FI82368C - Mammography procedure and device - Google Patents

Description

82368 ^ Mammography method and apparatus

Mammography and oceanic testing 5

The invention relates to a method for mammography imaging, in which the breast to be imaged is pressed and applied between holders attached to the imaging device, the holders of which are subjected to X-rays through the breast between the holders. inside a film cassette or the like.

The invention further relates to a mammography device comprising a body part on which a pivotable body part is mounted for rotation, preferably about a horizontal axis, and in which the body part is fitted with a radiation source and film cassette support devices and a means for imaging between the radiation source and said support devices. chest holders movable relative to each other to press the chest to be imaged between said holders.

Mammography refers to a method of breast scanning in which breasts are x-rayed. In connection with the imaging, the chest is already known to be pressed and spread between the holders of the imaging device.

Due to the quality of the fabric to be imaged, soft radiation is used in the imaging with an anode voltage of the X-ray tube of about 20 to 28 kV. This results in scattering problems that are greater the thicker the fabric to be imaged. However, in mammography it would be important to highlight the so-called micro-calcifications with a diameter of the order of 0.1 mm.

As is well known, three different projections are used for complete mammography imaging. In mass shots, only one usually vertical projection is used.

2 82368 ^ In addition to X-rays taken in different projections, magnification images of suspect points are taken if necessary.

Previously known devices can also be used. biopsiakuvaukseen. 5 Biopsy imaging refers to a method in which the breast is imaged. using a biopsy plate so that the openings in the biopsy plate appear on the X-ray image. In biopsy imaging, the film is developed with the breast to be imaged attached to its holders, and a possible finding is localized using holes in the biopsy plate, which are used to sample the suspected site.

With known mammography methods and devices, magnification images can also be taken, which is done by placing a special stand on top of the normal bra, by means of which the breast to be imaged is placed closer to the focus of the radiation source. The use of such a separate rack is cumbersome and it is therefore an object of the present invention to provide a new method and apparatus in which said separate rack becomes redundant.

20 In mammography, the aim is to compress the breast as flat as possible because soft secondary radiation is scattered. The thinner the breast, the less secondary radiation can be scattered. Different types of heating solutions are also used to prevent scattering.

With respect to the prior art related to the present invention, reference is made, by way of example, to mammography devices known from the following U.S. patents: 3,824,297, 3,971,950, 4,097,748, 4,599,738 and 4,613,982.

The prior art mammography devices have had several drawbacks which are intended to be eliminated in certain respects by the novel solutions of the present invention.

In the prior art devices, it has been difficult to obtain the breast to be imaged, preferably compressed and fastened between the holders belonging to the device. The breast compression lie included in the mammography imaging is often perceived as quite uncomfortable for patients, and when it is often accompanied by the need to reposition the imaging breast in a more favorable position, the disadvantage is felt to be quite embarrassing.

It is a further object of the invention to provide a highly automated mammography device.

mammografiamenetelmälle according to the invention is mainly characterized by the fact that the breast is placed alapitimen the upper surface 10 of which the imaged breast is compressed to the upper right portion of the upper punch outer tip portion that yläpaininta transferred articulation around inversely substantially alapitimen supporting plane parallel to the radiation source and the kuvautumisvälineiden respect to the supporting part of the fixed frame part and that the top - and when the lower holders become substantially parallel to each other, the parallel compression is continued, if necessary, by moving the upper pusher while maintaining its direction in its guides.

The device according to the invention is mainly characterized in that said upper holder is arranged to pivot about an axis substantially perpendicular to the central axis 20 so that the outer tip of the upper holder is pressed from the direction.

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Some advantageous features of the device according to the invention are shown in sub-review 3.

In the following, the invention will be described in detail with reference to the figures of the accompanying drawing, starting from a previously known solution.

Figures A and B show a prior art mammography sub-solution illustrating the prior art.

Fig. 1 is a schematic side view of the device according to the invention as a whole.

Figures Ia and Ib show a mammography description in different projection.

5

Figure 2 shows schematically the displacement of the upper pusher according to the invention.

Figure 3 schematically shows a mammography device according to the invention in a cassette removal situation after 10 biopsy scans.

Figure 4 shows the protections used in a mammography device according to the invention.

Figure 5 schematically shows a mammography device according to the invention in its normal imaging position.

Figure 6 schematically shows a device according to the invention in a blopsy imaging position.

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Figure 7 shows a mammograph device according to the invention in the magnification imaging position.

Figure 8 schematically shows the tilt mechanism of the upper pusher.

25

Figure 9 shows the width adjustment mechanism of the device.

Figures 10a-10d show various replaceable top press plates.

Figures A and B show a previously known mammography device solution in which the tube head 2 and the part 3 supporting the imaging means are mounted from the center of gravity P on the vertical frame 4 of the device 1. Such a device has the advantage that the device 1 can be roughly balanced. The disadvantage, however, is that the device 1 requires a locking slot.

In addition, the device according to this prior art solution causes both the need for height adjustment and the lateral displacement of the patient when moving from one projection C, D, E to another, which slows down and interferes with the imaging and prevents automation of the device when moving from one projection to another.

First, the basic structure of a device 5 1 according to the invention will be described with reference to Fig. 1. The device comprises a vertically displaceable vertical body 4, to which is attached a rotatable part about a horizontal axis bb, with a tube end 2 and press plates 6 and 7, and a film holder 3. The vertical body 4 is arranged to be vertically displaceable on a body part 54. or guides 57. In connection with the vertical guides 57 10, there are sliding housings 56a and 56b arranged around the vertical guides 57. Attached to the base 55 of the device is a motor 51 for rotating the transfer screw 52. In connection with the thread of the transfer screw 52, there is a threaded portion 53 through which the body 4 is moved vertically. To compensate for the weight 15 of the movable body 4 and other parts attached thereto, a gas spring 58 is placed between the body 4 and the base 55, which is attached at one end to the movable body 4 by a protruding part 59.

In the device 1 according to Figures 1a and Ib, the part 3 supporting the tube head 2 and the imaging means 20 is mounted on the vertical body 4 of the device 1 between the upper pusher 6 and the lower pusher 7 at the center axis aa of the device 1. The device eliminates the need to adjust the device and patient f, g, h (different positions of the breasts and M ^) when moving to another. However, the device requires special measures to balance the device 25 (explained in more detail in connection with Figure 13), but the special measures are reasonable in relation to the benefit to be achieved. In addition, the operation of the device is motorized, so that perfect balancing is neither necessary nor even necessary. Thus, the device can be used to increase the degree of automation used.

30

What is critical in mammography is that the most common cancer site is located in the upper quadrant of the breast near the body. Thus, it is important that the tissue at the root is included in the image. Using previously known devices, the caregiver spreads the chest from the back during the initial stage of its compression, and then when the upper pressure approaches the chest, the caregiver has no space and has to release his grip before the wrestler locks the chest. Instead, in the upper pressure solution according to the invention shown in Fig. 2, 6 82368 ^ leaves room for the caregiver to apply the breast to the lower palm 7 at the initial stage of compression, at the end of which the tip 6 'of the pusher 6 locks the breast. The upper pusher 6 is linearly mounted on the rod 10. Thus, the tip 6 'of the lower inclined upper pusher groove 6 engages the chest at its root J, after which the upper pusher 6 rotates around its tip 6', while the upper pusher 6 moves in its linear bearing 9 along the guide rod 10 . At the articulation point 8 there is an adjustable spring load which allows the upper pusher 6 to turn until it reaches its normal position 6a, i.e. in the position parallel to the lower pusher plate, after which the increase in parallel pressure 10 can be continued if the pusher 6a maintains its direction.

Figure 3 shows the device 1 according to the invention in a rigid situation corresponding to the removal of a film cartridge after a biopsy. In this case, the breast Mj 15 is still pressed between the upper pusher 6 and the lower pusher 7, but the cassette holder 22 and the tube end 2 have been driven by the motor 12 and the screw 13 slightly downwards to remove the cassette 21.

In Figures 2 and 3, the vertical body 4 of the device 1 has a rotating part 25 supported by bearings 30 and a fixed lower press plate 7. The film holder 22 and the tube end 2 are attached to a common body part 10 linearly mounted 23 about a horizontal axis bb. to the rotating part 25. In Fig. 3, the upper pusher 6 moves relative to the body part 10 in its bearings 9 and the lower pusher 7 is fixed. Thus, it is possible to switch to high-25 nose shooting without a separate attachment, even without detaching from the compression. In addition, the solution according to the invention can replace a biopsy cassette holder.

The vertical body part 10 is moved by means of a motor 12 and a screw 13. The rotating part 25 comprises a helical wheel 14 to which a helical 30 screw 15 and a first gear 16 and a rotating motor 17 are connected. The rotational movement is balanced by a balancing gas spring 18 connected at one end by a crank to the wheel 14 and at the other end by a shaft 18a. , h the rotation of the part 25 also takes place in parallel around the central axis aa of the parallel M, since the central axis-35 li aa substantially coincides with the axis of rotation bb of the part 25. Thus, • the need to adjust the height of the device 1 is eliminated when changing the shooting projection.

The device 1 according to the invention comprises the capability for biopsy imaging, so that a separate installation of the add-on is not required when switching to biopsy imaging; only the top press plate 6 needs to be replaced. The upper press plate 6 is selected according to the film size to be used. Film sizes can be, for example, 18 x 24 cm or 24 x 30 cm.

5 Upper press plates 6 of different sizes are required for the device 1 according to the invention, for both films, for the biopsy imaging plates and for the spot imaging plates. The top press plates 6 are made of a highly X-ray permeable material, preferably e.g. by making the transparent part made of polycarbonate or acrylic and connected to the width adjustment unit shown in Fig. 9. This makes the press plates simple and cheap.

Figure 4 shows the protections of the device 1 according to the invention. The upper guard 26 is articulated 27 to the upper pusher 6 and attached from its guide groove 28 15 to the pipe end 2. The lower guard curtain 29 is attached to the imaging support part 3 and the lower presser 7. The upper guard 26 protects the subject's head and chin and shoulders. only in high-resolution imaging to prevent the adipose tissue of the subject from entering between the lower body name 6 and the imaging means support portion 3.

Figure 3 shows a device 1 according to the invention in a normal shooting position. In this case, the lower presser plate 7 is driven onto the imaging means 21 but on the part 3. From the normal imaging it is possible to switch to the magnification imaging and the biopsy imaging 25 without removing the chest (between the upper presser 6 and the lower presser 7).

Figure 6 shows a device according to the invention in a blopsy imaging position.

Figure 7 shows a device 1 according to the invention in an enlarged view. In the device 1 according to the invention, the magnification ratio is freely selectable. Typically, the magnification ratio in magnification imaging is 1.5: 1, but in the solution according to the invention, the magnification ratio can be selected steplessly.

Fig. 8 schematically shows the articulation mechanism of the upper pusher 6, which allows the upper pusher 6 to grip the breast M at its root 35 8 82368 ^ as described in connection with Fig. 2, thus leaving the caregiver a space to "stretch" the breast at the initial stage of compression. When the upper pusher 6 has rotated against the load of the adjustable spring 31 to the normal position, i.e. substantially parallel to the lower pusher plate, the pressing can be continued as in the known solutions. During its pivoting movement, the tip 6 'of the pusher 6 remains vertical marked with a dotted line in Fig. 8. The part denoted by the reference numeral 9 'is a carriage which can move in the compression direction belonging to the mechanism. The articulation parts of the pusher 6 of the mechanism also include a crank 32 which, via a rod 33, engages a linear bearing housing 34, for example a crosspiece, the pivots of which are indicated by reference numeral 35 in Fig. 8. The adjustable spring 31 thus defines a pusher squeeze the chest.

Fig. 9 shows the width adjustment mechanisms of the replaceable press plates 6 to which an emergency release torque switch is connected. The width adjustment wheel 36 is in direct contact with the plinths, e.g. the brackets 37, to which the press plates 6 are attached. Between the shaft 42 and the brackets 37 there are parts 38 which allow only axial movement. The body 39 of the width adjustment mechanism engages the rods 33 shown in Figure 8. The shaft 42 is locked non-rotatable to the body by a torque switch 40 having, for example, a torque adjustment wheel with recesses 46 into which the pins 45 in the body are locked when the wheel is tightened.

: 25 Figures 10a-10d show various press plates. Fig. 10a shows a press plate 6A for a printing press measuring e.g. 30 x 24 cm. The press plate is adjustable to an adjusting mechanism 42 which is adjustable to different widths. The "8pot" imaging press plate 6B of Figure 10b with the aperture 47 is designated 43 and the biopsy press plate 44 is indicated by Figures 10c and 10d. References 42 ', 43', 44 'show the same portions as in Figures 10a and 10b, but smaller; e.g., for 24 x 18 cm shooting presses 6C.

As stated above, simple and inexpensive press plates can be used in the invention in connection with a common mechanism 42 35 adjustable for different widths. This results in substantial savings compared to the fact that six different top pushers have usually been required in the past.

It should be emphasized that only some examples of the application of the invention have been presented above and that the invention also encompasses several modifications of the method and apparatus of the invention which will be apparent to those skilled in the art, of which only the following should be mentioned. The method 5 and the device of the invention can also be applied in a mammography in which X-ray film is not used, but the image is detected by radiation-sensitive detectors known per se, e.g. electronic detectors, from which an electrical signal is obtained. The definition of 'film cassette or equivalent' used in the application includes such means for image detection and recording. Also within the scope of the invention are device modifications in which there is no separate parallel lower holder at all, but the lower holder is a film cassette or related parts or other similar image detection devices referred to above.

15

The following are claims within the scope of which the various details of the invention may vary within the scope of the inventive idea.

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Claims (3)

A method of mammography photography, in which the chest (M) to be photographed is pressed and spread between the holders (6,7) as attached to the photographic device, from one side of the lamina (6.7) directing an X-ray cone (R) through the chest (M) between the halls toward the photographic means (21) at a relation to the halls opposite the side of the X-ray source (2), which means Mr positioned within a film cassette or equivalent in connection with the body of the device, characterized therein; placing the chest (M 2) to be photographed on the upper surface of the lower holder (7), over which the chest (M 2) to be photographed is pressed from the root portion (J) of the upper portion of the chest with the outer tip portion (6). ') by the upper printing plant (6), the upper printing plant (6) being transmitted about its pivot point (8) by pivoting substantially in the direction of the support part of the lower holder (7) in the body portion (10) stationary in the hallway. nd to the radiation source (2) and the support portion (3) of the photographic means (21), and as the upper and lower halls (61.7a) become parallel to each other, if necessary, the breast is further pressed by moving the upper printing presses ( 6a) in its conduits with the retaining direction. 1 Patent claim 1. Menetelmä mammography acupuncture, jossa kuvattava rinta (M) puristetaan ja levitetään kuvauslaitteeseen kiinnitettyjen pitimien (6,7) wellin, joiden pitimien (6,7) toiselta puolelta kohdistetaan x-ray ultrasound lävitse pitimiin close to the X-ray peninsula (2) vastakkaisella puolella oleville kuvan-tamisvälineille (21) (M ^) puristetaan sen yläpuolen juuriosasta (J) yläpainimen (6) ulkokärkiosalla (6 '), one yläpaininta (6) siirretään nivelöinti-kohtansa (8) ympäri kääntäen olennaisesti alapitimen (7) kannatusosanteilan suunus ) kanatus-15 osaan (3) the neighborhood kiinteässä runko-osassa (10) yes one yäla ja ala-pitimien (61.7a) tullessa keskenään olennaisesti yh densuuntaisiksi jatketaan tarvittaessa rinnan puristusta edelleen siirtämällä yläpaininta (6a) suuntansa séilyttäen johteissaan. . 20 2. Mammography, joka käsittää runko-osan (4), johon on laakeroitu (30) kääntyvä runko-osa (25), sopivimmin vaaka-akselin (bb) ympäri käännettäväksi, yes johon runko-osaan (25) on sovitetthteil 2) yes filmikasetin (21) kanatuslaitteet sekä seatilylähteen (2) ja mainittujen kannatuslaitteiden vv kuvattavan rinnan pitimet (6.7), jotka ovat 25 siirrettävissä toisiinsa nen kuvattavan rinnan (M) puristamiseksi mainittujen , one mainittu yläpidin (6) on sovitettu rinnan keskiakseliin (aa) the neighborhood olennaisesti kohtisuoran akselin inmate the käännettäväksi site, one yälpitpitimen (6) ulko-kärjellä (6 ') painetaan kuvattavaa rintaa yes one tään jäkeen yläpidin on alaspäin siirrettäessä kääntyvä nivelöintiakselinsa ympäri olennaisesti alapitimen (7) tason suuntaiseksi. 3 (10), 11 82368 Ί ja että mainittu johdeosa (9) ja nivelöintiosa (8) pääsevät siirtymään toisiinsa the net. 5 10 15 20 25 30 35 12 82368 A mammography device comprising a body part (4), in which a ... "oscillating body part (25) is stored (30), most preferably said to be pivotable:" around the horizontal axis (bb), and in which body part (25) a radiation source (2) and support devices for a film cassette (21) "and brackets (6,7) for the chest to be photographed between the strainer (2) and said support devices can be moved, which holders can be moved in relation to each other to press the chest (M) to be photographed between said holders (6,7), characterized in that said upper holders (6) are arranged to be pivoted about an axis substantially perpendicular to the center axis of the chest (6). aa) in such a manner that with the upper tip (6 ') of the upper holder (6) the chest (M) to be photographed in the beginning is pressed. pressing above the chest from its root (J) and allowing the upper pourer thereafter to move downwardly on its articulation axis substantially in the direction of the plane of the lower holder (7). II Π 82368 Ί 3. Device according to claim 2, characterized in that the pressure plate of the Svre holder (6) is fixed with a guide shaft in such a guide part (9), which St moves linearly in the body part (10) between the pipe end (2) and the support part (3) for the photographic tools (21), and said guide member (9) and the guide member (8) will move in relation to each other. 10 15 20 25 30 35