WO1996014023A1 - Canule en matiere plastique pour l'examen intracorporel des tissus - Google Patents

Canule en matiere plastique pour l'examen intracorporel des tissus Download PDF

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Publication number
WO1996014023A1
WO1996014023A1 PCT/DE1995/001528 DE9501528W WO9614023A1 WO 1996014023 A1 WO1996014023 A1 WO 1996014023A1 DE 9501528 W DE9501528 W DE 9501528W WO 9614023 A1 WO9614023 A1 WO 9614023A1
Authority
WO
WIPO (PCT)
Prior art keywords
cannula
hollow
coaxial
hollow cannula
nmr
Prior art date
Application number
PCT/DE1995/001528
Other languages
German (de)
English (en)
Inventor
Norbert Heske
Original Assignee
Norbert Heske
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
Priority claimed from DE19500157A external-priority patent/DE19500157A1/de
Application filed by Norbert Heske filed Critical Norbert Heske
Publication of WO1996014023A1 publication Critical patent/WO1996014023A1/fr

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Classifications

    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48—NMR imaging systems
    • G01R33/58—Calibration of imaging systems, e.g. using test probes, Phantoms; Calibration objects or fiducial markers such as active or passive RF coils surrounding an MR active material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers

Definitions

  • the invention relates to a device for intra-corporal tissue examination or removal, with a hollow cannula, into the hollow channel of which a coaxial cannula or needle device adapted to the inner contour of the hollow cannula can be inserted.
  • tissue samples can be taken from the human body in a largely gentle manner without having to carry out a major surgical intervention.
  • the positioning of a hollow cannula within the human body, through which biopsy needles for tissue removal can be carried out, is usually carried out using optical examination methods, such as X-ray or ultrasound methods.
  • NMR nucleus magnetic resonance
  • the previously known hollow cannulas suitable for this purpose have magnetizable, mostly metallic material which interacts with the very high magnetic fields of the magnetic resonance imaging system.
  • the magnetization effect on the hollow cannula and, if applicable, the instruments which can be inserted therein, have such a lasting effect on the imaging quality of the NMR system that the outline of the hollow cannula visible on an NMR image is only blurred.
  • the degree of blurring is essentially determined by the magnetizability of the cannula material used and leads to various disadvantages:
  • An outline of the intracorporeally inserted hollow cannula which is only blurred, impairs the positioning accuracy of the tip of the hollow cannula.
  • the blurring of the needle contour on the NMR image leads to shielding effects, so that it is not possible to observe the tissue areas immediately adjacent to the cannula.
  • the needle magnetization leads to an image enlarging the needle contour, so that the surgeon during the Positioning the needle relative to a tissue site to be examined must also take into account the incorrectly illustrated size relationships of the hollow cannula.
  • the last-mentioned magnification effect leads, for example in the case of a hollow cannula measuring 2 mm in diameter, which itself or the coaxial cannula inserted into the interior of the hollow cannula shows signs of magnetization, to a contour smear on the NMR image which the hollow cannula has with a blurred one Represents width of approx. 10 mm.
  • this coronary effect which emerges around the cannula, can cover important tissue locations on the NMR image. With possible tumor sizes of diameters smaller than 10 mm, it is therefore possible for these tissue sites to be covered by the blurred conventional hollow cannulae.
  • the invention is based on the object of developing a device for intracorporeal tissue examination or removal with a hollow cannula, into the hollow channel of which a coaxial cannula or needle device adapted to the inner contour of the hollow cannula can be inserted, such that the use of the hollow cannula in NMR -Observation conditions provides considerable advantages in the optical imaging quality. Furthermore, the device with the aforementioned examination method is intended to provide exact marking assistance, so that certain tissue locations can be clearly marked spatially.
  • a device for intracorporeal tissue examination or removal with a hollow cannula, into the hollow channel of which a coaxial cannula or needle device adapted to the inner contour of the hollow cannula can be inserted is designed in such a way that the hollow cannula and / or the coaxial cannula consists of plastic.
  • the choice of the plastic material of the hollow cannula and of the objects which can be introduced into the hollow cannula should, if possible, not be magnetic for the use of NMR methods, so that irritations due to the high magnetic fields can be excluded.
  • PEEK polyether ether ketone
  • Victrex Sales Ltd. The manufacture of the cannulas from so-called PEEK (polyether ether ketone), which is available as a raw material, for example from the company "Victrex Sales Ltd.”, is particularly suitable.
  • PEEK polyether ether ketone
  • the wall diameters of the hoses must be thinned back to a suitable wall thickness so that the wall thickness corresponds to approximately 1/10 mm.
  • the cannulas can also be made from glass fiber-reinforced synthetic resin, so that a largely contrast-free, i.e. transparent imaging on an NMR image can be achieved, since these synthetic resins or plastics practically do not interact magnetically with the nuclear magnetic fields.
  • the first puncture of the hollow cannula into the tissue area to be examined is carried out with the aid of NMR observation a needle device inserted into the hollow cannula, which is preferably made of titanium.
  • Titanium is a metal that shows largely no interactions with the strong magnetic fields and is also extremely hard and rigid, so that a straight line penetration into the tissue is possible.
  • the titanium needle serves as a stabilizer for the flexible hollow cannula, which is made of the above plastic.
  • the tip of the titanium needle is sharp-edged and protrudes a little from the hollow cannula on the distal side. In this way, no tissue material can enter between the needle and the hollow cannula.
  • the sharp cutting edges of the needle tip ensure a clean cut of the tissue.
  • the representation of the titanium needle on an NMR image appears as a blurred image, so that the titanium needle should be removed for a fine alignment of the inserted cannula relative to the tissue site to be examined, especially since the insertion process necessary stiffness of the cannula is no longer so relevant.
  • the titanium needle is removed and an inner coaxial cannula, which is preferably also designed as a hollow cannula, is inserted into the hollow needle.
  • the inner coaxial cannula is closed at the distal tip, so that the coaxial cannula can be filled with liquid contrast medium by means of a suitable injection syringe.
  • the coaxial cannula is filled with paraffinic oils or with solutions that contain gadolinium due to their con- traction behavior particularly suitable.
  • the above-mentioned choice of contrast media makes it possible to adapt the coaxial cannula to the contrast image on the NMR image.
  • Gadolinium solutions have proven to be particularly suitable because they lead to white contrast surfaces which clearly stand out from the rest of the surroundings of the NMR imaging.
  • a further improvement in the optical representation quality of the cannulas described above on an NMR image can be achieved by providing an electrical conductor which is in the form of a coil at the distal cannula tip of a coaxial cannula which is hollow on the inside.
  • the coil axis is oriented parallel to the axis of the cannula.
  • the coil serves as a passive receiving antenna.
  • active coil operation is also conceivable, which provides the coil as a transmitting antenna.
  • the transmission pulses emitted by the coil can be received by a receiving device which is integrated in the NMR system and evaluated accordingly.
  • This active coil operation enables an accurate three-dimensional detection of the position of the coil within the NMR system.
  • the principle on which this position detection is based corresponds to the known methods in radar technology, which are also used not least in flight monitoring of air spaces (transponder principle).
  • the hollow cannula according to the invention should have approximately the mechanical robustness of a cannula made of metal in order to be able to rule out with certainty that no material chips remain inside the body. Tests have shown that cannulas made of glass fiber reinforced plastic have the required material properties.
  • a molded part having the inner contour of the hollow cannula is covered with a polyethylene tube, which forms a cover for an intimate but detachable contact between the molded part and the synthetic resin layer to be applied around the molded part.
  • the glass fiber tube consists of a fine-meshed glass fiber fabric with a typical thickness below one tenth of a millimeter.
  • the cannula is removed from the molded part and the PE tube is removed from the interior of the hollow cannula.
  • FIG. 1a, b are schematic side representations of a hollow cannula according to the invention.
  • Fig. Lc d schematic side view of a coaxial cannula (Mandra).
  • Fig. 2 made of titanium coaxial cannula
  • the shaft (1) of the hollow cannula shown in FIG. 1 is made of plastic over its entire length and is formed at its distal tip, which is marked with the region x, as a cutting edge (2) or as a flattened tip.
  • the area x is shown in an enlarged view, which shows the distal cutting edge (2).
  • the low wall thickness of the hollow cannula according to the invention is indicated from this representation, which usually has a maximum wall thickness of approximately one tenth of a millimeter.
  • FIG. 1c shows a coaxial cannula that can be inserted on the proximal side into the hollow cannula according to FIG.
  • the shaft (3) is made of plastic, which has no significant influence on the magnetic conditions in NMR processes.
  • the distal region of the coaxial cannula identified by y in FIG. 1c is shown enlarged in FIG. 1d. It can be seen from FIG. 1 that the coaxial cannula is hollow on the inside and can be removed or firmly closed at the distal area with a tapered closure shape (4).
  • the needle of which is to be inserted into the coaxial cannula it is possible to fill the coaxial cannula with a liquid contrast medium, for example paraffin-like oils or solutions mixed with gadolinum. After the filling process, the coaxial cannula is to be closed on the proximal side with a stopper (4 ').
  • a liquid contrast medium for example paraffin-like oils or solutions mixed with gadolinum.
  • FIG. 2 shows a coaxial cannula made of titanium, with which the piercing process is to be carried out.
  • the titanium cannula has to be inserted into the hollow cannula and inserted in this arrangement through the body to be examined.
  • the tip of the cannula is equipped with a cutting edge, so that the piercing process can be carried out without major tissue injuries if possible.
  • FIGS. 3 a, b and c show a cannula arrangement with an electrical coil arrangement which serves as a passive receiving antenna for the NMR fields for exact position determination.
  • FIG. 3 a shows an internally hollow coaxial cannula 5, at the distal tip 6 of which there is preferably a three- has side prism shape, a coil 7 is attached.
  • the axis of the coil 7 is oriented parallel to the cannula axis within the cannula.
  • Both coil connections end in a coaxial cable 8, which leaves the cannula on the proximal side (see FIG. 3b).
  • a suitable connecting piece 9 FIG. 3c
  • the coaxial cable is connected to an image-processing computer, which appropriately includes the signals received from the coil in the image processing. In this way, an exact positional representation of the coil on the NMR recording is possible.
  • the coil shape is shown on the picture with sharp outlines that correspond to the true proportions. There are no unwanted coronary effects that cover the immediate vicinity of the cannula.
  • the device according to the invention it is possible to carry out tissue sampling preferably in a controlled manner with the aid of nuclear magnetic resonance examination methods, without thereby influencing the imaging quality in a sustainable manner by the instruments required for tissue sampling.
  • tissue sampling preferably in a controlled manner with the aid of nuclear magnetic resonance examination methods, without thereby influencing the imaging quality in a sustainable manner by the instruments required for tissue sampling.
  • the prevailing contrast ratios of the respective images can be taken into account.
  • the method described above is not only limited to the examination of human or animal tissue, but can also be used for the analysis of all materials to be examined with the aid of NMR technology.

Abstract

La présente invention concerne un dispositif et un procédé de réalisation du dispositif ainsi qu'une utilisation préférentielle du dispositif intracorporel d'examen ou de prélèvement de tissus, avec une canule dans le canal de laquelle une canule coaxiale ou un dispositif à aiguille, adaptés aux contours intérieurs de la canule, peuvent être introduits. L'invention se caractérise en ce que la canule et la canule coaxiale sont en matière plastique. Des canules de ce genre sont employées pour l'examen en RMN de tissus, en raison de leur comportement spécifique lors de la formation d'images. Le dispositif de l'invention doit être pourvu d'un produit de contraste qui apparaît, sur les images RMN, comme une zone blanche qui reproduit les dimensions relatives à l'echelle exacte.
PCT/DE1995/001528 1994-11-04 1995-11-06 Canule en matiere plastique pour l'examen intracorporel des tissus WO1996014023A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DEP4439164.1 1994-11-04
DE4439164 1994-11-04
DE19500157.5 1995-01-04
DE19500157A DE19500157A1 (de) 1994-11-04 1995-01-04 Hohlkanüle zur intrakorporalen Gewebeuntersuchung aus Kunststoff

Publications (1)

Publication Number Publication Date
WO1996014023A1 true WO1996014023A1 (fr) 1996-05-17

Family

ID=25941633

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE1995/001528 WO1996014023A1 (fr) 1994-11-04 1995-11-06 Canule en matiere plastique pour l'examen intracorporel des tissus

Country Status (1)

Country Link
WO (1) WO1996014023A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0754954A1 (fr) * 1995-07-20 1997-01-22 Gec-Marconi Limited Procédé et appareil de résonance magnétique
WO1997007746A1 (fr) * 1995-08-31 1997-03-06 University College London Aiguille compatible avec l'imagerie par resonance magnetique
US5782764A (en) * 1995-11-07 1998-07-21 Iti Medical Technologies, Inc. Fiber composite invasive medical instruments and methods for use in interventional imaging procedures
US7693567B2 (en) 2004-05-21 2010-04-06 Ethicon Endo-Surgery, Inc. MRI biopsy apparatus incorporating a sleeve and multi-function obturator
US8932233B2 (en) 2004-05-21 2015-01-13 Devicor Medical Products, Inc. MRI biopsy device
EP2873372A1 (fr) * 2013-11-13 2015-05-20 Agron Lumiani Système d'aiguille de biopsie pour biopsie guidée par RM
US9638770B2 (en) 2004-05-21 2017-05-02 Devicor Medical Products, Inc. MRI biopsy apparatus incorporating an imageable penetrating portion

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2157828A (en) * 1984-04-19 1985-10-30 Jan Lesny Ultrasonic imaging apparatus and surgical instrument
EP0174011A2 (fr) * 1984-09-05 1986-03-12 TERUMO KABUSHIKI KAISHA trading as TERUMO CORPORATION Aiguille de ponction médicale
DE8709723U1 (fr) * 1986-07-21 1987-12-03 Sterimed Gesellschaft Fuer Medizinischen Bedarf Mbh, 6600 Saarbruecken, De
DE3937052A1 (de) * 1988-11-11 1990-05-17 Instrumentarium Corp Einrichtung fuer die untersuchung eines gegenstandes
EP0378095A1 (fr) * 1989-01-07 1990-07-18 B. Braun Melsungen AG Jeu d'instruments pour la ponction d'une cavité du corps
US5170789A (en) * 1987-06-17 1992-12-15 Perinchery Narayan Insertable NMR coil probe
US5250035A (en) * 1992-04-20 1993-10-05 Abbott Laboratories Cannula and stylet system
EP0566359A2 (fr) * 1992-04-14 1993-10-20 Ethicon, Inc. Canule chirurgicale éclairée
US5271400A (en) * 1992-04-01 1993-12-21 General Electric Company Tracking system to monitor the position and orientation of a device using magnetic resonance detection of a sample contained within the device

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2157828A (en) * 1984-04-19 1985-10-30 Jan Lesny Ultrasonic imaging apparatus and surgical instrument
EP0174011A2 (fr) * 1984-09-05 1986-03-12 TERUMO KABUSHIKI KAISHA trading as TERUMO CORPORATION Aiguille de ponction médicale
DE8709723U1 (fr) * 1986-07-21 1987-12-03 Sterimed Gesellschaft Fuer Medizinischen Bedarf Mbh, 6600 Saarbruecken, De
US5170789A (en) * 1987-06-17 1992-12-15 Perinchery Narayan Insertable NMR coil probe
DE3937052A1 (de) * 1988-11-11 1990-05-17 Instrumentarium Corp Einrichtung fuer die untersuchung eines gegenstandes
EP0378095A1 (fr) * 1989-01-07 1990-07-18 B. Braun Melsungen AG Jeu d'instruments pour la ponction d'une cavité du corps
US5271400A (en) * 1992-04-01 1993-12-21 General Electric Company Tracking system to monitor the position and orientation of a device using magnetic resonance detection of a sample contained within the device
EP0566359A2 (fr) * 1992-04-14 1993-10-20 Ethicon, Inc. Canule chirurgicale éclairée
US5250035A (en) * 1992-04-20 1993-10-05 Abbott Laboratories Cannula and stylet system

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0754954A1 (fr) * 1995-07-20 1997-01-22 Gec-Marconi Limited Procédé et appareil de résonance magnétique
US5735795A (en) * 1995-07-20 1998-04-07 Picker International, Inc. Marker for magnetic resonance imaging
WO1997007746A1 (fr) * 1995-08-31 1997-03-06 University College London Aiguille compatible avec l'imagerie par resonance magnetique
US5782764A (en) * 1995-11-07 1998-07-21 Iti Medical Technologies, Inc. Fiber composite invasive medical instruments and methods for use in interventional imaging procedures
US7708751B2 (en) 2004-05-21 2010-05-04 Ethicon Endo-Surgery, Inc. MRI biopsy device
US7711407B2 (en) 2004-05-21 2010-05-04 Ethicon Endo-Surgery, Inc. MRI biopsy device localization fixture
US7693567B2 (en) 2004-05-21 2010-04-06 Ethicon Endo-Surgery, Inc. MRI biopsy apparatus incorporating a sleeve and multi-function obturator
US7831290B2 (en) 2004-05-21 2010-11-09 Devicor Medical Products, Inc. MRI biopsy device localization fixture
US7862517B2 (en) 2004-05-21 2011-01-04 Devicor Medical Products, Inc. MRI biopsy device
US8932233B2 (en) 2004-05-21 2015-01-13 Devicor Medical Products, Inc. MRI biopsy device
US9392999B2 (en) 2004-05-21 2016-07-19 Devicor Medical Products, Inc. MRI biopsy device
US9504453B2 (en) 2004-05-21 2016-11-29 Devicor Medical Products, Inc. MRI biopsy device
US9638770B2 (en) 2004-05-21 2017-05-02 Devicor Medical Products, Inc. MRI biopsy apparatus incorporating an imageable penetrating portion
US9795365B2 (en) 2004-05-21 2017-10-24 Devicor Medical Products, Inc. MRI biopsy apparatus incorporating a sleeve and multi-function obturator
EP2873372A1 (fr) * 2013-11-13 2015-05-20 Agron Lumiani Système d'aiguille de biopsie pour biopsie guidée par RM

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