CN105792747A - Tracking an intraluminal catheter - Google Patents

Abstract

The invention generally relates to intraluminal imaging and methods of tracking one or more portions of a catheter during diagnostic and/or interventional treatment procedures based, at least in part, on a radiolucent feature of the catheter. The invention provides co-registration systems and methods for intraluminal imaging in which a volume of radiolucent negative space within a catheter, generated via translation of a sensor within the catheter, is used to track the location of one or more portions of the catheter, particularly the sensor. Thus, when a vessel is flushed with radiopaque contrast media during angiography, the system provides an improved method of tracking the location of the sensor, which would otherwise be difficult to determine with conventional methods.

Description

Follow the tracks of intraluminal catheter

The cross reference of related application

The application advocates the rights and interests enjoying in the priority of the U.S. Provisional Application that serial number is No.61/905422 that on November 18th, 2013 submits to, is incorporated by by reference herein at this.

Technical field

This patent disclosure relates generally to intracavity flow process, and more specifically, relate to following the tracks of conduit during diagnosis and/or intervention disposal process.

Background technology

In coronary artery, including the angiopathy that lumen of vessels is narrow, it is typically due to atheromatous plaque and causes, can cause reducing for the supply of blood flow of cardiac muscle, angina pectoris (chest pain) and final myocardial infarction (heart failure).At present, can be used for identifying and disposing this narrow of vessel lumen to the multiple intervention disposal of cardiovascular disease.The example of such disposal includes balloon angioplasty and/or disposes support.Diagnosing image is used to before the disposal to such obstruction and/or period identifies scope and/or the type of obstruction.Diagnosing image enables the surgeon to guarantee the effect appropriately disposing and verifying such disposal to diseased vessel.

Generally there are mode two kinds different and generate the diagnostic image for the cardiovascular disease identified and dispose in vascular system.The first kind of way of diagnosing image relates to the radiology image generating the stream of the tube chamber flowing through blood vessel.The purpose generating the image of such flowing is to identify the obstruction in the diseased vessel that limit blood flows.The scope of vessel lumen generally uses angiography to carry out imaging, angiography relates to the two dimension view drawing one or more blood vessel within the part of the vascular system of patient, by described one or more blood vessel, inject radiopaque contrast medium.Two dimension angiographic image also is able to carry out real time inspection by fluoroscopy.Doctor mainly use fluoroscopy come visually boot diagnostic and treatment conduit and/or seal wire pass through blood vessel.Catheter in blood vessel such as can include radiation opaque labelling, this radiation opaque labelling can be observed by fluoroscopic examination, so that doctor can be inserted in the patient along with conduit and/or recall the position/path following the tracks of such conduit from patient.

The second way of Ink vessel transfusing imaging generally comprises use and is arranged on supravasal intravascular probe blood vessel self is carried out imaging.The Ink vessel transfusing imaging of blood vessel is provided the various information about blood vessel, including, but it is not limited to, the composition of the cross section of tube chamber, the thickness of the deposit in blood vessel wall, the diameter of non-diseased part of blood vessel, the length of ill section and atheromatous plaque on the wall of blood vessel.

The conduit system having devised several type is tracked the atheromatous plaque deposit in blood vessel wall is carried out imaging by vascular system.The image mode of these advanced persons includes, but not limited to intravascular ultrasound (IVUS) conduit, nuclear magnetic resonance (MRI) conduit and optical coherence tomography (OCT) conduit.It addition, temperature measuring conduit and blood vessel elasticity imaging catheter have also shown for generating blood-vessel image data via intravascular probe.Other conduit mode having been proposed that include infrared or near infrared imaging.In operation, these Ink vessel transfusing are arranged on supravasal probe and carry out in the region of imaging mobile along blood vessel (such as, via retracting mechanism) in expection.Along with probe passes through area-of-interest, it is thus achieved that the set of view data, it is corresponding to a series of " sections " or the cross section of blood vessel, tube chamber and perienchyma.

Every kind of method that blood vessel carries out imaging as described above provides the advantage that, but also is subjected to shortcoming.Such as, although providing the Severe blockage for identifying in blood vessel and equipment being carried out the means of monitoring in real time, but angiography and fluoroscopy method lack the ability providing the details about blood vessel, this is partially due to the imperfect characteristic of angiogram data.Although Ink vessel transfusing imaging probe provides abundant Ink vessel transfusing information, such as blood vessel wall composition, such method is generally deficient of spatial orientation.

Owing to both image modes are that some current vascular imaging systems use both image modes patient to be diagnosed and dispose to supplementing each other simultaneously.More specifically, the data interworking that some current systems are configured to obtaining from both modalities is accurate, thus providing pin comprehensive picture coronarius for getting involved cardiologist.Such as announce described in 2006/0241465 and U.S.'s announcement 2007/0038061 interworking Barebone and method in the U.S., be incorporated by by reference herein at this.

The supernet that the vascular system of patient is the very little vein by extensive branch and tremulous pulse defines.So, accurate and robust the tracking to the conduit adopted during the Percutantnoeus coronary intervention that image guides and transducer is the key improving clinical workflow and result of flow.Therefore, when the Ink vessel transfusing image scanning (such as, IVUS, OCT etc.) based on conduit is punctual with angiography/fluoroscopy/X-ray scanning carries out interworking, it is important to be able to detect the feature of imaging catheter in radioscopic image.But, existing interworking Barebone and method are limited a bit in providing the ability to imaging catheter and the accurate tracking of transducer.

Such as, when by the Ink vessel transfusing image scanning based on conduit (such as, IVUS, OCT etc.) punctual with angiography/fluoroscopy/X-ray scanning carries out interworking, the position of conduit and transducer is likely difficult to be determined, this is partially due to the use of radiation opaque contrast medium that is injected in blood vessel when obtaining radiology image.As described earlier, imaging catheter is generally configured to be positioned along radiation opaque labelling the specific location of the imaging region of catheter body.Radiation opaque labelling is generally positioned near including the distal end of catheter of sensor region, its can during " retracting " image capturing longitudinal translation.When performing OCT and retracting image capturing, for instance, blood vessel generally utilizes radiation opaque contrast medium to be rinsed so that the whole tube chamber of described blood vessel becomes radiation opaque, so that the labelling being built in conduit and/or transducer is dimmed.The flushing of blood vessel enables to automated graphics process software (or even human eye) and be especially difficult to the position of conduit is tracked and visualizes.Owing to requiring to be accurately positioned and avoid the damage to blood vessel wall to conduit to disposing of plaque deposits, about blood vessel the inaccuracy of conduit and/or transducer position followed the tracks of and may cause the vascular system forbidden zone that existing procedure is very many.

Summary of the invention

Present invention generally provides the system and method during diagnosis and/or intervention disposal process, one or more parts of the conduit in vascular being tracked for the one or more distinguishing characteristicss being at least partially based on conduit.In one embodiment, during the translation of the sensor (such as, imaging probe) in conduit, described sensor generally when collection tube intracavity data along the length longitudinal translation of conduit.Described translation can be retracting sensor.The translation of sensor is caused residual internal volume or negative space within catheter sheath.Described negative space can serve as determining one or more parts of conduit, including the distinguishing characteristics of the position of sensor self, particularly in when there is the contrast medium of flushing in vascular.

In specific flow process, contrast medium can be imparted into vascular to allow to catch the view data of vascular.In one embodiment, described contrast medium can be radiopaque and allow to catch angiographic image.The negative space of described conduit can have radiation transparent amount.Term as used herein " radiation transparent " generally refers to electromagnetic radiation, especially that X ray and fluoroscopy is nearly transparent amount.During angiography, radiopaque contrast medium is imparted into blood vessel to allow to catch angiographic image, described angiographic image can carry out interworking standard with data in tube chamber, to provide the visualization of the enhancing to intracavity flow process and to assist the visualization to endovascular sensor and manipulation further.

During angiography, the radiation transparent negative space in conduit provides the decay that x-ray irradiation is relatively low so that described negative space has the outward appearance (such as, lighter color) different from perienchyma and/or guide-tube structure.Therefore, when utilize during angiography radiation opaque contrast medium rinse blood vessel time, one or more parts of conduit, for instance sensor, position can be tracked based on associated negative space.More specifically, the particular community of negative space, include, but not limited to shape, geometry and size, it is possible to be used for determining the position of sensor.Such as, the position of sensor can be determined based on the length (such as, the length of negative space is approximately equal to such as in the length retracting period movable sensor) of negative space.

Therefore, the invention provides the more accurate system and method during angiography flow process, one or more parts of conduit (such as, imaging probe) being tracked in interworking Barebone.The doctor using this system can continue to use interworking Barebone when performing intracavity flow process, without with only rely only on radiation opaque labelling, provide what the current system of little definition and inaccuracy location and method be associated to recall.

Ad hoc structure interested can be positioned and return these structures with less effort by the doctor using the system and method for the present invention, because the system and method for the present invention helps to overcome and the challenge directly detecting transducer shade in the internal blood vessel rinsed completely.Therefore, described flow process will take for less time, and patient and doctor will be exposed to less X-radiation.Additionally, the following the tracks of of one or more parts of conduit will be reduced by the additive method amount by the radiation opaque labelling of needs by the system and method based on the present invention.

According to particular aspects, the present invention includes the system for intracavity flow process.In one embodiment, a kind of system, including: sensor, described sensor is positioned in conduit and can catch data in the tube chamber of vascular；And the outer image mode of tube chamber, the outer image mode of described tube chamber can catch the outer view data of tube chamber of vascular.Described system also includes at least one processor, and at least one processor described is configured to: receive data in tube chamber in tube chamber during data capture during the translation in described vascular of the described sensor；The outer view data of tube chamber of described vascular is received during the described translation of described sensor；By accurate for outer to data in described tube chamber and described tube chamber view data interworking；And the radiation transparent feature of described conduit is detected when there is radiation opaque contrast medium.Described radiation transparent is characterized by conduit having to be derived from the translation of sensor lacks the internal volume of sensor or the part of negative space.In one embodiment, at least one processor described is additionally configured to identify the attribute of described negative space and further to being at least partly based on the attribute identified to determine the position of sensor.

According to other aspects, the present invention includes the method for intracavity flow process extraly.In one embodiment, a kind of method includes: utilize the sensor that is positioned in conduit to data in the tube chamber gather vascular；Utilize tube chamber image mode outward to gather the tube chamber view data outward of vascular；And by accurate for outer to data in described tube chamber and described tube chamber view data interworking.Described method is additionally included in the situation that there is radiation opaque contrast medium and gets off to detect the radiation transparent feature of conduit.Described radiation transparent is characterized by conduit have the usual section by the internal volume lacking sensor during data acquisition in tube chamber, the translation of sensor caused or negative space.Described method also includes identifying the attribute of described negative space and is at least partially based on the attribute of the described negative space identified to determine the position of sensor.

Accompanying drawing explanation

Fig. 1 is the indicative icon of the system for implementing the conduit image interworking standard according to the disclosure.

Fig. 2 is the graphical representation of the three-dimensional length of the tremulous pulse of the section including height pathological changes.

Fig. 3 is the graphical representation of the part of tremulous pulse that is removed of longitudinal section of depicted in figure 2 along the line 2, with the different key elements of but exemplary depictions atheromatous plaque.

Fig. 4 is the graphical representation to the tremulous pulse from Fig. 2 and Fig. 3, wherein, has been inserted in tremulous pulse according to the imaging catheter of the disclosure.

Fig. 5 is the detailed view of the section of tremulous pulse depicted in figure 4, and it includes imaging catheter in the artery.

Fig. 6 is the zoomed-in view of the distal section of the imaging catheter of Fig. 5, and what which illustrates image-forming component retracts operation.

Fig. 7 is the chart of the parts of the OCT system according to the disclosure.

Fig. 8 be a diagram that the block diagram of the detailed view of the OCT image engine of the OCT system of Fig. 7.

Fig. 9 is the schematic diagram of the OCT patient interface module according to the disclosure.

Figure 10 illustrates according to the disclosure pattern in the OCT image fiber track retracted during operation.

Figure 11 illustrates the pattern of the scanning line by the imaging operation of OCT image conduit being produced according to the disclosure.

Figure 12 is the display of the angiogram of tremulous pulse, according to described display, produces OCT image before according to the image procossing of the disclosure.

Figure 13 is the display of the angiogram of the tremulous pulse of Figure 12, and rear image procossing illustrates the radiation transparent feature of the conduit identified.

Detailed description of the invention

According to embodiments of the invention, mode herein by example describes method and system, including image data acquiring instrument and data/image processor, described data/image processor generates view at individual monitor, described view provides simultaneously and is installed in flexible thin component (such as, conduit, seal wire etc.) on the positional information that is associated of imaging probe (such as, IVUS transducer probe) and Ink vessel transfusing image.As being discussed in more detail in this article, the position of endovascular Ink vessel transfusing imaging catheter is carried out accurate tracking by the radiation transparent feature being configured to be at least partially based on during diagnosis and/or intervention disposal process conduit according to the system of the disclosure.

With reference first to Fig. 1, exemplary system is schematic representation for the form execution present invention accurate with the interworking of ivus image with angiography/fluoroscopy.Radiology and ultrasound data acquisition subsystem are known generally in the art.About radiology image data, patient 10 is positioned on angiography tables 12.Angiography tables 12 are arranged to the space providing enough angiography/fluoroscopy unit C-arm 14 to be positioned in operating position about the patient 10 on tables 12.The radiology image data gathered by angiography/fluoroscopy C-arm 14 are delivered to angiography/fluoroscopy processor 18 via transmitting cable 16.The radiology image data received are converted to angiography/fluoroscopic image data via cable 16 by angiography/fluoroscopy processor 18.Angiography/fluoroscopy (" radiology ") view data is initially stored in processor 18.

About the part of the system being associated with collection ultrasound image data, imaging catheter 20, for instance IVUS conduit, it is inserted in patient 10 body so that its far-end, including diagnostic probe 22 (being specially IVUS probe), near the expection image space of blood vessel.Although clearly not identifying in FIG, but the radiation opaque material being positioned about at probe 22 provides the instruction to probe 22 current locations in radiology image.By the mode of example, diagnostic probe 22 generates ultrasound wave, receives the ultrasonic echo representing the region close to diagnostic probe 22, and described ultrasonic echo is converted to the signal of telecommunication of correspondence.The signal of telecommunication of described correspondence is sent to proximal connector 24 along the length of imaging catheter 20.The IVUS version of probe 22 produces various configurations, arranges including single transducer element and multi-transducer element is arranged.Arranging for multi-transducer element, the array of transducer is likely to be arranged as follows: along imaging catheter 20 major axis linearly, about the major axis curve ground, around described major axis circumferentially etc. of conduit 20.

The proximal connector 24 of conduit 20 is communicatively coupled to conduit image processor 26.The signal received via proximal connector 24 is converted to the cross-sectional image of such as vessel segment by conduit image processor 26.It addition, conduit image processor 26 generates the longitudinal cross-section image of the section corresponding to the blood vessel shot along the length of blood vessel.The IVUS view data drawn by conduit image processor 26 is initially stored in processor 26.

The type of the diagnosing image data being gathered by diagnostic probe 22 and being processed by conduit image processor 26 changes according to the alternative of the present invention.According to specific alternative, diagnostic probe 22 is equipped with one or more sensor (such as, Doppler and/or pressure), it is used for providing hemodynamic data (such as, blood flow rate and pressure) to be also referred to as function flowing measurement result.In such alternative, conduit image processor 26 process function flowing measurement result.Therefore, represent and include vascular pressure, blood flow rate/volume, vascular cross-section composition it should be noted that, term " image " is intended to be broadly construed contain, run through the various modes of the vessel information of the tangential stress of blood, the tangential stress etc. in blood/blood vessel wall interface.When gathering for the hemodynamic data of the specific part of blood vessel, efficient diagnosis depends on the ability that the current location to the diagnostic probe 22 in vascular system visualized, observed simultaneously the function flowing tolerance of instruction cardiovascular disease.The interworking standard of hematodinamics and radiology image is easy to the accurate disposal to diseased vessel.Alternatively, replacing being arranged on supravasal sensor, described sensor can be installed on seal wire, for instance is installed in and has about 0.018 " on the seal wire of diameter.Therefore, according to embodiments of the invention, not only using various types of probe, but also use various flexible elongated element, such probe is installed to described flexible elongated element (such as, conduit, seal wire etc.) at far-end.

Mutual registration processor 30 receives the IVUS view data from conduit image processor 26 via line 32, and receives the radiology image data from radiology image processor 18 via line 34.Alternatively, the communication between sensor and described processor performs via wireless medium.Mutual registration processor 30 draws the mutual registering images including radiology and IVUS image from the view data derivation received.According to embodiments of the invention, the radiology image of position corresponding to the IVUS view data simultaneously shown provides instruction (such as, radiation opaque labelling artifact).The angiogram data received from radiology image processor 18 via line 34 is initially buffered in the Part I 36 of image data memory 40 by mutual registration processor 30.Afterwards, during the process of catheterization flow process, the IVUS and the radiation opaque marked image data that receive via line 32 and 34 are respectively stored in Part II 38 and the Part III 42 of image data memory 40.The frame of the individual volume drawing of stored view data is appropriately flagged (such as, timestamp, serial number etc.) so that IVUS picture frame is relevant to corresponding radiology (radiation opaque labelling) image data frame.In an embodiment, wherein, gathering hemodynamic data but not IVUS data, described hemodynamic data is stored in Part II 38.

It addition, on the surface of the extra labelling patient that can be placed in the visual field of angiography/fluoroscopy imaging device or be placed in the vicinity of patient.It is used to after the position of these labellings be positioned in the exact position on angiographic image radiation opaque labelling artifact.

Mutual registration processor 30 is from the data being previously stored in the Part I 36 of image data memory 40, Part II 38 and Part III 42 to draw mutual registering images.By the mode of example, select specific IVUS picture frame/section from Part II 38.Mutual registration processor 30 identifies the fluoroscopic image data corresponding to the IVUS view data selected from Part II 38 in Part III 42.Afterwards, the fluoroscopic image data from Part III 42 is superimposed upon the angiogram picture frame from Part I retrieval by mutual registration processor 30.Afterwards, the quasi-radiology of described interworking and IVUS picture frame are shown on image display 50 simultaneously each other side by side.The quasi-image data frame of interworking driving described display device 50 is also stored in long-term storage device 60, checks for follow-up in the session that the flow process being stored in image data memory 40 with the radiology gathered and IVUS view data separates.

nullAs what be generally understood that，System can be used to performing any number of medical science sensing flow process with patient depicted in figure 1，Such as intravascular ultrasound (IVUS)、Angiography、Virtual organization structure (VH)、Perspective IVUS (FL-IVUS)、Intravascular photoacoustic (IVPA) imaging、Blood flow reserve mark (FFR) is determined、Coronary flow reserve (CFR) is determined、Optical coherence tomography (OCT)、Computer tomography (CT)、Ultrasonography (ICE) in heart、Perspective ICE (FLICE)、Ink vessel transfusing pulsation is traced、Transesophageal ultrasonography (TEE)、Temperature measuring、Nuclear magnetic resonance (MRI)、Micro-nuclear magnetic resonance (mMRI or μM RI)，Or any other medical science known in the art sensing mode.Additionally, described system can be used to patient performs one or more disposal or treatment flow process, such as radio-frequency (RF) ablation (RFA), cold therapy, ATH or any other medical response flow process known in the art.

Any target of such as bodily tissue can be carried out imaging by the method and system of the present invention.In a particular embodiment, the system and method for the present invention carries out imaging in the tube chamber of tissue.The various tube chambers of the biological structure that can be imaged include, but it is not limited to, blood vessel, lymph and neural vascular system, the various structure of gastrointestinal, including small intestinal, large intestine, stomach, esophagus, colon, pancreatic duct, bile duct, common hepatic duct tube chamber, the tube chamber of reproductive system, including deferent duct, vagina, uterus, fallopian tube, the structure of urethra, including urine collecting pipe, renal tubules, ureter and bladder, and the structure of head and neck, and pulmonary system, including nasal sinuses, the parotid gland, trachea-bronchial epithelial cell and lung.

Fig. 2 is the graphical representation of the three-dimensional length to the tremulous pulse 100 including highly ill section.In fig. 2 it is shown that have the diseased arteries 100 of tube chamber 102.On the direction indicated by arrow 104, blood proximally 106 flows through tremulous pulse 100 to far-end 108.Tremulous pulse 100 is seen narrow zone 110.Fig. 3 illustrates the part charge of the narrow zone 110 of tremulous pulse 100.Arterial wall 112 includes three layers: inner membrance 114, middle film 116 and adventitia 118.External elastic membrane (EEL) 120 is the boundary between middle film 116 and external mold 118.Narrow 122 are positioned in tremulous pulse 100, and limit blood flow by tremulous pulse 100.Aileron (flap) 124 is illustrated at high stress areas 126 place of tremulous pulse 100.Close to narrow 122 be weak section 128, including necrotic cores 130.Break in the region usually occurring in such as weak section 128.

Fig. 4 but exemplary depictions has the imaging catheter 132 of far-end 134, and far-end 134 is inserted in the narrow zone 110 of tremulous pulse 100.In certain embodiments, imaging catheter 132 is inserted on seal wire 136, and this allows imaging catheter 132 to being maneuvered to the desired location in tremulous pulse 100.As depicted in figure 5, imaging catheter 132 includes imaging sensor 138, imaging sensor 138 is for carrying out imaging to diseased part and the normal segments of tremulous pulse 100.Imaging sensor 138 is such as rotary ultrasonic transducer, the array of ultrasonic transducer, such as phased array/cMUT, optical coherence tomography (OCT) probe, Spectrum Analysis probe, Angioscopy or for the other kinds of imaging sensor of view data in catcher.Far-end at imaging sensor 138 is tapered tipped 140, and it allows imaging catheter 132 on seal wire 136, particularly in dangerous bending place, it is easy to the blood vessel of stenosis or occlusion is followed the tracks of on ground.In other embodiments, tapered tipped 140 can be blind end.Imaging catheter 132 can be pulled or be inserted in the expection length of blood vessel, obtain the image-forming information along this expection length, and afterwards, the set according to the circumferential section image obtained from image-forming information, create the volume-based model of the blood vessel wall including ill and normal part.Some technology of such as IVUS allow the blood to flowing and thrombosis to carry out imaging.

Fig. 6 is the zoomed-in view of the distal section of the imaging catheter 132 of Fig. 5, and what which illustrates imaging sensor 138 retracts operation.As being discussed in more detail in this article, the image of the tube chamber 102 of blood vessel 100 can be caught by imaging sensor 138 via retracting method.As directed, retracting period, imaging sensor 138 and be coupled to imaging sensor 138 drive rod 140 can from being such as pulled (and/or rotate) by the primary importance in the sheath 146 indicated by the body mould profile of arrow 146 by catheter sheath 142, as indicated by arrow 144.Then, the internal volume 148 of catheter sheath 142 or " negative space " are retained in the position of the part of the imaging sensor 138 before retracting.

As previously described herein, one or more parts of imaging catheter 132 can include one or more radiation opaque element.Term " radiation opaque " collectively refers to visible amount in radiology image (such as, X-ray image) and under fluoroscopic examination.As directed, imaging sensor 138 such as can include radiation opaque element or labelling 141.Drive rod 140 and seal wire 136 can also include being positioned in radiation opaque labelling thereon.Radiation opaque labelling 141 can be observed by fluoroscopic examination, so that doctor can be inserted in the patient along with such conduit and/or recall the position/path following the tracks of such conduit from patient.

Retracting period, the negative space 148 stayed in catheter sheath 142 can serve as radiation opaque feature.Term as used herein " radiation transparent " collectively refers to electromagnetic radiation, especially that X ray and fluoroscopy is nearly transparent amount.Therefore, during fluoroscopic examination, negative space 148 can provide the decay that X irradiation is of a sufficiently low, the body structure coronarius making such as to utilize intracavity contrast medium imaging can pass through described conduit and be visualized, without picture quality being caused notable deterioration so that image is irregular about tube chamber, angioplasty result, thrombosis or vascular occlusion and can not understand.As being discussed in more detail in this article, when using the Ink vessel transfusing image scanning based on conduit (such as, IVUS, OCT etc.) punctual with the interworking of angiography/fluoroscopy/X-ray scanning, during the Percutantnoeus coronary intervention that image guides, the position of one or more parts of conduit 132, especially imaging sensor 138 can be at least partially based on radiation transparent negative space 148 and be followed the tracks of accurately.

In an exemplary embodiment, the invention provides the system that a kind of OCT image for catching is accurate with angiography/fluoroscopy/X-ray scanning interworking.The application that such as art preservation and diagnostic medical (such as, ophthalmology) are different adopts commercially available OCT system.OCT is also used in Interventional cardiology, for instance, assisted diagnosis coronary artery disease.2011/0152771 is announced in the U.S.；The U.S. announces 2010/0220334；The U.S. announces 2009/0043191；The U.S. announces 2008/0291463；Announce described in 2008/0180683 OCT system and method with the U.S., by reference its entire contents has been expressly incorporated herein at this.

In OCT, light source by the beam delivery of light to imaging device so that destination organization is carried out imaging.Being image intensifer and tunable filter in light source, described tunable filter allows user to select the wavelength of light to be amplified.In medical application, normally used wavelength includes near infrared light, for instance, the near infrared light between about 800nm and about 1700nm.

Typically, there are two kinds of OCT system, public course of the beam system and difference course of the beam system, they are different from each other based on the light distribution of system.Public course of the beam system sends the light of all generations by single optical fiber to generate reference signal and sample signal, and difference course of the beam system makes produced photo-fission so that a part for light is directed into sample and other parts are directed into reference surface.Public course of the beam interferometer is also in such as United States Patent (USP) 7999938；United States Patent (USP) 7995210；It is described with in United States Patent (USP) 7787127, by reference its entire contents is expressly incorporated herein at this.

In difference course of the beam system, the amplified signal from light source is imported in interferometer, and wherein a part for light is directed into sample, and other parts are directed into reference surface.The far-end of optical fiber is connected with conduit, for destination organization being inquired during inserting flow process at conduit.Reflection light from described tissue is recombined with the signal from reference surface, to form interference fringe (being measured by photodetector), thus allowing with micron order, destination organization to be carried out the imaging of accurate depth resolution.Example differential course of the beam interferometer is Mach Zehnder interferometer and Michelson interferometer.Difference course of the beam interferometer is also in such as United States Patent (USP) 7783337；United States Patent (USP) 6134003；It is described with in United States Patent (USP) 6421164, by reference the content of each of which is incorporated by herein at this.

Fig. 7 presents the high-rise chart of difference beam OCT system according to a particular embodiment of the invention.In order to carry out Ink vessel transfusing imaging, streamer is delivered to vessel lumen via the imaging catheter 826 based on optical fiber.Described imaging catheter is connected to the software on main work station by hardware.Described hardware includes imaging engine 859 and includes hand-held patient's interface module (PIM) 839 that user controls.The near-end of imaging catheter is connected to PIM839, PIM839 and is connected to imaging engine, as shown in Figure 8.

Fig. 8 gives the detailed view of the parts of imaging engine 859 (such as, bed-side unit).Imaging engine 859 holds power supply 849, light source 827, interferometer 931 and vairable delay line 835 and data acquisition (DAQ) plate 855 and optical controller plate (OCB) 854.Imaging engine 859 is connected to PIM839 by PIM cable 841, and imaging engine 859 is connected to main work station by engine cable 845.

Fig. 9 illustrates the light path in difference course of the beam system according to an exemplary embodiment of the invention.Light for image capturing is derived within light source 827.This light is split off between OCT interferometer 905 and auxiliary or " clock " interferometer 911.It is directed into the interferometric light of the OCT device 917 that is also split to divide and the device 919 that is split reconfigures with Asymmetric division ratio.The major part of light is directed in sample path 913, and remainder is directed in reference path 915.Sample path includes the optical fiber extending through PIM839 and imaging catheter 826 and the terminating at distal ends catching image at imaging catheter.

Typical Ink vessel transfusing OCT is directed to use with standard interventional technique and such as seal wire, guides the instrument of conduit and angioradiographic system to be incorporated in the target blood of patient by imaging catheter.Rotate and driven by spin motor 861, and translate and drive by retracting motor 865.

Figure 10 describes by rotating and translating the motion for image capturing defined.Blood in the blood vessel is rinsed to carry out imaging in time domain with clear resolution.Detecting that flushing triggers, via PIM or control station, while collecting the view data being delivered to control station screen, the imaging core of conduit rotates 1002, retracts or both.Using the light provided by imaging engine, light is sent in tissue by inner core with the array of the A sweep line of diagram in Figure 11, and detects the light of reflection.

Figure 11 illustrates the location in endovascular A sweep.Each position that wherein in A sweep A11, A12 ... A (N) is crossing with the surface of the feature (such as, blood vessel wall) in blood vessel 1006, reflects and detects coherent light.Conduit 826 is along translating by retracting the axle A that motor 865 pushes or pulls on.

Light that reflected, detection carries out transmitting to reconfigure with the light from reference path via beam splitter along the sample path of interferometer 831.Vairable delay line (VDL) 925 in reference path uses adjustable fiberoptic coil so that the length of reference path to match the length of sample path.Reference path degree can be adjusted at the stepper motor of translation stage translation mirror by under the control of firmware or software.Free Space Optics beam on inside VDL925 moves away from fixing input/output fiber along with mirror and experiences more delay.

Combination light from beam splitter is split into quadrature bias state, causes RF with polarizing different temporal interference stripe signals.The PIN diode that interferometric fringe signal is used on the OCB851 shown in Fig. 8 is converted into photoelectric current.Interfere, polarization is divided and detecting step is completed by the polarity diversity module (PDM) on OCB.Signal from OCB is sent to DAQ855, as shown in Figure 8.DAQ includes Digital Signal Processing (DSP) microprocessor and field programmable gate array (FPGA), signal to be digitized and communicates with main work station and PIM.Original optical interference signal is converted to significant OCT image by FPGA.DAQ also compresses data when necessary so that image transmitting bandwidth to be reduced to 1Gbps (such as, utilizing lossy compression method jpeg coder that frame is compressed).

Data are collected and are stored in from A sweep A11, A12 ..., A (N) in tangible non-transient memorizer.The set of A sweep generally defines B-scan.The data of all A sweep lines represent the 3-D view of tissue together.The data being commonly called the A sweep line of B-scan can be used the image in the cross section creating tissue, sometimes referred to as tomography view.The data system and a method according to the invention of A sweep line is processed, to generate the image of tissue.By suitably processing (such as, passing through fast Fourier transform) data, it is possible to prepare two dimensional image from 3-D data set.The system and method for the present invention provides tomography view, ILD or both is one or more.

As described earlier, it is configured to OCT data and angiography/fluoroscopic examination data are carried out interworking standard according to the system of the disclosure.The quasi-software of image interworking provides and utilizes multiple view on a display or utilize the multiple views around the three-D volumes of physiological structure interested to combine the ability of angiography, OCT and displacement information on multiple display.Angiogram such as can be included with OCT image interworking standard segmentation 3 d image data.The view data of shown interworking standard can be used to perform percutaneous coronary at for coronary tremulous pulse and get involved the guiding in (PCI) process.

Use the system and method for the present invention, i.e. with image collector positions jointly, there is radiation opaque labelling and the conduit of radiation transparent feature, using the teaching of the invention it is possible to provide for the improved system in image, the position of intraluminal catheter and its part positioned.In principle, described method can include using the image collector of such as part as imaging catheter (such as, use angiography) part of the vascular system of object is carried out imaging, described object is carried out imaging to determine the position of the radiation opaque labelling jointly positioned with image collector, and it is based at least partially on the described radiation opaque labelling position about the radiation transparent feature of the conduit in angiogram, the position of Ink vessel transfusing image is positioned.

Figure 12 is angiogram 1100 coronarius, from described angiogram, produces OCT image before according to the image procossing of the disclosure.After gathering initial pictures, it is possible to bestow radiation opaque contrast medium, and angiographic image can be shot.Angiography such as can use the one or more fluoroscopy mirrors being each installed in C-arm to perform.When using multiple fluoroscopy mirrors such as to realize higher precision and/or when further constraint interworking is quasi-, each fluoroscopy mirror can be positioned in unique angle place.Angle between two fluoroscopic examination sequences can between 30 degree and 90 degree.(one or more) fluoroscopic image sequence can be two-dimentional.

The real time imaging of vascular system is generally shown on a monitor during Ink vessel transfusing flow process so that technical staff or doctor can watch the manipulation to seal wire or conduit in real time.Described angiogram can utilize software to carry out processing and being shown on computers, or described image can be the closed-loop path image of the scintillation surface with visible fluorescence combination of materials.Newer fluoroscopic examination can use flat board (array) detector, and it is sensitive to the X-radiation of relatively low-dose, and provides the resolution improved than more conventional scintillation surface.

As shown in Figure 12, after utilizing radiation opaque contrast medium to rinse blood vessel, the some parts of conduit is likely difficult to be seen, especially imaging sensor.When performing OCT and retracting image capturing, for instance, blood vessel generally utilizes radiopaque contrast medium to be rinsed so that the whole tube chamber of described blood vessel becomes radiation opaque, so that the labelling being built in conduit and/or transducer is dimmed.The flushing of blood vessel enables to automated graphics process software (or even human eye) and be especially difficult to the position of conduit is tracked and visualizes.Owing to requiring to be accurately positioned and avoid the damage to blood vessel wall to conduit to disposing of plaque deposits, thus it is likely to result in a lot of vascular system deviation existing procedures to about the conduit of blood vessel and/or the inaccurate tracking of imaging sensor position.

Figure 13 illustrates the rear image procossing of the angiogram of Figure 12 to realize during OCT retracts flow process the tracking to imaging sensor better, particularly in when using in interworking Barebone.As about at least shown in Fig. 6 and describe, some imaging catheters do not pour contrast media in the inside of angiographic image its sheath 142 of trapping period chien shih.Therefore, retracting period, the negative space 148 retained in catheter sheath 142 can be radioparent (such as, being filled with such as air or normal saline).Radioparent negative space 148 by creating negative space in radioscopic image.The size (such as, shape, size etc.) based on negative space 148 that can be configured to image processing equipment according to the disclosure detects described negative space and further determines that the position of one or more parts of conduit (especially imaging sensor 138).

Such as, in certain embodiments, image tagged software or other algorithms can be used and automatically detect radiation transparent feature, and it will typically appear as the part along blood vessel, and has the conduit of remainder more light colour than image.After radiation transparent negative space 148 being detected, for instance, image tagged software can also determine the position of instruction imaging sensor 138 based on the size (such as, length) of negative space 148.As described, retracting of transducer 138 is obtained by negative space 148 from the length along conduit 132.Therefore, the length of the transducer 138 moved along conduit 132 is may be approximately equal to from the length retracting the negative space 148 obtained.Similarly, image tagged software can be used to automatically identify the position of radiation opaque labelling, and described position can be rendered as the fleck of color more darker than other parts of image.

It should be noted that, the system and method according to the disclosure is not limited to the use radiation opaque contrast medium when the position of the one or more parts to the conduit including imaging sensor is tracked.In certain embodiments, it is possible to other kinds of contrast medium is imparted into blood vessel by the type depending on sensor and the intracavity image mode being currently in use.Such as, during IVUS flow process, it is possible to microvesicle is used for the purpose of Contrast enhanced, the such as Contrast enhanced to carotid artery chamber-wall interface.In addition, although previous embodiment describes with reference to for view data in catcher, but system and a method according to the invention can include the non-imaged sensor of each attribute for catching tube chamber, such as, such as, for measuring blood flow reserve mark (FFR) probe of endovascular pressure.

Ad hoc structure interested will can be positioned and return these structures with less effort by the doctor using this system, because the system and method for the present invention helps to overcome and the challenge directly detecting transducer shade in the internal blood vessel rinsed completely.Therefore, described flow process will take for less time, and patient and doctor will be exposed to less X-radiation.Additionally, the following the tracks of of one or more parts of imaging catheter will be utilized the additive method amount by the radiation opaque labelling of needs by the system and method based on the present invention.

Other embodiments are also within the scope and spirit of the present invention.Such as, due to the characteristic of software, function described above can be adapted to software, hardware, firmware, hard wire or its combination in any and implements.The feature implementing function also is able to be physically located position, is implemented at different physical locations including the part being depicted so that function.The step of the present invention can use special Medical imaging hardware, the computer of general purpose or both perform.The method that those skilled in the art will recognize that as required or are most suitable for performing the present invention, the computer system of the present invention or machine include one or more processor (such as, CPU (CPU), graphics processing unit (GPU) or both), main storage and static memory, it communicates with one another via bus.Computer equipment generally includes and is coupled to processor or via the operable memorizer of input-output apparatus.

Exemplary input-output apparatus includes video display unit (such as, liquid crystal display (LCD) or cathode ray tube (CRT)).Computer system or machine according to the present invention also are able to include Alphanumeric Entry Device (such as, keyboard), arrow control equipment (such as mouse), disk drive unit, signal generate equipment (such as, speaker), touch screen, accelerometer, mike, cellular radio antenna and Network Interface Unit, it can utilize is NIC (NIC), unruled card or cellular demodulator.

Memorizer according to the present invention can include machine readable media, on described machine readable media, storage has instruction (such as, software), data or the one or more set of both, it is one or more that it implements in method described herein or function.When being run software by computer system, described software can also fully or at least partially reside in main storage and/or in processor, and described main storage and processor also constitute machine readable media.Described software can also be sent by network via Network Interface Unit or receive.

Although and computer-readable recording medium can be single medium in an exemplary embodiment, but term " machine readable media " will be understood that the single medium of one or more set including storage instruction or multiple medium (such as, centralized or distributed data base and/or the buffer being associated and server).Term " machine readable media " should also be as being believed to comprise any medium of the geometry that can store, encode or carry for the instruction run by machine, and it makes any one that machine performs in the method for the present invention.Term " machine readable media " therefore should be believed to comprise, but it is not limited to, solid-state memory (such as, subscriber identity module (SIM) card, safe digital card (SD card), miniature SD card or solid-state drive (SSD)), optics or magnetizing mediums and any other tangible storage media.Preferably, computer storage is entity, non-state medium, any one in such as aforementioned, and can be operatively coupled processor by bus.Namely the method for the present invention includes writing data in memorizer, and the physical conversion of the particle in computer storage is arranged, thus transformed tangible media presentation-entity physical object is such as, and the artery plaque in patient vessel.

As used in this article, "or" one word mean " with or or " sometimes see or be known as "and/or", unless otherwise noted.

It is incorporated by reference into

Run through the disclosure carry out the reference to the such as document of patent, patent application, patent disclosure, periodical, books, newspaper, web site contents and quote.Therefore its entire contents is expressly incorporated herein by all such documents for all purposes by reference.

Equivalence

Except those described herein and described embodiments, the various amendments of the present invention and its other embodiments many, to those skilled in the art, the full content according to the document, including with reference to the science quoted herein and patent documentation, will become clear from.The theme of the present invention comprises important information, example and guiding and can adjust with its various embodiments and equivalent thereof for the practice of the present invention.

Claims (24)

1., for a system for intracavity flow process, described system includes:

Sensor, it is located in conduit and can catch data in the tube chamber of vascular；

The outer image mode of tube chamber, it can catch the outer view data of tube chamber of described vascular；And

At least one processor, it is configured to:

During the translation in described conduit of the described sensor, data in described tube chamber are received during data capture in tube chamber；

The outer view data of described tube chamber of described vascular is received during the described translation of described sensor；

Outer to data in described tube chamber and described tube chamber view data is carried out interworking standard；And

The radiation transparent feature of described conduit is detected when there is radiation opaque contrast medium.

2. system according to claim 1, wherein, at least one processor described is additionally configured to identify the attribute of described radiation transparent feature, and is at least partially based on the described attribute identified of described radiation transparent feature to determine the position of described sensor.

3. system according to claim 2, wherein, described sensor during retracting flow process along the length longitudinal translation of described conduit.

4. system according to claim 1, wherein, described radiation transparent feature includes the section with the internal volume lacking described sensor of described conduit.

5. method according to claim 4, wherein, described internal volume includes one or more radiation transparent composition.

6. method according to claim 5, wherein, described internal volume includes air or normal saline.

7. system according to claim 6, wherein, the described attribute identified is to select from the group including shape, geometry and size.

8. system according to claim 7, wherein, the described attribute identified is relevant to the translation of described equipment.

9. system according to claim 1, wherein, the outer image mode of described tube chamber is based on X ray.

10. system according to claim 9, wherein, the outer image mode of described tube chamber is to select from the group including fluoroscopic examination, angiography and their combination.

11. system according to claim 1, wherein, described sensor is to select from the group including intravascular ultrasound probes, optical coherence tomography probe, Spectrum Analysis probe, Near-infrared Raman spectroscopy analysis probe, blood flow reserve mark probe and their combination.

12. system according to claim 1, wherein, described processor is additionally configured to show the described radiation transparent feature of described conduit on screen.

13. for a method for intracavity flow process, described method includes:

Utilize and be located in sensor in conduit to data in the tube chamber catch vascular；

Utilize tube chamber image mode outward to catch the tube chamber view data outward of described vascular；

Outer to data in described tube chamber and described tube chamber view data is carried out interworking standard；And

The radiation transparent feature of described conduit is detected when there is radiation opaque contrast medium.

14. method according to claim 13, also include the attribute identifying described radiation transparent feature, and be at least partially based on the described attribute identified of described transparent feature to determine the position of described sensor.

15. method according to claim 14, wherein, catch view data in described tube chamber and include translating during data acquisition described sensor in tube chamber.

16. method according to claim 15, wherein, the outer view data of described tube chamber is to gather during the described translation of described sensor.

17. method according to claim 15, wherein, described sensor during retracting flow process along the length longitudinal translation of described conduit.

18. method according to claim 13, wherein, described radiation transparent feature includes the section with the internal volume lacking described sensor of described conduit.

19. method according to claim 18, wherein, the described attribute identified is to select from the group including shape, geometry and size.

20. method according to claim 19, wherein, the described attribute identified is relevant to the translation of described equipment.

21. method according to claim 13, wherein, the outer image mode of described tube chamber is based on X ray.

22. method according to claim 13, wherein, the outer image mode of described tube chamber is to select from the group including fluoroscopic examination, angiography and their combination.

23. method according to claim 13, wherein, described sensor is to select from the group including intravascular ultrasound probes, optical coherence tomography probe, Spectrum Analysis probe, Near-infrared Raman spectroscopy analysis probe, blood flow reserve mark probe and their combination.

24. method according to claim 13, also include the described radiation transparent feature showing described conduit.