EP1558147A1 - Systeme de mesure de pression pour dispositifs de mesure par ultrasons - Google Patents

Systeme de mesure de pression pour dispositifs de mesure par ultrasons

Info

Publication number
EP1558147A1
EP1558147A1 EP03750234A EP03750234A EP1558147A1 EP 1558147 A1 EP1558147 A1 EP 1558147A1 EP 03750234 A EP03750234 A EP 03750234A EP 03750234 A EP03750234 A EP 03750234A EP 1558147 A1 EP1558147 A1 EP 1558147A1
Authority
EP
European Patent Office
Prior art keywords
measuring device
pressure
ultrasound
pressure measuring
ultrasonic
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP03750234A
Other languages
German (de)
English (en)
Inventor
Ulrich André Baumann
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to EP03750234A priority Critical patent/EP1558147A1/fr
Publication of EP1558147A1 publication Critical patent/EP1558147A1/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4272—Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue
    • A61B8/4281—Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue characterised by sound-transmitting media or devices for coupling the transducer to the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6843—Monitoring or controlling sensor contact pressure

Definitions

  • the present invention relates to a pressure measuring device for performing ultrasound measurements on living beings, in particular humans, according to the preamble of claim 1. Furthermore, it relates to an ultrasound measuring device with such a device and uses of the pressure measuring device and the ultrasound measuring device.
  • a commercial transducer In diagnostic ultrasound examinations, a commercial transducer is placed on the person to be examined using a contact gel, e.g. the skin of the abdominal wall. Commercially available equipment is used to generate an image from the signal emitted in the transducer and received again by reflection, which e.g. in medicine, the representation of organs and tissues lying deeper and hidden from the eye is permitted.
  • a contact gel e.g. the skin of the abdominal wall.
  • Commercially available equipment is used to generate an image from the signal emitted in the transducer and received again by reflection, which e.g. in medicine, the representation of organs and tissues lying deeper and hidden from the eye is permitted.
  • An object of the present invention is to provide a pressure measuring device for an ultrasound measuring head which has less of an adverse effect on the measuring properties of the ultrasound measuring head.
  • the pressure measuring device essentially consists of a rigid housing, for example in the form of a flat hollow cylinder.
  • a rigid membrane is embedded on the back, which is used for coupling to the ultrasonic measuring head.
  • the front is closed with a flexible membrane.
  • the interior is filled with an ultrasound-permeable liquid as completely as possible, ideally free of bubbles. It has been shown that in particular the flexible membrane, which is applied to the body surface of the patient, but also the rigid membrane have a strong influence on the quality of the ultrasound images and, in particular, their spatial or two-dimensional resolution.
  • a sufficiently small thickness should be chosen in particular.
  • silicone i.e. a silicone elastomer
  • the liquid must generally be ultrasonically transparent.
  • water-containing liquids and in particular glycerol-water mixtures have proven successful.
  • the liquid layers to be traversed by ultrasound should also be kept as thin as possible.
  • the pressure measuring device is used for the first time in the examination of pressure-dependent changes in the tissue of a patient, the examining person also being provided with the usual ultrasound images and information derived therefrom in addition to the pressure data.
  • the device according to the invention is also used in training: as is known, the ultrasound technique of the individual examiner differs individually. With the device, these different examination techniques / contact pressures of the transducer can be harmonized during training or when comparing results and / or trainees can learn the correct transducer contact pressure right from the start.
  • the contact pressure of the ultrasound head on the skin also plays a major role when assessing the blood flow to tissues. If the impression is too strong, the
  • Fig. 1 Schematic of an ultrasonic measuring head with pressure measuring device in side view
  • FIG. 3 shows a section according to III-III in FIG. 2;
  • the exemplary embodiment according to the invention is characterized in that the contact pressure, ie the directed force 1 of the ultrasound head 2 on the tissue 4 (for example the skin of a person), is quantitative during the examination is measured and displayed.
  • a sound-permeable pressure measuring device in the form of a measuring capsule 5 is coupled to a commercially available transducer 7. It is also conceivable for the pressure measuring device to be integrated into the transducer. The size and shape of the measuring capsule 5 can be varied depending on the application and task. In addition to the fixed coupling or constructive integration on or in the transducer, various couplings to known transducers are conceivable. As a rule, between the pressure measuring device and the
  • Ultrasound head also applied a gel 8 to improve the coupling.
  • the arrangement of a pressure measuring cell or a pressure sensor in the measuring capsule offers the particular advantage that long, liquid-filled lines from the measuring capsule to the measuring device are no longer necessary. Such lines are bulky compared to electrical lines and, if broken, lead to the system having to be refilled.
  • the liquid 11 in the interior of the measuring capsule 5 for the pressure measurement is connected via a line 12 to a pressure measuring device (not shown). Suitable pressure measuring devices are known per se and are therefore not described. Ideally, the liquid must be completely transparent for ultrasound. A glycerin-water mixture in a mass ratio of 85:15 has proven itself.
  • the measuring capsule 5 is closed by a flexible, ultrasound-permeable membrane 13 on the side, which serves to rest on the tissue 4.
  • silicone elastomer was found to be suitable, preferably the type MVQ (international code), which is characterized by the following data: hardness 50 ° Shore A density 1.15 g / cm 3 appearance milky transparent
  • the thickness of the membrane should also be as small as possible be, for example 0.4 to 0.5 mm, the material MVQ could easily be used with a thickness of 1 mm. Smaller thicknesses would be an advantage, but are easier to damage. By contrast, thicker membranes, in particular thicker than 3 mm, impair the ultrasound measurement result 13 too much.
  • a gel 17 is also applied between the membrane and the tissue surface 15 in order to improve the ultrasound coupling.
  • a window 20 is embedded in the rear side 19 of the measuring capsule 5.
  • the window 20 consists of an ultrasound-permeable material, which preferably has a low flexibility.
  • Teflon ® polyfluoroethylene, Du Pont
  • a significant deterioration in the quality of the ultrasound measurement was observed from a thickness of 1 mm, and the measurements were practically unusable from a thickness of 3 mm.
  • the window can also be curved as shown in FIG. 3.
  • the window 20 and the membrane 13 are held in a frame 24 made of metal.
  • the basic principle is that all the housing components of the measuring capsule 5, apart from the membrane 13, are made as rigid as possible.
  • the frame 24 which does not have to have any special properties with regard to ultrasound, it can also be used on others
  • Materials such as hard plastics, possibly with inserts.
  • holders 26 are fastened to the frame, between which the measuring head 7 is inserted.
  • the holders 26 can e.g. be equipped with spring elements (not shown) to hold the measuring head 7.
  • a variant with Velcro fasteners 28 is shown, which permit stable, but pressure-free fixing of the measuring head 7 on the measuring capsule 5.
  • the holders 26 are designed as wings 30 which can be pivoted about the rods 32 and which have a Velcro strip on their sides.
  • measuring capsule 5 A large number of variants are conceivable for the implementation of the connection between measuring capsule 5 and measuring head 7
  • the design as an inseparable connection i.e. as an ultrasonic measuring head with pressure measuring device.
  • Figg. 2 and 3 show a concrete construction of the measuring capsule 5.
  • the basic element is a ring 36 with a rectangular one Cross-section. An edge is chamfered on the outside at the bottom to form a contact surface 38 around the flexible membrane 13.
  • the membrane 13 is pressed on the circumference by a projection 40 of a first clamping ring 41 onto the bearing surface 38 and is thus fastened.
  • the clamping ring 41 can be clamped onto the ring 36 alone, but another fastening, such as gluing or screwing, is also conceivable in addition or as an alternative.
  • a second, flat clamping ring 42 rests on the top of the ring 36.
  • the window 20 is clamped between the clamping ring 42 and a step 43 on the underside of the ring 36.
  • An O-ring 45 is placed around the window 20 for sealing.
  • the cavity filled by the liquid 11 has a height of approximately 1 mm. This value is not critical in itself, but is favorable for measurements with high frequencies (see below).
  • the window 20 has a thickness on the circumference 47 corresponding to the distance between the clamping ring 42 and the projection 43.
  • the central zone 48 has a small thickness as described above, e.g. 0.5 - 0.7 mm in order to obstruct the ultrasonic passage as little as possible.
  • a curved design is shown as an adaptation to an ultrasound head with a curved forehead.
  • a bore 50 runs through the ring 36, into which the connection nipple 51 for the line 12 to the pressure measuring device is inserted. Further blind holes 53 are used to attach the holder 26 and to fasten the clamping ring 42 on the ring 36.
  • a disk-shaped design is shown, but other shapes such as, for example, rectangular are also conceivable Adaptation to the often rectangular forehead of ultrasonic measuring heads.
  • the interior 55 is filled with the ultrasound-transparent liquid as free of bubbles as possible.
  • vacuum can be applied via the nipple 51. Then you let the liquid flow in automatically, which then completely fills the interior.
  • a measurement with an ultrasound measuring head 7 with an upstream measuring capsule 5 is carried out essentially like a normal ultrasound measurement.
  • 4 shows an ultrasound image that can be obtained in this way.
  • the arrows 60, 61 point to the internal jugular vein, no pressure being exerted in the illustration on the left in FIG. 4, but pressure being exerted on the right.
  • the vein walls can be clearly seen in the normal (arrow 60) and in the compressed state (arrow 61).
  • the pressure on the body surface can now be changed. This enables the changes in the tissue caused by the locally changed pressure, such as e.g. to watch vein compression.
  • the measuring arrangement is first placed on the body surface without pressure before starting the measurement, a zero adjustment can be carried out in this state and then the contact pressure can be measured absolutely.
  • the rigid housing of the measuring capsule also has an advantageous effect, since it reduces the yielding and thus deformation of the flexible membrane when the contact pressure changes.
  • Reflections of the ultrasound in the measuring capsule can be felt or even to an imperceptible level can be reduced if at least the radiation surface of the ultrasound head rests only on the window 20 and in particular contact with the ring 41, 42 is avoided.
  • the measuring capsule is preferably made so large that the window 20 is larger than the front of the ultrasound head.
  • the rigid design of the window allows this oversizing because it forms a rigid rear wall.
  • the ultrasound head would be pressed into the window and surrounding, exposed areas of the window would bulge, as a result of which the measurement conditions would change overall and measurement errors would result.
  • the window will touch the front membrane 13 under the pressure of the ultrasound head, which would seriously falsify the measurement.
  • a measuring capsule specifically to an ultrasound head so that it completely covers the window.
  • a soft membrane can also be used because, despite its flexibility, it can no longer deform.
  • the ultrasound head rests on the housing ring 41, 42, which is significantly more rigid than the window 20, it can also cause more force to be transmitted directly to the skin via the ring, this contact pressure not being fully recorded.
  • the membrane 13 on the front is tensioned in the unfilled state, so that it is also in the filled state
  • Measuring capsule is essentially flat. It should be noted that too dry glycerin can have an adverse effect in this regard: due to its high hygroscopy, it inevitably absorbs water over a long period of time. The corresponding change in volume causes the membrane to deform.
  • the pressure measuring range is 0 to 700 mbar (millibars), especially for the main application, venous pressure determination.
  • Usual pressure sensors for this area offer a resolution of 1 to 2 bar.
  • the filling of the measuring capsule is carried out in a vacuum, preferably in a high vacuum, in order to achieve the best possible bubble and gas-free filling.
  • the liquid is also degassed before filling. It was observed that the reaction time of the system in particular decreases with a removable gas component. With a high gas content, on the other hand, the compressibility increases noticeably, which creates the risk that the membrane 13 is pressed in and bears against the window 20.
  • the measuring capsule can therefore be used with various ultrasonic measuring heads and, due to its low height, is also compatible with high frequencies.
  • the invention can also be used for measurements on animals.
  • Various materials can be used for the housing of the pressure measuring device, e.g. Sound-permeable plastic casting alone or in combination with reinforcing metal parts.
  • a preferred application is seen in the non-invasive measurement of venous pressure, in particular the pressure of the central veins.
  • a cardiac catheter is currently used for these measurements. This procedure is relatively complex and invasive. 6 - 12% complications are observed, even with serious consequences (David C. McGee NEJM 2003).
  • measuring the venous pressure using the measuring capsule is obviously risk-free and can be carried out quickly. In particular, several measurements can also be carried out in a short time in order to achieve a higher measurement accuracy by averaging.
  • the measuring head is pressed on until the vein shows a visible narrowing in the ultrasound image. This corresponds to a reduction in the cross-sectional area by approx. 25%.
  • the pressure measured by the measuring capsule is called "base pressure”.
  • the measuring head is pressed on until the vein is closed.
  • the measured pressure is the
  • Collapse pressure and base pressure are the pressure with which the ultrasound button is pressed onto the surface, i.e. the measured value of the measuring capsule.
  • Venous pressure is the pressure of the blood in the vein.
  • an elastic, sound-permeable material is used instead of the liquid-filled measuring chamber and the deformation is measured.
  • the deformation of the support membrane is measured, e.g. with pressure gauges.
  • a pressure measurement can also be a simple water column, 'in the in communication with the fluid Pressure gauge stands, take place.
  • the height of the liquid in the measuring capsule can be up to 5 mm or up to 1 cm.

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  • Life Sciences & Earth Sciences (AREA)
  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Acoustics & Sound (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

La présente invention concerne un système de mesure de pression (5) destiné à être couplé à une tête de mesure par ultrasons (7), comprenant un boîtier qui présente une fenêtre arrière en matériau rigide transparent aux ultrasons, par ex. PTFE, d'épaisseur maximale de 1 mm, et une ouverture avant qui est refermée par une membrane en élastomère de silicone d'épaisseur de préférence de 0,4 à 0,5 mm. L'espace interne est rempli d'un liquide transparent aux ultrasons, notamment d'un mélange glycérine-eau. Le système de mesure de pression de l'invention permet aux mesures par ultrasons connues d'être réalisées sur des êtres vivants par mesure de la pression d'appui.
EP03750234A 2002-10-28 2003-10-23 Systeme de mesure de pression pour dispositifs de mesure par ultrasons Ceased EP1558147A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP03750234A EP1558147A1 (fr) 2002-10-28 2003-10-23 Systeme de mesure de pression pour dispositifs de mesure par ultrasons

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
EP02405916 2002-10-28
EP02405916A EP1415596A1 (fr) 2002-10-28 2002-10-28 Dispositif de mesure de pression pour un dispositif de mesures ultrasonores
EP03750234A EP1558147A1 (fr) 2002-10-28 2003-10-23 Systeme de mesure de pression pour dispositifs de mesure par ultrasons
PCT/CH2003/000689 WO2004037091A1 (fr) 2002-10-28 2003-10-23 Systeme de mesure de pression pour dispositifs de mesure par ultrasons

Publications (1)

Publication Number Publication Date
EP1558147A1 true EP1558147A1 (fr) 2005-08-03

Family

ID=32088105

Family Applications (2)

Application Number Title Priority Date Filing Date
EP02405916A Withdrawn EP1415596A1 (fr) 2002-10-28 2002-10-28 Dispositif de mesure de pression pour un dispositif de mesures ultrasonores
EP03750234A Ceased EP1558147A1 (fr) 2002-10-28 2003-10-23 Systeme de mesure de pression pour dispositifs de mesure par ultrasons

Family Applications Before (1)

Application Number Title Priority Date Filing Date
EP02405916A Withdrawn EP1415596A1 (fr) 2002-10-28 2002-10-28 Dispositif de mesure de pression pour un dispositif de mesures ultrasonores

Country Status (3)

Country Link
EP (2) EP1415596A1 (fr)
AU (1) AU2003269669A1 (fr)
WO (1) WO2004037091A1 (fr)

Families Citing this family (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10092271B2 (en) 2011-04-13 2018-10-09 Cornell University Ultrasound transducer probe and methods
EP2710961B1 (fr) 2012-09-24 2019-08-07 Veinpress GmbH Dispositif de mesure de pression destiné à mesurer la pression d'une veine ou d'un organe et destiné à se combiner à une unité de mesure par ultrasons, ainsi que système et procédé de mesure de la pression d'une veine/d'un organe
US20150190111A1 (en) * 2014-01-03 2015-07-09 William R. Fry Ultrasound-guided non-invasive blood pressure measurement apparatus and methods
EP3541289B8 (fr) 2016-11-15 2020-04-08 Koninklijke Philips N.V. Mise en contact de dispositif à ultrasons
DE102017107331A1 (de) 2017-04-05 2018-10-11 Turck Holding Gmbh Ultraschallsensor
DE102017221330A1 (de) 2017-11-28 2019-05-29 Ulrich A. Baumann Druckmessvorrichtung zur Druckmessung und/oder Elastizitätsmessung einer Vene oder eines Organs und zur Kombination mit einer Ultraschallmesseinheit sowie System und Verfahren zur Druckmessung und/oder Elastizitätsmessung einer Vene oder eines Organs
CH719227A1 (de) * 2021-12-09 2023-06-15 Compremium Ag Vorrichtung zur Durchführung von Ultraschalluntersuchungen und Druckmessungen sowie Verfahren zu deren Montage.

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Publication number Priority date Publication date Assignee Title
JPS59147508U (ja) * 1983-03-25 1984-10-02 株式会社東芝 超音波プロ−ブ用アダプタ
US4603701A (en) * 1983-12-16 1986-08-05 Hewlett-Packard Company Stand-off device with special fluid
US4796632A (en) * 1986-08-11 1989-01-10 General Electric Company Standoff adapter for ultrasound probe
US6277076B1 (en) * 1988-05-11 2001-08-21 Lunar Corporation Ultrasonic densitometer with pre-inflated fluid coupling membranes
GB9213220D0 (en) * 1992-06-22 1992-08-05 Langton Christian M Ultrasound bone analyser
GB9414909D0 (en) * 1994-07-25 1994-09-14 Ritchie Roy Osteoporosis apparatus
US5782767A (en) * 1996-12-31 1998-07-21 Diagnostic Ultrasound Corporation Coupling pad for use with medical ultrasound devices

Non-Patent Citations (1)

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Title
See references of WO2004037091A1 *

Also Published As

Publication number Publication date
AU2003269669A1 (en) 2004-05-13
WO2004037091A1 (fr) 2004-05-06
EP1415596A1 (fr) 2004-05-06

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