JP2018522703A - 血管内データ視覚化方法 - Google Patents
血管内データ視覚化方法 Download PDFInfo
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Abstract
Description
この出願は、2015年7月25日に出願された米国仮出願第62/196,997号からの35U.S.C.119(e)の下の優先権の利益を請求し、その前文を本明細書中に参照として援用する。
本開示は、概して、血管内測定及び特徴検出並びに関連する診断方法及びデバイスに関する。
トグル制御、ダイヤル、及び数値的な選択入力から成る群から選択される。
図面は必ずしも原寸通りでなく、代わりに強調が例示的な原理の上に概ね置かれている。図面は全ての態様において例示的であると考えられるべきであり、本開示を限定することを意図せず、その範囲は特許請求の範囲によってのみ定められる。
1つの態様では、血管内治療部位を評価するための最適な三次元視覚化を創り出すためのコンピュータ実装方法が提供される。様々な実施形態において、本方法は、側枝形態学に基づいて最適なカメラ場所及び視点(view perspective)を自動的に決定して、治療部位の視覚化を容易にする。本方法は、医療デバイス(例えば、ステント)及び関連する配置デバイス(例えば、ガイドワイヤ)の検出を含むことができる。この特徴は、拘束された側枝を特定し且つ臨床医がステント細胞を変更して閉塞(obstructions)を緩和するのを助ける、分岐ステント留め(stenting)に特に有用である。本明細書に記載する1以上のステップを実行する血管内データ収集システムのソフトウェアモジュール67を使用して、側枝、ガイドワイヤ及び血管内データ視覚化の他の形態に関して本明細書に記載する様々な方法を実施することができる。
多数のガイドワイヤが使用される他の実施形態において、ガイドワイヤは、それぞれ、異なる色で示されてよく、或いは、ガイドワイヤは、色によって分類されてよい。例えば、側枝ガイドワイヤは1つの色で示されてよく、主血管ガイドワイヤは他の色で示されてよい。他の実施形態では、ガイドワイヤが主血管内腔を横切る場合には、ガイドワイヤを1つの色で示すことができ、側枝を横切る同じガイドワイヤの部分を異なる色で示すことができる。他の実施形態では、ガイドワイヤが側枝口を横切る場合又はガイドワイヤがステント細胞を通過する場合に、ガイドワイヤを異なる色で示すことができる。
本発明は、枝閉塞(branch obstruction)の程度を計算し且つ可視化するコンピュータ実装方法も提供する。病理(例えば、狭窄)又は医学的介入(例えば、拘束)の存在に起因する枝遮断を計算するために幾つかの方法を用いることができる。
本明細書に記載するシステム及び方法は、タンデム病変/びまん性疾患のような他の複雑な状態についての分岐、BVS、VFRのための特定の臨床応用に関連する介入前後の撮像ニーズを支援する診断情報を提供する。これらの実施形態は、以下の特徴を含む。
● フライスルー、縦方向及び枝ビューの3Dオプション
● BVS処置の考慮事項についてのOCT使用及びステント検出
● 分岐ケースのための超高解像度プルバック
● 多数の3D表示オプションに加えた3D上の独立したワイヤ選択
● ステント並置マッピングインジケータ;360度評価のためのステータスバーの追加
● 赤色/黄色についての並置指示範囲及びそれらの範囲を調整するカスタマイズ能力
● 様々なユーザインターフェース設計要素
並置閾値のようなステント並置値を確立するプロセスは、血管内診断システムの1人のエンドユーザと他のエンドユーザとで異なることがある。エンドユーザは、図15A、図15B、及び図15Cに示すようなインターフェースを用いてステントについての並置閾値を調整することができる。図15Aにおいて、ステント並置値を調整するためのユーザインターフェースは、OCTシステムのグラフィックユーザインターフェースに対して示されている。このインターフェースをIVUS及び他の撮像モダリティに使用することができる。点線によって示すステント支柱は、変更可能な特徴として1以上の表面に又はステント支柱に延びることができる矢印を有する。これは、並置が、ユーザが関心を有するものとして支柱上の又は支柱内の場所に対して特定されるのを可能にする。図15A及び図15Bにおいて、並置レベルを評点する或いは特定する3つのレベル又は閾値は、0〜200ミクロン、200〜300ミクロン、及び300〜600ミクロンの間にある。図15Bに示すように、示される3つの有色バーは、3つの並置閾値を設定されるのを可能にする。これらの閾値は、ステントの並置がいつどのように表示されるかを制御する。支柱並置距離は、ステント支柱及び内腔輪郭に対する図中の両頭矢印によって示されている。
以下の記述は、本明細書に記載の開示の方法を実行するのに適したデバイスハードウェア及び他の動作コンポーネントの概要を提供することを意図している。この記述は、開示の適用可能な環境又は範囲を限定することを意図しない。同様に、ハードウェア及び他の動作コンポーネントは、上述の装置の部分として適切なことがある。パーソナルコンピュータ、マルチプロセッサシステム、マイクロプロセッサベースの又はプログラム可能な電子デバイス、ネットワークPC、ミニコンピュータ、メインフレームコンピュータ、及び同等物を含む、他のシステム構成で、本開示を実施することができる。タスクがカテーテル又はカテーテル検査室の異なる部屋のような通信ネットワークを通じてリンクされる遠隔処理装置によって実行される分散コンピューティング環境においても本開示を実施することができる。
Claims (20)
- 血管内データ収集プローブを用いて得られる血管内情報を視覚化する方法であって、
複数の画像フレームを含む、血管についての血管内データを受信するステップと、
血管内データ収集システムのメモリデバイス内に前記血管内データを格納するステップと、
画像フレーム毎ベースで1つ又はそれよりも多くの側枝を検出するステップと、
画像フレーム毎ベースで内腔を検出するステップと、
前記側枝又は内腔のうちの少なくとも一方について第1の視角を決定するステップと、
前記側枝又は内腔のうちの少なくとも一方について三次元視覚化を表示するステップとを含む、
方法。 - 前記内腔は、内腔境界である、請求項1に記載の方法。
- 前記側枝又は内腔のうちの少なくとも一方に関する三次元フライスルーを表示するステップを更に含む、請求項1に記載の方法。
- 前記血管内データは、光コヒーレンス断層撮影データである、請求項1に記載の方法。
- 各画像フレームは、走査線のセットを含む、請求項4に記載の方法。
- 複数のステント支柱を検出するステップを更に含む、請求項1に記載の方法。
- 1つ又はそれよりも多くのガイドワイヤを検出するステップを更に含む、請求項1に記載の方法。
- 前記複数のステント支柱について第2の視角を決定するステップを更に含む、請求項6に記載の方法。
- 前記1つ又はそれよりも多くのガイドワイヤについて第3の視角を決定するステップを更に含む、請求項7に記載の方法。
- 前記三次元視覚化は、前記第1の視角で方向付けられる、請求項1に記載の方法。
- 前記三次元フライスルーは、入力デバイスを用いて1つ又はそれよりも多くの方向においてユーザ制御可能である、請求項3に記載の方法。
- 内腔輪郭の側枝円弧を決定するステップと、側枝円弧によって制約されるシリンダを適合させることによって側枝向きを推定するステップと、適合させられるシリンダの向きを選択するステップとを更に含む、請求項1に記載の方法。
- 血管内データの画像フレームの中間フレームを決定するステップと、前記中間フレーム上の中間円弧位置を決定するステップと、前記中間フレームのために血管内撮像プローブに向かって方向付けるよう三次元ビューについての初期カメラ位置を設定するステップとを更に含む、請求項1に記載の方法。
- ユーザ入力に基づいてステント並置閾値を制御するためのプロセッサベースのシステムであって、
1つ又はそれよりも多くのメモリデバイスと、
該1つ又はそれよりも多くのメモリデバイスと通信するコンピューティングデバイスとを含み、
前記1つ又はそれよりも多くのメモリデバイスは、前記コンピューティングデバイスによって実行可能な指令を含み、
該指令は、前記コンピューティングデバイスに、
ユーザ選択可能な入力を含むステント支柱並置閾値制御装置を含むユーザインターフェースを表示させ、
前記1つ又はそれよりも多くのメモリデバイスにユーザ入力ステント並置閾値を格納させ、
血管内プローブを用いて収集される血管内データセット内で1つ又はそれよりも多くのステントを検出させ、
前記1つ又はそれよりも多くのステント及び前記1つ又はそれよりも多くのステントと関連付けられる1つ又はそれよりも多くの印を表示させ、
前記印は、ステント支柱並置のレベルを表示し、該ステント支柱並置のレベルは、前記ユーザ選択可能な入力を用いて決定される、
プロセッサベースのシステム。 - 前記ステント支柱並置閾値制御装置は、スライダである、請求項14に記載の方法。
- 前記ユーザ選択可能な入力は、前記スライダの1つ又はそれよりも多くの値である、請求項15に記載の方法。
- 前記印は、1つ又はそれよりも多くの色である、請求項14に記載の方法。
- 前記スライダは、3つの並置閾値を定めるように構成される、請求項14に記載の方法。
- 前記ステント支柱並置閾値制御装置は、ステント支柱の前面に対するステント支柱並置を測定する、請求項1に記載の方法。
- 前記ステント支柱並置閾値制御装置は、フォーム充填可能なフィールド、ボタン、トグル制御装置、ダイヤル、及び数値的な選択入力から成る群から選択される、請求項1に記載の方法。
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