CN114601499A

CN114601499A - Multi-mode ultrasonic microprobe arthroscope imaging device and imaging system

Info

Publication number: CN114601499A
Application number: CN202210173623.3A
Authority: CN
Inventors: 王月香; 朱亚琼; 张强; 陈剑; 陈祥慧; 李墨琳; 易丹; 陈思明; 邢光辉
Original assignee: First Medical Center of PLA General Hospital
Current assignee: First Medical Center of PLA General Hospital
Priority date: 2022-02-24
Filing date: 2022-02-24
Publication date: 2022-06-10
Anticipated expiration: 2042-02-24
Also published as: CN114601499B

Abstract

The invention discloses a multimode ultrasonic microprobe arthroscope imaging device, which comprises: the system comprises an arthroscope and an ultrasonic microprobe matched with the arthroscope; the ultrasonic microprobe sequentially comprises from front to back: the device comprises a probe, an ultrasonic transducer, a driving motor, an image transmission optical fiber and a probe fixing device; the stator of the driving motor is fixedly connected with the shell of the probe; the rotor of the driving motor is connected with the ultrasonic transducer; the image transmission optical fiber is used for transmitting images and digital signals; the micro-probe fixing device is used for fixing the ultrasonic micro-probe, and the ultrasonic micro-probe is arranged in parallel with the arthroscope; the arthroscope sequentially comprises from front to back: objective lens, image sensor, control circuit and image fiber. Correspondingly, the invention also provides a multi-mode ultrasonic microprobe arthroscope imaging system using the imaging device. By adopting the technical scheme provided by the invention, multi-modal imaging can be realized, and clear and deep images can be obtained.

Description

Multi-mode ultrasonic microprobe arthroscope imaging device and imaging system

Technical Field

The invention relates to the technical field of surgical medical instruments, in particular to a multi-mode ultrasonic microprobe arthroscope imaging device and system.

Background

The high-frequency ultrasonic examination can clearly display soft tissues such as muscles, tendons and the like, and the application of the high-frequency ultrasonic examination to musculoskeletal tissues is gradually accepted by clinicians. The high-frequency ultrasound is important for early diagnosis and treatment of shoulder surrounding lesions, accelerating functional recovery of shoulder joints, improving life quality of patients and the like. The high-frequency ultrasound has higher diagnosis accuracy in full-thickness rotator cuff tear, and the inspection result of the high-frequency ultrasound is higher in consistency with the arthroscopic inspection result. However, the sensitivity of the external percutaneous high-frequency ultrasonic examination to the diagnosis of the rotator cuff tear is reduced, and the reasons for the result are many, for example: some tears are located in the tendon and the laceration is small; some torn parts are deeper and are shielded by anatomical sclerotin; some are accompanied by bleeding and synovium hyperplasia in the process of tendon laceration, and synovium tissues thickened on the bone surface can be easily used as normal tissues to cause missed diagnosis; in addition, the patient can not be matched with the posture examination due to pain in the examination process, and the diagnosis is not clear due to insufficient tendon exposure.

In recent 10 years, the arthroscopy diagnosis and treatment level of large joints such as knee joints, shoulder joints, hip joints and the like is greatly improved at home and abroad. With the continuous development of arthroscopy, a set of mature schemes is provided in all aspects of surgical indications, surgical approaches, examination and surgical methods, prevention of postoperative complications during surgery, and the like. Compared with the incision operation technology, the arthroscopic operation tool has the advantages of small wound, less damage to important structures such as functional muscle tissues and the like, good visual field in joints, capability of treating complicated diseases and damage during operation, alleviation of early postoperative pain, shortening of postoperative recovery period and the like. Thus, an increasing number of diseases can be treated arthroscopically, which has become the surgical mode of choice for many joint diseases. However, although the surgeon who performs arthroscopic surgery strictly masters the indications and the contraindications of the patient, knows the anatomical structure and has skillful and delicate operation skills, can select proper operation positions and operation approaches, and still has 4.6 to 10.6 percent of complications after the surgery. This may be associated with some unavoidable damage during arthroscopic procedures. Because only the surface of the anatomical structure is displayed to the operator in arthroscopy, and the damage condition inside and in the deep part of the anatomical structure needs to be detected by the operator by using a probe. Additional lesions may be present during the probing process, thus exacerbating the extent and extent of the lesions to varying degrees. For example, in the shoulder sleeve tear repair under the shoulder arthroscope, an operator needs to switch the position of the arthroscope lens back and forth on the shoulder joint cavity side and the deltoid muscle lower bursa side and assist the probe to determine the damage condition of both sides of the supraspinatus tendon, so that the surgical anesthesia time of a patient is increased, and the damage of different degrees exists.

In summary, the current conventional arthroscopic diagnostic methods have the following limitations, for example: the method can only display the surface condition of each tissue structure under an arthroscope, and cannot detect and inspect the tissue structure in the tissue and in the deep anatomical part which cannot be detected by the arthroscope; secondly, the system is not intelligent enough, the observation range is only limited in the projection range of the joint mirror surface, and the lens of the arthroscope is not flexible enough and cannot go deep into the anatomical structure to explore the pathological change condition at the position; the information transmission system is not evolved first enough, and with the rapid development of scientific technology and the arrival of the 5G information era, the information transmission system of the conventional arthroscope cannot be updated in time, and high-speed and high-efficiency remote medical service cannot be realized; fourthly, the blood supply condition in the pathological tissue can not be provided; the display surface is a two-dimensional plane image, and the three-dimensional space structure image of the organizational structure cannot be visually displayed; sixthly, the stiffness of torn tendons and muscles shown under the arthroscope cannot be measured to further assess their extensibility; the qualitative result of pathological changes cannot be further provided, such as the fat infiltration degree of repaired tendons and muscles of a patient after arthroscopic repair cannot be evaluated; and the quantitative data of pathological changes can not be further provided, such as muscle texture parameters, measurement of tendon tearing retraction distance of a rotator cuff tearing patient, muscle thickness after atrophy of muscles and the like.

Therefore, there is an urgent need for an imaging device that can accurately acquire detailed information of joint lesions during surgery and provide corresponding data to evaluate the postoperative condition after surgery.

Disclosure of Invention

In order to overcome the defects in the prior art, the invention provides a technical scheme of combining a multi-mode ultrasonic microprobe and an arthroscope. The multi-mode ultrasonic probe arthroscope imaging device can be used for acquiring detailed information such as the position, the size, the range, the blood flow condition, the peripheral corresponding muscle texture, the three-dimensional stereo morphology and the like of pathological changes in joints in an operation, or providing quantitative parameter values after the operation, such as: the tendon elasticity values were repaired in order to effectively assess the risk of postoperative re-laceration.

According to one aspect of the present invention, there is provided a multi-modality ultrasound microprobe arthroscopic imaging modality, the imaging modality comprising: the system comprises an arthroscope and an ultrasonic microprobe matched with the arthroscope;

the ultrasonic microprobe sequentially comprises from front to back: the device comprises a probe, an ultrasonic transducer, a driving motor, an image transmission optical fiber and a probe fixing device;

the stator of the driving motor is fixedly connected with the shell of the probe;

the rotor of the driving motor is connected with the ultrasonic transducer;

the image transmission optical fiber is used for transmitting images and digital signals;

the micro-probe fixing device is used for fixing the ultrasonic micro-probe, and the ultrasonic micro-probe and the arthroscope are arranged in parallel;

the arthroscope sequentially comprises from front to back: objective lens, image sensor, control circuit and image fiber.

According to a specific embodiment of the present invention, the ultrasonic microprobe includes a plurality of multi-modal ultrasonic microprobes having a diameter of 4 mm.

According to another embodiment of the present invention, the imaging mode of the ultrasound microprobe includes: high frequency two-dimensional ultrasound, ultrasound doppler, three-dimensional ultrasound, and ultrasound elastography.

According to yet another embodiment of the invention, the drive motor is a bending vibration mode ultrasonic motor;

the response time of the drive motor is less than 1 ms.

According to another embodiment of the present invention, the ultrasonic transducer is made of a piezoelectric composite of lead zirconate titanate and a polymer.

In accordance with another aspect of the present invention, there is provided a multi-modality ultrasound microprobe arthroscopic imaging system, the imaging system comprising: the system comprises a multi-mode ultrasonic microprobe arthroscope imaging device, a data receiving device, a data processing device and a data output device;

the multi-mode ultrasonic microprobe arthroscope imaging device is the multi-mode ultrasonic microprobe key endoscope imaging device as claimed in any one of claims 1 to 5.

According to an embodiment of the invention, the imaging system further comprises: a display device.

The multi-mode ultrasonic probe arthroscope imaging device creatively and organically combines the multi-mode ultrasonic microprobe with the arthroscope. The multi-mode ultrasonic probe arthroscope imaging device provided by the invention can achieve the following beneficial technical effects: firstly, the surface of a tissue structure of a patient can be observed in the operation, and the conditions of an internal tissue structure and an anatomical deep tissue structure can be detected in real time, simply and clearly; the diameter of the micro-ultrasonic probe matched with the arthroscope is small, the micro-ultrasonic probe can flexibly rotate, the micro-ultrasonic probe can enter deep tissues to be probed under the direct view of the arthroscope, and the observation surface is enlarged; the system is provided with a high-speed information transmission system, can realize rapid and convenient image information transmission, and conforms to the development trend of internet telemedicine; fourthly, the blood flow condition of the pathological change part can be checked by ultrasonic color Doppler, and the micro blood flow condition of the pathological change part can be detected by adopting a new ultrasonic technology; the three-dimensional ultrasonic technology can reconstruct a three-dimensional structure chart of the organization structure and provide a more visual three-dimensional stereo space acoustic image of the organization structure; sixthly, the stiffness of torn tendons and muscles in the joints can be detected by an ultrasonic elastography technology, the ductility of the torn tendons and muscles can be further evaluated, and feasibility suggestions are provided for subsequent operations; seventhly, fat infiltration conditions of pathological changes can be observed by using two-dimensional high-frequency ultrasound, so that the fat infiltration degree of tendons and muscles before and after a surgery of a patient can be clinically evaluated, and qualitative diagnostic information of imaging is provided; the ultrasonic measurement method can accurately measure the tendon tearing thickness retraction distance and the specific muscle thickness value after the affected side muscle is atrophied by using ultrasonic, provides muscle texture parameters, and provides parameter quantitative data for clinic so as to scientifically and effectively guide the selection mode of postoperative rehabilitation of patients in early stage.

Drawings

Other features, objects and advantages of the invention will become more apparent upon reading of the detailed description of non-limiting embodiments made with reference to the following drawings:

FIG. 1 is a schematic structural diagram of an embodiment of a multi-modality ultrasound microprobe arthroscopic imaging device according to the present invention;

FIG. 2 is a front view of an arthroscopic sleeve of a multi-modality ultrasound microprobe arthroscopic imaging device according to the present invention;

fig. 3 is a schematic structural diagram of an embodiment of a multi-modality ultrasound microprobe arthroscopic imaging system according to the present invention.

The same or similar reference numbers in the drawings identify the same or similar elements.

Detailed Description

The following disclosure provides many different embodiments, or examples, for implementing different features of the invention. To simplify the disclosure of the present invention, the components and arrangements of specific examples are described below. Furthermore, the present invention may repeat reference numerals and/or letters in the various examples. This repetition is for the purpose of simplicity and clarity and does not in itself dictate a relationship between the various embodiments and/or configurations discussed. It should be noted that the components illustrated in the figures are not necessarily drawn to scale. Descriptions of well-known components and processing techniques and procedures are omitted so as to not unnecessarily limit the invention.

Referring to fig. 1, the present invention provides a multi-modal ultrasound microprobe arthroscopic imaging apparatus, the imaging apparatus 10 comprising: a device body and an arthroscopic sleeve 15 disposed at the front end of the device body. To enable investigation of different tissues, the arthroscopic sleeve 15 is angularly adjustable relative to the device body.

A switch 11 and a probe switching button 13 are provided on the apparatus body. The switch 11 is used for controlling the whole opening and closing of the imaging device 10. The probe switching button 13 is used for switching a plurality of ultrasonic microprobes in the arthroscopic sleeve 15, and in the actual operation process, a proper ultrasonic microprobe can be selected as required.

For ease of handling, the imaging device 10 preferably further includes a handle 14. More preferably, the handle 14 is further provided with a snap for improving the holding stability of the imaging device 10. In addition, the image forming apparatus 10 further includes a USB interface 12, and the USB interface 12 may be used for charging and/or data transmission as needed.

As shown in fig. 2, it is preferable that the ultrasonic microprobe comprises a plurality of multi-modal ultrasonic microprobes having a diameter of 4 mm. The multimode ultrasonic microprobes are arranged in parallel in the arthroscope sleeve 15 and are arranged in parallel with the arthroscope 21.

Further, the arthroscopic sleeve 15 is preferably a cannula having a size of 15cm × 10 mm. In which 4 ultrasonic probes (equipped with 64 transducers and a distal ultrasonic probe at a frequency of 11 mhz) having a size of about 13 x 4mm were mounted. In the invention, the diameter of each ultrasonic probe is designed to be 4mm, which is beneficial to smooth and rapid switching in the tissue. Each probe has a different shape, for example: a triangular ultrasound microprobe 31, a regular elliptical ultrasound microprobe 32 and a square ultrasound microprobe 33. In addition, the ultrasound microprobe may be circular or other desired shape. The ultrasonic microprobe with different shapes can be selected to image tissue types with different positions and shapes.

It can be seen that the diameter of the arthroscope selected in the invention is slightly thicker than that of the traditional arthroscope, which not only does not influence the arthroscope to smoothly enter the joint and reach the target tissue region, but also can obtain clearer image information.

Wherein the imaging mode of the ultrasound microprobe includes but is not limited to: high frequency two-dimensional ultrasound, ultrasound doppler, three-dimensional ultrasound, and ultrasound elastography. By adopting the imaging device, the blood flow, the muscle texture, the tearing position, the tearing range and the tearing form (including the three-dimensional space form) of the rotator cuff can be displayed more real-timely and clearly in the shoulder arthroscopy through the ultrasonic technology of various modes, and the tendon stiffness can be detected immediately after the operation.

Further, the ultrasonic microprobe sequentially comprises from front to back: probe, ultrasonic transducer, driving motor, biography image optic fibre and probe fixing device.

The probe includes: low frequency probes (convex probes) and/or high frequency probes (linear probes).

The low-frequency probe is usually a convex array probe, and the probe surface area is large and the frequency is low. The frequency is generally between 3.5MHz and 6.0MHz, and the far field resolution is good. The low-frequency probe is generally used for examination of abdominal organs, is combined with an arthroscope, and can be used for evaluating the overall condition of deep quadratus with corresponding functions at an injured part.

The high-frequency probe is usually a linear array probe, the surface area of the probe can be large or small, and the frequency is high. The frequency is generally between 2.5MHz and 12.0MHz, and the near field resolution is good. The high-frequency probe is mainly used for scanning musculoskeletal tissues, blood vessels and superficial organs (such as thyroid, mammary gland, lymph nodes and the like), and can be combined with an arthroscope to evaluate the conditions of structural tissues, tendons around joints, blood vessels and nerves supplying corresponding functional muscles at damaged parts.

And the stator of the driving motor is fixedly connected with the shell of the probe. And the rotor of the driving motor is connected with the ultrasonic transducer. Preferably, the ultrasonic transducer and the rotor of the driving motor are fixed together by means of adhesion. More preferably, the rotor of the driving motor is connected to the ultrasonic transducer (or the acoustic mirror) through a shaft. The power line and the signal line of the ultrasonic transducer are connected to the fixed lead wire at the rear end of the probe from the ultrasonic transducer through a rotary connecting mechanism.

The driving motor is a bending vibration mode ultrasonic motor, and energy is transferred through friction force generated by bending vibration of the vibrator. Preferably, the response time of the drive motor is less than 1 ms. More preferably, the volume of the driving motor is 0.5mm, and the torque is 0.8N · cm. The driving motor has the advantages of small volume, large torque density, fast response time, low noise and energy consumption and the like.

The ultrasonic transducer is prepared from lead zirconate titanate and a high-molecular piezoelectric composite material. The ultrasonic transducer has the following characteristics: firstly, the electromechanical coupling coefficient is high, and the high-efficiency conversion can be carried out among different energy forms; secondly, the flexibility is good, and the material can be made into various shapes; the acoustic impedance is small, and the acoustic impedance is easy to match with media such as water, human tissues and the like; fourthly, the broadband transducer has wider pulse echo signal bandwidth and can be manufactured. The ultrasonic transducer is manufactured into a spherical focusing structure form, compared with a planar piston type form, the sound radiation area is relatively increased, the sound field density is increased, and the depth of field is lengthened; the acoustic energy is less lost than in a focused acoustic lens form.

The image transmission optical fiber is used for transmitting images and digital signals.

And the microprobe fixing device is used for fixing the ultrasonic microprobe. The ultrasonic microprobe is fixed inside the arthroscope sleeve. Preferably, the microprobe fixing device can be controlled by a control device, and the angle, distance, working mode and the like of the ultrasonic microprobe can be controlled by unlocking/closing the microprobe fixing device by the control device.

The arthroscope sequentially comprises from front to back: objective lens, image sensor, control circuit and image fiber. In the working process, image information is obtained through the objective lens and the image sensor, and is transmitted to a rear processing mechanism through the image transmission optical fiber. The operation of the arthroscope is controlled by a control circuit.

Referring to fig. 3, further, the invention also provides a multi-mode ultrasonic microprobe arthroscope imaging system. The imaging system includes: the system comprises a multi-mode ultrasonic microprobe arthroscope imaging device, a data receiving device, a data processing device and a data output device. The multi-mode ultrasonic microprobe arthroscope imaging device adopts the multi-mode ultrasonic microprobe key endoscope imaging device provided by the invention.

The imaging system can be used with other devices with display function, but for more convenience and simplicity, it is preferable that the imaging system further includes: a display device. And the display device is used for displaying the image acquired by the imaging device.

The multi-mode ultrasonic joint mirror imaging device is manufactured by fixing the multi-mode ultrasonic microprobe at the front end of the top of the joint mirror, and the multi-mode ultrasonic microprobe can flexibly rotate under the direct view of the joint mirror to further probe the lesion at the position covered by the internal focus and the anatomical structure or the deep lesion. The arthroscope and the ultrasonic microprobe are organically combined into the multi-mode ultrasonic microprobe arthroscope, so that the defects of conventional ultrasonic examination and arthroscope can be effectively overcome.

Compared with the conventional ultrasonic examination, the multi-mode ultrasonic microprobe arthroscope imaging system remarkably shortens the distance between the ultrasonic probe and the damaged part, avoids a lot of interference of external ultrasonic, and effectively avoids the unclear examination caused by factors such as anatomical bone structure shielding, damaged part depth observation, patient position mismatch and the like of the conventional external ultrasonic.

Compared with a conventional arthroscope, the multi-mode ultrasonic micro-probe arthroscope imaging system can further play a role in ultrasonic examination on the basis of the surface of a visual injury part, can be used for scanning deep tissue structures and tendon body injury conditions by using a micro-ultrasonic high-frequency probe in an operation, can comprehensively evaluate the size and range of injury in a high-frequency ultrasonic gray scale imaging mode, and can measure the corresponding functional muscle and nerve atrophy conditions of the injury part, evaluate fat infiltration and the like; not only can make accurate diagnosis, but also effectively avoids the continuous lens transition in arthroscopy and the damage caused by blind probing with a probe or the need of separating and cutting the tissue at the shallow part due to the deeper damaged part; the operation time of the operation is shortened, the anesthesia time of the patient is also reduced, the operation wound can be further lightened, and the adverse reaction and the complication of the patient after the operation are effectively reduced. Shear wave elastography, texture analysis technology and the like of ultrasonic examination can be immediately applied for evaluation after arthroscopy, wherein the elasticity value quantifies the stiffness of joint tendons and muscle after injury and operation repair tissues, and the tension can be effectively reflected; texture analysis can quantitatively measure the degree of muscle fat infiltration, which plays a predictive guidance for postoperative pain and joint function recovery of patients.

The multi-mode ultrasonic microprobe arthroscope imaging device and the system provided by the invention are flexible and convenient to use, and the acquired image information is detailed and accurate.

Although exemplary embodiments and their advantages have been described in detail, it should be understood that various changes, substitutions and alterations can be made herein without departing from the spirit and scope of the invention as defined by the appended claims. For other examples, one of ordinary skill in the art will readily appreciate that the order of the process steps may be varied while maintaining the scope of the present invention.

Moreover, the scope of the present application is not intended to be limited to the particular embodiments of the process, machine, manufacture, composition of matter, means, methods and steps described in the specification. As one of ordinary skill in the art will readily appreciate from the disclosure of the present invention, processes, machines, manufacture, compositions of matter, means, methods, or steps, presently existing or later to be developed, that perform substantially the same function or achieve substantially the same result as the corresponding embodiments described herein may be utilized according to the present invention. Accordingly, the appended claims are intended to include within their scope such processes, machines, manufacture, compositions of matter, means, methods, or steps.

Claims

1. A multi-modality ultrasound microprobe arthroscopic imaging apparatus, the imaging apparatus comprising: the system comprises an arthroscope and an ultrasonic microprobe matched with the arthroscope;

the ultrasonic microprobe sequentially comprises from front to back: the ultrasonic imaging device comprises a probe, an ultrasonic transducer, a driving motor, an image transmission optical fiber and a probe fixing device;

the rotor of the driving motor is connected with the ultrasonic transducer;

2. The imaging apparatus of claim 1, wherein the ultrasound microprobe comprises a plurality of multi-modal ultrasound microprobes having a diameter of 4 mm.

3. The imaging apparatus of claim 1, wherein the imaging mode of the ultrasound microprobe comprises: high frequency two-dimensional ultrasound, ultrasound doppler, three-dimensional ultrasound, and ultrasound elastography.

4. The imaging apparatus of claim 1, wherein the drive motor is a bending vibration mode ultrasonic motor;

the response time of the drive motor is less than 1 ms.

5. The imaging device of claim 1, wherein the ultrasound transducer is fabricated from a composite of lead zirconate titanate and a polymeric piezoelectric material.

6. A multi-modality ultrasound microprobe arthroscopic imaging system, the imaging system comprising: the system comprises a multi-mode ultrasonic microprobe arthroscope imaging device, a data receiving device, a data processing device and a data output device;

7. The imaging system of claim 6, further comprising: a display device.