EP3641654A1 - Ensemble pour l'imagerie et/ou le traitement d'un tissu cerebral - Google Patents
Ensemble pour l'imagerie et/ou le traitement d'un tissu cerebralInfo
- Publication number
- EP3641654A1 EP3641654A1 EP18732744.0A EP18732744A EP3641654A1 EP 3641654 A1 EP3641654 A1 EP 3641654A1 EP 18732744 A EP18732744 A EP 18732744A EP 3641654 A1 EP3641654 A1 EP 3641654A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- window
- plate
- patient
- acoustic
- probe
- 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.)
- Pending
Links
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N7/02—Localised ultrasound hyperthermia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2/2875—Skull or cranium
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0808—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the brain
-
- 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
- A61B8/4209—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
-
- 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
- A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
-
- 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
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/48—Diagnostic techniques
- A61B8/481—Diagnostic techniques involving the use of contrast agent, e.g. microbubbles introduced into the bloodstream
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3962—Markers, e.g. radio-opaque or breast lesions markers palpable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/3009—Transparent or translucent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N2007/0004—Applications of ultrasound therapy
- A61N2007/0021—Neural system treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N2007/0052—Ultrasound therapy using the same transducer for therapy and imaging
Definitions
- the present invention relates to the general technical field of ultrasound devices for the imaging and / or treatment of brain tissue - human or animal - by ultrasound in order to assist a practitioner in the establishment of a diagnosis and / or to treat a pathology.
- Imaging or treating brain tissue Various techniques are known for imaging or treating brain tissue. 1. Imaging
- Brain imaging can be used to allow the practitioner to follow the evolution of a brain injury or a brain tumor for diagnostic purposes and / or surgery.
- the most commonly used imaging techniques are computed tomography (CT) and magnetic resonance imaging (MRI). Although these techniques are effective, they have disadvantages. In particular, CT is being used less and less because of the risk of neoplasia. Magnetic resonance imaging is expensive and requires the injection of contrast material to the patient.
- Imaging techniques based on the use of ultrasound for imaging brain tissue are also known. However, these techniques are hampered by the difficulty of transmitting ultrasound through the cranial box of the patient. 2. Treatment
- EP 2 539 021 discloses an apparatus for treating disorders of the brain comprising:
- an implantable ultrasound device made of non-ferromagnetic material
- connection means between the ultrasonic device and the control unit is connection means between the ultrasonic device and the control unit.
- this device is as follows. Once the ultrasound device implanted in the skull of the patient, a succession of treatment sessions are lavished on him to treat the pathology that affects him. At each new treatment session, the intracorporeal device is connected to the control unit via the connection means.
- an external ultrasonic device can have the following advantages:
- the ultrasound emitter may be more complex than is feasible in an implantable version; for example, an external transmitter may have multiple channels, allowing electronic adaptation of the shape of the beam to the target,
- the window may be smaller than the area to be treated
- the acoustic transmitter for example to best counter the evolution of the disease (treatment of a local relapse zone for example)
- WO2016202955 discloses a detection apparatus for imaging at least two areas of a brain of a subject.
- the sensing apparatus includes a support including a frame for attachment to the subject's skull, the frame defining an interior portion that is transparent to the ultrasonic waves.
- the detection apparatus also includes a removable imaging device including a platform, an ultrasonic probe, a movable platen supporting the ultrasonic probe, and a fastener for cooperating with three support pins to temporarily lock the platform to support.
- a removable imaging device including a platform, an ultrasonic probe, a movable platen supporting the ultrasonic probe, and a fastener for cooperating with three support pins to temporarily lock the platform to support.
- a device is not implantable under the skull of the subject.
- US2014 / 0330123 discloses a sonic window adapted to close an opening formed in the skull of a patient.
- the sonic window includes an outer surface and an inner surface each including holes.
- Document US2015 / 0321026 describes a device for regulating the focal depth of an ultrasound energy emitted for treating or imaging tissue.
- the regulator includes an ultrasonic transducer and a spacer for positioning between the ultrasound transducer and the patient's skin. Elements may be provided in the spacer, these elements having an acoustic impedance different from that of the spacer to promote or block the passage of ultrasonic waves.
- a regulating device is not implantable.
- An object of the present invention is to provide a set for the imaging and / or treatment of brain tissue by ultrasound to overcome at least one of the aforementioned drawbacks.
- the invention provides an assembly for imaging and / or treating a brain tissue comprising:
- At least one acoustic window intended to be implanted at an opening in the skull of a patient, said acoustic window being covered with skin of the skull of the patient once implanted, and a wave generation probe ultrasound intended to be positioned at the right of the acoustic window,
- the acoustic window comprises a plate transparent to the ultrasonic waves and at least one locator locatable through the skull of the patient's skin to facilitate the positioning of the probe in the right of said acoustic window prior to the generation of ultrasonic waves .
- WO2016202955 does not disclose an assembly in which the acoustic window is intended to be covered with skin once implanted. Furthermore, WO2016202955 does not disclose an assembly wherein the acoustic window comprises a locator locatable through the skull skin of the patient. Indeed, the three pins of the support do not constitute positioning marks. On the contrary, these pawns form, with the fastening element of the platform, temporary locking means of the platform 16 on the frame 14. Moreover, no positioning mark is necessary in the detection apparatus according to WO2016202955 since the window is not intended to be implanted under the skin of the skull of the subject to be treated.
- US2014 / 0330123 does not disclose an assembly in which an acoustic window includes a locator locatable through the skin of the patient's skull.
- the holes constitute, with the anchoring elements, means for fixing the sonic window in the opening formed through the skull of the patient.
- US2015 / 0321026 does not describe an assembly in which the acoustic window is intended to be covered with skin once implanted. Furthermore, US2015 / 0321026 does not describe an acoustic window including one (or more) locator (s) locatable through the skin of the skull of the patient. On the contrary, in US2015 / 0321026, the spacer (including the acoustic impedance elements different from that of the spacer) is intended to be positioned on the skin. Furthermore, US2015 / 0321026 does not teach the person skilled in the art that the integration of a locator locatable through the skin of the skull - such as a marker visible by ultrasound - to an implantable window can promote its detection. once implanted (and covered with skin of the patient's skull).
- the acoustic window may comprise a plurality of unit positioning marks that are different from one another
- At least one positioning mark may be a mechanical part detectable by touching through the skin of the patient
- the mechanical part may consist of a pin extending outwardly from an upper face of the plate, at least one positioning marker may be an optically visible marker, in particular by infrared, or by ultrasound or by magnetic resonance imaging,
- the marker may comprise an echogenic structure
- At least two positioning marks may consist of optically visible markers or by ultrasound or by magnetic resonance imaging, each marker including:
- At least two positioning marks may consist of optically visible markers or by ultrasound or by magnetic resonance imaging, each marker consisting of a blind hole of different depth,
- the thickness of the plate may be chosen equal to an integer multiple of half the wavelength in the plate of the ultrasonic waves generated by the probe,
- the plate may be composed of a superposition of layers of different materials, said superposition including at least one layer of rigid material and at least one layer of flexible material,
- the window may comprise mechanical reinforcements extending at the periphery of the plate.
- FIGS. 1, 3, 5 and 6 schematically illustrate various embodiments of an acoustic window
- FIGS. 2 and 4 schematically illustrate the acoustic windows once implanted in the skull of a patient
- FIGS. 7 and 8 schematically illustrate a mode of detection of centering markers of an acoustic window
- FIG. 9 illustrates an exemplary method of treating a pathology using a set of treatment of a brain tissue.
- the set for imaging and / or treating brain tissue includes:
- a probe capable of generating ultrasonic waves. This set allows a practitioner to verify the evolution of brain tissue by imaging and / or treat brain tissue using ultrasound.
- the probe is intended to be manipulated by the practitioner. It comprises a housing in which is housed at least one transducer (not shown) for the generation of ultrasonic waves.
- the window 10 is intended to be implanted in the patient, in particular at an opening in his cranial box 4. This provides protection to the brain and prevents its deformation due to pressure changes.
- the window 10 and the probe will be described in more detail with reference to FIGS. 1 to 9.
- the window 10 comprises a plate 1 and one (or more) marker (s) 2 positioning to detect the center of the plate 1 once the window 10 implanted.
- Plate Plate 1 may be substantially flat. Alternatively, the plate 1 may be curved to follow the curvature of the cranial box 4 of the patient. In particular, the plate can be made by three-dimensional printing, its shape being provided to follow the curvature of the skull of the patient.
- the plate 1 is advantageously made of an acoustically transparent material to allow ultrasonic waves to pass through the window 10 in order to image and / or treat brain tissue.
- the material chosen to constitute the plate 1 preferably has a low acoustic absorption to limit heating of the window 10 during the emission of ultrasonic waves by the probe. Indeed, during the passage of ultrasonic waves through the window 10, a portion of the energy is absorbed by the plate 1. This absorbed energy is converted into heat. By choosing a material having a low acoustic absorption to form the plate 1, it limits the risk of heating of the window 10 and therefore burning of the patient.
- the material chosen to constitute the plate 1 also preferably has an acoustic impedance close to 1.5 Mega-Rayleigh to limit the reflections of the acoustic wave on the window.
- the material chosen to constitute the plate 1 is rigid, non-brittle and has a high thermal conductivity (to promote the evacuation of heat generated during the passage of ultrasonic waves through the window 10 and in the brain tissue).
- the material can be:
- polystyrene such as polyethylene, polystyrene, acrylic, polyetheretherketone (PEEK) or poly (methyl methacrylate) (PMMA),
- PEEK polyetheretherketone
- PMMA poly (methyl methacrylate)
- thermoplastic elastomer such as PEBAX.
- the plate 1 is generally rectangular, but it should be noted that the plate 1 may have any shape, such as a circular shape.
- the dimensions of the plate 1 (length and width) can be between 1 and 15 centimeters.
- the dimensions of the acoustic window may vary depending on the depth of the brain tissue (including a tumor) to be treated or imaged. For example, in the case of a deep tumor, the dimensions of the acoustic window may be smaller than the dimensions of the tumor, whereas in the case of a superficial tumor (ie close to the cranial box), the dimensions of the window will preferably be equal to (or greater than) the dimensions of the tumor.
- the acoustic window will be chosen as small as possible while taking It takes into account the dimensions of the area to be treated, its depth and the possibility of inclining ultrasound emission with respect to the window.
- the thickness "e" of the plate 1 is chosen equal to an integer multiple of half the wavelength in the plate 1, ultrasonic waves generated by the probe. This makes it possible to improve the transmission coefficient of the ultrasonic waves in the plate 1, even in the event of significant impedance mismatch between the impedance of the material constituting the plate 1 and the external environment.
- the plate 1 is composed of a superposition of layers of different materials transparent to the ultrasonic waves.
- the plate 1 is composed of a layer of rigid material extending between two layers of flexible material:
- the layer of rigid material makes it possible to increase the mechanical strength of the plate 1, while
- the layers of flexible material make it possible to limit the risks of dispersion of pieces of the layer of rigid material in the event of breakage thereof.
- the window may also include one or more acoustic impedance matching layer (s).
- the acoustic impedance matching layer (s) is made of a material - such as parylene or silicone - whose acoustic impedance is between the impedance of the transducers of the probe and the impedance acoustic of the target area.
- the presence of adaptation layers makes it possible to limit the reflections of ultrasonic waves at the interface between the transducer 21 and the acoustic window and between the window and the fabric.
- the window is made of a relatively "heavy" material and thick to be mechanically solid (for example epoxy, or even ceramic) and the reflection coefficient is high, to limit the reflection, we can add a layer (or two , one on each side) of a quarter of the wavelength of thickness, and ideally of impedance (Zplaque x Zeau) A 0.5 according to the well-known formula.
- This material may for example be a silicone (if the plate is epoxy) or epoxy (if the plate is ceramic or metal). More generally, we can optimize a multilayer structure to have a low reflection coefficient and good mechanical rigidity by choosing the appropriate thicknesses and materials. Another solution is to use an exactly thick wavelength window divided by 2 without a quarter wave plate.
- the window 10 may also comprise reinforcements for increasing the mechanical strength of the plate 1.
- the reinforcements extend for example at the edges of the plate 1.
- Reinforcements may consist of rods of rigid material - such as titanium or stainless steel or any other biocompatible metal known to those skilled in the art - integrated in the plate 1.
- the reinforcements may be in the same material as the plate 1.
- the reinforcements may consist of one (or more) peripheral zone (s) of the plate 1 having a thickness (es) greater than the thickness of a central zone of the plate. 1.
- the plate may include thick areas to enhance its mechanical strength and thinned areas for better transmission of ultrasonic waves.
- the plate 1 can be implanted:
- the plate 1 is adapted to be flush with the opening in the cranial box of the patient.
- the dimensions and shape of the plate 1 are adapted to the size and shape of the opening that has been formed through the cranial box 4 of the patient.
- the window 10 illustrated in FIG. 1 can be attached to the cranial box 4 by gluing, for example by using an adhesive - such as cyanoacrylate.
- an adhesive - such as cyanoacrylate.
- the adhesive is applied to the lateral edges of the plate 1, and the latter is fitted into the opening formed through the cranial box 4. Once the adhesive has hardened, the window 10 is secured to the 4.
- the window can be attached to the cranial box 4 using any other means known to those skilled in the art such as brackets (not shown).
- this solution makes the window 10 almost "invisible” once the window 10 covered with skin 3, the latter extending in the extension of the cranial box 4.
- the acoustic window may be adapted to cover the opening while extending above the patient's cranial box (see Figures 3-4).
- the acoustic window comprises through holes 13 formed between the upper faces 1 1 and lower 12 of the plate 1. These orifices 13 extend at the periphery of the plate 1, along each edge of the plate. The orifices 13 are intended to receive fastening elements - such as bone anchoring screws - for fixing the window 10 on the cranial box 4.
- the dimensions of the plate 1 are greater than the dimensions of the opening formed in the cranial box 4 so that the window 10 is intended to be fixed on the cranial box 4 .
- This embodiment reduces the constraints for the practitioner in achieving the opening in the cranial box. Indeed, the practitioner is no longer obliged to make an opening to dimensions and shape very precise with respect to the dimensions and shape of the plate 1.
- the window 10 also comprises one (or more) positioning marker (s) 2.
- the positioning marker (s) 2 allows the practitioner to identify the position of the plate 1 and thus to position the probe to the right of said plate 1 in order to image and / or treat an underlying brain tissue.
- the use of positioning marks makes it possible to reduce the time required to implement an imaging session and / or treatment of the cerebral zone, in particular with respect to a solution based on the use of a set neuro-navigation.
- each positioning mark may consist of:
- a mechanical element detectable tactilely by the operator through the skin of the patient or
- An optically visible position marker for example in the infrared range.
- the choice among these different types of positioning mark is independent of the implantation variant chosen for the acoustic window (ie acoustic window extending in the extension of the cranial box or above the cranial box). Moreover, these different types of positioning mark can be used in combination in the same acoustic window 10.
- the window comprises several positioning marks arranged on a plate, these can all be different. This makes it easier to repeat the positioning and orientation of the probe during successive sessions of imaging and / or treatment of brain tissue.
- the positioning mark 2 is a mechanical element.
- the positioning mark 2 consists of a pin extending outwards at the upper face 1 1 of the plate 1. This allows to reveal a protuberance on the skin 3 covering the piece
- the window comprises a single pin disposed in the center of the plate 1.
- the window 10 can comprise several pions (in particular two, three, four, etc.).
- the window 10 may comprise four pins 2 arranged near the corners of the rectangular plate 1 on the upper surface 11 of the plate.
- the shape and dimensions of the mechanical positioning mark may vary depending on the application.
- the positioning mark may consist of a crater whose peripheral edges extend towards the outside of the plate and whose central region is hollowed out in the thickness of the plate.
- the window 10 comprises centering markers 2a, 2b, 2c, 2d (respectively 21 to 24 and 25 to 27) visible by ultrasound, optics or MRI.
- the window 10 comprises four centering markers 2a, 2b, 2c, 2d (respectively 21 to 24) arranged at the four corners of the rectangular plate 1.
- Each centering marker consists for example of a metal structure or an echogenic hard plastic structure.
- the window comprises three centering markers 25, 26, 27 arranged at three corners of the rectangular plate 1.
- Each centering marker consists for example of a blind or through hole.
- centering markers makes it possible to have markers integrated into the plate 1 without protuberance on the upper face 11 of the plate 1.
- These centering markers are for example detectable using the transducers of the imaging probe and / or treatment in ultrasound mode A (also called “A-scan” or “A-mode”).
- the ultrasound mode A is based on the emission of acoustic information and the reception of echoes along a propagation line.
- the probe may include specific transmitters / receivers (operating in A mode) for detecting centering markers.
- the centering markers detected using the probe can be positioned precisely above the window 10 prior to the application of ultrasonic waves to image or treat brain tissue.
- Markers detectable by ultrasound or optics can coexist with markers detectable by MRI.
- the first are in a known geometric relationship with the second.
- the centering markers are all identical.
- the ultrasonic, optical or MRI detectable centering markers may all be different, as illustrated in FIGS. 5 and 6. This allows the practitioner to identify each centering marker individually.
- each marker 21, 22, 23, 24 comprises a substrate 210, 220, 230, 240 having a first acoustic impedance and an element 213, 223, 233, 243 having a second acoustic impedance.
- the second acoustic impedance element 213, 223, 233, 243 is buried at a different depth in the substrate 210, 220, 230, 240 so that the distribution of the elements 213, 223, 233, 243 in the substrate 210, 220, 230, 240 constitutes a code enabling the identification of said marker 21, 22, 23, 24.
- each centering marker consists of a blind hole of identical diameter and of different depth; more precisely, the window includes:
- FIG. 7 there is illustrated a detection mode of the four markers 21, 22, 23, 24 shown in Figure 5 and each including an element 213, 223, 233, 243 disposed in a substrate 210, 220, 230 , 240, the second acoustic impedance elements extending at different depths in the substrate:
- the front face 21 1, 221, 231, 241 of the substrate 210, 220, 230, 240 constitutes a first ultrasound reflector (due to the difference in acoustic impedance between the substrate and the tissue in contact with the front face ), this front face extending on the upper face 1 1 of the plate 1,
- the rear face 212, 222, 232, 242 of the substrate 210, 220, 230, 240 constitutes a second ultrasound reflector (because of the difference in acoustic impedance between the substrate and the tissue in contact with the rear face) , this rear face extending on the lower face 12 of the plate 1, and
- the second acoustic impedance element 213, 223, 233, 243 - which may consist of a gaseous inclusion in the body of the substrate - constitutes a third ultrasound reflector extending between the front faces 21 1, 221, 231,
- the reflected waves OR1, OR2, OR3, OR4 by the elements 213, 223, 233, 243 are recorded by the probe at different times t1, t2, t3, t4. the recording times of the waves reflected by the first and second reflectors 21 1, 221, 231, 241 and 212, 222, 232, 242.
- each blind hole constitutes a first ultrasound reflector
- the rear face 252, 262, 272 of the plate constitutes a second ultrasound reflector.
- the reflected waves ORa, ORb, ORc by the bottoms 251, 261, 271 of the blind holes are recorded by the probe at times ta, tb, te different relative to the times of recording of the waves reflected by the rear face of the plate.
- the assembly comprises a window 10 according to the third embodiment. of realization.
- the practitioner implants (step 100) the window 10 in the skull of the patient. It makes one (or more) opening (s) in the skull of the patient, and fixed a window 10 in the opening (or in each respective opening) by gluing or anchoring.
- the practitioner can fill the free space between the window 10 and the dura mater with a suitable material (gel or saline solution).
- the practitioner covers the window with the skin 3 of the patient.
- the incision of the patient's skin is practiced so as to prevent the resulting scar the closing of the skin after implantation of the window covers the window (the quality of transmission ultrasonic waves being reduced through the scars).
- a succession of imaging sessions and / or treatment of brain tissue can be provided to the patient.
- the practitioner implements a step of detecting (step 200) the position of the window 10. It switches the probe into a tracking mode (transducers of the probe or specific transmitters / receivers activated in Ultrasound mode A), applies an ultrasound transmission gel to the patient's hair, and moves the probe over the patient's skull to detect the position of the window 10.
- a tracking mode transducers of the probe or specific transmitters / receivers activated in Ultrasound mode A
- applies an ultrasound transmission gel to the patient's hair, and moves the probe over the patient's skull to detect the position of the window 10.
- a processing unit connected to the probe sends information to indicate to the practitioner that a centering marker has been detected.
- the processing unit can define which of the centering markers has been detected and provide information to the practitioner on the direction in which it is preferable to move the probe to detect the other three centering markers. For example, if the detected centering marker is the marker disposed in the upper left corner of the window 10, the processing unit instructs the practitioner to move the probe in a downward and a right direction. When the four centering markers are detected, the processing unit sends information to the practitioner asking him to hold the probe stationary. Optionally, the probe may be removed to reapply transmission gel to the patient's hair above the window before repositioning (step 300) the probe to the right of the window 10. Once the probe is positioned, the practitioner switches the operating mode of the probe from the registration mode to a treatment or imaging mode. The transducers are activated to imitate or treat brain tissue (step 400).
- the reader will have understood that many modifications can be made to the invention described above without physically going out of the new teachings and advantages described herein.
- optically visible position marker for example in the infrared range.
- each positioning mark could consist of a detectable element that is detectable and detectable by ultrasound and / or MRI.
- one (or more) ultrasonically or MRI-detectable locator (s) may be combined with one or more mechanically identifiable element (s). tactilely or optically within the same acoustic window.
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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FR1755562A FR3067610B1 (fr) | 2017-06-19 | 2017-06-19 | Ensemble pour l'imagerie et/ou le traitement d'un tissu cerebral |
PCT/EP2018/066203 WO2018234280A1 (fr) | 2017-06-19 | 2018-06-19 | Ensemble pour l'imagerie et/ou le traitement d'un tissu cerebral |
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EP3641654A1 true EP3641654A1 (fr) | 2020-04-29 |
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EP18732744.0A Pending EP3641654A1 (fr) | 2017-06-19 | 2018-06-19 | Ensemble pour l'imagerie et/ou le traitement d'un tissu cerebral |
Country Status (4)
Country | Link |
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US (1) | US20200138580A1 (fr) |
EP (1) | EP3641654A1 (fr) |
FR (1) | FR3067610B1 (fr) |
WO (1) | WO2018234280A1 (fr) |
Families Citing this family (5)
Publication number | Priority date | Publication date | Assignee | Title |
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EP3897463A4 (fr) * | 2018-12-19 | 2022-09-14 | Longeviti Neuro Solutions LLC | Implant crânien à fenêtre durale |
US20200375745A1 (en) * | 2019-05-14 | 2020-12-03 | Gliaview Llc | Ultra-sound compatible artificial cranial prosthesis with customized platforms |
CA3215765A1 (fr) * | 2021-04-20 | 2022-10-27 | Samantha F. Schafer | Structures et procedes pour modifier un traitement par ultrasons |
FR3131218B1 (fr) * | 2021-12-28 | 2024-02-02 | Carthera | Procede et systeme pour la detection d’une borne de connexion |
WO2023179866A1 (fr) | 2022-03-24 | 2023-09-28 | Sorbonne Universite | Rupture transitoire de la barrière neurovasculaire d'un être humain et ses utilisations pour le traitement de la sclérose latérale amyotrophique |
Family Cites Families (7)
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US7833253B2 (en) * | 2006-01-17 | 2010-11-16 | Biodynamics Llc | Craniotomy closures and plugs |
WO2011101039A1 (fr) | 2010-02-22 | 2011-08-25 | Universite Pierre Et Marie Curie (Paris 6) | Appareil de traitement d'affections du cerveau et procédé pour sa mise en œuvre |
US20130289411A1 (en) * | 2012-04-26 | 2013-10-31 | dBMEDx INC | Apparatus to removably secure an ultrasound probe to tissue |
WO2013184798A1 (fr) * | 2012-06-07 | 2013-12-12 | Ulthera, Inc. | Dispositifs et procédés de régulation de profondeur focale à ultrasons |
WO2014179720A1 (fr) * | 2013-05-02 | 2014-11-06 | University Of South Florida | Fenêtres soniques implantables |
JP7015694B2 (ja) * | 2015-06-16 | 2022-02-03 | アンスティチュ ナショナル ドゥ ラ サンテ エ ドゥ ラ ルシェルシュ メディカル | 検出装置および検出装置の作動方法 |
US20170086785A1 (en) * | 2015-09-30 | 2017-03-30 | General Electric Company | System and method for providing tactile feedback via a probe of a medical imaging system |
-
2017
- 2017-06-19 FR FR1755562A patent/FR3067610B1/fr active Active
-
2018
- 2018-06-19 EP EP18732744.0A patent/EP3641654A1/fr active Pending
- 2018-06-19 US US16/623,974 patent/US20200138580A1/en active Pending
- 2018-06-19 WO PCT/EP2018/066203 patent/WO2018234280A1/fr unknown
Also Published As
Publication number | Publication date |
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FR3067610A1 (fr) | 2018-12-21 |
FR3067610B1 (fr) | 2019-07-26 |
WO2018234280A1 (fr) | 2018-12-27 |
US20200138580A1 (en) | 2020-05-07 |
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