- 學位論文
三維超音波影像於體外震波碎石術之腎結石碎片分析
Renal Calculi Fragmentation Analysis using 3D Ultrasound Imaging for Extracorporeal Shock Wave Lithotripsy
摘要
體外震波碎石治療已普遍應用於治療腎結石患者，此方法主要使用X光或超音波影像定位結石的位置並進行觀察，目前患者在治療中所接受震波次數約3000次，須藉由X光或超音波影像來評估碎石程度以停止治療，因此，結石碎片的評估是結石治療時間長短之依據。本研究利用超音波影像系統來評估結石碎片，在結石碎裂的過程中，超音波影像也會隨之改變，因此可利用此特性以取得即時結石碎裂情況。一般而言，在體外震波治療過程，結石碎裂之影像會產生不同強度及型態的變化，對於碎片較大者，通常會使得超音波產生較強的反射，但對於小碎片而言，則顯示較弱反射。在治療過程中，結石位置可能會發生改變，可利用影像紋理特徵來評估碎裂情況，因此本研究建立三維超音波影像並結合影像特徵值之分析，以取得影像中的石頭碎裂程度，藉由模擬與實際結石碎裂，探討應用於體外震波治療結石及時評估之可行性。此三維影像分析系統可提高治療的效果，同時提供體外震波治療之停止時機參考，並可在影像分析中顯示三維影像紋理特徵及石頭碎裂程度，其中又以Entropy之影像特徵值最佳。
並列摘要
Extracorporeal shock wave lithotripsy has been widely used for the treatment of patients with renal calculi. This method is currently using X-ray or ultrasound imaging to locate the position of the stones and do observations. Currently, patients in the treatment receive about 3,000 shock waves, and need to use X-ray or ultrasound imaging to evaluate the extent of the fragmentation of the stones in order to stop treating. Therefore the stone fragments evaluation is based on the duration of the stones treatment. In this study, we use ultrasound imaging system to estimate the fragmentation of the stones. During the stone fragmentation process, the ultrasound images will change. Generally speaking, in the course of extracorporeal shock wave lithotripsy therapy, fragmentation of the stones will produce changes of intensity and patterns in the image. As for larger stones, they usually produce stronger reflections. But for the fragments, the ultrasound reflections are much weaker. During treatment, the stones fragments may vary their positions. Thus the texture of the image can be used to estimate the fragmentation progress. This study established a three-dimensional ultrasound imaging and combined the analysis of image texture in order to obtain figures representing fragmentation level. We use the simulation and actual stone fragments to investigate the feasibility of applied extracorporeal shock wave lithotripsy. This three-dimensional image analysis system could be used to improve the effectiveness of the treatment, while providing stop timing reference for the extracorporeal shock wave therapy. The image analysis shows that three dimensional texture figures relate to the fragmentation level of the stone.
參考文獻
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