NL1043064B1 - "methods and devices for imaging pulmonary and/or cardiac vasculature" - Google Patents
"methods and devices for imaging pulmonary and/or cardiac vasculature" Download PDFInfo
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- NL1043064B1 NL1043064B1 NL1043064A NL1043064A NL1043064B1 NL 1043064 B1 NL1043064 B1 NL 1043064B1 NL 1043064 A NL1043064 A NL 1043064A NL 1043064 A NL1043064 A NL 1043064A NL 1043064 B1 NL1043064 B1 NL 1043064B1
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- gas
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- pulmonary
- lead
- mri
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
- A61B5/004—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part
- A61B5/0044—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part for the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0263—Measuring blood flow using NMR
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0275—Measuring blood flow using tracers, e.g. dye dilution
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/007—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests for contrast media
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/844—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents folded prior to deployment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M2005/006—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests for gases, e.g. CO2
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Public Health (AREA)
- Engineering & Computer Science (AREA)
- Physics & Mathematics (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Pathology (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biophysics (AREA)
- Radiology & Medical Imaging (AREA)
- Hematology (AREA)
- Cardiology (AREA)
- Physiology (AREA)
- Vascular Medicine (AREA)
- High Energy & Nuclear Physics (AREA)
- Anesthesiology (AREA)
- Magnetic Resonance Imaging Apparatus (AREA)
Abstract
The present invention relates to methods and devices for imaging pulmonary and/or cardiac vasculature. In particular, a medical electrical lead for delivering noble gases to the pulmonary and/or cardiac vasculature of the patient, an imaging system, a gas delivery instrument, a method for MR imaging and a computer program product are provided.
Description
METHODS AND DEVICES FOR IMAGING PULMONARY AND/OR CARDIAC VASCULATURE
Field of the Invention
[001] The present invention relates to improvements of images produced by magnetic resonance imaging (MRI).
Background of the Invention
[002] Conventionally, MRI has been used to produce images by exciting the nuclei of hydrogen molecules (present in water protons) in the human body. However, such conventional MR images do not always provide clinically useful imaging results, especially if body portions such as pulmonary and/or cardiac vasculature are to be imaged.
Objects and Summary of the Invention
[003] In order to improve the quality of the imaging, it was recently discovered that polarized noble gases (for example polarized 3He or 129Xe) dissolved in the body portion to be imaged enable better results due to higher MRI signal intensity. In the context of the present patent application, polarized 129Xe will be referred to as 129Xe.
[004] Such dissolved phase imaging has proven to be challenging. However, we have found that good clinical results can be achieved if the 129Xe dissolved in the body portion to be imaged is excited by means of radio frequency (RF) pulses.
[005] It is an aspect of the present invention to provide devices and methods which help to obtain useful images of dissolved 129Xe in the pulmonary and/or cardiac vasculature.
[006] One aspect of the application refers to a medical electrical lead for delivering 129Xe to the pulmonary and/or cardiac vasculature of a patient (a human or an animal), said lead comprising an elongate body having a distal tip region, and said distal tip region including a gas outlet.
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[007] Preferably, a fixation element, such as a stent structure, is provided to hold the distal tip region with the gas outlet in place. However, there may be other measures for keeping the distal tip region in the desired position. The fixation element is, for example, a substantially radially expandable structure adapted to be convertable from a radially collapsed configuration to a radially expanded configuration. In an alternative embodiment the distal tip of the lead is held in place by an anchor comprising radial needles.
[008] A further aspect relates to the above lead, wherein the radially expandable structure includes a biocompatible coating.
[009] A further aspect relates to the radially expandable structure being MRI-safe. In the context of the present patent application, MRI-safe shall mean that the health of the patient having the lead inserted in a cardiac vessel is not placed at risk by strong magnetic fields of the MRI unit.
[010] The main purpose of the lead is to be inserted into a cardiac vessel and to emit gas, this being 129Xe. The fixation element ensures that the tip of the lead is held in place and that the gas outlet remains in the same position throughout the procedure.
[011] A further aspect of the invention relates to an imaging system comprising the above medical electrical lead as well as an MRI unit for generating an MR image of the pulmonary and/or cardiac vasculature of a patient. Moreover, the system includes an RF unit for exciting dissolved-phase 129Xe using at least one RF pulse. Finally, a controller is provided, which is configured to control the flow of 129Xe emitted by the gas outlet, excite RF pulses, and subsequently generate MR images.
[012] A further aspect of the invention is directed to a method for obtaining MR images using dissolved 129Xe. The method preferably includes positioning a patient in an MRI apparatus having a magnetic field associated therewith. 129Xe gas is delivered to the pulmonary region of the patient's body. Preferably, the 129Xe is inhaled, and due to the relatively high solubility of 129Xe, the inhaled 129Xe gas enters the body in the lung air
187KA 2559 spaces in a relatively short period of time and either exists in the lung space as a gas and/or a gas that dissolves into adjacent vasculature, tissues, spaces, or organs. Thus, the solubility of 129Xe in the body is such that it generates a hyperpolarized dissolved imaging phase. A predetermined region (i.e . a region of interest) of the patient's body, which has a portion of the dissolved phase 129Xe therein, is excited using an RF excitation pulse. At least one MR image associated with the dissolved phase 129Xe is acquired after said excitation pulse.
[013] Especially if images of the cardiac vasculature are to be acquired, it is also possible to directly deliver 129Xe gas to the predetermined region of the patient's body by injection into the heart tissue and/or by emitting gas through the tip of the medical lead described above.
[014] A further aspect relates to the detection of ischemia and/or a myocardial infarction of the patient.
[015] The application also relates to a computer program product that includes a medium readable by a controller, the medium having stored thereon instructions for the above imaging system for emitting gas through a lead into the patient's body, applying RF pulses to the body portion in which said gas is dissolved and producing images of said portion, comprising: a first sequence of instructions which, when executed by the controller, triggers a signal for opening a gas valve for emitting gas through the tip of the lead, and a second sequence of instructions which, when executed by the controller, causes RF pulses to be applied to the body portion in which said gas is dissolved, and a third sequence generating MR images of said portion.
Brief Description of the Drawings
Figure la is a flowchart showing the general concept of the invention;
Figure lb is a schematic diagram of the human body illustrating the dissolution of 129Xe, application of RF pulses and subsequent MR imaging according to the method of the present invention;
Figure 2a shows a medical lead, which is inserted into the cardiac vasculature (in the unexpanded state); and
187KA 2559
Figure 2b shows the medical lead of Fig. 2a inserted into the cardiac vasculature (in the expanded state and during emission of gas through the tip of the lead).
Detailed Description of Embodiments
[016] Fig. la shows the general concept of the invention:
Step 1: 129Xe is delivered to the patient by inhalation or injection and the 129Xe is dissolved in portions of the patient's body;
Step 2: RF pulses are emitted to the portions of the patient's body which contain dissolved 129Xe; this results in excitation of the dissolved 129Xe; and
Step 3: MR images of the body portions containing the excited dissolved 129Xe are acquired.
[017] As shown in Fig. lb, subsequent to inhalation, at least a portion of 129Xe enters into a dissolved state such that it enters the pulmonary vasculature, including the boundary tissue, cells, membranes.
[018] Furthermore, Fig. lb also shows an MRI unit for generating an MR image of the pulmonary and/or cardiac vasculature. It also shows an RF unit for exciting dissolved-phase 129Xe using at least one RF pulse. Furthermore, a controller (not shown) for controlling the flow of gas emitted by the gas outlet of the lead (and/or an inhalation machine for providing 129Xe), for exciting RF pulses, and for subsequently generating MR images, is shown.
[019] After positioning a patient in the MRI unit having a magnetic field associated therewith, and delivering 129Xe gas to a predetermined region of the patient's body, according to the invention, dissolved-phase 129Xe is excited in the pulmonary and/or cardiac vasculature using at least one RF excitation pulse, and subsequently at least one MR image associated with a dissolved-phase polarized gas is acquired.
[020] As said above, it is also possible to directly deliver 129Xe to a region of the heart (such as via injection into the left ventricular muscle) so as to image the perfusion of the heart.
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Delivery directly to the right atrium/ventricle can allow perfusion imaging of the return side of the heart. In any event, 129Xe delivery can be via injection of various phases such as, but not limited to, gaseous, dissolved, or liquid phase.
[021] Conventional image perfusion methods for this area employ radioactive tracers. The use of 129Xe, which is an inert noble gas, can beneficially replace radioactive tracers, which may expose the subject to potentially dangerous elements.
[022] Fig. 2a shows the distal tip region of a lead 2 inserted into the cardiac vasculature 1 prior to acquiring MR pictures from the patient shown in Fig. lb.
[023] As soon as the distal tip region is in place, the radially expandable structure 3 is converted from the collapsed state thereof into an expanded state, as shown in Fig. 2b. This can be achieved by pulling a tendon 5 with a certain force (see F in Fig. 2b).
[024] The gas outlet 4 is placed at the distal most part of the lead. The gas bubbles shown in Fig. 2b (at the right of Fig. 2b) emitted therefrom then dissolve in blood and allow for images of high quality to be acquired as outlined above.
[025] Other applications of the present invention include, but are not limited to: identification and assessment of the presence or absence and/or severity of cardiac ischemias and/or infarctions; localization and assessment of thrombi and plaque.
187KA 2559
The invention also relates, inter alia, to the following aspects:
1. A medical electrical lead for delivering noble gases to the pulmonary and/or cardiac vasculature of a patient, the lead having a distal tip region including: a gas outlet; and a fixation element including a substantially radially expandable structure adapted to be convertible from a radially collapsed configuration to a radially expanded configuration.
2. The lead of aspect 1, wherein the distal tip of the lead is held in place by an anchor comprising radial needles.
3. The lead of aspect 1, wherein the radially expandable structure includes a biocompatible coating.
4. The lead of aspect 1, wherein the radially expandable structure is MRI-safe.
5. An imaging system comprising:
a medical electrical lead for delivering 129Xe to the pulmonary and/or cardiac vasculature of a patient; the lead having a distal tip region including: a gas outlet and a fixation element, the fixation element including a radially expandable structure adapted to be convertible from a radially collapsed configuration to a radially expanded configuration; and an MRI unit for generating an MRI image of the pulmonary and/or cardiac vasculature of the subject;
an RF unit for exciting dissolved-phase 129Xe using at least one RF pulse and a controller for controlling the flow of 129Xe emitted by the gas outlet of the lead, for exciting RF pulses and for subsequently generating MR images.
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6. A gas delivery instrument configured to transport and emit noble gas to a body conduit including an extruded body comprising a stent-like mechanism to provide stable positioning within the conduit by exerting pressure on the conduit.
7. A method for MR imaging of the pulmonary and/or cardiac vasculature using dissolved-phase 129Xe , comprising the steps of:
positioning a patient in an MRI apparatus having a magnetic field associated therewith;
delivering 129Xe gas to a predetermined region of the patient's body, exciting dissolved-phase 129Xe in the pulmonary and/or cardiac vasculature using at least one RF excitation pulse, and acquiring at least one MRI image associated with the dissolved phase 129Xe after said excitation pulse.
8. The method of aspect 7, further comprising the step of identifying one or more of: (a) detection of ischemia or (b) a myocardial infarction of the patient.
9. A computer program product that includes a medium readable by a controller, the medium having stored thereon instructions for emitting gas through a lead into the patient's body, applying RF pulses to the body portion in which said gas is dissolved and producing images of said portion, comprising:
a first sequence of instructions which, when executed by the controller, triggers a signal for opening a gas valve for emitting gas through the tip of the catheter, a second sequence of instructions which, when executed by the controller, causes RF pulses to be applied to the body portion in which said gas is dissolved, and a third sequence generating MRI images of said portion.
Claims (9)
Priority Applications (1)
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NL1043064A NL1043064B1 (en) | 2018-10-31 | 2018-10-31 | "methods and devices for imaging pulmonary and/or cardiac vasculature" |
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NL1043064A NL1043064B1 (en) | 2018-10-31 | 2018-10-31 | "methods and devices for imaging pulmonary and/or cardiac vasculature" |
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NL1043064B1 true NL1043064B1 (en) | 2020-06-02 |
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Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1188417A2 (en) * | 2000-09-07 | 2002-03-20 | Heartport, Inc. | Method and apparatus for delivery of therapeutic agents to the heart |
US20040143179A1 (en) * | 2000-03-13 | 2004-07-22 | Bastiaan Driehuys | Diagnostic procedures using direct injection of gaseous hyperpolarized 129Xe and associated systems and products |
DE10324365A1 (en) * | 2003-05-27 | 2005-01-05 | Forschungszentrum Jülich GmbH | Device with a space for receiving hyperpolarized noble gas |
DE10324353A1 (en) * | 2003-05-27 | 2005-01-13 | Forschungszentrum Jülich GmbH | Method for transporting a hyperpolarized noble gas |
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Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040143179A1 (en) * | 2000-03-13 | 2004-07-22 | Bastiaan Driehuys | Diagnostic procedures using direct injection of gaseous hyperpolarized 129Xe and associated systems and products |
EP1188417A2 (en) * | 2000-09-07 | 2002-03-20 | Heartport, Inc. | Method and apparatus for delivery of therapeutic agents to the heart |
DE10324365A1 (en) * | 2003-05-27 | 2005-01-05 | Forschungszentrum Jülich GmbH | Device with a space for receiving hyperpolarized noble gas |
DE10324353A1 (en) * | 2003-05-27 | 2005-01-13 | Forschungszentrum Jülich GmbH | Method for transporting a hyperpolarized noble gas |
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