WO1993016639A1 - Device for creating a tridimensional mark integral with the head of a patient - Google Patents

Device for creating a tridimensional mark integral with the head of a patient Download PDF

Info

Publication number
WO1993016639A1
WO1993016639A1 PCT/FR1993/000164 FR9300164W WO9316639A1 WO 1993016639 A1 WO1993016639 A1 WO 1993016639A1 FR 9300164 W FR9300164 W FR 9300164W WO 9316639 A1 WO9316639 A1 WO 9316639A1
Authority
WO
WIPO (PCT)
Prior art keywords
patient
head
arms
sole
cross
Prior art date
Application number
PCT/FR1993/000164
Other languages
French (fr)
Inventor
Nicholas Daly
Martine Delannes
Jacques Bonnet
Alphonse Petitjean
Original Assignee
Beverly
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Beverly filed Critical Beverly
Publication of WO1993016639A1 publication Critical patent/WO1993016639A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/50—Clinical applications
    • A61B6/501—Clinical applications involving diagnosis of head, e.g. neuroimaging, craniography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/08—Auxiliary means for directing the radiation beam to a particular spot, e.g. using light beams
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods

Definitions

  • the present invention relates to a device with the aid of which it is possible to create a reference mark for the head of a patient and more precisely for determining the position of internal zones thereof and which constitutes a support for the precise positioning of the patient's head under a surgical device and more specifically radiotherapy.
  • Numerous devices are known which make it possible to associate a reference frame with the head of a patient and to identify in this reference frame the internal zones which are involved by means, for example, of a radiiotomography or any other device for spatial localization of these zones. .
  • This device includes means for being reproducibly attached to the patient's head. It then constitutes on the head of this patient the means of its precise positioning in the repository of a different apparatus, for example a surgical apparatus or the placement of electrodes.
  • One of these devices comprises a chassis formed by a rear central mast at the top of which extends a cross member.
  • the device comprises lateral arms whose spacing is adjustable and the position relative to a median of the cross-member is identifiable. These arms have olives to penetrate the ear holes and at their ends are connected by a hoop comprising in its center a trigger guard intended to overlap the nose and secured to an index perpendicular to the crosspiece.
  • the arch is of adjustable dimensions both in curvature and in width.
  • the central mast can be placed in a support belonging to the reference system of the examination or treatment device.
  • the drawback of this device lies in the limits of its use. It does not, in fact, made of the presence of this central rear mast, to proceed to radiotherapies evolving in a longitudinal median plane of the head of a patient. It also does not allow to reach tumors located in the posterior pits.
  • the lateral arms and the hoop form a relatively flexible structure which deforms when it is put in place in order to secure it firmly in the atrial orifices. When it is put back in place, it requires a lot of skill and skill on the part of the practitioner to ensure good reproducibility of the position, taking particular account of these deformations which occurred during the initial positioning.
  • this device is awkward to set up on a table or in the repository of a device. Finally, it is not very comfortable for the patient.
  • the invention intends to bring an improvement to this device which is essentially due to another architecture of the apparatus which eliminates its intrinsic deformations and allows its easy use both in surgery and in radiotherapy.
  • the invention therefore relates to a device intended to constitute a reference outside the head of a patient in which it is possible to locate one or more cerebral zones in order to ensure their treatment, in particular by radiotherapy, comprising a chassis carrying a rear cross member itself carrying two lateral arms equipped with means for cooperating with the ear orifices of the head, these arms being perpendicular to the cross member and having an adjustable spacing along the cross member, the ends of these arms, opposite those sliding on the crosspiece, being joined by a hoop provided in its middle part with a trigger guard intended to bear on the nose.
  • the frame comprises two vertical uprights supporting the crosspiece by its two ends, each upright being mounted to slide- adjustable in a lower base.
  • the median plane of the device is thus free of obstacles for a radius which would be there.
  • Each base is secured to a base sole of the chassis which extends upstream of the uprights and under the space between the two lateral arms.
  • each lateral arm is in the form of a frame, one end of which is coupled to the cross member while the other end is equipped with a clamping nut for a jamb sliding in the vertical plane.
  • each leg comprises a slide receiving a secondary cross member equipped with the trigger guard and comprising means for clamping the cross member in the slide.
  • the trigger guard can be adjusted in position in a guide perpendicular to the cross member.
  • each lateral arm constitutes a support for locating plates which include means for their precise and reproducible positioning on this arm.
  • the sole has at least one centering stud of a removable support for the occipital part of the patient's head.
  • this support is made of light synthetic material, the profile of its upper face is adjusted to the profile of the particular patient it concerns and comprises on its face opposite the profile, at least one recess to cooperate in its centering on the sole. with the aforementioned stud.
  • FIG. 1 is a general view of the device according to the invention
  • FIG. 2 illustrates the support of the patient's head which is inserted between the latter and the device of the invention.
  • FIG. 3 is the view of an accessory (spirit level) for adjusting the device.
  • FIG. 4 is an external view of an alternative embodiment of the lateral arms and the hoop of the device.
  • the device of the invention comprises a chassis 1 formed by a substantially rectangular sole 2 at one end of which are attached two bases 3 and 4.
  • the sole associated with the bases constitutes the horizontal seat of the device with which are associated on the one hand a super ⁇ structure built on vertical uprights 5 and 6 from the bases and on the other hand a support 7 (pad) for the head of a patient and adapted to the profile of this head.
  • Each upright 5 and 6 has a foot 8, 9 which is sliding horizontally relative to the base 3, 4 corres ⁇ pondant.
  • a horizontal groove 10 in the base forms a guide slide for each of the feet and a locking button 11 passes through a lumen 12 and, by tightening, makes it possible to immobilize the foot 8, 9 along the slide 10 of each corresponding base 3, 4.
  • Each leg 8, 9 has a groove 13 inside which the uprights proper 5 and 6 can slide vertically, and can be immobilized by means of a tightening button 14.
  • the uprights 5 and 6 carry the ends of a cross member 15 to which are fixed two parallel arms 16 and 17, which are perpendicular thereto. The fixing of these two arms is ensured by means of a shoe 18, 19 which can slide along the cross-member 15 and which can be immobilized on the cross-member by means of a button 20, 21 for sliding clamping with the shoe corresponding to the cross member 15 provided for this purpose with two slots 22 and 23.
  • Each arm 16, 17 is equipped with a centering member 24, 25 intended to cooperate with the atrial orifices of the patient's head.
  • each arm has a guide for the end of a hoop 26 which carries in its middle a trigger guard 26a capable of being placed in abutment on a front part of the nose of the patient.
  • the free ends of branches of the arch 26 slide in the guides 27, 28 integral with the arms 16 and 17 and can be locked there by a tightening button 29.
  • the arch 26 is further adjustable in its center, to increase or reduce the distance between the free ends of the branches and "brace" the arms 16 and 17 (for example to keep the olives 24 and 25 in the patient's ears).
  • Trigger guard 26a is further adjustable in its center, to increase or reduce the distance between the free ends of the branches and "brace" the arms 16 and 17 (for example to keep the olives 24 and 25 in the patient's ears).
  • index 30 directed towards the crosspiece 15 which constitutes the materialization of the plane of symmetry of the patient's head which must be made to coincide with the middle of the crosspiece 15, medium materialized by a notch 31 provided in a plate 32 attached to the crossmember removably.
  • a pad 7 is placed on the sole 2 of the chassis of the device, the pad having an upper surface 34 cut in a standard manner to be substantially adapted to the rear profile of the head of a patient. or custom-made after having raised the particular profile of the head which it is intended to support.
  • the underside of this pad will rest, once in place, on the sole 2 and will be centered there by means of orifices 35 for housing the centering pads 36 which the sole.
  • the material in which the pad is made is a light and inexpensive material such as a foam of synthetic material or an expanded synthetic material. It will be very easy to cut and the pad can be considered a disposable wedge.
  • the patient places his head on the sole 2 equipped with the pad support 7, the top of the skull being located on the side of the notch 37. Having released all the locking members of the superstructure of the device, the patient's head is capped with this superstructure by introducing the uprights 5 and 6 into their legs 8 and 9.
  • this superstruc ⁇ ture is adjusted to the patient's head by accommodating the olives 24, 25 in his ears, by adjusting the position of the rear crossmember to allow this centering by means of the feet which are immobilized on the bases , by blocking the uprights 5 and 6 on the feet, by blocking in the center of the arch the spacing of the branches of the arch 26, by applying the trigger guard 26a .
  • the triangular arm structure as shown in FIG. 1 has the disadvantage of offering its greatest transverse flexibility at the level of the ears of the patient, that is to say at the place where the force of 'support which guarantees centering and securing of the device and the head.
  • the arch is made of flexible and deformable material and therefore does not cooperate properly in the bracing of the end of the lateral arms.
  • the lateral arms 40, 41 are in the form of a rectangular frame comprising at one of their ends a plate for their fixing in the shoes 18 and 19 of FIG. 1.
  • Their other end is equipped a nut 42, 43 which forms a slide, here in dovetail, for a jamb 44, 45 which can be adjusted in position in a vertical plane.
  • Each leg has a graduation 46 which makes it possible to identify its position relative to a fixed index 47 which the slide comprises.
  • Each nut 42, 43 can be rotatably mounted around an axis such as that 48 of Figure 4 and angularly indexed around this axis in a few determined positions or by a locking means allowing a continuous variation of its orientation with mark and graduation for reproducibility of the setting.
  • a fixed inclination corresponding to an angle of the legs 44, 45 of the order of 70 to 80 ° could be suitable for the majority of patients.
  • Each nut 42, 43 comprises a means 49 for blocking the jamb.
  • the free end of the legs 44, 45 is itself equipped with a slide 50, 51 (here also in dovetail) for a secondary crosspiece 52 which carries a bridge 53 similar to that 26a . of Figure 1. Indexes 54, 55, graduations 56, 57 and locking means 58, 59 allow the fixing and the location of the position of the trigger guard 53 on the nose of the patient. To further improve this positioning, the trigger guard 53 can slide perpendicularly to the cross-member 52 in a slide 60 which it has for this purpose. A maneuvering button 61 is used to move the cross-member 52 in its guides and, screwed and unscrewed, to adjust the position of the trigger guard 53 in its slide 60.
  • the presence of the ear centralizers such as 62 is preferably mounted on the arms 40, 41 by the intermediate an axis 63 parallel to the axis 48 on which it can slide a little against a spring which constitutes a member limiting the force of application of the device in the ears of the patient.
  • This arrangement is advantageous because it allows to avoid the trauma created by an inexperienced operator who, to avoid a "play" in the subjugation of the patient's head, would exert too strong a pressure and forcing the two arms 40 and 41 to come together.
  • This taring effort can of course be adjustable by means, for example of an adjustment button 64.
  • this "superstructure" of the apparatus of the invention is less deformable than that described with regard to FIG. 1 because the parts which work in flexion (arms and legs) have large sections and that the part upper part of the arch is reduced to a crosspiece 52 normally without constraint which is not the case with the deformable arch 25.
  • the reaction of the patient's head on the arms 40, 41 is always of the same intensity: the flexio, however slight it results, is therefore always the same and the reproducibility the implementation is only more precise.
  • side plates 65, 66 which can be attached to the arms 40, 41.
  • These plates are intended to constitute markers for the radiographic examination of the patient's head.
  • they have in their thickness a network of "wires" opaque to the exploratory rays.
  • the first filament 67 will for example be a small tube filled with water with added copper sulphate and the other 68, a tub filled with barium sulfate.
  • the plate 65 like the plate 66, provided with a grid of this type constitutes a mark attached to the device.
  • the attachment of these plates is achieved by centering by means of the two studs 69, 70 which frame the arm 41 corresponding to one of its ends and by an orifice 71 which cooperates with a stud 72 on the other end of the arm .
  • a bayonet bolt 73 operated by a button 74 secures each plate.
  • the device also comprises an upper plate, not shown in the drawing, which is simply placed and centered on the main cross member 15 of the apparatus and placed on the secondary cross member 52.

Abstract

The device according to the invention is intended to create a mark outside the head of a patient wherein it is possible to determine the location of one or a plurality of cerebral areas in order to apply a treatment, particularly by radiotheraphy, the device comprising a frame (1) carrying a rear beam (15) which carries two side arms (16, 17) fitted with means (24, 25) cooperating with the auricular orifices of the head, said arms being perpendicular to the beam (15) and having a spacing which may be adjusted along the beam, the extremities of the arms which are opposite to those sliding on the beam being joined by an arch (26) adjustable in length and shape and provided in its medial portion with a saddle (26a) which is intended to bear on the nose of the patient while an index (30) is associated to the saddle in order to form, with a medial mark of the beam, a lateral symetry mark. According to the invention, the frame (1) has two vertical uprights (5, 6) supporting the beam (15) by its two extremities, each upright being mounted with vertical and horizontal slide motion which is adjustable in a lower base (3, 4) by means of feet (8, 9).

Description

Dispositif pour créer un repère tridimensionnel solidaire de la tête d'un patient. Device for creating a three-dimensional marker fixed to the head of a patient.
La présente invention concerne un dispositif à l'aide duquel il est possible de créer un repère de référence pour la tête d'un patient et plus précisément pour la détermination de la position de zones internes de celles-ci et qui constitue un support pour la mise en place précise de la tête du patient sous un appareil de chirurgie et plus spécialement de radiothérapie.The present invention relates to a device with the aid of which it is possible to create a reference mark for the head of a patient and more precisely for determining the position of internal zones thereof and which constitutes a support for the precise positioning of the patient's head under a surgical device and more specifically radiotherapy.
On connaît de nombreux dispositifs permettant d'associer à la tête d'un patient un référentiel et de repérer dans ce référentiel les zones internes qui sont en cause par le moyen par exemple d'une radiotomographie ou tout autre appareil de localisation spatiale de ces zones.Numerous devices are known which make it possible to associate a reference frame with the head of a patient and to identify in this reference frame the internal zones which are involved by means, for example, of a radiiotomography or any other device for spatial localization of these zones. .
Ce dispositif comporte des moyens pour être fixé de manière reproductible sur la tête du patient. Il constitue alors sur la tête de ce patient le moyen de sa mise en place précise dans le référentiel d'un appareil différent, par exemple un appareil de chirurgie ou de mise en place d'élec¬ trodes.This device includes means for being reproducibly attached to the patient's head. It then constitutes on the head of this patient the means of its precise positioning in the repository of a different apparatus, for example a surgical apparatus or the placement of electrodes.
L'un de ces dispositifs appelé adaptateur comporte un châssis formé d'un mât central arrière au sommet duquel s'étend une traverse. Aux extrémités de cette traverse, 1'appareil comporte des bras latéraux dont 1'écartement est réglable et la position par rapport à une médiane de la traverse est repérable. Ces bras possèdent des olives pour pénétrer dans les orifices auriculaires et à leur extrémité sont reliés par un arceau comportant en son centre un pontet destiné à chevaucher le nez et solidaire d'un index perpendi¬ culaire à la traverse. L'arceau est de dimensions réglables tant en courbure qu'en largeur. Le mât central peut être placé dans un support appartenant au système de référence de l'appareil d'examen ou de traitement.One of these devices, called an adapter, comprises a chassis formed by a rear central mast at the top of which extends a cross member. At the ends of this cross-member, the device comprises lateral arms whose spacing is adjustable and the position relative to a median of the cross-member is identifiable. These arms have olives to penetrate the ear holes and at their ends are connected by a hoop comprising in its center a trigger guard intended to overlap the nose and secured to an index perpendicular to the crosspiece. The arch is of adjustable dimensions both in curvature and in width. The central mast can be placed in a support belonging to the reference system of the examination or treatment device.
L'inconvénient de ce dispositif tient dans les limites de son utilisation. Il ne permet en effet pas, du fait de la présence de ce mât arrière central, de procéder à des radiothérapies évoluant dans un plan médian longitudinal de la tête d'un patient. Il ne permet pas non plus d'attein¬ dre des tumeurs situées dans les fosses postérieures. De plus, les bras latéraux et 1'arceau forment une structure relativement souple qui se déforme lors de sa mise en place afin de l'assujettir fermement dans les orifices auriculai¬ res. Lors d'une remise en place, il demande beaucoup d'habi¬ tude et de doigté de la part du praticien pour assurer une bonne reproductibilité de la position, en tenant compte notamment de ces déformations intervenues lors de la mise en place initiale. Par ailleurs ce dispositif est mal commode à mettre en place sur une table ou dans le référentiel d'un appareil. Enfin, il est peu confortable pour le patient. L'invention entend apporter un perfectionnement à ce dispositif tenant essentiellement à une autre architecture de l'appareil qui élimine ses déformations intrinsèques et permet son utilisation aisée tant en chirurgie qu'en radio¬ thérapie. A cet effet, l'invention a donc pour objet un dispositif destiné à constituer un repère extérieur à la tête d'un patient dans lequel il est possible de localiser une ou plusieurs zones cérébrales afin d'assurer leur traitement, notamment par radiothérapie, comportant un châssis porteur d'une traverse arrière elle-même porteuse de deux bras latéraux équipés de moyens pour coopérer avec les orifices auriculaires de la tête, ces bras étant perpendiculaires à la traverse et ayant un écartement réglable le long de la traverse, les extrémités de ces bras, opposées à celles coulissant sur la traverse, étant réunies par un arceau pourvu dans sa partie médiane d'un pontet destiné à prendre appui sur le nez.The drawback of this device lies in the limits of its use. It does not, in fact, made of the presence of this central rear mast, to proceed to radiotherapies evolving in a longitudinal median plane of the head of a patient. It also does not allow to reach tumors located in the posterior pits. In addition, the lateral arms and the hoop form a relatively flexible structure which deforms when it is put in place in order to secure it firmly in the atrial orifices. When it is put back in place, it requires a lot of skill and skill on the part of the practitioner to ensure good reproducibility of the position, taking particular account of these deformations which occurred during the initial positioning. Furthermore, this device is awkward to set up on a table or in the repository of a device. Finally, it is not very comfortable for the patient. The invention intends to bring an improvement to this device which is essentially due to another architecture of the apparatus which eliminates its intrinsic deformations and allows its easy use both in surgery and in radiotherapy. To this end, the invention therefore relates to a device intended to constitute a reference outside the head of a patient in which it is possible to locate one or more cerebral zones in order to ensure their treatment, in particular by radiotherapy, comprising a chassis carrying a rear cross member itself carrying two lateral arms equipped with means for cooperating with the ear orifices of the head, these arms being perpendicular to the cross member and having an adjustable spacing along the cross member, the ends of these arms, opposite those sliding on the crosspiece, being joined by a hoop provided in its middle part with a trigger guard intended to bear on the nose.
Selon une caractéristique de l'invention le châssis comporte deux montants verticaux supportant la traverse par ses deux extrémités, chaque montant étant monté à coulisse- ment réglable dans un socle inférieur. Le plan médian de l'appareil est ainsi exempt d'obstacles pour un rayon qui s'y trouverait.According to a characteristic of the invention, the frame comprises two vertical uprights supporting the crosspiece by its two ends, each upright being mounted to slide- adjustable in a lower base. The median plane of the device is thus free of obstacles for a radius which would be there.
Chaque socle est solidaire d'une semelle de base du châssis qui s'étend en amont des montants et sous l'espace compris entre les deux bras latéraux.Each base is secured to a base sole of the chassis which extends upstream of the uprights and under the space between the two lateral arms.
Par ailleurs, dans un mode préféré de réalisation, chaque bras latéral est en forme de cadre dont une extrémité est attelée à la traverse tandis que l'autre extrémité est équipée d'une noix de serrage pour un jambage coulissant dans le plan vertical.Furthermore, in a preferred embodiment, each lateral arm is in the form of a frame, one end of which is coupled to the cross member while the other end is equipped with a clamping nut for a jamb sliding in the vertical plane.
L'extrémité supérieure de chaque jambage comporte une glissière recevant une traverse secondaire équipée du pontet et comportant des moyens de serrage de la traverse dans la glissière.The upper end of each leg comprises a slide receiving a secondary cross member equipped with the trigger guard and comprising means for clamping the cross member in the slide.
Enfin sur cette traverse le pontet peut être ajusté en position dans un guide perpendiculaire à la traverse.Finally on this cross member the trigger guard can be adjusted in position in a guide perpendicular to the cross member.
Il faut remarquer en outre que chaque bras latéral constitue un support pour des plaques de repérage qui comportent des moyens pour leur mise en place précise et reproductible sur ce bras.It should also be noted that each lateral arm constitutes a support for locating plates which include means for their precise and reproducible positioning on this arm.
On notera de plus que la semelle comporte au moins un plot de centrage d'un support amovible de la partie occipitale de la tête du patient. De manière avantageuse, ce support est en matériau synthétique léger dont le profil de sa face supérieure est ajusté au profil du patient particulier qu'il concerne et comporte sur sa face opposée au profil, au moins un évidement pour coopérer à son centrage sur la semelle avec le plot susdit.It will also be noted that the sole has at least one centering stud of a removable support for the occipital part of the patient's head. Advantageously, this support is made of light synthetic material, the profile of its upper face is adjusted to the profile of the particular patient it concerns and comprises on its face opposite the profile, at least one recess to cooperate in its centering on the sole. with the aforementioned stud.
D'autres caractéristiques et avantages ressortiront de la description donnée ci-après d'un exemple de réalisation du dispositif de l'invention.Other characteristics and advantages will emerge from the description given below of an exemplary embodiment of the device of the invention.
Il sera fait référence aux dessins annexés dans lesquels : - la figure 1 est une vue générale du dispositif selon 1'invention,Reference will be made to the appended drawings in which: FIG. 1 is a general view of the device according to the invention,
- la figure 2 illustre le support de la tête du patient qui s'intercale entre cette dernière et le dispositif de l'invention.- Figure 2 illustrates the support of the patient's head which is inserted between the latter and the device of the invention.
- la figure 3 est la vue d'un accessoire (niveau à bulle) de réglage du dispositif.- Figure 3 is the view of an accessory (spirit level) for adjusting the device.
- la figure 4 est une vue extérieure d'une variante de réalisation des bras latéraux et de l'arceau du disposi- tif.- Figure 4 is an external view of an alternative embodiment of the lateral arms and the hoop of the device.
Le dispositif de l'invention comporte un châssis 1 formé d'une semelle 2 sensiblement rectangulaire à l'une des extrémités de laquelle sont attachés deux socles 3 et 4. La semelle associée aux socles constitue l'assise horizontale du dispositif à laquelle sont associés d'une part une super¬ structure construite sur des montants verticaux 5 et 6 issus des socles et d'autre part un support 7 (coussinet) pour la tête d'un patient et adapté au profil de cette tête.The device of the invention comprises a chassis 1 formed by a substantially rectangular sole 2 at one end of which are attached two bases 3 and 4. The sole associated with the bases constitutes the horizontal seat of the device with which are associated on the one hand a super¬ structure built on vertical uprights 5 and 6 from the bases and on the other hand a support 7 (pad) for the head of a patient and adapted to the profile of this head.
Chaque montant 5 et 6 possède un pied 8, 9 qui est coulissant horizontalement par rapport au socle 3, 4 corres¬ pondant. Une rainure horizontale 10 du socle forme glissière de guidage pour chacun des pieds et un bouton de blocage 11 traverse une lumière 12 et, par serrage, permet d'immobiliser le pied 8, 9 le long de la glissière 10 de chaque socle correspondant 3, 4.Each upright 5 and 6 has a foot 8, 9 which is sliding horizontally relative to the base 3, 4 corres¬ pondant. A horizontal groove 10 in the base forms a guide slide for each of the feet and a locking button 11 passes through a lumen 12 and, by tightening, makes it possible to immobilize the foot 8, 9 along the slide 10 of each corresponding base 3, 4.
Chaque pied 8, 9 comporte une rainure 13 à l'inté¬ rieur de laquelle les montants proprement dits 5 et 6 peuvent coulisser verticalement, et peuvent être immobilisés au moyen d'un bouton de serrage 14. En partie supérieure, les montants 5 et 6 portent les extrémités d'une traverse 15 à laquelle sont fixés deux bras parallèles 16 et 17, qui lui sont perpendiculaires. La fixation de ces deux bras est assurée par l'intermédiaire d'un sabot 18, 19 qui peut coulisser le long de la traverse 15 et qui peut être immobilisé sur la traverse au moyen d'un bouton 20, 21 de serrage coulissant avec le sabot correspon¬ dant le long de la traverse 15 pourvue à cet effet de deux lumières 22 et 23.Each leg 8, 9 has a groove 13 inside which the uprights proper 5 and 6 can slide vertically, and can be immobilized by means of a tightening button 14. In the upper part, the uprights 5 and 6 carry the ends of a cross member 15 to which are fixed two parallel arms 16 and 17, which are perpendicular thereto. The fixing of these two arms is ensured by means of a shoe 18, 19 which can slide along the cross-member 15 and which can be immobilized on the cross-member by means of a button 20, 21 for sliding clamping with the shoe corresponding to the cross member 15 provided for this purpose with two slots 22 and 23.
Chaque bras 16, 17 est équipé d'un organe de centrage 24, 25 destiné à coopérer avec les orifices auricu¬ laires de la tête du patient. A son extrémité opposée à celle équipée du sabot chaque bras possède un guide pour l'extré¬ mité d'un arceau 26 qui porte en son milieu un pontet 26a susceptible d'être placé en appui sur une partie frontale du nez du patient. Les extrémités libres de branches de l'arceau 26 coulissent dans les guides 27, 28 solidaires des bras 16 et 17 et peuvent y être bloquées par un bouton de serrage 29. L'arceau 26 est en outre réglable en son centre, pour augmenter ou diminuer 1'écartement de 1'extrémité libre des branches et "entretoiser" les bras 16 et 17 (pour par exemple maintenir les olives 24 et 25 dans les oreilles du patient) . Le pontet 26a. est enfin associé à un index 30 dirigé vers la traverse 15 qui constitue la matérialisation du plan de symétrie de la tête du patient qu'il faut faire coïncider avec le milieu de la traverse 15, milieu matérialisé par une encoche 31 prévue dans une plaque 32 rapportée sur la traverse de manière amovible.Each arm 16, 17 is equipped with a centering member 24, 25 intended to cooperate with the atrial orifices of the patient's head. At its end opposite to that fitted with the shoe, each arm has a guide for the end of a hoop 26 which carries in its middle a trigger guard 26a capable of being placed in abutment on a front part of the nose of the patient. The free ends of branches of the arch 26 slide in the guides 27, 28 integral with the arms 16 and 17 and can be locked there by a tightening button 29. The arch 26 is further adjustable in its center, to increase or reduce the distance between the free ends of the branches and "brace" the arms 16 and 17 (for example to keep the olives 24 and 25 in the patient's ears). Trigger guard 26a . is finally associated with an index 30 directed towards the crosspiece 15 which constitutes the materialization of the plane of symmetry of the patient's head which must be made to coincide with the middle of the crosspiece 15, medium materialized by a notch 31 provided in a plate 32 attached to the crossmember removably.
Il peut en effet être utile d'ajuster l'horizonta¬ lité de la traverse en utilisant un niveau à bulle 33 qui peut être fixé à la traverse 15 à la place de la plaque 32 préalablement retirée.It may indeed be useful to adjust the horizontality of the cross member using a spirit level 33 which can be fixed to the cross member 15 in place of the plate 32 previously removed.
Pour accueillir la tête du patient, on met en place un coussinet 7 sur la semelle 2 du châssis de l'appareil, le coussinet ayant une surface supérieure 34 taillée de manière standard pour être sensiblement adaptée au profil arrière de la tête d'un patient ou usinée sur mesure après avoir relevé le profil particulier de la tête qu'il est destiné à soute¬ nir. La face inférieure de ce coussinet reposera, une fois en place, sur la semelle 2 et y sera centrée au moyen d'orifices 35 de logement des plots de centrage 36 que comporte la semelle. Le matériau dans lequel est réalisé le coussinet est un matériau léger et bon marché tel qu'une mousse de matière synthétique ou une matière synthétique expansée. Sa découpe en sera très facile et le coussinet peut être considéré comme une cale jetable. On appréciera l'avantage d'un coussinet profilé ajusté à la tête du patient si ce patient doit subir une pluralité de séances de soins. Le coussinet personnalisé, conservé d'une séance à l'autre, aide en effet à la mise en place rapide de l'appareil autour de la tête du patient. On notera enfin la présence d'une échancrure 37 à l'arrière de la semelle entre les deux socles 3 et 4. Elle constitue un évidement pour le passage du rayonnement devant atteindre les fosses postérieures. En effet la tête du patient, soutenue par le coussinet, s'étend partiellement au- dessus de cette échancrure.To accommodate the patient's head, a pad 7 is placed on the sole 2 of the chassis of the device, the pad having an upper surface 34 cut in a standard manner to be substantially adapted to the rear profile of the head of a patient. or custom-made after having raised the particular profile of the head which it is intended to support. The underside of this pad will rest, once in place, on the sole 2 and will be centered there by means of orifices 35 for housing the centering pads 36 which the sole. The material in which the pad is made is a light and inexpensive material such as a foam of synthetic material or an expanded synthetic material. It will be very easy to cut and the pad can be considered a disposable wedge. We will appreciate the advantage of a contoured pad adjusted to the patient's head if this patient must undergo a plurality of treatment sessions. The personalized pad, kept from one session to the next, indeed helps the rapid installation of the device around the patient's head. Finally, note the presence of a notch 37 at the rear of the sole between the two bases 3 and 4. It constitutes a recess for the passage of radiation to reach the posterior pits. Indeed, the patient's head, supported by the pad, extends partially above this notch.
La reproductibilité de la mise en place de l'appa¬ reil est garantie par les différents moyens de repérage et les graduations que les éléments mobiles possèdent les uns par rapport aux autres. Au moment de la première mise en place, le patient place sa tête sur la semelle 2 équipée du support coussinet 7, le sommet du crâne étant situé du côté de 1'échancrure 37. Ayant relâché tous les organes de blocage de la superstruc¬ ture de l'appareil, on coiffe la tête du patient de cette superstructure en introduisant les montants 5 et 6 dans leurs pieds 8 et 9.The reproducibility of the installation of the device is guaranteed by the different locating means and the graduations that the movable elements have relative to each other. At the time of the first fitting, the patient places his head on the sole 2 equipped with the pad support 7, the top of the skull being located on the side of the notch 37. Having released all the locking members of the superstructure of the device, the patient's head is capped with this superstructure by introducing the uprights 5 and 6 into their legs 8 and 9.
De manière classique, on ajuste cette superstruc¬ ture à la tête du patient en logeant les olives 24, 25 dans ses oreilles, en ajustant la position de la traverse arrière pour permettre ce centrage au moyen des pieds que l'on immobilise sur les socles, en bloquant les montants 5 et 6 sur les pieds, en bloquant au centre de 1'arceau 1'écartement des branches de l'arceau 26, en appliquant le pontet 26a. sur le nez du patient, en bloquant l'arceau par les boutons 29, en ajustant la position des bras 16 et 17 par rapport a la partie médiane de la traverse matérialisée par la fente 31 et visée grâce à 1'index 30 et en les bloquant dans cette position, et enfin le cas échéant en ajustant l'horizontalité de la traverse grâce au niveau à bulle 33 substitué à la plaque 22 et en agissant au moyen de vérins à vis 38 et 39 prévus à l'extrémité des socles 3 et 4.Conventionally, this superstruc¬ ture is adjusted to the patient's head by accommodating the olives 24, 25 in his ears, by adjusting the position of the rear crossmember to allow this centering by means of the feet which are immobilized on the bases , by blocking the uprights 5 and 6 on the feet, by blocking in the center of the arch the spacing of the branches of the arch 26, by applying the trigger guard 26a . on the patient's nose, blocking the headband by the buttons 29, adjusting the position of the arms 16 and 17 relative to the middle part of the cross member materialized by the slot 31 and aimed by means of the index 30 and by blocking them in this position, and finally if necessary by adjusting the horizontality of the cross member thanks to the bubble level 33 substituted for the plate 22 and by acting by means of screw jacks 38 and 39 provided at the end of the bases 3 and 4.
Pour pouvoir reproduire cette mise en place on relève la valeur des réglages lue sur les différentes graduations 40 entre socles et pieds, 41 entre pieds et montant, 42 entre bras et traverse, 43 à l'extrémité de chaque branche de l'arceau 26 et 44 au niveau des vérins à vis. Les valeurs relevées sont consignées dans le dossier du patient de manière à pouvoir être reproduite à chacune de ses séances de traitement. L'architecture dégagée de la structure de base du châssis de cet appareil permet d'augmenter le confort du patient et les possibilités d'emploi de cet appareil. Dans la variante de la figure 4, on a proposé une superstructure améliorée permettant de réduire au maximum la flexibilité des bras latéraux et de l'arceau supérieur afin de réduire les sources d'erreur dans la remise en place sur la tête d'un patient.In order to be able to reproduce this installation, the value of the settings read on the different graduations 40 between bases and feet, 41 between feet and upright, 42 between arms and crosspiece, 43 at the end of each branch of the arch 26 and 44 at the level of the screw jacks. The values recorded are recorded in the patient's file so that they can be reproduced at each of their treatment sessions. The architecture released from the basic structure of the chassis of this device makes it possible to increase patient comfort and the possibilities of using this device. In the variant of FIG. 4, an improved superstructure has been proposed making it possible to reduce as much as possible the flexibility of the lateral arms and of the upper arch in order to reduce the sources of error in replacing it on the head of a patient. .
En effet la structure de bras triangulaire telle que représentée à la figure 1 présente 1'inconvénient d'offrir sa plus grande flexibilité transversale au niveau des oreilles du patient c'est-à-dire à 1'endroit où s'exerce la force d'appui qui garantit le centrage et la solidarisa- tion de l'appareil et la tête. En outre l'arceau est en matière souple et déformable et de ce fait ne coopère pas correctement à 1'entretoisement de l'extrémité des bras latéraux.Indeed, the triangular arm structure as shown in FIG. 1 has the disadvantage of offering its greatest transverse flexibility at the level of the ears of the patient, that is to say at the place where the force of 'support which guarantees centering and securing of the device and the head. In addition, the arch is made of flexible and deformable material and therefore does not cooperate properly in the bracing of the end of the lateral arms.
A la figure 4, les bras latéraux 40, 41 sont en forme de cadre rectangulaire comportant à l'une de leurs extrémités une plaquette pour leur fixation dans les sabots 18 et 19 de la figure 1. Leur autre extrémité est équipée d'une noix 42, 43 qui forme une glissière, ici en queue d'aronde, pour un jambage 44, 45 pouvant être réglé en position dans un plan vertical. Chaque jambage possède une graduation 46 qui permet de repérer sa position par rapport à un index fixe 47 que comporte la glissière. Chaque noix 42, 43 peut être montée tournante autour d'un axe tel que celui 48 de la figure 4 et indexée angulairement autour de cet axe dans quelques positions déterminées ou par un moyen de blocage permettant une variation continue de son orientation avec repère et graduation pour la reproductibilité du réglage. On s'est cependant rendu compte qu'une inclinaison fixe correspondant à un angle des jambages 44, 45 de l'ordre de 70 à 80° pouvait convenir pour la majorité des patients. Chaque noix 42, 43 comporte un moyen de blocage 49 de jambage.In FIG. 4, the lateral arms 40, 41 are in the form of a rectangular frame comprising at one of their ends a plate for their fixing in the shoes 18 and 19 of FIG. 1. Their other end is equipped a nut 42, 43 which forms a slide, here in dovetail, for a jamb 44, 45 which can be adjusted in position in a vertical plane. Each leg has a graduation 46 which makes it possible to identify its position relative to a fixed index 47 which the slide comprises. Each nut 42, 43 can be rotatably mounted around an axis such as that 48 of Figure 4 and angularly indexed around this axis in a few determined positions or by a locking means allowing a continuous variation of its orientation with mark and graduation for reproducibility of the setting. However, it has been realized that a fixed inclination corresponding to an angle of the legs 44, 45 of the order of 70 to 80 ° could be suitable for the majority of patients. Each nut 42, 43 comprises a means 49 for blocking the jamb.
L'extrémité libre des jambages 44, 45 est elle-même équipée d'une glissière 50, 51 (ici également en queue d'aronde) pour une traverse secondaire 52 qui porte un pontet 53 semblable à celui 26a. de la figure 1. Des index 54, 55, des graduations 56, 57 et des moyens de blocage 58, 59 permettent la fixation et le repérage de la position du pontet 53 sur le nez du patient. Pour améliorer encore cette mise en place, le pontet 53 peut coulisser perpendiculaire¬ ment à la traverse 52 dans une glissière 60 qu'elle possède à cet effet. Un bouton 61 de manoeuvre sert au déplacement de la traverse 52 dans ses guides et, vissé et dévissé, au réglage de la position du pontet 53 dans sa glissière 60.The free end of the legs 44, 45 is itself equipped with a slide 50, 51 (here also in dovetail) for a secondary crosspiece 52 which carries a bridge 53 similar to that 26a . of Figure 1. Indexes 54, 55, graduations 56, 57 and locking means 58, 59 allow the fixing and the location of the position of the trigger guard 53 on the nose of the patient. To further improve this positioning, the trigger guard 53 can slide perpendicularly to the cross-member 52 in a slide 60 which it has for this purpose. A maneuvering button 61 is used to move the cross-member 52 in its guides and, screwed and unscrewed, to adjust the position of the trigger guard 53 in its slide 60.
On aura noté, sur les faces intérieures des bras 40, 41, la présence des centreurs auriculaires tels que 62. Chacun d'eux ou au moins l'un d'entre eux est de préférence monté sur les bras 40, 41 par l'intermédiaire d'un axe 63 parallèle à l'axe 48 sur lequel il peut un peu coulisser à 1'encontre d'un ressort qui constitue un organe limiteur de la force d'application de l'appareil dans lès oreilles du patient. Cette disposition est avantageuse car elle permet d'éviter les traumatismes créés par un opérateur inexpéri menté qui, pour éviter un "jeu" dans l'assujettissement de l tête du patient, exercerait une pression trop forte e forçant le rapprochement des deux bras 40 et 41. Cet effort de tarage peut bien entendu êtr réglable au moyen, par exemple d'un bouton de réglage 64. I sera plus confortable pour le patient de prévoir sur le centreurs 62 des orifices ou évidements lui permettant d mieux entendre. On comprend que cette "superstructure" de l'appa reil de l'invention est moins déformable que celle décrite e regard de la figure 1 du fait que les pièces qui travaillen en flexion (bras et jambages) présentent des section importantes et que la partie supérieure de l'arceau se résum a une traverse 52 normalement sans contrainte ce qui n'es pas le cas de l'arceau déformable 25.It will have been noted, on the inner faces of the arms 40, 41, the presence of the ear centralizers such as 62. Each of them or at least one of them is preferably mounted on the arms 40, 41 by the intermediate an axis 63 parallel to the axis 48 on which it can slide a little against a spring which constitutes a member limiting the force of application of the device in the ears of the patient. This arrangement is advantageous because it allows to avoid the trauma created by an inexperienced operator who, to avoid a "play" in the subjugation of the patient's head, would exert too strong a pressure and forcing the two arms 40 and 41 to come together. This taring effort can of course be adjustable by means, for example of an adjustment button 64. It will be more comfortable for the patient to provide on the centralizers 62 orifices or recesses allowing him to hear better. It is understood that this "superstructure" of the apparatus of the invention is less deformable than that described with regard to FIG. 1 because the parts which work in flexion (arms and legs) have large sections and that the part upper part of the arch is reduced to a crosspiece 52 normally without constraint which is not the case with the deformable arch 25.
Par ailleurs grâce au dispositif de "tarage" de centreurs auriculaires, la réaction de la tête du patient su les bras 40, 41 est toujours de même intensité : la flexio si minime soit-elle qui en résulte est donc toujours la mêm et la reproductibilité de la mise en place n'en est que plu précise.In addition, thanks to the device for "taring" the ear centralizers, the reaction of the patient's head on the arms 40, 41 is always of the same intensity: the flexio, however slight it results, is therefore always the same and the reproducibility the implementation is only more precise.
Enfin, on a également représenté sur cette figur 4 des plaques latérales 65, 66 qui peuvent être rapportée sur les bras 40, 41. Ces plaques sont destinées à constitue des repères pour 1'examen radiographique de la tête d patient. A cet effet elles comportent dans leur épaisseur u réseau de "fils" opaques aux rayons exploratoires. Pa exemple, dans une rainure en V de la plaque 65 on a plac deux filaments superposés l'un 67 dans le fond du V et u matériau opaque à 1'exploration par résonnance magnétiqu nucléaire et un autre 68 de diamètre plus important en u matériau opaque à l'exploration aux rayons X. Le premie filament 67 sera par exemple un petit tube rempli d'ea additionnée de sulfate de cuivre et l'autre 68, un tub rempli de sulfate de baryum. La plaque 65, comme la plaque 66, pourvue d'un quadrillage de ce type constitue un repère attaché au dispositif. L'attachement de ces plaques est réalisé par un centrage au moyen des deux plots 69, 70 qui encadrent le bras 41 correspondant à l'une de ses extrémités et par un orifice 71 qui coopère avec un plot 72 de l'autre extrémité du bras. Un verrou 73 à baïonnette manoeuvré par un bouton 74 assure la fixation de chaque plaque. le dispositif comprend également une plaque supérieure, non représentée au dessin, qui est simplement posée et centrée sur la traverse principale 15 de 1'appareil et posée sur la traverse secondaire 52. Finally, there is also shown in this figure 4 side plates 65, 66 which can be attached to the arms 40, 41. These plates are intended to constitute markers for the radiographic examination of the patient's head. To this end, they have in their thickness a network of "wires" opaque to the exploratory rays. For example, in a V-groove in the plate 65, two superimposed filaments were placed, one 67 in the bottom of the V and an opaque material for exploration by nuclear magnetic resonance and another 68 of larger diameter in u material. opaque to X-ray exploration. The first filament 67 will for example be a small tube filled with water with added copper sulphate and the other 68, a tub filled with barium sulfate. The plate 65, like the plate 66, provided with a grid of this type constitutes a mark attached to the device. The attachment of these plates is achieved by centering by means of the two studs 69, 70 which frame the arm 41 corresponding to one of its ends and by an orifice 71 which cooperates with a stud 72 on the other end of the arm . A bayonet bolt 73 operated by a button 74 secures each plate. the device also comprises an upper plate, not shown in the drawing, which is simply placed and centered on the main cross member 15 of the apparatus and placed on the secondary cross member 52.

Claims

REVENDICATIONS
1. Dispositif destiné à constituer un repère extérieur, solidaire de la tête d'un patient, dans lequel il est possible de localiser une ou plusieurs zones cérébrales afin d'assurer leur traitement, notamment par radiothérapie, comportant un châssis (1) porteur d'une traverse (15) arrière porteuse de deux bras latéraux (16,17) équipés de moyens (24, 25, 62) pour coopérer avec les orifices auriculaires de la tête, ces bras étant perpendiculaires à la traverse (15) et ayant un écartement réglable le long de la traverse, les extrémités de ces bras opposées à celles coulissant sur la traverse étant réunies par un arceau pourvu dans sa partie médiane d'un pontet (26a., 53) destiné à prendre appui sur le nez du patient, caractérisé en ce que chaque bras latéral (40, 41) est en forme de cadre dont une extrémité est attelée à la traverse (15) tandis que l'autre extrémité est équipée d'une noix (42, 43) de serrage pour un jambage (44, 45) coulissant dans le plan des bras, l'extrémité supérieure de chaque jambage (44, 45) comportant une glissière (50, 51) recevant une traverse secondaire (52) équipée du pontet (53) et comportant des moyens de serrage (58, 59) de la traverse dans la glissière.1. Device intended to constitute an external marker, integral with the head of a patient, in which it is possible to locate one or more cerebral zones in order to ensure their treatment, in particular by radiotherapy, comprising a frame (1) carrying a '' a rear crossmember (15) carrying two lateral arms (16,17) equipped with means (24, 25, 62) for cooperating with the ear orifices of the head, these arms being perpendicular to the crossmember (15) and having a adjustable spacing along the cross, the ends of these arms opposite to those sliding on the cross being joined by a hoop provided in its median part with a trigger guard (26a., 53) intended to bear on the nose of the patient, characterized in that each lateral arm (40, 41) is in the form of a frame, one end of which is coupled to the cross-member (15) while the other end is fitted with a clamping nut (42, 43) for a jamb (44, 45) sliding in the plane of the arms, the upper end of each leg (44, 45) comprising a slide (50, 51) receiving a secondary crosspiece (52) equipped with the trigger guard (53) and comprising clamping means (58, 59) of the cross in the slide.
2. Dispositif selon la revendication 1, caractérisé en ce que le pontet (53) est ajustable en position dans un guide (60) perpendiculaire à la traverse (52).2. Device according to claim 1, characterized in that the trigger guard (53) is adjustable in position in a guide (60) perpendicular to the crosspiece (52).
3. Dispositif selon la revendication 1 ou la revendication 2, caractérisé en ce que les moyens (62) de centrage auriculaire sont attelés au bras correspondant (40, 41) en coulissement perpendiculaire (63) au plan du bras (40, 41) à 1'encontre d'un ressort de tarage de l'effort d'appli¬ cation- du dispositif sur la tête du patient.3. Device according to claim 1 or claim 2, characterized in that the means (62) for atrial centering are coupled to the corresponding arm (40, 41) sliding perpendicular (63) to the plane of the arm (40, 41) to Encountering a calibration spring for the application of the device on the patient's head.
4. Dispositif selon l'une quelconque des revendica¬ tions précédentes, caractérisé en ce que le châssis (1) comporte deux montants (5,6) verticaux supportant la traverse (15) par ses deux extrémités, chaque montant étant monté à coulissement vertical et horizontal réglable par l'intermé¬ diaire de pieds (8,9) dans un socle (3,4) inférieur.4. Device according to any one of the preceding claims, characterized in that the frame (1) comprises two vertical uprights (5,6) supporting the cross-member (15) by its two ends, each upright being mounted at vertical and horizontal sliding adjustable by means of feet (8,9) in a base (3,4) lower.
5. Dispositif selon la revendication 4, caractérisé en ce que chaque socle (3,4) est solidaire d'une semelle (2) de base du châssis qui s'étend en amont des montants (5,6) et sous l'espace compris entre les deux bras latéraux (16,17).5. Device according to claim 4, characterized in that each base (3,4) is integral with a sole (2) base of the chassis which extends upstream of the uprights (5,6) and under the space between the two lateral arms (16,17).
6. Dispositif selon la revendication 5, caractérisé en ce que chaque socle (3,4) est principalement situé d'un côté des montants (5,6), la semelle (2) étant située de l'autre côté.6. Device according to claim 5, characterized in that each base (3,4) is mainly located on one side of the uprights (5,6), the sole (2) being located on the other side.
7. Dispositif selon l'une quelconque des revendica¬ tions 4 à 6, caractérisé en ce que la partie de la semelle (2) située au voisinage de l'aplomb de la traverse (15) est échancrée (37). 7. Device according to any one of claims 4 to 6, characterized in that the part of the sole (2) located in the vicinity of the vertical alignment of the crosspiece (15) is notched (37).
8. Dispositif selon l'une quelconque des revendica¬ tions 4 à 7, caractérisé en ce que l'extrémité de chaque socle (3,4) opposée à la semelle (2) est équipée d'un vérin à vis (38,39) .8. Device according to any one of claims 4 to 7, characterized in that the end of each base (3,4) opposite the sole (2) is equipped with a screw jack (38,39 ).
9. Dispositif selon l'une quelconque des revendica- tions 7 à 9, caractérisé en ce que la semelle (2) comporte au moins un plot (36) de centrage d'un support (7) profilé amovible de la partie occipitale de la tête du patient, ce support comportant sur une face opposée à celle profilée au moins un évidement (35) pour coopérer à son centrage sur la semelle (2) avec le plot (36) susdit.9. Device according to any one of claims 7 to 9, characterized in that the sole (2) comprises at least one stud (36) for centering a support (7) removable profile of the occipital part of the head of the patient, this support comprising on a face opposite to that profiled at least one recess (35) to cooperate in its centering on the sole (2) with the aforementioned stud (36).
10. Dispositif selon l'une quelconque des revendi¬ cations précédentes, caractérisé en ce que les bras latéraux (40, 41) constituent un support pour des plaques (65, 66) comportant des lignes de repère (67, 68) constituées pour chacune d'elles par deux filaments encastrés dans une rainure de la plaque, l'un des filaments étant opaque aux rayons exploratoires d'un appareil à résonnance magnétique nucléai¬ re, l'autre étant opaque aux rayons X. 10. Device according to any one of the preceding revendi¬ cations, characterized in that the lateral arms (40, 41) constitute a support for plates (65, 66) comprising reference lines (67, 68) formed for each of them by two filaments embedded in a groove of the plate, one of the filaments being opaque to the exploratory rays of a nuclear magnetic resonance apparatus, the other being opaque to X-rays.
PCT/FR1993/000164 1992-02-28 1993-02-18 Device for creating a tridimensional mark integral with the head of a patient WO1993016639A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR92/02393 1992-02-28
FR9202393A FR2687918B1 (en) 1992-02-28 1992-02-28 DEVICE FOR CREATING A SOLIDAR THREE-DIMENSIONAL MARK OF THE HEAD OF A PATIENT, SUITABLE FOR RADIOTHERAPY.

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Publication Number Publication Date
WO1993016639A1 true WO1993016639A1 (en) 1993-09-02

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CN106345073A (en) * 2016-09-28 2017-01-25 浙江省肿瘤医院 External ear genitalia holder for head and neck positioning frame accessory in radiotherapy

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CN106345073A (en) * 2016-09-28 2017-01-25 浙江省肿瘤医院 External ear genitalia holder for head and neck positioning frame accessory in radiotherapy
CN106345073B (en) * 2016-09-28 2022-10-04 浙江省肿瘤医院 Radiation therapy head and neck positioning frame Accessory external ear hole fixer

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FR2687918B1 (en) 1998-09-25

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