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研究生:黃朝陽
研究生(外文):Chao-Yang Huang
論文名稱:無標記註冊之機械手臂導引系統應用於腦室積水引流穿刺手術
論文名稱(外文):Application of Robotic Navigation System with No-Marker Registration to VP Shunt Surgery
指導教授:楊宏智楊宏智引用關係
口試日期:2017-07-13
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:機械工程學研究所
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:75
中文關鍵詞:CT影像腦室積水引流穿刺手術機械式巡航系統水腦症3D Scanner無標記註冊自動化
外文關鍵詞:CT imageVP Shunt surgeryRobotic Surgical Navigation SystemHydrocephalusNo-Marker Registrationautomatic
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醫學影像的出現,為手術帶來了劃時代的變革,微創手術也從原本的高度挑戰性變成日漸普及。然而現今的臨床手術,即使有了CT影像,確認病灶位置後,仍然多憑藉著醫生的經驗動刀。以腦室積水引流穿刺手術為例,缺乏經驗的醫師往往很難一次就下刀至正確位置,造成引流管移位、重複穿刺、感染等情況,手術對病人來說缺乏安全性及穩定性。
過去本研究曾開發出一套機械式巡航系統,利用機械手臂搭配雷射測儀距儀,搭配自行開發之標靶球假體,輔以3D Slicer三維影像重建軟體、及Matlab GUI圖形化人機介面進行數學演算、座標疊合與訊息傳遞,為醫師做好整組手術的臨床規劃。然而使用這個方法仍有實務上的改進空間:病人在照CT影像時,需在病人臉上貼上標記點 (Fiducial Marker),並且在手術前都不能移動標記點的位置,對病人來講是相當困擾的,醫生執行手術也會被標記點阻擋而造成手術不便。
本研究擬開發出一套機械式導引系統,針對水腦症的病患,協助醫師進行腦室積水引流穿刺手術,將3D Scanner與過去建置之機械式巡航系統結合,搭配影像註冊軟體,以及自行開發之演算法,建立起一套無標記註冊腦室引流穿刺導引手術的流程,解決病人需在臉上貼標記的困擾,同時改良前期的手術規劃流程,使得整個流程更加自動化,提高醫師手術效率及精準度。
The appearance of the medical image reform the method of surgery, which makes Minimally-Invasive Surgery become more and more popular. Though we use CT image to make sure where the lesions are, Doctors actually perform surgery by their experience. Take the VP Shunt Surgery for example, doctors who are lack of experience may cause some conditions, including mal-position, repeated insertions or infection, which is not safe and stable enough for the patients.
Last year we developed a Robotic Surgical Navigation System, using a robot arm and a laser pointer, combined with the CT images’ information, 3D-printed skull and MATLAB GUI interface, planning a complete clinical surgery process for the doctor. However, there still room for improvement for clinical needs, for example, we should put the Fiducial Marker on the patient’s face while CT scanning, and can’t take away the marker until the surgery begin in the process, which is inconvenient for both the patients and doctors.
This year, we combine the Robotic Surgical Navigation System developed last year with 3D Scanner, Register software and some numerical inputs / outputs and calculations, expect to create a process for No-marker Registration Robotic Navigation System apply in VP Shunt Surgery on Hydrocephalus patient. Not only solve the problem of marker, but also make the system more automatic, making the surgery more accurate and efficient.
誌謝 I
摘要 III
Abstract IV
目錄 V
圖目錄 VIII
表目錄 XI
第一章 緒論 1
1.1 研究背景 1
1.1.1 側腦室腹膜腔引流術 (VP shunt) 1
1.1.2 影像導航手術 3
1.2 研究動機 4
1.3 研究目的 4
1.4 研究架構 5
1.5 論文架構 6
第二章 文獻回顧 8
2.1 醫學影像三維重建技術 8
2.1.1 電腦斷層掃描 8
2.1.2 醫療數位影像傳輸協定-DICOM 10
2.1.3 常見三維影像重建軟體 11
2.2 醫學導航系統 15
2.2.1 電腦斷層掃描系統 15
2.2.2 機械式導引系統 18
2.3 註冊與座標疊合 21
2.3.1 三點重心法 22
2.3.3 奇異值分解法 (Singular Value Decomposition) 24
2.4 小結 26
第三章 機械導引系統架構與整合 27
3.1 機械式定位掃描器 27
3.1.1 ABB-IRB120機械手臂 27
3.1.2 Keyence IL-600雷射測距儀 28
3.1.3 Sense 3D掃描器 29
3.1.4夾具 31
3.2 標靶球假體 32
3.3 ImplantMAX-影像註冊軟體 33
3.4 RobotStudio- ABB機械手臂控制軟體 35
3.5 系統整合 36
3.6 小結 36
第四章 自動化導引手術流程及方法 37
4.1 CT斷層掃描 38
4.2 3D掃描 38
4.3 影像掃描註冊 39
4.3.1 輸入影像 39
4.3.2 取特徵點進行註冊 40
4.3.3 放入穿刺針 42
4.3.4 輸出穿刺點座標 43
4.4 掃描器校正 44
4.4.1 奇異值分解 (SVD) 法校正 44
4.4.3 自動化取點 45
4.5 自動化軌跡規劃 47
4.6 小結 49
第五章 實驗結果與誤差分析 50
5.1 影像掃描註冊驗證 50
5.2 掃描器校正驗證 53
5.2.1 製作校正塊 54
5.2.2 奇異值分解(SVD)法驗證 57
5.2.3 掃描器校正實驗結果 59
5.3 手術規劃實驗 61
5.4 誤差分析 64
5.4.1 系統誤差 64
5.4.2 操作誤差 66
5.5 小結 67
第六章 結論及未來展望 68
6.1 結論 68
6.2 未來展望 69
參考文獻 71
作者簡歷 74
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