RU2461355C2 - Method for evaluating angioarchitecture of orbital artery and its branches - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, ophthalmology. Lifetime ultrasound colour Doppler mapping is accompanied by frame recording of a part of orbital blood vessels. It enables making 4-6 frames with an ultrasound sensor inclined for each frame. The frames are digitised in Photoshop, overlapped to make a cover frame.

EFFECT: method provides forming a real-time lifetime angioarchitecture image of all the vessels found at the various levels in the orbit in the cover frame simultaneously.

5 dwg, 1 ex

Description

The present invention relates to the field of medicine, namely to ophthalmology.

A known method of studying the anatomy of the vessels of the orbit of the eye on cadaveric material (Sudakevich D.I. Architectonics of the intraocular blood supply system. M: Medicine. - 1971, p. 111). For this, an solution of ether-celloidin-cinnabar is injected through the internal carotid artery. After a day, i.e. after full fixation, the contents of the orbit together with the optical channel and cavernous sinus are removed and the type of branching is visually evaluated.

The disadvantages of this method include the fact that it is impossible to carry out in vivo determination of the architectonics of the orbital artery and its branches.

The closest in technical essence to the proposed one is a method of intravital ultrasound color dopplerographic mapping (CDL) of the eye vessels with registration in the image frame of part of the orbital blood vessel (Erikson SI, Hendrix LE, Massaro BM et al. // Radiology. - 1989. - Vol. 173. No. 11. - P.511-516).

Color Doppler mapping (CFM) allows you to display information on the speed of movement of structures in each of the image elements on the monitor screen. CFM mode allows you to see in real time in color a two-dimensional picture of blood flow. When a particular vessel is in the orbit of the eye, its image is fixed in the frame.

The disadvantages of this method include the fact that in the CDC mode it is technically impossible to achieve the simultaneous image of all orbital vessels, since the arteries are at different levels in the orbit. Ultrasound scanners allow you to fix on a single frame only part of a blood vessel.

The problem to which the invention is directed, is to develop a method for the intravital determination of angioarchitectonics of the orbital artery and its branches.

The technical result of the proposed method is the ability to obtain an accurate intravital image of the angioarchitectonics of all vessels located at different levels in the orbit of the eye, simultaneously.

The technical result is achieved by the fact that the method for determining the angioarchitectonics of the orbital artery and its branches is carried out by intravital ultrasound color dopplerographic mapping with registration in the frame of part of the orbital blood vessels of the eye.

Distinctive techniques of the proposed method are that they receive 4-6 frames, while the angle of inclination of the U3 sensor is changed for each frame. The resulting frames are digitized and superimposed on each other in the Photoshop program, combining into a common frame, i.e. carry out their merger.

From the analysis of patent and specialized literature, the authors found that the proposed technical solution has features that distinguish it not only from the prototype, but also from other technical solutions in this field of medicine. We have not found a method for intravital determination of the architectonics of the orbital artery and its branches, containing the distinctive techniques of the proposed method. These differences allow us to conclude that the claimed technical solution meets the criteria of the invention of "novelty."

The inventive method allows to achieve the technical result seen by the applicant and the authors, namely, to provide the ability to obtain an accurate intravital image of the angioarchitectonics of all the vessels of the eye’s orbit at the same time, i.e. on one frame. The author of the proposed method obtained 6 options for normal branching of blood vessels, which is completely consistent with the known data (Sudakevich D.I. Architectonics of the intraocular blood supply system, M .: Medicine. - 1971, p.24-31). The above allows us to conclude that the proposed method meets the criterion of "inventive step".

The method comprising the claimed invention is intended for use in healthcare. This method can be used in ophthalmology to study the orbital artery and its branches. The possibility of its implementation is confirmed by the methods and means described in the application, therefore, the proposed solution meets the criteria of the invention "industrial applicability".

The inventive method is as follows.

The study is carried out in the office of ultrasonic diagnostic methods with a 7.5 MHz sensor in the color dopplerographic mapping (CFM) mode. The patient is in a supine position, he is lubricated with a regular gel for ultrasound examination. With closed eyelids, the vessels of the orbit of the eye are found by the ultrasonic sensor of the ALOKA SSD-3500 scanner. The image of the orbital artery in the area of the optic opening of the sphenoid bone is carried out by transorbital access by localizing the siphon a.carotis int. at a depth of 7-8 cm and reducing the location zone to 4.5-5.5 cm. The blood stream from the sensor is encoded in red, the blood flow directed to the sensor in blue. The images of the GA and its branches obtained on the display were recorded on a VCR, then the frame recording was digitized and converted to DVD format. Processing of video products was carried out in the computer program Womble Multimedia MPEG wideo wizard DVD. Separate frames were selected for each patient, for each artery. The frames were arranged in separate folders with the names of the patients.

Further, separate frames of the arteries were superimposed on top of each other in the next computer program - Photoshop, which resulted in one frame that depicted the eyeball and orbital space with the vessels located there. As a result of this, an image of the orbital artery and its branches in orbit in one frame is obtained.

The essence of the proposed method for determining the angioarchitectonics of the orbital artery and its branches is illustrated by an example of a specific implementation.

Example 1. Patient Verkhoturova OI, 79 years old. Diagnosis: Open-angle glaucoma OUG IA. VIS (0.9 N / K).

On examination, the cornea of the right eye is transparent, the anterior chamber is of medium depth, the crystalline lens is transparent. The fundus: the optic nerve disc is pale pink with a pale tinge on the nasal side, the borders are clear, the ratio of excavation to the optic nerve disc = 0.5, the veins are slightly dilated, the arteriovenous ratio is 1: 2. Gonioscopy: the anterior chamber angle is open, there is an uneven redistribution of endopigment in the Schlemm canal. When color dopplerographic mapping appeared on the monitor screen, a window appeared in which: Peak systolic velocity (PSV), final diastolic velocity (EDV), Resistance Index (RI), Ripple Index (RI).

With UZDG on the right (PSV) in the orbital artery - 26.2 cm / s, (EDV) - 5.8 cm / s, (PI) - 1.708, (RI) - 0.809, (PSV) in the central retinal artery - 10, 1 cm / s, (EDV) - 2.7 cm / s, (PI) - 2,486, (RI) - 1,000, (PSV) in the study of the posterior short ciliary artery (SSCA) - 14.9 cm / s, (EDV ) - 3.6 cm / s, (PI) - 2.794, (RI) - 1.000, (PSV) in the study of the posterior long ciliary artery (ZDCA) - 18.9 cm / s, (EDV) - 3.1 cm / s, (PI) - 2,794, (RI) - 1,000.

Then, according to the proposed method, 4 frames of images of various sections of the orbital vessels were recorded:

- Frame No. 1 - Orbital artery (Figure 1);

- Frame No. 2 - Central retinal artery (Figure 2);

- Frame No. 3 - The posterior short ciliary artery (Figure 3);

- Frame No. 4 - The posterior long ciliary artery (Figure 4).

After combining these 4 frames in the Photoshop program, an exact intravital image of the angioarchitectonics of all vessels located at different levels in the orbit of the eye is obtained on one frame (Figure 5). The resulting combined image makes it possible to minimize the amount of blood loss during surgery in the orbit of the eye.

In total, according to the claimed method, 60 patients were examined in whom certain types of branching were established for various vascular pathologies of the eye. The author established the relationship between the types of branching of the orbital artery from vascular diseases of the eye.

Thus, the proposed method allows to obtain an intravital image of all orbital vessels in one frame. The proposed method is atraumatic, non-invasive, safe, highly reliable and can be used in any ophthalmic department equipped with appropriate equipment.

The proposed method can be used before and after surgical intervention in orbit in order to choose an approach to the vessels of the orbital space, minimizing the risk of damage to the vascular trunks.

Claims (1)

A method for determining angioarchitectonics of the ophthalmic artery and its branches by conducting intravital ultrasound color dopplerographic mapping with registration of part of the orbital blood vessels of the eye in the frame, characterized in that they receive 4-6 frames, while the angle of the ultrasound sensor is changed for each frame, the received frames are digitized and in the program "Photoshop" lay on top of each other, combining into a common frame.

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