Wilkmann Christoph, Ito Nobutake, Penzkofer Tobias, Isfort Peter, Na Hong-Sik, Hennes Michael, Disselhorst-Klug Catherine, Mahnken Andreas H, Kuhl Christiane K, Bruners Philipp
Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 , Aachen, Germany,
Int J Comput Assist Radiol Surg. 2015 May;10(5):629-36. doi: 10.1007/s11548-014-1096-7. Epub 2014 Jun 28.
Percutaneous punctures are often performed under computed tomography (CT) guidance using a freehand method. Especially in challenging cases, initial accuracy of the needle placement is highly dependent on the radiologist's experience. Thus, a miniature lightweight guidance device was developed which is capable of assisting a radiologist during the needle placement process.
The device utilizes an accelerometer to measure the needle's tilt by calculating a set of orientation angles. This set can be matched with the coordinate system of the CT imaging software during a simple alignment process. After that, the needle's orientation can be expressed in terms of projected angles in the axial and sagittal planes. The accuracy of the device was evaluated in a phantom study, and initial clinical trials were carried out performing facet joint punctures in a swine cadaver.
The sensor was embedded in a cube with dimensions of [Formula: see text] and a total weight of about 11 g which can be attached to the puncture needle at its rear end or handgrip. A graphical user interface (GUÌ) has been created offering visual real-time orientation guidance. Results of the phantom experiments showed differences between planned target and performed puncture angles of [Formula: see text] for in-plane and [Formula: see text] for out-of-plane punctures.
The results of the phantom and ex vivo study suggest that the device is useful to assist a radiologist in CT-guided percutaneous punctures and helps navigating the needle with high precision.
经皮穿刺通常在计算机断层扫描（CT）引导下采用徒手方法进行。特别是在具有挑战性的病例中，针放置的初始准确性高度依赖于放射科医生的经验。因此，开发了一种微型轻便引导装置，能够在针放置过程中协助放射科医生。
该装置利用加速度计通过计算一组定向角来测量针的倾斜度。在一个简单的对准过程中，这组角度可以与CT成像软件的坐标系相匹配。之后，针的定向可以用轴向和矢状面中的投影角来表示。在体模研究中评估了该装置的准确性，并在猪尸体上进行小关节穿刺开展了初步临床试验。
传感器嵌入到一个尺寸为[公式：见原文]、总重量约11克的立方体中，该立方体可连接到穿刺针的后端或手柄处。创建了一个图形用户界面（GUI），提供视觉实时定向引导。体模实验结果显示，平面内穿刺的计划靶点与实际穿刺角度之间的差异为[公式：见原文]，平面外穿刺为[公式：见原文]。
体模和离体研究结果表明，该装置有助于在CT引导下经皮穿刺时协助放射科医生，并有助于高精度地引导针。
