanning;

step 2: determining a puncture layer plane at a CT workstation;

and step 3: moving the examining bed to the position corresponding to the puncture layer; the laser positioning line of the frame is positioned on the layer projected by the short axis of the human body to determine the optimal puncture layer, thereby facilitating the measurement and puncture operation;

and 4, step 4: determining a perpendicular bisector of the visual field of the puncture layer as a reference line, establishing a two-dimensional coordinate, enabling a Y axis of the two-dimensional coordinate to coincide with the perpendicular bisector, and enabling an intersection point of the perpendicular bisector on the X axis to be a point I; the point I is taken as a projection point of a laser positioning line in the CT frame on the long axis of the human body, and the percutaneous lung puncture positioning method under the guidance of CT is further standardized and normalized;

and 5: determining a projection point P on the skin along the Y-axis direction of a sampling point on a puncture layer as a puncture point;

step 6: measuring the distance L1 between the point P and the point I, namely the distance between the actual puncture point of the human body and the Y-axis laser positioning projection line of the machine frame;

and 7: measuring the distance L2 between the point P and the edge of the tumor, namely the depth of the needle insertion;

and 8: according to L1, puncture is carried out from point P along the X-axis laser positioning line on the skin by using a coaxial trocar;

and step 9: the coaxial trocar is superposed with the X-axis laser positioning line of the frame through a point P, and the edge of the tumor is punctured according to the preset needle insertion depth L2;

the whole process from the beginning of scanning to the end of puncture material drawing is completed within 12 +/-3 minutes averagely, no mark is needed on the body surface of a patient, lead wire positioning is not needed, the work flow is obviously reduced, the psychological burden of the patient is relieved, the number of times of positioning and scanning is reduced, the operation time is obviously shortened, the puncture error is less than 2mm, the technology is convenient and easy to master, equipment is not needed to be additionally configured in the conventional CT, and the clinical application and popularization prospect is good.

Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; such modifications and substitutions do not depart from the spirit and scope of the present invention, and they should be construed as being included in the following claims and description.