JP2015013217A - 血管セグメントを画像化する方法および装置 - Google Patents
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Abstract
【解決手段】上記装置は、(たとえばハウジングなどの)人工物(208)と、流体送給機構と、画像化機構(204)とを含む。上記ハウジングは、上記人工物内に形成された開孔(221)を含む。上記流体送給機構は実質的に透明である所定体積の流体を、上記ハウジングに形成された開孔に対して送給すべく構成される。上記画像化機構は、上記所定体積の透明流体が上記開孔に対して送給された後に、所定画像化法を用いて上記構造の表面を画像化すべく構成され、上記画像化機構および/または上記人工物は、上記構造の上記表面を画像化する間に上記構造の上記表面に沿い(引戻しデバイス215により)平行移動される。
【選択図】図2A
Description
本発明は、光学的放射を使用して表面を画像化する方法および装置に関し、より詳細には、光学的放射を使用して血管の内部目標表面を画像化する方法および装置に関する。
本発明は、2004年8月24日に出願された米国特許出願第60/604,138号の優先権を主張するものであり、その全ての開示内容は言及したことにより本明細書中に援用される。
急性心筋梗塞(“AMI”)は、合衆国および各工業国における死亡の主な原因である。過去15年間に行われた調査によれば、不安定プラークと称される最小限のまたは目立たない狭窄アテローム硬化性プラークは、冠状動脈血栓症、心筋虚血および突然心臓死の前触れであることが例証されている。死後の研究によると、突然心臓死の約80%における原因障害として、ひとつの種類の不安定プラークすなわち薄寸被膜線維アテローム(thin-cap fibroatheroma)(“TCFA”)が特定された。TCFAの90%以上は、主な冠状動脈(左前下行枝−LAD;左回旋枝−LCx;および右冠状動脈−RCA)の各々の最も基端側の5.0cmのセグメント内に見出される。TCFAは典型的に、組織学的には以下の特徴により特徴付けられる最小閉塞的なプラークである:a)薄寸の線維被膜(<65μm)、b)大寸の脂質溜まり、および、c)線維被膜の近傍にて活性化されたマクロファージ。これらの特徴は、生体力学的ストレスに応じてTCFAを破裂させる傾向があると仮定される。破裂に続き、組織因子などの凝結因子の放出により、血栓形成に対する原因箇所および急性冠状動脈事象に対する可能性が生まれる。AMIの大部分に対してはTCFAが伴うが、最近の解剖研究によれば、侵食を伴う即ち表面的に石灰化された小結節を伴う冠状動脈プラークもまた血栓を析出して冠状動脈を突然に閉塞し得ることが示されている。
各図を通し、特に明記しない限り同一の参照番号および記号は、図示された実施例の同様の特徴、要素、構成要素または部分を表すべく用いられる。更に、以下において本発明は図面を参照して詳細に記述されるが、該記述は図示実施例に関してその様に行われるものである。
D1=R(λ1)/R(λ2)
D2=R(λ1)/[R(λ1)+R(λ2)]
D3=[R(λ1)−R(λ2)]/[R(λ1)+R(λ2)]
D4=[R(λ1)−R(λ2)]/R(λ2)
Claims (63)
- 第1流体と接触する構造を画像化する装置であって、
人工物と、
上記人工物に関する外部箇所へと所定体積の第2流体を送給すべく構成された流体送給機構と、
上記所定体積の第2流体が上記外部箇所へと送給される間およびその後の少なくとも一方にて上記構造を画像化すべく構成された画像化機構であって、当該画像化機構または上記人工物の少なくとも一方は、上記構造を画像化する間において表面の延長の軸心に略々対応する経路に沿い平行移動されるという画像化機構とを備えて成る、
装置。 - 前記人工物はハウジングである、請求項1記載の装置。
- 前記第2流体は透明流体である、請求項1記載の装置。
- 前記構造は血管である、請求項1記載の装置。
- 前記流体送給機構は前記人工物に対して作動的に接続されたポンプである、請求項1記載の装置。
- 前記流体送給機構は前記人工物に対して作動的に接続された注入器である、請求項1記載の装置。
- 前記人工物は該人工物内に形成された開孔を含む、請求項1記載の装置。
- 前記流体送給機構は、
前記第2流体を収容する透明流体リザーバと、
上記第2流体リザーバに対して接続された第1端部と前記ハウジングの前記開孔に対して接続された第2端部とを有する送給管路とを備えて成る、請求項7記載の装置。 - 前記人工物の前記開孔は前記ハウジングの末端に配置される、請求項7記載の装置。
- 前記人工物の前記開孔は前記画像化機構の近傍に配置される、請求項7記載の装置。
- 前記画像化機構は、
前記構造の表面に対して光を導向すべく構成された導向機構と、
上記導向機構に対して作動的に接続された少なくとも一本の光ファイバと、
上記少なくとも一本の光ファイバに対して作動的に接続された画像処理機構とを含む、請求項1記載の装置。 - 前記導向機構は前記画像化機構の前記末端における光学機器を含む、請求項11記載の装置。
- 前記導向機構はレンズおよび光導向要素を含む、請求項11記載の装置。
- 前記導向要素は光の少なくともひとつの方向を変更すべく構成された光学的機構であり、
上記光学的機構は上記光を、前記人工物の長軸に対して実質的に平行な方向から、該人工物の上記長軸に対して実質的に直交する方向へと導向し得る、請求項13記載の装置。 - 前記レンズは前記光を、前記人工物を約0.5mm〜5mmだけ越えた箇所に焦点合わせする、請求項13記載の装置。
- 前記画像化機構に対して作動的に接続されると共に該画像化機構を回転すべく構成された回転機構を更に備えて成る、請求項1記載の装置。
- 前記回転機構は少なくとも約30回転/秒より速く且つ多くとも約1,000回転/秒であるという速度にて回転する、請求項16記載の装置。
- 前記画像化機構は前記構造を画像化する間に前記人工物内で回転される、請求項1記載の装置。
- 前記画像化機構に対して作動的に接続されると共に前記人工物に対して該画像化機構を平行移動させるべく構成された引戻し機構を更に備えて成る、請求項1記載の装置。
- 前記引戻し機構は少なくとも約1mm/秒かつ多くとも約100mm/秒の速度にて前記画像化機構を平行移動する、請求項19記載の装置。
- 前記引戻し機構は前記画像化機構を約10mm/秒の速度で平行移動させる、請求項19記載の装置。
- 前記人工物の少なくとも一部分は透明である、請求項1記載の装置。
- 前記画像化法は、時間領域光コヒーレンス・トモグラフィ、スペクトル領域光コヒーレンス・トモグラフィ、または、光学周波数領域画像化法である、請求項1記載の装置。
- 前記第2流体は前記画像化法により利用される放射に対して実質的に透明である、請求項1記載の装置。
- 前記人工物を自身内に受容すべく構成された案内カテーテルを更に備えて成る、請求項1記載の装置。
- 前記流体送給機構は前記流体を前記案内カテーテルの基端に対して送給し、且つ、
上記流体は上記案内カテーテルを貫通して形成された開孔を通して流れる、請求項25記載の装置。 - 前記画像化機構は前記構造に関するデータを獲得し、
上記データを受信する処理機構であって、該データの関数として前記流体送給機構または上記画像化機構の少なくとも一方を制御し得る処理機構を更に備えて成る、請求項1記載の装置。 - 前記処理機構は、該処理機構により以前に受信された情報に基づき前記流体送給機構および前記画像化機構の少なくとも一方を制御する、請求項27記載の装置。
- 前記処理機構は前記画像化機構の平行移動を制御する、請求項28記載の装置。
- 前記処理機構は前記流体送給機構の流体送給を制御する、請求項28記載の装置。
- 前記処理機構は、前記画像化機構の平行移動および前記流体送給機構の流体送給を制御する、請求項28記載の装置。
- 前記処理機構は前記画像化機構の平行移動を制御する、請求項1記載の装置。
- 前記人工物または前記画像化機構の少なくとも一方を含むカテーテルを更に備えて成る、請求項1記載の装置。
- 前記流体送給機構は前記カテーテルの内側部分を通して前記第2流体を送給する、請求項34記載の装置。
- 前記画像化機構は、画像を獲得するためのビームであって前記カテーテルの外側へと伝達されるというビームを放出する画像化用光学機器を含む、請求項34記載の装置。
- 第1流体と接触する構造を画像化する方法であって、
(a)流体送給機構を用いて所定体積の第2流体の一部分を上記構造の基端側の領域に送給する段階と、
(b)段階(a)の後、上記所定体積の第2流体が外部箇所へと送給される間またはその後の少なくとも一方にて、人工物に関係付けられた画像化機構を用いて上記構造の少なくとも一部分を画像化する段階であって、上記画像化機構または上記人工物の少なくとも一方は、上記構造の画像化の間またはその後の少なくとも一方にて表面の延長の軸心に略々対応する経路に沿い平行移動されるという段階とを備えて成る、
方法。 - 前記第2流体は透明流体である、請求項36記載の方法。
- 前記構造は血管である、請求項36記載の方法。
- 前記構造の前記表面は血管の内側表面である、請求項36記載の方法。
- 前記流体送給機構はポンプである、請求項36記載の方法。
- 前記流体送給機構は注入器である、請求項36記載の方法。
- (c)段階(a)の後、前記構造の少なくともひとつの特性を獲得する段階と、
(d)段階(a)の後、(i)前記流体送給機構を用いて前記所定体積の第2流体の更なる部分を上記構造に対して局所的である更なる領域へと送給する、および、(ii)上記少なくともひとつの特性が特定結果の範囲の外側および内側の一方であるならば前記を平行移動する、の少なくとも一方を行う段階とを更に備えて成る、請求項36記載の方法。 - 前記段階(c)および(d)は反復的に実施される、請求項42記載の方法。
- もし血液が検出されるならば画像品質の評価値は特定レベルより低い、請求項42記載の方法。
- もし前記構造の前記画像が血液により少なくとも部分的に遮蔽されるならば画像品質の評価値は特定レベルより低い、請求項42記載の方法。
- (e)前記第1流体および前記構造の少なくとも一方の特性を獲得する段階と、
(f)上記特性が特定結果の範囲の外側および内側の一方であるならば上記構造の画像化を中断する段階とを更に備えて成る、請求項36記載の方法。 - (g)前記流体送給機構を用いて前記所定体積の第2流体の別の部分を前記構造に対して局所的である別の領域へと送給する段階と、
(j)前記特性が特定結果の範囲の外側および内側の一方であるならば上記構造の画像化をやり直す段階とを更に備えて成る、請求項46記載の方法。 - 前記段階(g)、(h)、(i)および(j)は反復的に実施される、請求項47記載の方法。
- 前記画像化機構は所定の画像化法を利用する、請求項47記載の方法。
- 前記画像化法は光コヒーレンス・トモグラフィである、請求項49記載の方法。
- 前記画像化法は、スペクトル領域光コヒーレンス・トモグラフィおよび光学周波数領域画像化法の少なくとも一方である、請求項42記載の方法。
- 前記第2流体は実質的に透明な流体である、請求項47記載の方法。
- 前記画像化機構は所定の画像化法を利用し、且つ、
前記第2流体は上記画像化法により利用される放射線に対して実質的に透明である、請求項36記載の方法。 - 前記段階(b)は前記構造に関係付けられたデータを獲得する段階を更に備え、且つ、
当該方法は、(c)上記データの関数として前記流体送給機構および前記画像化機構の少なくとも一方を制御する段階を更に備えて成る、
請求項36記載の方法。 - 前記段階(c)は前記画像化機構の平行移動を制御する段階を備える、請求項54記載の方法。
- 前記段階(c)は前記流体送給機構の流体送給を制御する段階を備えて成る、請求項54記載の方法。
- 前記段階(c)は、前記画像化機構の平行移動および前記流体送給機構の流体送給を制御する段階を備えて成る、請求項56記載の方法。
- 前記制御下位段階は反復的に実施される、請求項57記載の方法。
- 反復の間において前記画像化機構は更に平行移動される、請求項57記載の方法。
- 反復の間において前記画像化機構は更に平行移動される、請求項57記載の方法。
- 前記段階(b)は反復的に実施されることで前記構造の異なる区画を表す一群の画像を生成する、請求項36記載の方法。
- 前記段階(c)は、前記一群の画像の内の各画像を該一群の画像の内の別の画像に対して関係付ける段階を更に備えて成る、請求項61記載の方法。
- 第1流体と接触する構造を画像化し得るソフトウェア機構であって、
a.処理機構により実行されたときに、流体送給機構を用いて所定体積の第2流体の一部を上記構造に対して局所的である領域へと送給することに関する情報を、上記処理機構に受信させるべく構成された第1群の命令と、
b.上記処理機構により実行されたときに、画像化機構を用いて上記構造の少なくとも一部分を画像化すべく構成された第2群の命令とを備え、
上記データは、画像化機構により獲得されたデータに関連し、
上記画像化機構には人工物が組み合わされ、且つ、
上記所定体積の第2流体の少なくとも一部分が上記構造に対して局所的である上記領域へと送給された後で上記構造を画像化する間、上記画像化機構および上記人工物の少なくとも一方は、表面の延長の軸心に略々対応する経路に沿い平行移動される、
ソフトウェア機構。
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US60413804P | 2004-08-24 | 2004-08-24 | |
US60/604,138 | 2004-08-24 |
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JP2013026897A Division JP5727531B2 (ja) | 2004-08-24 | 2013-02-14 | 血管セグメントを画像化する方法および装置 |
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US11278206B2 (en) | 2015-04-16 | 2022-03-22 | Gentuity, Llc | Micro-optic probes for neurology |
JP2018527995A (ja) * | 2015-08-31 | 2018-09-27 | ジェンテュイティ・リミテッド・ライアビリティ・カンパニーGentuity, LLC | 撮像プローブおよびデリバリデバイスを含む撮像システム |
US11064873B2 (en) | 2015-08-31 | 2021-07-20 | Gentuity, Llc | Imaging system includes imaging probe and delivery devices |
JP2021176552A (ja) * | 2015-08-31 | 2021-11-11 | ジェンテュイティ・リミテッド・ライアビリティ・カンパニーGentuity, LLC | 撮像プローブおよびデリバリデバイスを含む撮像システム |
US11583172B2 (en) | 2015-08-31 | 2023-02-21 | Gentuity, Llc | Imaging system includes imaging probe and delivery devices |
JP7404310B2 (ja) | 2015-08-31 | 2023-12-25 | ジェンテュイティ・リミテッド・ライアビリティ・カンパニー | 撮像プローブおよびデリバリデバイスを含む撮像システム |
US11937786B2 (en) | 2015-08-31 | 2024-03-26 | Gentuity, Llc | Imaging system includes imaging probe and delivery devices |
US11684242B2 (en) | 2017-11-28 | 2023-06-27 | Gentuity, Llc | Imaging system |
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JP2008510586A (ja) | 2008-04-10 |
EP2272421A1 (en) | 2011-01-12 |
EP2272420A1 (en) | 2011-01-12 |
US20110178398A1 (en) | 2011-07-21 |
JP5727531B2 (ja) | 2015-06-03 |
KR20070058523A (ko) | 2007-06-08 |
US9763623B2 (en) | 2017-09-19 |
JP2013106973A (ja) | 2013-06-06 |
EP1793731A1 (en) | 2007-06-13 |
US8208995B2 (en) | 2012-06-26 |
US9254102B2 (en) | 2016-02-09 |
JP2013106972A (ja) | 2013-06-06 |
WO2006024015A1 (en) | 2006-03-02 |
JP5324095B2 (ja) | 2013-10-23 |
EP2275024A2 (en) | 2011-01-19 |
US20060058622A1 (en) | 2006-03-16 |
EP2275024A3 (en) | 2011-05-04 |
EP2272420B1 (en) | 2013-06-19 |
KR20120062944A (ko) | 2012-06-14 |
EP1793731B1 (en) | 2013-12-25 |
US20120035454A1 (en) | 2012-02-09 |
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