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研究生：	魯祿康 Lu, Lu-Kan
論文名稱：	體外震波碎石機改良結石追蹤系統之性能評估 Performance Evaluation of an Improved Stone Tracking System of Extracorporeal Shock Wave Lithotriptors
指導教授：	梁勝明 Liang, Shen-Min
學位類別：	碩士 Master
系所名稱：	工學院 - 航空太空工程學系 Department of Aeronautics & Astronautics
論文出版年：	2004
畢業學年度：	92
語文別：	英文
論文頁數：	97
中文關鍵詞：	震波、超音波結石追蹤系統、體外震波碎石機
外文關鍵詞：	extracorporeal Shock Wave Lithotriptors, ultrasound-based stone tracking system. shock wa
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　　體外震波碎石機（Extracorporeal Shock Wave Lithotriptor，ESWL）在現今醫療運用相當廣泛，但一般在療程中大概只有30%至50%的震波能量會落在結石上，其原因為震波衝擊、患者呼吸及患者身體的移動導致結石位置偏移，而導致震波落在其他正常組織上。針對以上缺點，本論文採用影像處理及伺服馬達控制的技術，對結石作即時追蹤，讓每次發射出去的震波都能落在結石上。在影像處理方面由超音波影像計算出結石的位置，再經由伺服馬達控制將聚焦點移動到計算出來的結石位置，重覆執行以上的程序即可達到定位與即時追蹤的效果。
　　但在經過許多實驗後，我們發現某些鈣化的腎臟組織所產生的超音波影像，與結石的影像極為類似，使得結石辨認有時會發生困難。因此，我們又對此軟體加以修正，增加其他辨認條件，乃是結合超音波下結石亮點及其下方所產生的陰影，二者一起用來辨認結石。在此，我們針對此一新系統做測試。在相符合率試驗中，不追蹤的結果為68.8%，舊系統為89.9%，新系統為94.34%，在結石破碎有效性試驗中，不追蹤的結果為49.51%，舊追蹤系統為85.11%，新系統為89.5%；在結石粉碎重量測試中，不追蹤為49.12%，舊系統與新系統皆為100%，但舊系統的追蹤平均失敗次數為22.15次，新系統為5.31次，失敗率各為0.738%及0.177%。

　　Extracorporeal Shock Wave Lithotripsy is widely used in clinical treatment of renal calculi. Generally, only 30-50% of shock waves are focused on the kidney stone, because of stone’s motion due to the shock wave strikes and patient’s respiration or movement. The stone motion also results that a great amount of shock waves are focused on normal tissues instead of the stone. This study utilizes the servomotor control and image processing technologies to track the stone during treatment so that the shock waves generated are focused on the stone. In order to track the stone in a real time, the stone ultrasound image is used to determine the stone location. A servomotor control system is used to automatically move the geometrical focus of the shock wave reflector to the stone location.
　　It was found that there are some problems existing on the current stone-tracking system established in our laboratory. Occasionally, the images of some calcified tissues are similar to the stone images, resulting in a difficulty for stone identification. Thus it is necessary to modify the existing software of image processing that used the frame matching technique by adding more stone detection skills. Here we combine the bright region of stone with the stone shadow in ultrasound image for detecting a stone. The modified image processing software is tested by performing some testing－coincidence, efficiency, and fragment weight tests. It is found that the coincidence ratio for the improved software is improved from 89.9% to 94.3%, the efficiency ratio is improved from 85.1% to 89.5%, and the fragment weight ratio retains 100% at a stone-tracking condition. Without a stone-tracking condition, the coincidence ratio is only 68.8%, 49.5% for efficiency ratio, and 49.1 for the fragment weight ratio. Moreover, the average number of miss tracking is improved from 22.2 to 5.3. The corresponding failure rate is 0.18% for the improved software and 0.74% for the original software.

ABSTRACT………………………………………………………………………i
CONTENTS………………………………………………………………………iii
LIST OF TABLES………………………………………………………………vii 
LIST OF FIGURES………………………………………………………………viii 
NOMENCLATURES…………………………………………………………………xii 

Chapter1:
    INTRODUCTION
     1-1 Motivation and problem………………………………………………1
     1-2 Review of Papers………………………………………………………2
     1-3 Property of Shock Wave Focusing……………………………………3
     1-4 Contents in This Book…………………………………………………6
     
Chapter2:
    An Ultrasound-based Real-time Tracking System
     2-1 Introduction…………………………………………………………………8
     2-2 Electrohydraulic Shock Wave Generators………………………………9
     2-3 Applications of Extracorporeal Shock Wave Lithotriptors………10
     2-4 Principle of Real-time Stone Tracking System……………………12
     2-5 PMAC AC Servo Motor Controller………………………………………15
     2-6 Stone Detection Technique………………………………………………17
Chapter3:
MATERIALS AND METHODS
     3-1 Introduction………………………………………………………………20
     3-2 Equipment for Experiments………………………………………………20
          3-2-1 Extracorporeal Shock Wave Lithotriptor (ESWL)…………20
          3-2-2 Shock Wave Generator……………………………………………24
          3-2-3 Water Tank and Electrodes……………………………………26
          3-2-4 Ultrasound Scanner………………………………………………29
          3-2-5 Probe Holder………………………………………………………30
          3-2-6 Image Grabbing System…………………………………………31
      3-3 Performance Evaluation of Stone Tracking System………………32
      3-4 Coincidence Test…………………………………………………………33
      3-5 Stone Fragmentation Efficiency Test………………………………39
      3-6 Fragment-to-Weight Ratio Test in a Simulated Animal Model……45
      3-7 Gap Adjustment Test………………………………………………………52

Chapter4:
RESULTS AND DISCUSSION
     4-1 Introduction……………………………………………………………………………60
     4-2 Coincidence Test………………………………………………………………………60
          4-2-1 Evaluation of the coincidence ratio in non-tracking condition…60
          4-2-2 Evaluation of the coincidence ratio with frame matching technique    in tracking condition…………………………………………61
          4-2-3 Evaluation of the coincidence ratio with shadow tracking technique in tracking condition……………………………61
      4-3 Stone Fragmentation Efficiency Test…………70
4-3-1 Evaluation of the stone fragmentation efficiency ratio in fixed                                            condition…………………………………………………………70
          4-3-2 Evaluation of the stone fragmentation efficiency ratio in non-tracking condition………………………………………70
          4-3-3 Evaluation of stone fragmentation efficiency ratio with frame matching technique in tracking condition………………71
          4-3-4 Evaluation of stone fragmentation efficiency ratio with shadow tracking technique in tracking condition………………71
     4-4 Fragment-to-Weight Ratio Test in a Simulated Animal Model…………76
          4-4-1 Evaluation of the fragment-to-weight ratio in non-tracking condition…………………………………………………………76
          4-4-2 Evaluation of the fragment-to-weight ratio with frame matching technique in tracking condition……………………………76
          4-4-3 Evaluation of the fragment-to-weight ratio with shadow tracking technique in tracking condition……………………………76
     4-5 Gap Adjustment Test…………………………………86
          4-5-1 Evaluation of the stone fragments ratio without adjustment……86
          4-5-2 Evaluation of the stone fragments ratio with adjustment…………86
          4-5-3 Evaluation of the stone fragment ratio without adjustment in a simulated animal model………………………………………86
          4-5-4 Evaluation of the stone fragment ratio with adjustment in a simulated animal model………………………………………87
          4-5-5 Evaluation of the stone fragment ratio with adjustment in a simulated animal model after 3000 shock waves…………87


Chapter5:
    CONCLUSIONS AND FUTURE WORK
     5-1 Conclusions………………………………………………………………93
     5-2 Future Work………………………………………………………………93
          
REFERENCES……………………………………………………………………………95

                                    

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校內：2005-07-08公開
校外：2005-07-08公開

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