Surgery – Diagnostic testing – Detecting nuclear – electromagnetic – or ultrasonic radiation
Reexamination Certificate
1999-09-03
2002-01-08
Casler, Brian L. (Department: 3737)
Surgery
Diagnostic testing
Detecting nuclear, electromagnetic, or ultrasonic radiation
C600S461000, C128S916000
Reexamination Certificate
active
06336899
ABSTRACT:
BACKGROUND OF THE INVENTION
The present invention relates to an ultrasonic diagnosis apparatus, which is capable of scanning ultrasonic beams in three-dimensional configuration in real time and displaying a three-dimensional image thereof, and more particularly, to an apparatus for navigating a paracentetic needle toward a target such as lesion or the like in a object while watching an ultrasonic image.
In the biopsy of the liver in the clinical application, namely the biopsy for diagnosing the property of the parenchyma of hepar, the biopsy for diagnosing the property of the tumor or the like, or a treatment method of liver cancer in the treatment application, namely a method for forcing hepatoma cells to necrose by pouring ethanol into the hepatoma, a diagnosis and a treatment are generally performed by inserting a paracentetic needle into the inside of the body of the patent (hereinafter referred to as paracentisis).
In this paracentsis, conventionally various kinds of paracentisis methods have been invented, and have been applied to the diagnosis and the treatment. Except for the case in which the paracentetic needle may be penetrated into the body in a blind manner, it often happens that the paracentisis is performed together with a monitoring method in which a paracentetic target such as lesion or the like is confirmed while an image such as X-ray photofluorograph image or the like is observed in real time. Particularly, in recent years, in order to further heighten the safety and reliability of the treatment, diagnotic treatment skill (hereinafter referred to as the ultrasonic paracentisis) has become a major method in which the paracentetic needle is guided by using ultrasonic images in the place of X ray fluorograms.
This ultrasonic paracentisis is a paracentisis using images in which both the paracentetic target and the paracentetic needle are drawn out on the same tomographic layer of a real time ultrasonic image so that the treatment is performed while watching the travel of the paracentetic needle. For example, in the case of the abdomen, major blood vessels inside and outside of the liver and peripheral organs can be easily drawn out together with dilated bile ducts and gall bladders as ultrasonic tomographic images. As a consequence, there is provided an advantage in that a selective paracentisis can be performed in which the paracentetic target can be arbitrarily selected and the paracentetic needle can be penetrated thereinto with the result that the scope of the clinical application and the treatment application is widened. For example, in the application of the ultrasonic paracentisis in liver diseases, a reliable paracentisis of the tumor can be performed with respect to a localized lesion. Besides, a route for paracentisis can be selected while deviating around gall bladders and the lungs with the result that there is provided an advantage in that the paracentisis will contribute toward the reduction in complications such as choleperitoneum, hemopneumothrax or the like.
As an ultrasonic device which is used in such ultrasonic paracentisis, a mechanical scanning type or an electronic scanning type real-time devices are adopted. In these real-time devices, a sector or a convex probe or the like is used which allows the attachment of a linear probe exclusively used for paracentisis as an ultrasonic probe and a paracentetic adapter for guiding the paracentetic needle in a definite direction. Particularly, in recent years, the electronic scanning type device becomes prevalent, and an electronic linear probe or an electronic sector probe is used in many cases along with the usage of the real-time devices.
With all the advantages of safety and a high reliability as compared with X ray flurograph or the like, the ultrasonic beams device which is used in the conventional ultrasonic paracentisis has a problem in that since the paracentetic needle is elastic, the direction of the needle tip is sometimes deviated from the guide direction. In such a case, since the Up of the paracentetic needle disappears from the inside of the two-dimensional tomographic image which is displayed in real time, the position of the tip of the needle must be searched while allowing the ultrasonic probe to be operated. As a consequence, there arises a problem that an operation of trading the position of the tip of the needle and correcting the insertion direction of the needle which is directed toward the paracentetic target such as the lesion or the like while observing the two-dimensional tomographic image becomes difficult in may cases with the result that a considerable amount of training is required for such an operation.
SUMMARY OF THE INVENTION
Accordingly, it is an object of the present invention to provide an ultrasonic diagnosis apparatus for easily and reliably guide the paracentetic needle at the time of using the ultrasonic paracentisis.
The inventors of the present invention studied in detail more safe and accurate paracentetic needle guiding means with respect to the paracentisis method which is combined with the ultrasonic diagnosis apparatus, and they noted a method for navigating a paracentetic needle toward a paracentetic target while confirming the position of the paracentetic needle on a three-dimensional image by combining the paracentisis method with an ultrasonic beams device which is capable of scanning ultrasonic beams in a three-dimensional manner in real time and displaying the three-dimensional image (3D image).
The method for navigating the paracentetic needle using this 3D image is constituted centering on the following four points: 1) a method for displaying a tomographic image (a method for displaying a tomographic image which is appropriate for recognizing a position relation between a direction in which the tip of the needle is directed and a lesion which is selected as a paracentetic target), 2) a method for detecting the position of the needle and a track of the movement of the needle, 3) a three-dimensional display method (a display method in which the direction in which the tip of the needle is directed is seen from just above), and 4) a method for recognizing a 3D image, the position of the object and the direction relation thereof. Concrete examples of the aforementioned methods will be explained hereinbelow.
1) Method for Displaying Tomographic Image
Even in the case where the tip of the needle is deviated from a guide direction of a paracentetic adapter and in the case where the needle is penetrated without a guide for paracentisis, this method for displaying the tomographic image enables
1
a
) displaying a location of the tip of the needle constantly within the tomographic image and displaying a location (region) toward which the tip of the needle is directed,
1
b
) visibly recognizing whether or not the tip of the needle or the whole needle is located in front of or at the rear surface of the tomographic layer or how much the tip of the needle or the whole needle is deviated from the tomographic layer without changing a tomographic by layer which is set at first, namely, by an image in which a lesion constituting a paracentetic target is caught.
For example, as the tomographic layer
1
a
), there is available
1
a
-
1
) a surface (into which a straight line enters) which contacts a straight line connecting a tip point of the needle and a insertion point of the needle into the living body, and, at the same time, a surface which is vertical with respect to a surface of a transducer of a ultrasonic probe,
1
a
-
2
) a surface which passes through a tip of a needle, an insertion point of the needle into the living body, and a reference point (for example, a central point of a surface of a transducer),
1
a
-
3
) a surface (into which a straight line enters) which contacts a line obtained by a straight line recursion by sampling the tip of the needle, and at the same time, a surface which is vertical with respect to the surface of the transducer, and
1
a
-
4
) a surface which passes through a reference point (for example, a central point of the t
Casler Brian L.
Imam Ali M.
Kabushiki Kaisha Toshiba
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