Orkisz M, Farchtchian T, Saighi D, Bourlion M, Thiounn N, Gimenez G, Debré B, Flam T A
CREATIS, CNRS Research Unit, INSERM, Lyon, France.
J Urol. 1998 Oct;160(4):1237-40.
We describe a method to reduce the number of shocks necessary to fragment renal stones during extracorporeal shock wave lithotripsy by automatically taking into account stone movements.
Echotrack computer software was developed and implemented on a lithotriptor. One software module uses image processing to detect instantaneous stone location based on ultrasound images generated by the lithotriptor. A second module uses the detected location to control the shock wave generator position, and automatically adjusts it to improve coincidence between the focal volume and stone. The reliability of the tracking algorithm was clinically tested in 65 patients with renal stones. These in vivo tests were qualitative and the goal was to assess software ability to track stones during actual treatments. A quantitative evaluation of the reduction in shocks necessary for fragmentation was performed in vitro. Artificial stones were moved according to computer generated trajectories. Each trajectory was applied once with and once without automatic adjustment of the generator position.
The in vivo tests demonstrated software ability to track stones as far as they were visible in the images. During in vitro tests automatic adjustments of the generator position reduced the number of shocks necessary to fragment stones completely by a factor of 1.64.
Image based renal stone tracking software that automatically adjusts the shock wave generator position according to the displacement of renal stones is useful during extracorporeal shock wave lithotripsy. Treatment time was significantly shorter with this software.
我们描述了一种通过自动考虑结石移动来减少体外冲击波碎石术中粉碎肾结石所需冲击波次数的方法。
开发了Echotrack计算机软件并在碎石机上实施。一个软件模块利用图像处理根据碎石机产生的超声图像检测结石的瞬时位置。另一个模块利用检测到的位置控制冲击波发生器的位置，并自动进行调整以提高焦点区域与结石之间的重合度。在65例肾结石患者中对跟踪算法的可靠性进行了临床测试。这些体内测试是定性的，目的是评估软件在实际治疗过程中跟踪结石的能力。在体外对粉碎所需冲击波次数的减少进行了定量评估。人工结石按照计算机生成的轨迹移动。每条轨迹在发生器位置自动调整和不自动调整的情况下各应用一次。
体内测试证明软件能够在图像中可见结石的情况下对其进行跟踪。在体外测试中，发生器位置的自动调整使完全粉碎结石所需的冲击波次数减少了1.64倍。
基于图像的肾结石跟踪软件，可根据肾结石的位移自动调整冲击波发生器的位置，在体外冲击波碎石术中很有用。使用该软件治疗时间明显缩短。
