CN107049370B - A kind of prostate biopsy external member - Google Patents

A kind of prostate biopsy external member Download PDF

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Publication number
CN107049370B
CN107049370B CN201710368990.8A CN201710368990A CN107049370B CN 107049370 B CN107049370 B CN 107049370B CN 201710368990 A CN201710368990 A CN 201710368990A CN 107049370 B CN107049370 B CN 107049370B
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contact force
ultrasonic transducer
end portion
remote front
sensor
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CN107049370A (en
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叶慧
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Beijing Intelligent Top Gem Of A Girdle-Pendant Medical Science And Technology Of Dragon Development Co Ltd
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Beijing Intelligent Top Gem Of A Girdle-Pendant Medical Science And Technology Of Dragon Development Co Ltd
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Priority to PCT/CN2018/087394 priority patent/WO2018214805A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/0233Pointed or sharp biopsy instruments
    • A61B10/0241Pointed or sharp biopsy instruments for prostate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3403Needle locating or guiding means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3403Needle locating or guiding means
    • A61B2017/3413Needle locating or guiding means guided by ultrasound

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

Object of the present invention is to guide prostate biopsy using high precision electro magnetic orientator real-time tracking ultrasonic transducer and puncture needle, and provide the orientation of a kind of ultrasonic transducer that can be calculated in the external member of prostate biopsy and the wave beam by ultrasonic transducer transmitting;And it can determine being aligned or not aligned with for the two axis.Once the axis is aligned, the tension that ultrasonic transducer can be carried out on operation and contact force sensor can be read to establish institutional framework and contact force, it is consequently for accurately judging the spatial position of puncture needle, by multimodal medical image registration and integration technology, higher-quality targeting guiding puncture is provided in conjunction with the Diagnostic Superiority of preoperative MRI image and the guiding in real time advantage of TRUS image.

Description

A kind of prostate biopsy external member
Technical field
The invention belongs to medical instrument fields, are specifically related to a kind of for prostate biopsy external member.
Background technique
Prostate cancer is one of most common cancer in males, and its lethality ranks in non-skin cancer Two.Currently, the most popular prostate cancer screening method is serum PSA screening, followed by passed through in real-time 2D Lower six times or more the biopsies carried out of endorectal ultrasonography guidance.As the part of this program, prostate is usually divided into 6 etc. The region of volume.It is one or many from each acquisition in this six regions in a manner of system but substantially direction-free Biopsy.This program is known as sextant biopsy.
Due to sextant biopsy is at low cost and relative to detection prostate cancer other methods it is relatively simple and extensive It uses.However, sextant biopsy has shown have serious false negative rate, and may about biopsy actual position not Accurately.Seek ways to return sb.'s kindness usually using the primary standard of prostate accuse sextant biopsy as a result, on the primary standard figure of prostate, disease Reason doctor manually explains biopsy results.This figure is substantially inaccurate, because the Pathology Doctors ' explained is not known The true position of biopsy.The systemic aspiration biopsy of transrectal ultrasonography (TRUS) guidance seems the technical problem for solving above-mentioned, Because of its real-time, imaging is radiationless, and the performances such as inexpensive and easy to operate have become the important indicator for checking diagnosis of prostate cancer. But ultrasonic imaging speed is fast, although can in art real time imagery, due to the limited resolution of ultrasonography, image Discrimination between middle soft tissue is not also high, though the position of energy real-time tracing sample conduit, it can not be by image to pathological tissues Be accurately positioned, lead to be based purely on the method for sampling of ultrasound, it is not high to the sensitivity of cancer detection, only 60% to 85%.
Summary of the invention
The purpose of the present invention is guide forefront using high precision electro magnetic orientator real-time tracking ultrasonic transducer and puncture needle Gland puncture, and a kind of external member for prostate biopsy is provided.Its working principle is that external member is flexible cylindrical body pipeline, such as There is no power or if power is parallel to distal end axis on fruit pipe end, the coupling part of flexible cylindrical body pipeline Distal end and proximal end alignment, and distal end axis is aligned with the axis of the distal part of flexible cylindrical body pipeline; On the contrary, if there are asymmetric force, the two malalignements on end.
According to above-mentioned physical model, in all cases, can calculate the ultrasonic transducer in the external member of prostate biopsy with And the orientation of the wave beam by ultrasonic transducer transmitting;And it can determine being aligned or not aligned with for the two axis.Once the axis Alignment, the tension that ultrasonic transducer can be carried out on operation and contact force sensor can be read to establish knot of tissue Structure and contact force are consequently for accurately judging the spatial position of puncture needle, by multimodal medical image registration and integration technology, It is worn in conjunction with the Diagnostic Superiority of preoperative MRI image and the guiding in real time advantage of TRUS image to provide higher-quality targeting guidance Thorn.This method is mainly for following technical problem existing in the prior art:
Prostate MRI and ultrasound image difference are big, prostate is squeezed by probe and generated in larger deformation and ultrasound image Can be used for being registrated feature is less etc. that reasons, the registration of prostate MRI-TRUS image require clinician and take a significant amount of time Manual segmentation is done to MRI and TRUS data, and the unstable of segmentation result is affected to registration effect, relatively has clinical practice Property be Xu S, the prostate based on electromagnetic positioners that Kruecker J is proposed targets lancing system, and the system is first to preoperative MRI and 3D TRUS image carries out manual rigid registration, then carries out two peacekeepings three using magnetic tracking in puncture process Transrectal ultrasonography image registration is tieed up, is finally schemed according to two-dimensional ultrasonic image in preoperative rigid registration result logistic and preoperative MRI The space transformational relation of picture, however, 3D TRUS data used in the system are based on the electromagnetic location being attached on ultrasonic probe Sensor and serial two-dimension images data reconstruction obtain, and the method is computationally intensive, sweep time is long, and rebuild scanning process probe Different degrees of extruding easily is caused on prostate, influences reconstruction precision.
The present invention accurately positions ultrasonic probe and puncture needle by means of electromagnetic location instrument, manual by MRI and 3D TRUS Rigid registration, using MRI image to the high specific of early prostate cancer, accurate selective positioning penetrating area is as perceptual interest Area, this selective aspiration biopsy is different from previous sextant biopsy method, and sextant biopsy is usually respectively from prostate Top, middle part and bottom, the left and right sides are divided into six parts, carry out representative sample taking-up, this random biopsy be The prediction carried out when without accurately grasping cancer position, not can guarantee the high detection rate of cancer, using of the invention only to sense Reconnaissance piercing method in interest region is entirely capable of being supplied to the prostatic lesion of doctor clearly, three-dimensional by preoperative image information Region, to improve the recall rate of prostate cancer, and a kind of prostate biopsy external member proposed by the invention solve it is traditional Image rebuilding method is computationally intensive, spend the time long and rebuilds the shape as caused by ultrasonic probe extruding prostate in scanning process Be deteriorated the different disadvantages such as cause reconstruction precision low, improves the accuracy of three-dimensional data.
The technical scheme is that
Puncturing kit is inserted in place in the chamber in the body of subject, the puncturing kit has epitheca, is embedded in institute Outer intrathecal puncture needle and hose are stated, the tail end outer rim of the epitheca connects first position sensor, and the puncture needle has for operation The handle tail end and contact the remote front-end by inspection position that person holds;Contact force sensor, position positioned at the remote front-end portion Transmitter, receiver and ultrasonic transducer in the remote front-end portion, and second on rear side of the remote front-end portion Position sensor;
The puncture needle is manipulated to and the target detection point contact in the wall of the chamber;
Puncture needle remote front-end front is established in response to the reading of the contact force sensor and the target goes out Desired contact force between pin mark;And
Position and the orientation of second position sensor are sensed according to electromagnetic location instrument, which utilizes generation magnetic field Coil, by generating magnetic field and sensing signal with scheduled swept volume.
Further, the second position sensor includes the spring of duplex form, is arranged on rear side of remote front-end portion In and contact force sensor nearside;The portions of proximal of contact force sensor is configured around longitudinal axis.
Further, when spring is there is no power or if power is parallel to the axis of symmetry, the distal end of spring and close Side end alignment, and the axis of symmetry is aligned with the longitudinal axis of the distal part of hose;If there are asymmetric force on spring, Then the two malalignements;According to variable signal of the spring in magnetic field, ultrasonic transducer is calculated and by ultrasonic transducer The orientation of the wave beam of transmitting;And determine being aligned or not aligned with for the two axis.
Further, processor can determine angular deflection of the remote front-end portion relative to portions of proximal, thus can calculate Contact force and misalignment amount with portions of proximal.
Further, processor directly exports the 3 D tropism of ultrasonic transducer and is derived there by ultrasonic transducer The direction of the wave beam of transmitting;Ultrasonic transducer can be improved by being calibrated relative to second position sensor orientation to wave beam Direction.
Further, the receiver in the remote front-end portion is one group of three coil;Three coils be based on by Incident radiation that the transmitter generates and generative power dependent signals;The analysis of the power dependent signals provides distal end The orientation of the axis of proximal end relative to the spring in contact force sensor, that is, the amount of bow of helical spring.
As another embodiment of the invention, the present invention also provides a kind of equipment, characterized by comprising: punctures set Part, electromagnetic location instrument and information process unit,
The puncturing kit has epitheca, embedded in the outer intrathecal puncture needle and hose, the tail end outer rim of the epitheca First position sensor is connect, the puncture needle has remote front-end of the handle tail end held for operator with contact by inspection position; Contact force sensor positioned at the remote front-end portion, transmitter, receiver and ultrasonic transduction positioned at the remote front-end portion Device, and the second position sensor on rear side of the remote front-end portion;
Puncture needle remote front-end front is established in response to the reading of the contact force sensor and the target goes out The processor of desired contact force between pin mark;And
The information process unit of ultrasound image is established in response to the processor and the ultrasonic transducer echo-signal,
The position of the electromagnetic location instrument sensing second position sensor and orientation, the electromagnetic location instrument utilize generation magnetic field Coil, by generating magnetic field and sensing signal with scheduled swept volume;
Further, the second position sensor includes the spring of duplex form, is arranged on rear side of remote front-end portion In and contact force sensor nearside;The portions of proximal of contact force sensor is configured around longitudinal axis.
Further, the receiver in the remote front-end portion is one group of three coil;Three coils be based on by Incident radiation that the transmitter generates and generative power dependent signals;The analysis of the power dependent signals provides distal end The orientation of the axis of proximal end relative to the spring in contact force sensor, that is, the amount of bow of helical spring.
Further, the processor exports the ping emitted by ultrasonic transducer via the receiver, and passes through Wave beam is calibrated relative to position sensor orientation to improve ultrasonic transducer direction.
Detailed description of the invention
The drawings described herein are used to provide a further understanding of the present invention, constitutes part of this application, this hair Bright illustrative embodiments and their description are used to explain the present invention, and are not constituted improper limitations of the present invention.In the accompanying drawings:
Fig. 1 is the system using the puncturing kit treatment tissue of embodiment according to the present invention.
Fig. 2 is the remote front-end graphic illustration according to the puncturing kit in the operating position of embodiment of the present invention.
Fig. 3 is the fragmentary elevational view according to the remote front-end of the puncturing kit of embodiment of the present invention.
Fig. 4 is the graphic illustration according to the receiver of embodiment of the present invention.
Specific embodiment
It is below with reference to the accompanying drawings and in conjunction with the embodiments, next that the present invention will be described in detail.
The improvement that the present invention carries out in terms of the puncturing kit with ultrasonic transducer, main includes two aspects.
Puncturing kit structure is improved
Operative process analysis:
When operation, patient lies low, and the puncturing kit of per rectum is entered prostate, ultrasonic wave warp by rectum by intervention doctor It crosses rectal wall, prostate and rectum interface and enters prostate from prostate side, in order to which guarantee ultrasonic signal penetrates energy Power, working frequency is usually in 6.5MHz or so, since preoperative doctor has obtained lesion region in medical imaging modalities equipment Position, intervention doctor chooses area-of-interest by rule of thumb and carries out to needle, and that six parts are integrally carried out to prostate is equal by traditional (prostate top, middle part and bottom, the left and right sides) is divided to be improved to only puncture the pathological tissues reconnaissance of above-mentioned area-of-interest, Respectively to the previous-next of the pathological tissues, L-R, anterior-posterior six direction reconnaissance, such as Fig. 1;Since rectum and prostate are not It is connected to organ, puncture needle can only carry out in rectum, and puncturing kit can only be moved up and down in rectum, so if needing as far as possible In the case where reducing the thorn points and depth that puncture needle enters prostate, puncture needle direction of advance need to be adjusted, i.e. hand It holds puncture needle handle tail end and carries out axis itself rotation where the handle, so that puncture needle is to inserting needle of pathological tissues the case where It is lower that 6 points of samplings are realized by disengaging and rotation.
Puncturing kit improves:
For the operation that assists a physician, the puncture needle handle tail end of puncturing kit includes to mention to the processor being located in console For the position sensor of signal.Fig. 1, which is illustrated, carries out ultrasonic therapy using puncturing kit corresponding to one embodiment of the invention The fundamental block diagram of system.In this embodiment, patient therapy device includes simultaneously ultrasonic transducer 45 and ultrasonic imaging energy converter. The two energy converters can be separating apparatus, or can be integrated equipment, wherein being shown with high-strength focused super Sound and imaging ultrasound element are located in same transducer head.Control imaging and the operation of ultrasonic transducer 45 are system controllers 113, which may include one or more processors with general or specialized program, to execute above-mentioned function. System controller 113 provides control signal to transmitter 48, which selects the ultrasonic wave provided by ultrasonic transducer 45 The frequency of signal.In one embodiment, operation power grade is by emitting the test signal of multiple and different power grades simultaneously The echo signal that the test signal emitted generates is parsed and is selected.When the desired characteristics for observing echo signal When, such as when detecting in echo signal the certain power distribution on different fundamental frequencies and resonant component, for specific by inspection portion The ultrasound diagnosis power grade of position is just selected.
Imaging transducer 108 is controlled by imaging ultrasound controller 110, which includes passing The ultrasonic components of system, such as transmitting/reception switch, Beam-former, radio frequency amplifier and signal processor.Ultrasonic controller 110 output feeds back to ultrasonic signal processing device 111, to generate for showing on video monitor 112 or other display equipment The ultrasound image signal shown.Described image signal is storable in computer-readable medium (DVD, video-tape etc.), by printer It gets or stores in other ways, so as to follow-up diagnosis or analysis.
Second position sensor 50 (or computer control diverter) is controlled by system controller 113, to generate multiple senses Region of interest to carry out biopsy to tissue.In one embodiment, second position sensor 50 mechanically adjusts ultrasonic transducer 45 Angle orientation or x, y location and focal regions depth.In another embodiment, sensor 50 motorized adjustment ultrasound in the second position is changed The angle orientation or x of energy 45 focal regions of device, the depth of 45 focal regions of y location and ultrasonic transducer.
By floor push 115, ultrasonic energy can be selectively delivered to ultrasonic transducer 45 by doctor or its assistant.Separately Outside, doctor can be used control panel 114 on one or more control keys manually change the size and shape of area-of-interest with And the other functions of system.
In some embodiments, system may include picture position controller 109, change the orientation of imaging transducer 108, It enables a physician to different angle or checks in Different Plane want target puncturing tissue.Picture position control can be mechanical Or it is DYN dynamic, and can be controlled by system controller 113.
Referring now to Fig. 2, for according to the puncturing kit being shown in operating position of embodiment of the present invention The graphic illustration of 41 ends.Puncture needle 40 is forced into be contacted with rectum diaphragm 105.However, contact force be it is asymmetrical, thus The spring 51 of contact force sensor 43 is caused to bend.Be not close to rectum diaphragm 105 by inspection position 47, but with rectum diaphragm 105 Form angle 106.The axis of symmetry 461 and longitudinal axis 52 are misaligned, but with the intersection of angle 107.
The contact of puncturing kit 41 is as shown in Figure 3 by the remote front-end at inspection position 47: positioned at the remote front-end portion 42 Contact force sensor 43, transmitter 48, receiver 44 and ultrasonic transducer 45 positioned at the remote front-end portion 42, and be located at 49 second position sensor 50 on rear side of the remote front-end portion;
The 40 remote front-end front 42 of puncture needle and described is established in response to the reading of the contact force sensor 43 Target goes out the processor (not shown) of the desired contact force between pin mark;And
The information process unit of ultrasound image is established in response to the processor and 45 echo-signal of the ultrasonic transducer,
The position of the electromagnetic location instrument sensing second position sensor 50 and orientation, the electromagnetic location instrument utilize generation magnetic The coil of field, by generating magnetic field and sensing signal with scheduled swept volume;
Operator can be by the data of viewing console provided in response to the processor of above-mentioned sensing signal, in conjunction with letter Number processing circuit is by receiving, amplifying, filtering and digitizing the signal from first position sensor, regulation handle tail end.
The second position sensor 50, the spring 51 including duplex form, setting 49 on rear side of the remote front-end portion in And the nearside of contact force sensor 43.The portions of proximal 49 of contact force sensor 43 is configured around longitudinal axis 52.When When spring 51 is bent, longitudinal axis 52 need not be aligned with the axis of symmetry 46.In other words, contact force sensor 53 serves as end 41 Connector between the segment of 43 nearside of contact force sensor.If power is not present on end 47 or if power is parallel to symmetrically The distal part of axis 46, then distal end and the proximal end alignment of spring 51, and the axis of symmetry 46 and conduit is (positioned at connecing The nearside of touch force sensor 43) longitudinal axis 52 be aligned.If there are asymmetric force on end 47, the two axis are not right It is quasi-.In all cases, the orientation of ultrasonic transducer 45 and the wave beam emitted by ultrasonic transducer 45 can be calculated;And it can be true The two fixed axis are aligned or not aligned with.
Further, including,
The processor is swashed via the cable for passing to the console by being located at the transmitter 48 in the remote front-end portion The living ultrasonic transducer 45 exports the 3 D tropism of ultrasonic transducer 45, and is derived there and is emitted by ultrasonic transducer 45 The direction of wave beam.Further, including,
The processor exports the ping that is emitted by ultrasonic transducer 45 via the receiver 44, and by relative to The orientation of second position sensor 50 calibrates wave beam to improve 45 direction of ultrasonic transducer.
Receiver 10 as shown in Figure 4, receiver 10 preferably include be wrapped on air-core two or more simultaneously And more preferably three cell windings 101,102,103.Coil has mutually orthogonal axis.The length of coil 102 and conduit Axis is advantageously aligned.Coil 101,102,103 is closely separated along the axis of conduit, to reduce second position sensor Diameter and so that the sensor is adapted to be incorporated into the remote front-end portion.
For most applications, catheter distal end be relative to the position of reference system and the quantitative measurment of orientation must It wants.This needs at least two nonoverlapping radiators, which generates at least two distinguishable magnetic fields AC, the radiator Relative to reference system corresponding position and be oriented to known;Radiator driver, the radiator driver are preferably to radiate Device provides AC signal continuously to generate the magnetic field AC;And position sensor, the position sensor include at least two non-parallel biographies Sensor is to measure the magnetic fluxes as caused by described at least two distinguishable magnetic fields.The quantity of radiator multiplied by sensor number Amount is equal to or more than the quantity of the freedom degree of expectation quantitative measurment of the sensor relative to the position of reference system and orientation.Work as expectation When determining six positions and the orientation coordinate of the distal end of conduit, at least two coils are needed in receiver 10.Preferably The accuracy and reliability of position measurement are improved using three coils.It, can in some applications for wherein needing less dimension Only single coil is needed in receiver 10, which is oriented as the dipole emission axis vertical take-off with transmitter.
The signal that lead 104 is used to detect cell winding 101,102,103 is transmitted via the proximal end of conduit It is handled to signal processor, to generate desired position information.Preferably, lead 104 is that twisted pair is picked up simultaneously with reducing And it can be by further electrical shielding.
The foregoing is only a preferred embodiment of the present invention, is not intended to restrict the invention, for the skill of this field For art personnel, the invention may be variously modified and varied.All within the spirits and principles of the present invention, made any to repair Change, equivalent replacement, improvement etc., should all be included in the protection scope of the present invention.

Claims (3)

1. a kind of external member for prostate biopsy, characterized by comprising: puncturing kit, electromagnetic location instrument and information processing list Member, the puncturing kit have epitheca, embedded in the outer intrathecal puncture needle and hose, and the tail end outer rim of the epitheca connects first Position sensor, the puncture needle have remote front-end portion of the handle tail end held for operator with contact by inspection position;It is located at The contact force sensor in the remote front-end portion, transmitter, receiver and ultrasonic transducer positioned at the remote front-end portion, with And the second position sensor on rear side of the remote front-end portion;
Go out between pin mark in response to the reading of the contact force sensor to establish puncture needle remote front-end portion and target The processor of desired contact force;And
The information process unit of ultrasound image is established in response to the processor and the ultrasonic transducer echo-signal,
The position of the electromagnetic location instrument sensing second position sensor and orientation, the electromagnetic location instrument utilize the line for generating magnetic field Circle, by generating magnetic field and sensing signal with scheduled swept volume;The processor is exported via the receiver by ultrasound The ping of energy converter transmitting, and improve ultrasonic transduction by being calibrated relative to second position sensor orientation to wave beam Device direction.
2. a kind of external member for prostate biopsy according to claim 1, which is characterized in that
The second position sensor includes the spring of duplex form, setting on rear side of the remote front-end portion in and contact force pass The nearside of sensor;The portions of proximal of contact force sensor is configured around longitudinal axis.
3. a kind of external member for prostate biopsy according to claim 1, it is characterised in that including,
The receiver in the remote front-end portion is one group of three coil;Three coils are based on being generated by the transmitter Incident radiation and generative power dependent signals;The analysis of the power dependent signals provides distal end and passes relative to contact force The orientation of the axis of the proximal end of spring in sensor, that is, the amount of bow of helical spring.
CN201710368990.8A 2017-05-26 2017-05-26 A kind of prostate biopsy external member Active CN107049370B (en)

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PCT/CN2018/087394 WO2018214805A1 (en) 2017-05-26 2018-05-17 Prostate puncture kit

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CN107049370B (en) * 2017-05-26 2019-08-06 北京龙慧珩医疗科技发展有限公司 A kind of prostate biopsy external member
CN109044530A (en) * 2018-07-17 2018-12-21 哈尔滨理工大学 A kind of multi-modal sensory perceptual system and data fusion method of operation on prostate robot
CN110037779B (en) * 2019-05-05 2020-09-29 深圳大学 Handheld intervention device and use method thereof
CN110151270B (en) * 2019-05-10 2024-01-30 中国科学院苏州生物医学工程技术研究所 Vibration puncture device, frequency adjustment method and ultrasonic imaging system
CN110811702A (en) * 2019-12-03 2020-02-21 贵州中医药大学第一附属医院 Bronchoscope intelligence biopsy forceps

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