CN104739377B - It is intravascular while carry out OCT image and device for pressure measurement, system and method - Google Patents
It is intravascular while carry out OCT image and device for pressure measurement, system and method Download PDFInfo
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- CN104739377B CN104739377B CN201510126214.8A CN201510126214A CN104739377B CN 104739377 B CN104739377 B CN 104739377B CN 201510126214 A CN201510126214 A CN 201510126214A CN 104739377 B CN104739377 B CN 104739377B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0062—Arrangements for scanning
- A61B5/0066—Optical coherence imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/02141—Details of apparatus construction, e.g. pump units or housings therefor, cuff pressurising systems, arrangements of fluid conduits or circuits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
Abstract
The invention discloses a kind of intravascular while carry out OCT image and device for pressure measurement, system and method, wherein measurement apparatus includes imaging pressure catheter and drive control mechanism, wherein：Imaging pressure catheter includes catheter fiber and the fibre-optical probe being connected, and power transmission shaft is provided with outside catheter fiber；The fiber end face of fibre-optical probe is provided with globe lens and light penetrating device, and the end of the fibre-optical probe is provided with pressure sensor；Drive control mechanism, including rotation control unit and unit, rotation control unit connecting conduit optical fiber and external fiber are withdrawn, and control power transmission shaft to drive fibre-optical probe rotation；Withdraw unit control controls fibre-optical probe to be moved radially along blood vessel by power transmission shaft.The present invention can realize the measurement to blood vessel feature image and intravascular pressure in same conduit.
Description
Technical field
The present invention relates to cardiovascular detection field, more particularly to one kind is intravascular while carries out OCT image and pressure measxurement
Device, system and method.
Background technology
Coronary artery disease (CAD) is the No.1 reason that the whole world causes death.Due to the heap of atherosclerotic plaque
Product, rupture and thrombus, coronary artery disease (CAD) can cause pectoralgia (angina pectoris), myocardial ischemia and sudden cardiac death.For that
A little patients for not dying suddenly or having chronic angina symptom, the treatment of suitable patch include percutaneous coronary intervention operation
(PCI).Cardiac interventional expert is performed the operation by PCI places support processing lesion, but many results of study think heart branch in recent years
Frame is abused, or at least excessively more careful and fastidious when considering only to use support using many disputes of initiation, doctor.In addition
Because lower-cost drug therapy has been introduced in market, research finds that they are also effective.In treatment stable disease
We have seen that the gentle decline of stent endoprosthesis during patients with coronary heart disease.These factors, along with increasing public
Opinion, three kinds of new blood vessel imaging/measuring apparatus and consumptive material：1) intravascular ultrasound (IVUS), 2) optical coherence tomography
(OCT) and 3) blood flow reserve fraction (FFR) technology can help whether doctor props up and mount for each patient's preoperative evaluation exactly
Enter and postoperative evaluation, more and more important effect is played in coronary disease lesion examining.
A large amount of clinical datas show that intravascular pressure measurement is particularly important for coronary intervention procedure, the most frequently used
Metering system blood flow reserve fraction (Fractional Flow Reserve, FFR) has reacted narrow coronary artery for heart muscle perfusion
Influence, it is considered to be the goldstandard of the coronary artery order of severity is evaluated in intrusive mood detection mode, therefore updated Guidelines are recommended, for that
The stenotic lesion of ischemic may be caused a bit, I class evidences are proposed as using FFR evaluations hemadostewnosis degree.FFR uses band pressure
The seal wire of sensor is inserted into artery, and seal wire end to investigated lesion measures.Generally by the blood vessel of adenosine
It is interior to be administered to induce maximum congested (highest CBF), while carry out pressure measxurement and divided by master to narrow with Pressure wire distal end
The pressure of artery, measure FFR values.FFR parameter currently used for clinical practice with determine whether the patient of coronary artery pathological changes should
This is treated using support.
Although FFR technologies have proved to be valuable intervention diagnosis measurement means, FFR can not be used individually in many cases
To instruct intervention to perform the operation：1) human factor of pressure measxurement sometimes, which can provide FFR values, might not indicate the serious of vascular lesion
Degree；2) due to faulty measurement accuracy, the FFR values near the boundary for receiving treatment may give intervention expert to bring and choose
War；3) in many cases, blood vessel blockage is derived from the grumeleuse of diseased region, and FFR is not lesion degree in these cases
True measurement；4) FFR does not provide any information to arterial wall in itself, therefore is consequently not used for optimization and needs to be placed support
Type or length.
Because above and other the reason for not enumerating, Cardiac interventional expert needs to obtain on coronary artery wall construction
Information carry out guidance of interventional treatment to provide more data.
Optical coherence tomography (Optical Coherence Tomography, OCT) is exactly such high-resolution
(10 micron order) angio-architecture imaging technique.In intracardiac OCT, conduit is inserted into artery to obtain 10 microns of resolution ratio section
And 3-D view, make it possible the visualization of the detailed micro-structural feature of arterial blood tube wall.Intracardiac OCT has been demonstrated to
It is enough to distinguish the various relevant Clinical symptoms such as the presence for including lipid, inflammation, calcification, grumeleuse (thrombus).OCT is caught in three dimensions
These information caught can effectively describe the degree and type of culprit vessel lesion, so as to be used to guiding intervention as significant data
Treatment procedure.Other OCT also can be used in non-criminal's lesion that imaging not yet causes thrombus.Treat these coronary vasodilator lesions hair
Non- criminal's lesion before life is a kind of promising, for improving the concept of CAD incidence and mortalities.
FFR and OCT technology have all widely been received by doctor, but OCT conduits and FFR seal wires are as individual equipment point at present
Open what is used, so the duration of inspection is added, complexity, and patient's use cost.
The content of the invention
The goal of the invention of the present invention be to establish one can complete simultaneously to the microcosmic Imaging Study of vascular tissue and
The device of endovascular pressure measxurement.
The technical solution adopted for the present invention to solve the technical problems is：
There is provided a kind of intravascular while carry out OCT image and device for pressure measurement, including imaging pressure catheter and driving are controlled
Mechanism processed, wherein：
Imaging pressure catheter includes catheter fiber and the fibre-optical probe being connected, and transmission is provided with outside the catheter fiber
Axle；The fiber end face of the fibre-optical probe is provided with globe lens and light penetrating device, and the end of the fibre-optical probe is provided with pressure sensor；
Into catheter fiber a part of optical signal after globe lens reflects directive vascular wall, backtracking, is wrapped after reflection
The reflection OCT light beams of the topographical information containing vascular wall；Another part optical signal is by light penetrating device directive pressure sensor, through reflection
Afterwards along backtracking, obtain including the reflected pressure light beam of blood stream pressure information；The reflection OCT light beams and the reflected pressure
Light beam is transferred out by the catheter fiber；
Drive control mechanism, including rotation control unit and withdraw unit, the rotation control unit connecting conduit optical fiber
And external fiber, and control power transmission shaft to drive fibre-optical probe rotation；It is described withdraw unit control by power transmission shaft control optical fiber spy
Head moves radially along blood vessel.
In device of the present invention, the outside of the fibre-optical probe is provided with sleeve pipe.
In device of the present invention, protective case is provided with outside the power transmission shaft.
In device of the present invention, the imaging pressure catheter also includes transparent casing, with the protective case and described
Sleeve pipe connection is integrated.
In device of the present invention, the protective case is rigid protective set.
In device of the present invention, the diameter of the imaging pressure catheter is not more than 550 microns.
In device of the present invention, the pressure sensor is interferometer, fiber grating or deformable film.
Present invention also offers a kind of intravascular while carry out OCT image and pressure-measuring system, including frequency swept laser,
Optical splitter, delay line, polarizer, optical circulators, splicer, coherent optical receiver, signal processing module, image workstation are whole
End and intravascular while carry out OCT image and device for pressure measurement, the drive control mechanism in the device passes through optical fiber and light
Learn circulator connection；
Image workstation terminal control frequency swept laser produces sweeping laser signal, is divided into two parts through optical splitter, one
Lease making delay line, polarizer obtain standard laser signal and enter splicer, and another part light enters measurement through optical circulators and filled
Put；The reflection OCT light beams and reflected pressure light beam obtained by measurement apparatus is after optical circulator, with standard laser signal
Converge to splicer and produce interference signal, interference signal is received and converted into electric signal by coherent optical receiver, and electric signal is through putting
Greatly with passing to signal processing module after digital-to-analogue conversion, finally shown in image workstation terminal.
Present invention also offers a kind of intravascular while carry out OCT image and pressure measurement method, comprise the following steps：
Frequency swept laser produces sweeping laser signal, is divided into two parts through optical splitter, a part of delayed line, polarizer obtain
To standard laser signal；
Another part light enters measurement apparatus through optical circulators, passes through the rotation control unit control in drive control mechanism
Power transmission shaft processed drives catheter fiber rotation so that 360 degree of scannings can be carried out in the blood vessels in the incident optical signal of fibre-optical probe,
And correspondingly receive the optical signal by vascular wall and pressure sensor reflection；
After 360 degree of rotations are completed in certain to fibre-optical probe in the blood vessels, fibre-optical probe is driven along blood by withdrawing unit
Pipe is radially moved into next sample point, completes 360 degree of scannings once again, by that analogy, obtains the light letter reflected in one section of blood vessel
Number；
The optical signal of reflection converges generation interference signal with standard laser signal, and interference signal is converted into electric signal, electricity
Signal is amplified with being handled to obtain complete blood vessel cross section pattern and number pressure in the blood vessel of one end after digital-to-analogue conversion
According to, and show.
The beneficial effect comprise that：The present invention sets globe lens and light penetrating device on fibre-optical probe, uses ball
Reflection from lens OCT light beams are used for OCT image, using globe lens and light penetrating device separating pressure light beam to pressure sensor, so that
The dual purpose of the measurement to blood vessel feature image and intravascular pressure is realized in same conduit.
Further, imaging pressure catheter diameter of the invention is not more than 550 microns, therefore will not change 2mm coronary arterys
Haemodynamics, so as to accurately measure this kind of endovascular pressure.
Brief description of the drawings
Below in conjunction with drawings and Examples, the invention will be further described, in accompanying drawing：
Fig. 1 is that the embodiment of the present invention is intravascular while carry out the structural representation of OCT image and device for pressure measurement；
Fig. 2 is the structural representation of imaging pressure catheter of the embodiment of the present invention；
Fig. 3 is that the embodiment of the present invention is intravascular while carry out OCT image and the structural representation of pressure-measuring system.
Embodiment
In order to make the purpose , technical scheme and advantage of the present invention be clearer, it is right below in conjunction with drawings and Examples
The present invention is further elaborated.It should be appreciated that specific embodiment described herein is only to explain the present invention, not
For limiting the present invention.
As shown in figure 1, the embodiment of the present invention intravascular while carrying out OCT image and device for pressure measurement 10 and including imaging
Pressure catheter and drive control mechanism, both can be connected by opto-mechanical mechanisms.
Imaging pressure catheter includes catheter fiber 14 and the fibre-optical probe 16 being connected, and the outside of catheter fiber 14 is provided with transmission
Axle 15；As shown in Fig. 2 the fiber end face of fibre-optical probe 16 is provided with globe lens 162 and light penetrating device 163, the light penetrating device 163
Prism or gradual index lenses can be selected for effectively transmission transmitted light and reflected light, the light penetrating device 163 in central role.The light
The end of fibre probe 16 is provided with pressure sensor 161；A part of optical signal into catheter fiber 14 reflects by globe lens 162
Directive vascular wall 18 afterwards, backtracking after reflection, obtain including the reflection OCT light beams of vascular wall topographical information；Another part
Optical signal, after reflection along backtracking, obtains believing comprising blood stream pressure by the directive pressure sensor 161 of light penetrating device 163
The reflected pressure light beam of breath；Reflection OCT light beams and reflected pressure light beam are transferred out by catheter fiber 14.It can be seen that this hair
In bright embodiment identical light source is used for the pressure light beam of pressure measxurement and the OCT light beams for producing OCT image.
Drive control mechanism, including rotation control unit 12 and withdraw unit 13, the connecting conduit light of rotation control unit 12
Fibre 14 and external fiber 11, and control power transmission shaft 15 to drive fibre-optical probe 16 to rotate；Withdraw the control of unit 13 and pass through power transmission shaft 15
Control fibre-optical probe 16 moves radially along blood vessel.
The core of catheter fiber 14 is fiber cores, and it is the optical channel of light signal transduction, and one layer outside fibre core is
Refractive index is less than the fibre cladding of fiber cores refractive index, to form good fiber waveguide；Glazing is closely covered outside fibre cladding
Fine transmission shaft tube so that optical fiber also can controlled rotation.In one embodiment of the present of invention, protection can be provided with outside power transmission shaft
Set, protective case is stainless steel or other rigid protective sets.
In one embodiment of the present of invention, the outside of fibre-optical probe 16 is provided with sleeve pipe 19.
In one embodiment of the present of invention, the imaging pressure catheter also includes transparent casing 17, and main function is optical fiber
Protection and the optical information of printing opacity detection vascular wall, it is arranged on the outside of protective case and sleeve pipe 19.
Laser signal enters catheter fiber 14 by optical fiber 11 through opto-mechanical mechanisms.Rotation control unit 12 and withdraw unit
13 control catheter fibers 14 in power transmission shaft 15 drive fiber spinning so that fibre-optical probe 16 incident optical signal in the blood vessels
360 degree of scannings can be carried out and correspondingly receive the optical signal that is reflected by vascular wall 18 and pressure sensor 161.360 degree of rotations
Complete blood vessel cross section pattern and pressure data can be obtained by turning scanning.360 degree of rotations are completed when fibre-optical probe 16 to obtain
After taking the complete vascular wall cross-sectional morphology in certain, withdraw unit 13 drive fibre-optical probe 16 be radially moved into along blood vessel it is next
Individual sample point, 360 degree of scannings are completed once again and obtain complete vascular wall cross section pattern and pressure data herein.By that analogy,
Catheter fiber 14 can complete one section of blood vessel radial direction and the complete pattern in cross section and pressure data.Fibre-optical probe 16 is to carry out essence
One group of optical prism lens combination of close processing.In addition corresponding pressure sensor device is also provided with the part of fibre-optical probe 16.
The diameter of the whole catheter fiber of the present invention is not more than 550 microns, suitable in 2mm~3.5mm coronary artery, existing market
Upper commercial similar catheter fiber diameter is all higher than 800 microns, it is sufficient to changes the haemodynamics of 2mm coronary arterys, so that can not essence
Really measure this kind of endovascular pressure.
It is as shown in figure 3, intravascular while carry out the structural representation of OCT image and pressure-measuring system for the embodiment of the present invention
Figure, including frequency swept laser 21, optical splitter 22, delay line and polarizer 23, optical circulators 24, splicer 25, coherent light connect
Receive device 26, signal processing module 27, image workstation terminal 28 and above-described embodiment intravascular at the same carry out OCT image and
Device for pressure measurement 10, the drive control mechanism in the device 10 are connected by optical fiber 11 with optical circulators 24.
Image workstation terminal 28 controls frequency swept laser 21 to produce sweeping laser signal, is divided to through optical splitter 22 for two
Point, a part of delayed line and polarizer 23 obtain standard laser signal and enter splicer 25, and another part light is through optics annular
Device 24 enters measurement apparatus 10；The reflection OCT light beams and reflected pressure light beam obtained by measurement apparatus 10 goes in ring by optics
Delay line is passed to after device 24 and polarizer 23 is resent to image information and endovascular pressure letter that receiving terminal obtains vascular wall
Breath, i.e., splicer 25 is convergeed to standard laser signal and produces interference signal, interference signal is received simultaneously by coherent optical receiver 26
Electric signal is converted into, electric signal is amplified with passing to signal processing module 27 after digital-to-analogue conversion, finally in image workstation terminal
28 displays, are finally completed the measurement to blood vessel feature image and intravascular pressure.
As shown in Fig. 2 the fiber end face of the fibre-optical probe 16 of the embodiment of the present invention employs globe lens and light penetrating device
Combination, flashlight pass through globe lens 162, are partly refracted and (are defined as OCT light beams), be partly transmitted and (be defined as pressure light
Beam).OCT light beam directive vascular walls, at this moment the OCT light beams comprising vascular wall topographical information globe lens 162 is reflected back by vascular wall,
The optical circulators 24 that former road is gone back in Fig. 3, then incoming delay line and polarizer 23 are resent to receiving terminal and obtain vascular wall
Image information and endovascular pressure information.After pressure light beam is transmitted by globe lens 162, continue to penetrate through light penetrating device 163
To pressure sensor 161 (pressure sensor 161 can be interferometer, fiber-optic grating sensor or deformable membrane etc.), sheet
Pressure sensor 161 in inventive embodiments Fig. 1 is one layer of deformable film, and deformable film experiences intravascular blood stream pressure, and instead
Injection pressure light beam, the reflected pressure light beam at this moment containing blood stream pressure information are saturating to light penetrating device 163 and ball by backtracking
Mirror 162, merge, the optical circulators 24 that former road is gone back in Fig. 3, be finally reached to blood vessel with the OCT light beams reflected
The dual purpose of the measurement of feature image and intravascular pressure.
In the system of the present invention, the wavelength of light is continuously adjustabe, and the light of different wave length enters the blood vessel of different depth
Tissue produces different reflected lights, and different interference signal of video signal are produced after converging from the light of standard laser signal.Reflectivity is made
For tissue depth function can by the Fourier transformation of spectrum interference signal is conversed come.Vascular wall group can so be obtained
Knit grade depth, and the contour image of 10 micrometer resolutions.
System based on above-described embodiment, it is of the invention intravascular while carry out OCT image and pressure measurement method, mainly
Comprise the following steps：
Frequency swept laser produces sweeping laser signal, is divided into two parts, a part of delayed line and polarizer through optical splitter
Obtain standard laser signal；
Another part light enters measurement apparatus through optical circulators, passes through the rotation control unit control in drive control mechanism
Power transmission shaft processed drives catheter fiber rotation so that 360 degree of scannings can be carried out in the blood vessels in the incident optical signal of fibre-optical probe,
And correspondingly receive the optical signal by vascular wall and pressure sensor reflection；
After 360 degree of rotations are completed in certain to fibre-optical probe in the blood vessels, fibre-optical probe is driven along blood by withdrawing unit
Pipe is radially moved into next sample point, completes 360 degree of scannings once again, by that analogy, obtains the light letter reflected in one section of blood vessel
Number；
The optical signal of reflection converges generation interference signal with standard laser signal, and interference signal is converted into electric signal, electricity
Signal is amplified with being handled to obtain complete blood vessel cross section pattern and number pressure in the blood vessel of one end after digital-to-analogue conversion
According to, and show.
It should be appreciated that for those of ordinary skills, can according to the above description be improved or converted,
And all these modifications and variations should all belong to the protection domain of appended claims of the present invention.
Claims (9)
- It is 1. a kind of intravascular while carry out OCT image and the device of pressure measxurement, it is characterised in that including imaging pressure catheter and Drive control mechanism, wherein：Imaging pressure catheter includes catheter fiber and the fibre-optical probe being connected, and power transmission shaft is provided with outside the catheter fiber；Institute The fiber end face for stating fibre-optical probe is provided with globe lens and light penetrating device, and the end of the fibre-optical probe is provided with pressure sensor；Into A part of optical signal of catheter fiber directive vascular wall after globe lens reflects, backtracking, obtains including blood after reflection The reflection OCT light beams of tube wall topographical information；Another part optical signal is by light penetrating device directive pressure sensor, edge after reflection Backtracking, obtain including the reflected pressure light beam of blood stream pressure information；The reflection OCT light beams and the reflected pressure light beam Transferred out by the catheter fiber；Drive control mechanism, including rotation control unit and withdraw unit, the rotation control unit connecting conduit optical fiber and outer Portion's optical fiber, and control power transmission shaft to drive fibre-optical probe rotation；The unit that withdraws controls fibre-optical probe along blood vessel by power transmission shaft Move radially.
- 2. device according to claim 1, it is characterised in that the outside of the fibre-optical probe is provided with sleeve pipe.
- 3. device according to claim 1, it is characterised in that be provided with protective case outside the power transmission shaft.
- 4. device according to claim 3, it is characterised in that the imaging pressure catheter also includes transparent casing, and described Protective case connects as one.
- 5. device according to claim 3, it is characterised in that the protective case is rigid protective set.
- 6. device according to claim 1, it is characterised in that the diameter of the imaging pressure catheter is not more than 550 microns.
- 7. device according to claim 1, it is characterised in that the pressure sensor be interferometer, fiber grating or Deformable film.
- 8. device according to claim 1, it is characterised in that the light penetrating device is prism or gradual index lenses.
- 9. system that is a kind of intravascular while carrying out OCT image and pressure measxurement, it is characterised in that including frequency swept laser, divide Light device, delay line, polarizer, optical circulators, splicer, coherent optical receiver, signal processing module, image workstation terminal And intravascular any one of claim 1-7 while OCT image and the device of pressure measxurement are carried out, in the device Drive control mechanism is connected by optical fiber with optical circulators；Image workstation terminal control frequency swept laser produces sweeping laser signal, is divided into two parts, part warp through optical splitter Delay line, polarizer obtain standard laser signal and enter splicer, and another part light enters measurement apparatus through optical circulators；It is logical Reflection OCT light beams and reflected pressure light beam that measurement apparatus obtains are crossed after optical circulator, is converged with standard laser signal Produce interference signal to splicer, interference signal is received and converted into electric signal by coherent optical receiver, electric signal it is amplified with Signal processing module is passed to after digital-to-analogue conversion, is finally shown in image workstation terminal.
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| CN204500629U (en) * | 2015-03-20 | 2015-07-29 | 武汉阿格斯科技有限公司 | Ink vessel transfusing carries out OCT imaging and pressure gauge and system simultaneously |
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