RU2611905C2 - Device for training in diagnostics of pathology of internal organs by echo-contrast method - Google Patents

Device for training in diagnostics of pathology of internal organs by echo-contrast method Download PDF

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RU2611905C2
RU2611905C2 RU2015116589A RU2015116589A RU2611905C2 RU 2611905 C2 RU2611905 C2 RU 2611905C2 RU 2015116589 A RU2015116589 A RU 2015116589A RU 2015116589 A RU2015116589 A RU 2015116589A RU 2611905 C2 RU2611905 C2 RU 2611905C2
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tube
pathological
form
circuit
center
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RU2015116589A
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RU2015116589A (en
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Дарья Юрьевна Венидиктова
Алексей Васильевич Борсуков
Сергей Викторович Титов
Иван Александрович Тимашков
Алексей Викторович Ковалев
Татьяна Геннадьевна Морозова
Ирина Анатольевна Бузулукова
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Государственное бюджетное образовательное учреждение высшего профессионального образования "Смоленский государственный медицинский университет" Министерства здравоохранения Российской Федерации
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    • GPHYSICS
    • G09EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09BEDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine

Abstract

FIELD: medicine.
SUBSTANCE: invention relates to medical equipment and can be used for training specialists for echo-contrast ultrasound analysis and assessment of pathology of internal organs. Device comprises container with transparent elastic cover and system formed by bifurcations and fistulas tubes arranged in center at middle of height, diameter of which is reduced from 10 mm on periphery to 2 mm in center, with metering device at inlet and outlet shut-off valve by forming two independent circuits. One circuit is vascular reproducing blood supply of parenchymatous organs and it is made in form of pairwise connected series of elements formed by tubes connected in form of hexagon, formed by third-order bifurcations of vascular circuit supply tube and fistulas of first order of vascular circuit discharge tube. Second circuit is pathological simulating blood supply of pathological centers and it is made of two elements, formed by tubes connected in form of hexagon, formed by 2nd-order bifurcations of pathological circuit supply tube and fistulas of first order of pathological circuit discharge tube and arranged so, that their adjacent walls contact along entire length and movement of echo-contrast substance occurs in opposite directions. Blood supply of pathological centers is modelled in form of three tubular loops arranged on pathological circuit discharge tube. Loop, modelling aneurism, forms ellipsoid expansion in middle. Loop, modelling metastasis, is coiled tube in form of ball, wherein tube entering it passes in center of ball, and extends at its outer surface. Loop, modelling hemangioma is also coiled tube in form of ball, wherein tube entering it passes along external surface of ball, and projects from its center.
EFFECT: invention provides fast and simple method of training.
1 cl, 2 dwg

Description

The invention relates to medicine, namely to devices for training specialists in conducting echo-contrast ultrasound examinations and evaluating the pathology of internal organs, as well as for verifying the diagnostic effectiveness of echo-contrast drugs.

In the diagnosis of internal diseases, the use of echoconstraining of internal organs is known. Its essence is that echo-contrast preparations are injected intravenously, which within a certain time reach the organ of interest, and then, under ultrasonic monitoring, the existing pathology is detected. Currently, doctors are trained according to the traditional “mentor - student” scheme. An important stage of training is an independent assessment by a specialist of all phases (arterial, early venous and late venous) of contrast under ultrasound control. To obtain practical skills, a multiple procedure is required (up to 40 times), which takes a lot of time, because examination of one patient takes from 5 to 30 minutes. At the same time, one specialist can train no more than two people at a time. Thus, this training method requires well-trained personnel and a long time to develop professional skills.

There are no special devices and models for training specialists in the diagnosis of pathology of internal organs using echoconstraining in the available literature.

The technical result of the application of the invention is to simplify the teaching methodology and reduce the training time.

The essence of the invention lies in the fact that the proposed device for teaching the diagnosis of pathology of internal organs by echo cancellation, including a reservoir with a transparent elastic cap and placed in it at the middle of the height of the system formed by bifurcations and anastomoses of tubes, the diameter of which decreases from 10 mm on the periphery to 2 mm in the center, with a dispenser at the entrance and a lockable drain at the exit, forming two independent circuits in the center of the system, one of which, vascular, reproduces the blood supply to the parenchymal gans and is made in the form of a pairwise connected row of tubular hexagonal elements formed by third-order bifurcations of the supply tube of the vascular circuit and first-order fistulas of the discharge tube of the vascular circuit, and the second pathological circuit models the blood supply to pathological foci and is made in the form of two tubular hexagonal elements formed by bifurcations the second order of the supply tube of the pathological contour and the anastomoses of the first order of the discharge tube of the pathological contour and mutual arranged in such a way that their adjacent walls are in contact along the entire length, and the movement of the echocontrast substance in them goes in opposite directions, and the blood supply to the pathological foci is modeled in the form of three tubular loops on the discharge tube of the pathological contour, while the loop simulating an aneurysm forms an ellipsoid in the middle expansion, the loop modeling the metastasis forms a ball, the tube entering it goes to the center of the ball, and the exit - along its outer surface, and the loop modeling the hemangioma, also forms a ball, but the tube entering it goes along the outer surface of the ball, and the one coming out from its center.

In addition, the vascular contour has the ability to rotate along the axis, and the pathological one is fixed in the reservoir.

Another difference of the device is that the height of the reservoir should be greater than the length of the vascular circuit.

Tubular hexagonal elements of the device, their design, the diameter of the tubes and the relative position clearly reproduce the blood supply to the parenchymal organs and pathological foci. An elastic cap is required to create congruent contact with an ultrasonic ultrasound transducer. The location of the system inside the reservoir and the ratio of the lengths of the vascular contour to the height of the reservoir are due to the need to rotate the vascular contour. The proposed design of the device as a whole allows you to quickly and easily learn to recognize the features of blood flow through blood vessels, as well as the angioarchitectonics of pathological lesions such as aneurysm, metastasis, hemangioma during ultrasound examination of patients using echo-contrast drugs.

The invention is illustrated by figures, where in figure 1 presents a General view of the device, in figure 2 - model of pathological lesions.

The proposed device consists of a tank 1 with a transparent elastic cap 2, for example, in the form of a polyethylene film fixed in a rubberized loop worn on the tank 1. The tank 1 has a pair of holes on opposite walls for fixing the tube system inside and feeding an echo-contrast substance into it . System mounting holes are level

Figure 00000001
tank heights 1. The tube system is formed by bifurcations and anastomoses of tubes, the diameter of which uniformly decreases from 10 mm in the periphery to 2 mm in the center. The tube system has an inlet 3 for supplying an echo-contrast material, equipped with a tap, and a drain in the form of an outlet pipe 4 with a tap. The tube system consists of two independent closed circuits A and B, each of which is connected to the input 3 by means of a common bifurcating supply tube 5, one branch 6 of which feeds circuit A, and the other 7 - circuit B. Circuit A, conditionally called vascular, is a model blood supply to the parenchymal organs and consists of four tubular elements of hexagonal shape 8 formed by third-order bifurcations of the supply tube 9 of circuit A and the first-order fistulas of the discharge tube 10 of circuit A. Elements 8 are interconnected by pop By means of second-order bifurcation of the supply tube 9 of circuit A on one side and the second-order anastomosis of the outlet pipe 10 of circuit A. The discharge tube 10 of circuit A forms a third anastomosis by means of which circuit A is connected to a common discharge pipe 11 for both circuits having an outlet pipe 4 and a tap for draining the echo contrast material. The vascular circuit A is installed in the tank 1 in such a way that its imaginary axis passes through the branch 6 of the common supply tube 5 and the third anastomosis of the common outlet tube 10 and has the possibility of rotation along the axis. Rotation along the axis is provided by couplings 12 mounted on the end of the branch 6 of the common supply tube 5 and on the end of the common outlet tube 11 connected to the circuit A. The couplings 12 enter the corresponding holes of the tank 1, located opposite each other, fixedly connected to the circuit A and freely rotate at the end of branch 6 of the common supply tube 5 and at the end of the common outlet tube 11. Circuit B, conditionally called pathological, reproduces the blood supply to three pathological foci: a capillary aneurysm, which has the form of an ellipsoid expansion , Metastasis vascular tumors deep entrance and exit at the outer surface thereof, and hemangioma, characterized by receptacles for input and output of the outer surface - from its middle. Circuit B consists of two tubular elements of hexagonal shape 13 and 14, formed by the bifurcation of the second level of the supply tube 15 of circuit B and located relative to each other so that their adjacent walls are in contact along the entire length and the movement of the echo-contrast material in them goes in opposite directions, simulating venous and arterial blood supply. Each of the hexagonal elements 13 and 14 of circuit B is connected to a common outlet pipe 11 for both circuits by means of a second-order infusion of outlet pipe 16 of circuit B. Blood supply to the pathological lesions is modeled on the discharge pipe 16 of circuit B in the form of three tubular loops. The loop simulating aneurysm 17 forms an ellipsoid extension in the middle. The loop simulating metastasis 18 forms a tangle, where the tube 19 entering into it deepens into the middle of the tangle, and the exit 20 goes along its outer surface. The loop simulating hemangioma 21 also forms a ball, but the tube 22 entering it goes along the outer surface of the ball, and the exit 23 goes deep into the middle.

The preferred tank size is 30 × 20 × 15 cm. The tube system is mounted at approximately the same level.

Figure 00000002
heights, so that when the contour A is in a vertical position, it remains immersed in the gel for ultrasound examination.

For the manufacture of hard plastic can be used. The tube system can be made of a transparent, flexible, plastic material (PVC), and can also be made by 3D printing. The preferred inner diameter of the tubes for models of pathological lesions is 1.5 mm, the wall thickness is 1 mm. As a reservoir lid, it is preferable to use a film stretched over the frame to create good contact between the ultrasound sensor and the surface.

To teach the diagnosis of pathology of internal organs using echoconstraining, reservoir 1 with a system of tubes is filled with gel for ultrasound studies. The gel should cover both contours and the contour in an upright position. The tank 1 is covered with a transparent cover 2 to create a contact surface for the ultrasonic sensor. Using a syringe or an automatic dispenser, an echo-contrast agent in an amount of 1 to 4.5 ml is fed into the system through a tap at the inlet 3, adjusting the speed and frequency of delivery depending on the purpose of the training. An automatic dispenser allows you to apply the drug at a speed of arterial (about 500 mm / s), venous (about 150 mm / s) or capillary (about 1 mm / s) blood flow. Through a common supply tube 5, the echo-contrasting substance, being divided into two streams, enters the circuit A and circuit B, and then, continuing to separate into separate streams, fills the lumen of the tubes of the hexagonal elements 8,13 and 14, after which the drug enters the system of the outlet tubes 10 , 11 and 16. Passing through the discharge tube 16, the drug fills in the models of pathological formations: aneurysm 17, metastasis 18 and hemangioma 21 and enters the common excretory tube 11, and from there to the discharge outlet 4. In this case, the flow of the drug in the adjacent walls of the heck agonal elements 13 and 14 of circuit B comes in opposite directions, thereby simulating venous and arterial blood flow parenchymal organs. If necessary, for better visualization, the vascular circuit A can be rotated around its axis at any angle and 360 ° by rotating the sleeve 12. The ultrasound probe is mounted on the elastic cap 2 in the position necessary for the best visualization (longitudinal, transverse, diagonal) in the tube section of interest system. At the same time, the ultrasound apparatus monitor shows how the echo-contrast substance moves in the tube system that simulates the blood supply to the parenchymal organs during the three phases of echocontrast (arterial, early venous and late venous). At the end of the operation, the drain valve 4 is moved to the open position, the echo-contrast substance is drained from the device under the influence of gravity and high-speed pulse. In case of poor drainage, it is possible to remove the echo-contrast drug from the system by means of a syringe connected to the opening of the drain valve 4.

In addition, the device allows you to evaluate the diagnostic effectiveness of echo-contrast drugs by criteria such as the visibility of the substance on the ultrasound apparatus, flow rate, the possibility of creating a laminar and turbulent fluid flow. Laminar and turbulent fluid flow in the system is created by changing the frequency and feed rate of the echo-contrast substance.

Working with the model provides the following knowledge and skills.

Skill of quick selection of ultrasound scanning mode for optimal visualization of various pathologies; the skill of differential diagnosis between artifacts that occur during fluid movement and Doppler signals; comparison of the received image in real time by a specialist doctor with a conditional data bank; training of manual skill within the framework of the “hand-sensor-monitor-eye” system.

The use of the proposed device provides the following advantages:

- allows you to quickly learn how to adequately assess the three phases of echoconstraining (arterial, early venous and late venous) on a phantom that fully reproduces the contrasting phases of the pathology of the internal organs of a person, using various parameters of the contrasting phases (speed, direction, shape of the tube-vessels);

- allows you to evaluate the diagnostic effectiveness of echo-contrast drugs.

Claims (2)

1. A device for teaching the diagnosis of pathology of internal organs by echo contrast, characterized in that it contains a reservoir with a transparent elastic cap and placed in it in the center at the middle of the height of the system, formed by bifurcations and anastomoses of tubes, the diameter of which decreases from 10 mm on the periphery to 2 mm in the center, with a dispenser at the entrance and a shut-off valve at the exit, forming two independent circuits, one of which, the vascular, reproduces the blood supply to the parenchymal organs and is made in the form of paired a connected series of elements formed by tubes connected in the form of hexagons formed by third-order bifurcations of the supply tube of the vascular circuit and first-order fistulas of the discharge tube of the vascular circuit, and the second pathological circuit models the blood supply to pathological foci and is made in the form of two elements formed by tubes connected in the form of hexagons formed by second-order bifurcations of the supply tube of the pathological contour and first-order fistula of the abduction trumpet the tubes of the pathological contour and arranged in such a way that their adjacent walls are in contact throughout, and the movement of the echocontrast substance occurs in opposite directions, while the blood supply to the pathological foci is modeled in the form of three tubular loops placed on the discharge tube of the pathological contour, a loop simulating an aneurysm, forms an ellipsoid expansion in the middle, a loop simulating metastasis is folded from a tube in the form of a coil, and the tube entering it passes into the center of the coil And exiting - on its outer surface, and the loop simulating hemangioma, also rolled out of the tube as the coil, and part of it passes through the tube outer surface of the coil, and is exiting from its center.
2. The device according to p. 1, characterized in that the vascular circuit is installed in the reservoir with the possibility of rotation, and the pathological - motionless.
RU2015116589A 2015-04-29 2015-04-29 Device for training in diagnostics of pathology of internal organs by echo-contrast method RU2611905C2 (en)

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU849287A1 (en) * 1979-10-08 1981-07-23 Винницкий Медицинский Институтим. H.И.Пирогова Educational model for demonstrating blood circulation in vessels
SU1599882A1 (en) * 1988-06-08 1990-10-15 Харьковский научно-исследовательский институт терапии Device for modeling echo-cardiographic signals
US6039573A (en) * 1995-12-21 2000-03-21 Schering Aktiengesellschaft Portable apparatus for simulating ultrasonic examinations
UA20549U (en) * 2006-09-28 2007-01-15 Oleh Borysovych Dynnyk Simulator for the ultrasonic visualization of redistribution of blood flow in splanchnic vessels
US20140004488A1 (en) * 2011-03-17 2014-01-02 Mor Research Applications Ltd. Training, skill assessment and monitoring users of an ultrasound system

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU849287A1 (en) * 1979-10-08 1981-07-23 Винницкий Медицинский Институтим. H.И.Пирогова Educational model for demonstrating blood circulation in vessels
SU1599882A1 (en) * 1988-06-08 1990-10-15 Харьковский научно-исследовательский институт терапии Device for modeling echo-cardiographic signals
US6039573A (en) * 1995-12-21 2000-03-21 Schering Aktiengesellschaft Portable apparatus for simulating ultrasonic examinations
UA20549U (en) * 2006-09-28 2007-01-15 Oleh Borysovych Dynnyk Simulator for the ultrasonic visualization of redistribution of blood flow in splanchnic vessels
US20140004488A1 (en) * 2011-03-17 2014-01-02 Mor Research Applications Ltd. Training, skill assessment and monitoring users of an ultrasound system

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Effective date: 20170430