基于三维超声造影融合成像的子宫肌瘤射频治疗方法学研究

Microwave, radiofrequency and HIFU aimed by ultrasound are common interventional therapeutic method for hysteromyoma with less trauma.However,single mode of ultrasonography has some defects such as unsharpness bouncary, insensitivity of blood flow, not solid and the gasification created simultaneously is strongly affects the sonogram. So to get high qualitative picture when monitoring the interventional therapeutic procedure is a hot spot and nodus of study in ultrasound territory. This study would combine registry and fusion navigation together, joint gray-scale ultrasound , color Doppler and 3D ultrasound imaging. According to the the special treatment for hysteromyoma, we will use electromagnetic position sensor to gather two - dimensional echocardiography and ultrasound contrast chart characteristics such as size, location , edge , and blood flow which aim directly at creating core technology of two-dimensional ultrasound images and three - dimensional ultrasound imaging image registration calibration, setting up fusion navigation mode of three and two-dimensional ultrasound image, plan to solve problem of ultrsound quality. At the same time , we use preoperative images of three - dimensional ultrasound imaging and postoperative registration techniques to verify the accuracy and usefulness of this method .

超声引导下微波、射频及HIFU等技术治疗子宫肌瘤是临床上最具推广潜力的微创介入疗法。然而，目前单一模式的超声图像用于介入引导存在着病灶边缘不清晰、血流不敏感、无立体定位且不能解决术中高热气化导致的图像干扰与伪像等问题。因此，如何得到高质量的超声图像以适应介入治疗的需要是目前国内、外超声领域研究的热点、难点问题。本项目拟将图像配准技术及融合导航模式与医学临床信息相结合，联合灰阶超声、彩色多普勒超声和三维超声造影等多模式超声图像，针对子宫肌瘤介入治疗的特殊性，应用电磁位置感应器，采集待治肌瘤二维超声图及超声造影图上的大小、位置、边缘及血流等特征信息，行二维超声图像与三维超声造影图像配准标定的核心技术的研发，建立三维超声造影图像与二维超声图像相融合的导航模式，拟解决子宫肌瘤介入治疗中超声图像质量问题。同时，本研究采用术前三维超声造影图像与术后三维超声造影图像配准技术以验证此方法的准确性和实用性。

子宫肌瘤是最常见的妇科良性肿瘤，子宫肌瘤射频治疗的有效率高达90%~100%，但治愈率仅为51.72%~76.51%。如何提高超声图像对病灶治疗前、后的监测能力成为治疗成败的关键。鉴于三维超声造影图像技术及融合导航模式的建立在临床诊断治疗、质量保证和疗效评价等诸多方面均具有重要的应用价值，且国内外尚未见基于三维超声造影图像配准技术在子宫肌瘤介入治疗中的方法学研究报道。本项目将三维超声造影技术及图像配准技术与医学图像信息相结合，以射频治疗的子宫肌瘤为研究对象，针对子宫肌瘤的多样性和复杂性的特征，采用基于内部特征的非刚性图像配准法，使子宫及子宫肌瘤的三维超声造影图像与常规二维超声图像的对应点达到空间位置和解剖结构的一致性，研发适于子宫肌瘤治疗的最优化的超声图像融合导航系统，辅助超声医生及妇产医生提高子宫射频治疗的准确性、安全性，实现病灶彻底消融。