WO2000009014A1 - Combined ultrasound-radiography apparatuses - Google Patents

Combined ultrasound-radiography apparatuses Download PDF

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Publication number
WO2000009014A1
WO2000009014A1 PCT/EP1999/005917 EP9905917W WO0009014A1 WO 2000009014 A1 WO2000009014 A1 WO 2000009014A1 EP 9905917 W EP9905917 W EP 9905917W WO 0009014 A1 WO0009014 A1 WO 0009014A1
Authority
WO
WIPO (PCT)
Prior art keywords
ultrasonic
applicator
compression plate
ultrasound
geh
Prior art date
Application number
PCT/EP1999/005917
Other languages
German (de)
French (fr)
Inventor
Kari Richter
Original Assignee
Kari Richter
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 to DE1998137264 priority Critical patent/DE19837264A1/en
Priority to DE19837264.7 priority
Priority to DE19837262.0 priority
Priority to DE19837262A priority patent/DE19837262A1/en
Priority to DE19837259A priority patent/DE19837259A1/en
Priority to DE19837259.0 priority
Application filed by Kari Richter filed Critical Kari Richter
Publication of WO2000009014A1 publication Critical patent/WO2000009014A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42Details of probe positioning or probe attachment to the patient
    • A61B8/4209Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/44Constructional features of the device for radiation diagnosis
    • A61B6/4417Constructional features of the device for radiation diagnosis related to combined acquisition of different diagnostic modalities
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/50Clinical applications
    • A61B6/502Clinical applications involving diagnosis of breast, i.e. mammography
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0825Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the breast, e.g. mammography
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4416Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42Details of probe positioning or probe attachment to the patient
    • A61B8/4272Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue
    • A61B8/4281Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue characterised by sound-transmitting media or devices for coupling the transducer to the tissue

Abstract

The invention relates to medical ultrasound apparatuses and/or combined ultrasound-radiography apparatuses for examining the human breast. According to the invention, an ultrasound applicator (14) which is surrounded by ultrasonic coupling fluid (23) in a liquid-tight manner is arranged such that it can be displaced along a distance in and/or on at least one compression plate (2, 4) which is also arranged such that it can be displaced. Ultrasonic coupling fluid which is distributed in a perfectly homogeneous manner with regard to the layer thickness and which has a maximal layer thickness equal to the height of the ultrasonic transducer elements (15) is located in the beam path in order to carry out the radiography examination in a manner which is independent of the direction of projection of the X-ray radiation in relation to the human breast, and/or the ultrasonic coupling fluid is completely removed from the beam path for carrying out the radiography examination.

Description

Combined ultrasonic X-ray equipment

description

The invention relates to medical ultrasonic diagnostic equipment and / or combined ultrasonic X-ray devices with at least one movably arranged compression plate, in a special embodiment a combined ultrasonic X-ray examination apparatus, comprising two opposed and relatively movably arranged compression bodies, between which an examination room is located and what in both cases along a path arranged movably ultrasound applicators include that can be removed for carrying out X-ray examination completely from the beam path. The invention further relates to a medical examination apparatus having at least one movably arranged compression plate having a container filled with ultrasonic coupling fluid interior, wherein an ultrasound transducer array along a straight track borrowed movable is arranged. Here, in a first embodiment, the ultrasonic coupling fluid during both the X-ray examination and as a prerequisite for the ultrasound in the interior of the compression plate left (Case / variant 1 as claimed in claim 2.1.), Whereby both the design of the height of the inner space of the compression plate, the design of the ultrasonic -Applikators ensure, as well as the related ultrasonic coupling fluid that the arrangement has a low X-ray absorption. In a specific embodiment, the coupling liquid is according to the ultrasonic examination completely removed from the interior of the compression plate (Fall / 2 variant according to claim 2.2.). The invention further relates to an ultrasonic applicator which is located in the interior of a housing in a compression plate, wherein the housing has in an outgoing from the ultrasound applicator sound path an opening (Fall / variant according to claim 3 2.3.). Application is the combined X-ray and ultrasound examination in mammography and ultrasound echography.

A medical ultrasound device is disclosed in Japanese Unexamined Patent Publication 60-190853. The investigation unit is designed for ultrasound examination of the female breast. It comprises two mutually movably arranged compression plates, which are designed for fixing and compressing the chest. In a first embodiment, both compression plates have an interior space, wherein opposite to a respective ultrasonic transducer array are arranged movably in an ultrasonic coupling fluid. One of the transducer devices is formed for sending and receiving Ultraschallsigna- len. The second ultrasonic transducer assembly is provided for receiving. In another embodiment, an ultrasound transducer array is arranged to be movable in a direction of movement in only one of the compression plates. The ultrasonic transducer assembly includes a plurality of series-arranged ultrasonic transducer elements. The ultrasonic transducer array is connected to an evaluation unit which extracts information about the internal structure of the under examination zone from the empfan--related signals. This information is displayed on a computer connected to the evaluation circuit monitor. Because the transducer array is in the coupling fluid, a good sound even coupling of the ultrasound transducer assembly is guaranteed to the compression plate. Leaves open the description, such as the mechanical drive of the ultrasonic transducer array is configured. With this device, an ultrasound examination should be carried out. hence the layer thickness of the case does not matter. It is not intended to remove the liquid between the individual studies again, which is not necessary in an exclusive ultrasound. In U.S. Patent 4,681, 120 is over the filling and partial evacuation of a container, in which the chest is moved to the exclusive ultrasound, reported by the balance differently sized breast volumes should be achieved to the examination room. A complete emptying of the container is not provided for this reason, the container is not a compression plate. Since it is not intended ter completely to empty a canister, no means are provided, which are removed via the pumping fluid out even last remaining liquid residues. In the publication by A. Hernandez et al. (Acquisition and Visualization steroscopic of Three-Dimensional Ultrasonic Breast Data, in LEEE Transactions on Ultrasonics, ferro-electrics and Frequency Control, Vol. 43, 1996, p 576-80), the movement of the Schallkop- fes in a closed housing by means of rod and gear described. The drive mechanism is located on the compression plate. However, the solution described can not be used for movement of the probe within a compression plate. A combined ultrasound X-ray examination apparatus of the aforementioned type is known from DE-OS 4,309,597th The described therein combined ultrasonic X-ray examination apparatus is adapted for examination of the female breast and has two mutually movably arranged compression plates, with which the breast can be compressed and fixed. One on top of the compression plates arranged X-ray tube can illuminate a arranged on the lower compression plate film to record before conventional x-ray mammograms. In addition, ultrasound information of the fixed breast can be generated on the basis of echo signals. For this purpose, an ultrasonic applicator is on the upper compression plate of the compression plate so that faces the X-ray tube (also referred to as an ultrasonic transducer, the ultrasonic transducer array or probe) in a carriage on a guide system arranged movably. The carriage is moved manually or stepper-motor driven to the compression plate in order to scan the entire study area with ultrasonic waves. The ultrasonic applicator must be sonically coupled to the surface of the compression plate thereby, they will cause undesirable echo signals, which cause image artifacts. In the document FR 2733142 AI investigating the compressed breast is described by X-ray and ultrasound gen. A disadvantage of both inventions described that does not run exactly how the coupling of the applicator is made to the compression plate, and no means are provided which remove the coupling agent is complete after the ultrasound scan, so it does not interfere with the X-ray examination. In U.S. Patent No. 5,479,927 has been proposed in a combined ultrasonic X-ray examination apparatus for improving the sound moderate coupling of the ultrasound transducer array that either a suitable coupling agent is used or that the surface of the compression plate is covered with an additional thin gel pad. Since the coupling means located in the beam path between the X-ray tube and the film is expected to be avoided by a little uneven distribution with an undesired image on the mammogram. In addition, intermediate layers act for the X-rays such as filters, which can cause undesirable hardening of the X-ray. In ultrasound examinations of the breast two ways a sound moderate coupling an ultrasound applicator are known. First, the ultrasound applicator directly to the skin surface may still be connected via an ultrasonic coupling agent, also carried out in certain studies, an indirect coupling of the ultrasound applicator an ultrasound-transmitting compression plate, attending an ultrasonic coupling agent is generally used. A device for the indirect coupling of the ultrasound applicator is known from US-PS 5,603,326. Particularly in the case of a combined X-ray ultrasound examination of the female breast, the sound smooth coupling of the ultrasound applicator is not made directly on the skin surface, but on the compression plate.

An ultrasound applicator is the subject of the above mentioned US Patent No. 5,479,927. The ultrasound applicator therein comprises a device with which see a sliding / coupling means intermediate the ultrasound applicator and the surface of the compression plate may be applied. The ultrasonic applicator comprises a housing provided with an ultrasonic transducer. In the casing spacers are formed at the lower end. Between the individual spacer elements, a free space of the housing walls is provided. The spacers raise the contact surface of the ultrasonic transducer and the housing slightly from the surface of the compression plate. The interior of the housing is filled with a spongy material which is impregnated with a suitable lubricant / coupling fluid. In application, the spacer and the sponge-like material in contact with the compression plate. In this way, a thin film of lubricant / coupling agent is applied to the plate. The housing also allows for handling of the ultrasonic applicator, without touching the sponge-like material. The sliding / coupling agent remains in this feed on the surface of the compression plate. This layer can lead to a subsequently created X-ray mammogram artifacts. It can not be assumed namely, that the layer of lubricant / coupling means is of uniform thickness distributed on the compression plate, whereby the X-ray radiation in function of the thickness of the sliding / coupling agent is absorbed to different extents.

In the patent application DE 3733439 AI a device for distancing superficial organs from the transducer is described as older ultrasound equipment had resolution problems at close range (which was overcome with newer devices) and by which the representation is not lung sound head near structures was possible. The container is an artificial fabric layer (so-called delay line.) A continuous scanning of the compressed breast on a compression plate is not possible with such a device.

Of the invention are the tasks underlying the medical investigation mentioned monitoring device so further develop that the ultrasound can transducer assembly with minimum mechanical effort precise in or on the / the compression plate / s are moved to provide a combined ultrasonic X-ray examination apparatus, wherein the ultrasonic transducer array is well coupled to the compression body, the same time deterioration of the Röntgenmammogramms by ultrasonic coupling fluid is comparatively avoided and to develop a corresponding ultrasound applicator, which is well ultrasonically coupling to a surface on the one hand and not to the other generated caused by the sliding / couplant artifacts in the X-ray mammogram. The object has been on the one hand achieved in that in medical ultrasonic examination devices movably arranged compression plates (2, 4), ultrasonic coupling liquid and having disposed along a distance moving ultrasonic applicator (14) at least one of the movably arranged compression plates (2) a with ultrasonic coupling fluid (23) filled fluid-tight interior (12) of the height of the acoustic elements of the ultrasound applicator (14), wherein the ultrasonic applicator (14), which is connected to a with a drive (25) connected to the rod, in which the electrical cable (31) of the ultrasound applicator (14) liquid-tightly be led out of the interior. During the X-ray examination of the ultrasonic applicator is removed from the beam path while the interior of the compression plate is filled out completely and in a uniform layer thickness by the coupling liquid. Here, the minimization of the height of the inner space of the compression plate to the level of the sound elements by lateral guide of the electric cables realized the low greatest possible by its layer thickness, X-ray absorption of the non-removable while the X-ray examination coupling liquid, which also by their chemical composition has a low X-ray absorption beyond. In order for the ultrasonic inspection apparatus can be used as a combined ultrasonic X-ray examination apparatus. On the other hand, the object is achieved in that in a combined ultrasonic X-ray examination apparatus, comprising two opposed and relatively movably arranged compression bodies (2, 4), between which an examination room is located, one of the compression plates (2) an internal space (12 ), wherein the connected with a drive ultrasonic transducer array is arranged such that means (32, 34, 36, 40) for filling the inner space (12) with ultrasonic coupling fluid (23) and for removing ultrasonic coupling fluid (23) are provided from the inner space (12) and that the ultrasonic applicator according to the ultrasonic examination (14) - as in the case of variants 1 and 3 - can be completely removed from the beam path. In the inventive Option 1 - and only this - the coupling agent is currency rend the X-ray examination is not removed. But why come as coupling liquids those having a low X-ray absorption in question, such as oils or alcohols, any other liquid with low X-ray absorption, which allows an ultrasonic coupling. As oils to mineral oils are, in particular light mineral oil as alcohols such as ethanol or propanol. In the event that the devices (coupling fluid, additional structures to realize the coupling) can not be removed from the beam path, all measures aimed that the arrangement is as thin as possible to stop the X-ray radiation is not too strong. In the case in which the coupling fluid can be removed from the compression plate, to create the ultrasonic images of the interior is filled with the ultrasonic coupling fluid. So that the ultrasound applicator is well coupled sonically to the compression plate. Before developing the X-ray mammogram, the coupling liquid is removed from the interior. Hence image artifacts (eg hardness increases) avoided the X-ray mammogram due to coupling means. In an advantageous embodiment, a wiping element is connected with the ultrasonic applicator. The wiper member removes residues of coupling fluid on the surface of the interior space by is moved back to a rest position after removal of the coupling liquid from the interior of the ultrasound applicator. The rest position is located - as with all other variants 1 to 3 also - than can be represented by X-ray range.

A particularly advantageous embodiment is characterized in that the interior has a uniform cross-section in the direction of movement of the ultrasound applicator that a slide is connected to the ultrasound applicator, which sealingly abuts on the inner surfaces querschnit limitation collapsing. The slide cleans the interior delimiting forming inner walls on the one hand, on the other hand, the slider can make a piston, the filling and emptying of the inner space or at least support.

In a further advantageous embodiment is a remote from the examination room and the interior wall delimiting the compression plate designed to be removable or can be folded away. The wall is folded down after emptying of the interior space to the X-ray is monitoring in order to reduce the layer thickness between the X-ray tube and the actual object to be examined further. Hereby the previously conventional mammography would constellation when X despite ultrasonic coupling completely unchanged. Particularly effective this solution may be used when the compression plate is perpendicular (when lying mammography), is filled from below with liquid, wherein the ultrasonic applicator moves with the liquid level to the top. Because of gravity and which is regulated by the pump the liquid level, the housing need not be sealed up, which facilitates the Abklappung of the second part of the compression plate after removal of the ultrasound applicator and the coupling liquid. Surprisingly, it has been found that the ultrasound applicator can be moved with little mechanical effort precisely in the compression plate and an impairment of Röntgenmammogramms was avoided by ultrasonic coupling fluid by the coupling liquid is removed roughly by the ultrasonic inspection and before carrying out the X-ray examination and remaining droplets are also removed, were at least converted to a uniform liquid film. According to the invention, the complete removal is desirable in the case 2, while 1 no distortion of the X-ray image occurs due to the uniform layer thickness of the coupling means in the cavity of the compression plate

Only in the case of Option 1, it is imperative to make the arrangement as flat as possible in 2, it could also be less flat since the coupling agent is completely removed. It is advantageous only here to keep the double compression plate as flat as possible, to minimize unnecessary plenty of fluids must be moved during filling and emptying.

In the variants 1 and 2, the coupling of the ultrasound applicator is released to the compression plate characterized in that it comprises a filled with liquids cavity for ultrasound examination.

According to the invention are the rod, which, together with the drive for scanning of the examination area of ​​a secure guidance of the ultrasound applicator within the compression plate and the ultrasound applicator substantially in one plane. In order for a maximum approach of the upper and lower wall of the compression plate is possible, so that the compression plate can be made flat. In particular, when used in a combined ultrasonic X-ray examination apparatus, the influence of the ultrasound coupling agent to the X-ray imaging is minimized.

An advantageous embodiment of the invention is characterized in that the rod is designed as a hollow rod and in that connected to the ultrasound applicator electric wires are led out through the hollow rod of the compression plate. So that the drive serves at the same time to the liquid-tight lead-out of the electric wires which are required for operation of the ultrasound applicator.

In a further advantageous embodiment of the ultrasound applicator is designed as ultrasonic array having a plurality of serially arranged ultrasonic transducer elements. Thus in each case a cross-sectional plane can be ultrasonically scanned completely in a single position of the ultrasonic array.

In a further advantageous embodiment, the ultrasonic array fills transversely to the direction of the interior. Thus, an ultrasound scan is to the edge of the compression plate possible, firstly, to the other side walls of the Innenrau- mes may serve as guide for the ultrasound applicator.

In the case of variant 3, the ultrasonic applicator according to the invention is in a housing and is moved together with the latter on the side facing away from the patient of a commercially available compression plate without a cavity. only the coupling fluid is located between the acoustic window of the Appli- kators and the compression plate - as in the cases 1 and 2 also - and no additional layer is part of the housing. The design of the housing in the region which is in direct contact with the compression plate, on the one hand ensures a seal which holds the coupling fluid within the housing, furthermore the possibility of movement of the ultrasound applicator and the housing on the compression plate and on the other hand, the complete removal of Koppeimittels of the compression plate in the areas over which the applicator has been moved. The sealing means ensure the application of the ultrasound applicator that is mounted in the housing sliding / coupling agent remains in this and can not leak out and thereby couples the ultrasonic transducer assembly to the surface sonically. At the same time, however, prevented from remaining on the surface in a movement of the ultrasound applicator on the surface slip / coupling agent. The liquid seal means cause the one hand a sealing of the Inneneraums, but allow the other hand, that the ultrasound applicator able to slide on the surface.

According to an advantageous embodiment, the sliding on the surface is facilitated if the liquid sealing means additionally comprise a textile-like material. A further advantageous embodiment is characterized in that the liquid sealing means comprise rollers of a resilient material. The rollers are so arranged as to further facilitate the movement of the ultrasound applicator in two opposite directions. A further advantageous embodiment is characterized in that a wiping element is fixed to the housing, which can be activated in a first movement of the ultrasound applicator and deactivated in a second movement direction. Thus a most extensive removal of the sliding / coupling medium is ensured after the investigation. In the phase of ultrasonic imaging, the wiping member is deactivated, with the backward movement of the ultrasound applicator in a home or rest position, the wiper element is activated, whereby then the sliding / coupling means is removed from the surface again.

According to a further advantageous embodiment, means for drying the surface are arranged on the housing, which can be activated in a first movement direction of the ultrasound applicator and deactivated in a second movement direction. The means for drying is used in addition to the wiping member to the complete drying of the surface,

A further advantageous embodiment is characterized in that a sealable fluid fill is disposed in the housing. Furthermore spent lubricant / coupling fluid can be refilled. According to a further advantageous embodiment, a sealing verschließba- re vent opening is arranged in the housing.

A further advantageous embodiment is characterized in that means for pressing the opening sealing the fluid sealing means is connected to the surface to be coupled with the housing. The means for pressing the liquid sealant to be coupled to the surface may be formed in addition in that order a guide of the ultrasound applicator can be carried out over the surface.

In a further advantageous embodiment with a vertical position of said compression plates (in lying mammography) can be dispensed with analogous to the design of the double compression plate at the option 2 on the upper wall of the applicator umschlie- sequent and filled with coupling fluid housing, since a seal by gravity is achieved by a force of gravity following a horizontal liquid surface is established. The coupling liquid fills the housing as before the transducer containing completely and is sealed against the compression plate on three sides in the manner described above by the liquid sealant. At the upwardly directed overall fourth side turns by gravity a horizontal liquid level a, the coupling liquid fills the housing to the breast near-wall boundary of the vertical walls of the housing. Due to the possible absence of sealing means in the area of ​​chest wall facing the open side of the housing even better representation of the breast tissue near-wall succeeds. ensure the devices according to the variants 1 to 3, that the coupling of the ultrasonic applicator is achieved at the patient-remote side of the compression plate by means of a liquid. For this purpose, the ultrasound applicator must be able to move, so he scanned the area and can be removed after the examination of the imaging area so as not to overlay the X-ray image. According to the variant 1, the problem is solved in that the coupling liquid is distributed uniformly through the hollow interior of the compression plate the same, while in the cases 2 and 3, the coupling liquid is completely removed before the X-ray examination. It is imperative that the coupling fluid must not be unevenly distributed in the least on the compression plate, otherwise it leads to disruption of the radiograph. So could even lead to distortions of the X-ray image as the low-energy Mammografiestrahlung can represent the smallest differences in density smallest drops. The inventive devices of the variants 1 to 3, an ultrasonic image is generated bisjzum edge of the patient-facing edge of the compression plate, so that the breast near-wall areas of the breast are shown. The devices of the invention do not lead to a dead space in this area of ​​the compression plate. The devices are all common Mammografieaufnahmewinkeln (craniocaudal, mediolateral and mediolateral oblique projection) and thus able to work in all spatial directions. Between the acoustic window of the ultrasound applicator and the patient side facing away from the compression plate for all three variants only the coupling medium and no additional intermediate layers, as would absorb sound energy and interfere with the ultrasound image.

The space between acoustic window of the ultrasound applicator and compression plate was kept ideally as small as possible, since a greater thickness of the coupling agent would lead to sound loss and reduction in the imaging area of ​​the breast. A capillary layer of the coupling agent between the acoustic window and the compression plate is in this case perfectly adequate for the purpose of coupling and was ensured with the present invention. The showcase of the ultrasound applicator moves to the optimum imaging as close as possible on the patient's surface facing away from the patient-side wall of the double-walled compression plate (cases 1 and 2) and the patient-side facing away from the normal compression plate (case 3).

The essence of the invention lies in the development of an ultrasound device and / or combined ultrasound X-ray device for the investigation of the human breast with at least one movably arranged compression plate to which movably arranged in and / or surrounded ultrasound applicator liquid-tight manner by ultrasonic coupling fluid along a path is. In this case, for carrying out the X-ray examination, regardless of the projection direction of the X-ray radiation is in the film thickness achieved with respect to the human breast a complete uniform distribution of the ultrasonic coupling fluid with a maximum layer thickness of the height of the ultrasonic transducer elements in the beam path and / or the ultrasonic coupling fluid to implementation of the X-ray is monitoring completely out of the beam path away. The device according to the invention are that

- at least one of the movably arranged a compression plates filled with ultrasonic coupling fluid liquid-tight inner space in a combined ultrasonic X-ray examination apparatus (12) of the height of the acoustic elements (15) of the ultrasound applicator has. Inside is the ultrasonic applicator which is connected to a with a drive (25) connected to the rod (7), in which the electrical cable of the ultrasonic transducer elements (15) liquid-tightly be led out of the interior space and wherein the ultrasonic applicator according to the ultrasound can be completely removed from the optical path; - in a combined ultrasonic X-ray examination apparatus, comprising two opposed and relatively movable arranged compression bodies (2, 4), between which an examination room is located, one of the compression plates an interior (12), wherein said a drive (25) connected ultrasonic applicator (14) is arranged. There are means (32, 34, 36, 40) for filling the vehicle interior, with ultrasonic coupling fluid (23) and for removing ultrasonic coupling fluid from the interior. The ultrasonic applicator (14) can be completely removed after the ultrasound from the beam path;

- the ultrasonic coupling fluid (23) and the ultrasound applicator (14) in a housing (13) on the patient side facing away from a commercially available compression plate (2) are located, comprising an opening (1 1) in the area of ​​the sound path. The opening is fluid sealing means (37, 49, 50, 51) edged for sealing the housing interior space (9) opposite to a ultrasonically to be coupled surface (39), wherein said liquid sealing means at the same time a movement of the ultrasound applicator (14) and housing on the allow ultrasonically to be coupled surface (39) for the continuous creation of ultrasonic sectional images, and for the complete removal of the transducer housing and for performing the X-ray examination.

The examination apparatus according to the variant 1 is that to minimize the X-ray absorption, the height of the interior space (12) to the height of the ultrasound transducer elements (15) of the ultrasound applicator (14) is limited to the compression plate (2). By senkrech- te guide the electric cable of the ultrasonic transducer (15) in relation to the sound path, the rod (7) and the ultrasound applicator (14) are arranged substantially in one plane. The rod (7) acts as a straight and rigidly formed hollow rod connected by one with the ultrasonic transducer elements (15) electrical leads (31) from the compression plate (2) is led out. The ultrasonic applicator (14) as ultrasonic array (5) having a plurality arranged in a series of ultrasonic transducer elements (15), wherein the ultrasound array (5) fills the interior space transverse to the straight path (12). The compression plate (2) and the interior (12) are rectangular. The driving device (25) for movement of the ultrasound applicator (14) is located inside or outside of the double-walled compression plate in the middle or outside of the coupling liquid. As coupling liquids with a low X-ray absorption are oils, such as mineral oil or light mineral oil and alcohols such as ethyl alcohol or propyl alcohol, are used.

The core of the examination apparatus according to the variant 2 is that the compression plate (2) having an interior (12) is provided, in which the ultrasound applicator (14) moves. The coupling liquid (23) is completely removed after the examination, whereby in addition to pumping additional means (32, 34, 36, 40) to remove even the last residues of liquid are used. The interior (12) of the compression plate (2) can be opened and one of the interior forming panels - the patient facing away from second plate which is the same as the actual compression plate - be removed after removal of the coupling liquid from the beam path. The double-walled compression plate (2) lying perpendicular with mammography. It is filled from below with liquid, wherein the ultrasonic applicator (14) moves with the liquid level to the top. The upwardly open interior space (12) facilitates the Abklappung of the second part of the compression plate after removal of the transducer (14) and the coupling fluid (23) after the ultrasound applicator has moved back to the starting position and the coupling liquid was completely removed. The driving device (25) for movement of the ultrasound applicator (14) may be located inside of the double compression plate (2) in the middle of the coupling liquid (23). containing the electrical leads (31) of the ultrasound applicator rod (7) during a movement of a fluid-tight from the interior (12) to remove and out. The drive (25) can also be located outside of the double-walled compression plate (2). To fill the interior space (12) with ultrasonic coupling fluid (23) and for removing ultrasonic coupling fluid from the interior of the means (32, 34, 36, 40) are available. The compression body (2, 4) are formed as flat plates which are parallel to each other. The ultrasonic applicator (14) comprises a plurality of arranged in a row ultrasound transducer elements (15). A slider (40) can be connected to the ultrasound applicator (14). The interior (12) has a ventilation opening (38) and in the direction of movement of the ultrasound applicator (14) has a uniform cross-section. Of the ultrasound applicator (14) associated slider (40) to the cross section delimiting the inner walls sealingly on. The means for filling and emptying comprises a reservoir (36) comprising a fluid transfer device, wherein the reservoir (36) via a liquid line (32) to the interior (12) is connected. A remote from the examination space and the interior space (12) restricting wall (46) of the compression plate (2) is detachable or can be folded formed. The core of the examination apparatus according to the variant 3 is that the housing (13) emanating in a from the ultrasound applicator (14) sound path having an opening (1 1). Here, the releasing the sound path of the ultrasound applicator opening of the housing of the liquid sealing means (49, 51, 37) (9) of the edged for sealing the housing inner space of the ultrasound applicator-containing housing with respect to a ultrasonically Toggle zukoppelnden surface (39). The ultrasonic applicator (14) is located in a housing and is moved together with this on the patient side facing away from the compression plate. there is only the coupling fluid between the sound path of the applicator and the compression plate. The design of the housing in the region which is in direct contact with the compression plate is, on the one hand by a seal (37) which holds the coupling fluid within the housing as well as by the possibility of movement of the ultrasound applicator and the housing on the compression plate and the other, by the complete removal of the coupling means of the compression plate in the areas over which the ultrasound applicator has been moved guaranteed. The examination apparatus comprising ultrasound applicator (14) according to Variant 3 includes liquid seal means (49,51,37) adapted for coupling to a flat surface (39) are formed. They additionally comprise a textile-like material and rolls (49) of an elastic material. The housing (13) comprises two parallel longitudinal sides and the longitudinal sides connecting the lateral sides. The fluid sealing means consist of two rollers (49) which are arranged on the long sides as well as of sealing members (51) on the transverse sides between the rollers, wherein the sealing pieces (51) cover the side the rollers (49) sealingly. On the housing (13) is fixed a wiping element (52) which is activatable in a first direction of movement of the ultrasound applicator (14) and deactivated and positioned on a longitudinal side in a second direction of movement. On the housing (13) further includes means for drying (53) the surface (39) arranged to be activated in a first movement direction of the ultrasound applicator (14), can be deactivated in a second movement direction and are arranged at a longitudinal side. They comprise an absorbent material, a textile material, a resilient foam material, a carrier element (54) - wherein the carrier element is designed to replace the absorbent material - and a heating element (55). In the casing (13) is a sealable fluid fill (45) and a vent (47) is arranged. By means for pressing (41, 44, 50) of the opening (11) sealing liquid seal means (49, 51) the surface to be coupled (39) to the housing (13) is connected. In a further embodiment of the examination apparatus with ultrasound applicator (14), the housing (13) with a horizontal emitting and receiving direction of the ultrasonic waves in a from the ultrasound applicator (14) emanating sound path an opening (11) in the direction of the sound path, and an opening (65) on.

The inventive ultrasound applicator (14) is provided in this further embodiment for coupling with a vertically standing compression plate. It is characterized Siert characterize in that it is arranged in an inner space (9) of up to the opening (11) and the opening (65) sealed housing (13) and fixed to the housing (13)., Wherein the opening (11) generated in the sound path of an ultrasonic applicator in the transmission case (14) and is located in the receiving case, one of the ultrasound applicator (14) for receiving sound wave. The ultrasonic applicator (14) comprises a plurality of transducer elements arranged in a row (15) are individually activatable. The housing (13) is designed in the form of a rectangular box open on two sides. To which the opening (1 1) delimiting three edges of the housing (13) is circumferentially a seal (37) on an outer surface (39) of a compression plate (2) is placed, wherein the opening (1 1) in the application has sideways, while the opening (65) facing up. Upon movement of the ultrasonic applicator (14) of the imaging area before performing an X-ray examination are radicals of coupling fluid through activated wiping elements (52) and means for drying (53) in the region of the opening (65) are removed. In a likewise possible horizontal guide of the ultrasound applicator (14) on the vertical compression plate (2) the opening (65) by omitting one of the narrow walls of the housing is formed.

The inventive use of the ultrasonic medical device and / or combined ultrasound X-ray device is the investigation of the human breast, the use of the ultrasound applicators (14) in medical ultrasound equipment, and / or combined ultrasound X-ray devices. The features of the invention can be gathered from the claims also apparent from the description, and the individual features represent advantageous protectable embodiments, either singly or together in the form of combinations, is sought for with this document protection. The combination is known (combined ultrasonic X-ray apparatus, ultrasound applicator) and new elements (onsplatte low height of the compres-, coupling means with low X-ray absorption, complete removal of the coupling means, ultrasound applicator with sealing means), which influence each other and in their new overall effect result in a benefit of use and the desired result, which is that now a combined ultrasonic X-ray examination by minimizing the X-ray absorption necessary for the ultrasonic coupling structures is made possible in that during through in the film thickness completely equal distribution of the coupling agent or its complete removal an X-ray examination without distortion of X-ray image will be the X-ray examination and yet a good ultrasound coupling is ensured. The combination also extends to the cases mentioned in the description / variants 1 to 3 and claims 2.1. to 2.3 .. The invention is illustrated with reference to embodiments, but is not limited to these examples.

embodiments

Example 1: Monitoring Equipment shows (FIG) 1 shows a perspective view of a first embodiment of a medical examination apparatus with two compression plates, wherein a drive for an ultrasonic applicator outside a compression plate is disposed and

2 shows a perspective view of a second embodiment of a medical examination apparatus, wherein the drive is disposed within a compression plate. 1 shows a perspective view of a medical examination apparatus for breast examinations with two parallel and mutually movable arranged compression plates (2, 4). The mechanism for adjusting the compression plates (2, 4) is not given here for reasons of clarity, only the double arrows (56) symbolize a corresponding displacement and adjustment. Alternatively, one of compres- can onsplatten such. For example, the compression plate (4), may also be fixedly arranged. then carried out according to a compression, and fixation of a body part to be examined only by the adjustment of the compression plate (2).

The compression plate (2) has a rectangular internal space (12) in which an ultrasonic transducer array (5) is arranged. The ultrasonic traveling array (5) is long corresponds in the interior (12) of a straight line back and forth movably arranged, as indicated by a double arrow (57) is illustrated. The ultrasonic transducer array (5) comprises a plurality of transversely in a row direction of movement (57) arranged ultrasonic transducer elements (15) extending up to the opposite side walls (17) of the interior (12) erstrek- ken. The ultrasonic applicator (14) is connected via a bracket (19) with a straight here, and one for a continuous movement of the ultrasonic transducer array (5) is sufficiently rigid hollow rod (7). The hollow rod (7) is guided through a gasket (3) and guide (41) from the compression plate (2). The hollow rod (7) is aligned parallel to the movement path of the ultrasonic transducer array (5) and lies substantially with the ultrasonic transducer array (5) in one plane. The interior (12) is completely filled with an ultrasonic coupling fluid for coupling the ultrasonic moderate individual ultrasonic transducer elements (15) on the underside of the compression plate (2). The hollow rod (7) is connected to a mechanical drive, the reciprocating movement (double arrow 29) causes the rod (7) with appropriate control. may play examples for a forward movement by the drive (25) away gradually carried out continuously to produce a sequence of mutually parallel sectional images and the return to a rest position. In the preparation of the slice images of the ultrasonic transducer array (5) is registered distance traveled to the individual educational Schnit to be able to assign each other. For this purpose, the movement steps of the motor are detected by a control member.

For the operation of the ultrasonic transducer elements (15) required electrical connection lines (31), starting from the ultrasonic transducer elements (15) through the interior of the hollow rod (7) from the interior (12) of the compression plate (2) to an evaluation unit (33 ) guided. The evaluation unit (33) comprises the functional units of a conventional ultrasonic diagnostic apparatus such. B. ultrasonic transmitter, ultrasonic receiver and processing circuitry for producing on a monitor (35) displayable image signals.

If the medical examination apparatus in accordance with such in the initially above-cited DE-OS 4309597 additionally having an X-ray source and an X-ray detector Equipped for creating Röntgenbildem of the examined part of the body, then the compression plate (2) in order to avoid hardness increases in the X-ray image caused designed by the filtering effect of the coupling liquid, as flat as possible. In this case, the interior (12) is only slightly higher than the ultrasonic transducer array (5). The free cross-section need only be so great that the coupling fluid can be displaced without much resistance to movement of the ultrasonic transducer array (5).

In the illustrated embodiment in FIG 2 of the compression plate (2) with the ultrasonic transducer array (5) is a toothed rack (7A) to the ultrasonic transducer array (5). The drive in the direction of movement (57) takes place via a in the compression plate (2) arranged electric motor (25A). To a shaft of the electric motor (25A) is mounted a toothed wheel (63) in the rack (7A) engages. Connecting leads of the electric motor (25A) are felt liquid-tight from the interior (12). The seal (3) is so elastic that it also when engaged in the spaces between the teeth of the rack (7A) the interior space (12) liquid-tight seals. The remaining details are as described already with reference to FIG. 1 Example 2: Combined ultrasonic X-ray inspection system

Show it:

Figure 3 shows a schematic representation of a combined ultrasonic X-ray

Examination apparatus comprising, disposed in the interior of a compression plate ultrasound applicator, wherein the interior with coupling means can be filled and emptied,

4 shows in a side view in cross-section a first embodiment of the compression plate with internal transducer assembly,

Figure 5 is a perspective view of a second embodiment of the compression plate with internal transducer assembly and Figure 6 shows the compression plate of Figure 3 with the collapsed wall.

3 shows the parts essential for the invention of a combined ultrasonic X-ray examination apparatus are shown schematically, further details of which are at the outset already cited DE-OS refer 4,309,597th The combined ultrasonic X-ray examination apparatus is designed in particular for the study of human breast and comprises two compression members in the form of flat and uniformly thick plates (2, 4) which are opposite each other and positioned relative to each other movably mounted on a not shown tripod. The upper compression plate (2) is at least movable relative to the support, as indicated by a double arrow (6) is to be illustrated. The to be tested chest (1) is between the two compression plates (2, 4) positioned, the obe- re compression plate (2) is then towards the second compression plate (4) moves until the chest (1) for an examination sufficiently compressed and is fixed. Above the upper compression plate (2) an X-ray source (8) is arranged. Of the X-ray source (8) radiated X-rays passing through the upper compression plate (2) and the examined breast (1), and then impinges on a on the lower compression plate (4) arranged X-ray film (10). As X-ray image converter and digital systems are in question. Further details of the X-ray part of the combined ultrasonic X-ray examination apparatus, such as anti-scatter grid, currency cassettes, control for the X-ray source (8), etc., correspond to those of conventional X-ray mammography device. They are not shown for the sake of clarity. The upper compression plate (2) as a hollow body having an interior (12), wherein an ultrasonic applicator (14) in the form of a transducer array arranged in a series of transducer elements (15) (see Figure 5 and 6) reciprocatably between the left and the right side wall (16) or (18) is arranged. This reciprocating movement transverse to the row of transducer elements (15) and by a double arrow (20) lisiert symbolic. For coupling of the ultrasound applicator (14) to the compression plate (2) of the interior (12) with an ultrasonic coupling fluid (23) is filled. The second compression plate (4) facing side (21) of the compression plate (2), which also serves as a compression surface for compressing and fixing the breast is made of an ultrasound-transmitting material, so that from the ultrasound applicator (14) ultrasonic waves generated via the coupling liquid (23) and the wall may enter the object to be examined. Likewise, reflected echo signals are received by the ultrasonic applicator (14) again. The transmitting and receiving direction of the ultrasonic transducer arrangement is characterized by a double arrow (22). Since the inner space (12) liquid-tightly gestal- tet is allowed in principle any spatial orientation of the compression plates (2, 4).

The driving of the ultrasonic transducer assembly for movement within the compression plate (2) via a linkage (24), the liquid-tight from the compression plate (2) and then led to a motor (26) is connected. With the linkage (24) belonging to the ultrasound applicator (14) signal lines (27) from the interior (12) to an electronic unit (28) felt. The Elektronikeinl eit (28) the necessary for the operation of the ultrasonic device functional units, such as transmitter, receiver, signal processing, position detection of the ultrasound applicator (14) for correct spatial assignment of the ultrasound images, etc. The information contained in the echo signals are then subjected to display device (30) supplied. Specifically, the functional units in the already mentioned DE-OS 4309597 describes, will be omitted to further remarks here.

For filling and emptying of the interior space (12) with ultrasonic coupling means (23) opens a liquid duct (32) on the right side wall (18) into the interior (12). By means of a pump (34), the ultrasonic coupling fluid (23) from the interior space into a storage container (36) - or vice versa from the reservoir (36) to be pumped into the interior (12). A ventilation opening (38) for the interior (12) facilitates the filling and emptying of the interior space (12).

An x-ray mammogram is created after the ultrasonic coupling fluid (23) has been removed from the interior (12) and the ultrasound applicator (14) located on the right-hand side wall (18) is in a rest position. Artifacts causing ultrasonic coupling fluid (23) is removed as well as the ultrasonic applicator (14) from the beam path of the X-ray source (8). Ultrasound images, whether in the form of sectional images or in the form of projection images are created after the interior (12) is filled with the ultrasonic coupling fluid (23) again. Figure 4 shows the compression plate (2) in a sectional view. Here, in a Varian te of the ultrasound applicator (14) with a slider (40), which sealingly fills the entire cross-section and the interior (12) enräume in two variable Teilin (12A) and (12B) divides similar a piston in a cylinder. The linkage (24) is designed in the form of a hollow rod, wherein the signal lines (27) are laid. A seal (42) seals the interior portion (12B) on the implementation of the rod (24) to the outside. The slider (40), instead of the pump (34) - imbibe by a movement toward the left side wall (16) of the coupling liquid (23) into the then enlarging interior part (12B) - not shown here. In the opposite movement of the ultrasound applicator (14) towards the right side wall (18) the volume of the part interior space (12B) decreased, the ultrasonic coupling fluid is not shown in the Vorratsbehäher (36) in Figure 4, is pressed. The slider (40) simultaneously cleans the inside walls of the interior (12) of residues of the ultrasonic coupling fluid (23).

The variant of the compression plate (2) with internal ultrasound applicator (14) shown in Figures 5 and 6 is preferably provided for a vertical arrangement. The breast is in contrast to conventional X-ray mammography device from above, symbolized by an arrow (44) between the compression plates (2 and 4) accommodated. . The liquid pipe (32 flows into a lower side wall of the compression plate (2) The interior (12) so that - if necessary after opening a shut-off valve (not shown here) - (in lower position reservoir 36) alone a means of gravity and without the aid of pump are emptied from the ultrasonic coupling fluid (23). the filling of the internal space (12) is carried out with the pump (34).

facing wall (46) folded away, symbolized by a curved double arrow (48) - in the depicted in Figure 6 variation, in addition to the X-ray source (8) - not shown here. So that the layer thickness can be reduced in the beam path of the x-ray radiation source. In the closed state (Figure 5) encircling seals ensure the liquid-tight interior space (12). For removing last traces of ultrasonic coupling liquid on the side facing the examination space side of the compression plate (2) of the ultrasound applicator (14) may be provided with a wiping member, similar to the slide (40). The wall (46) may also be in the principle shown in figure 3 the horizontal arrangement of the compression plates (2 and 4) executed folded away.

Example 3: Ultrasonic applicator which: Figure 7 is a perspective view of a first embodiment of the ultrasonic applicator with sealing means,

FIG 8 is a sectional view of the first embodiment,

9 is a perspective view of a second embodiment of the ultrasonic applicator rollers, FIG 10 in a side view of an ultrasonic applicator with a deactivated wiping member and deactivated means for drying the surface and

FIG 11 is a side view of the ultrasonic applicator according to FIG 4 with activated wiping member and activated means for drying. FIG 12 is a perspective view of the ultrasonic applicator with sealing means of Figure 7 in a vertical direction of movement.

7 shows a perspective view of a first simple design variant of the ultrasound applicator of the invention. An ultrasonic applicator (14) in an interior (9) of up to an opening (11) sealed housing (13). Here, the ultrasound applicator (14) is fixed to the housing (13), which over- For reasons of clarity is not represented here. The opening (1 1) is generated in the sound path of an ultrasonic applicator in the transmission case (14) or in the case of receiving one of the ultrasound applicator (14) for receiving sound wave. The ultrasonic applicator (14) comprises a plurality of transducer elements arranged in a row (15) are individually activatable. The housing (13) is designed in the form of a rectangular box open on one side. To which the opening (11) defining edges of the housing (13) is circumferentially a seal (37) made of an elastic material, for example a rubbery material, attached. In the application of the ultrasonic applicator with its seal (37) on an outer surface (39) of a compression plate (2) is placed, here has the opening (1 1) in the application down. The compression plate (2) consists of an ultrasonically transparent material, so that from the ultrasound applicator (14) can pass emitted ultrasonic waves, and can occur over an opposite inner surface in a correspondingly sonically docked study area. On a side surface of the housing (13) is fixed to a guide (41), which can be moved on the compression plate (2) transversely to the arrangement of the Wandlerele- elements (15) of the ultrasound applicator (14). The direction of movement back and forth on the compression plate (2) is symbolized by a double arrow (58). In addition, over the guide (41) is still a pressure in the direction of compression plate (2) (arrow 60) is exerted, so that the seal (37) by means of the surface (39) liquid-tightly the compression plate (2) the interior space (9) of the housing concludes. The guide (41) is constructed in the form of a rigid tube, wherein electrical leads (31) for the ultrasound applicator (14) from the interior (9) are out felt. As must be expected consumption of the coupling means in use, the housing is additionally provided with a closable fluid fill (45) and a closable vent port (47). FIG 8 shows, in a sectional view of the ultrasonic applicator according to FIG 7. The radiating surface (64) of the ultrasound applicator (14) is arranged at a small distance from the outer surface (39) of the compression plate (2). This prevents that the radiating surface (64), which may also be an acoustic lens on the surface (39) of the compression plate (2) grinds. Likewise, the distance is chosen so that in the inner space filled (9) coupling fluid safe (64) and the outer surface (39) fills the space between the emitting surface. The main direction of the emitted ultrasonic waves as well as the main sensitivity direction is symbolized by a double arrow (59). The circumferential seal (37) is provided at its contact surface with a layer (43) from a thin textile material in order to improve the sliding properties. The textile material has openings, for example it is formed like a grid, wherein the apertures with the material from which the seal is made, are flush-filled. As must be expected consumption of the coupling means in use, the housing is additionally provided with a closable fluid fill (45) and a closable vent port (47). In the embodiment shown in a perspective view in FIG 9 second variant of the ultrasonic applicator of the sliding properties in the directions of movement as sealing elements rollers (49) are made of an elastic material on both opposite longitudinal sides of the housing (13) to improve. The rollers (49) form a part of the seal. The rollers (49) are mounted in a tubular guide (50) enclosing the rolls (49) with egg nem angle of slightly greater than 180 °, whereby the rollers (49) securely in the guides (50) are held. At the longitudinal sides connecting transverse sides of the housing (13) sealing pieces (51) are also arranged, which still cover the rollers (49) is additionally laterally sealing. The sealing pieces (51) are similar to the seal (37) constructed as described already with reference to FIG. 7 and 8 The distance between the rollers (49) to each other may be dimensioned so that the tubular guides to the rollers (49) protrude into the otherwise rectangular inner space (9), so that the guides (50) also adjacent to the housing (13) for supporting and attaching said ultrasound applicator (14) are used, as shown in FIG 6 and 7. FIG. For stability reasons, the rollers (49) can also be arranged at a greater distance from each other. Overall, the opening (1 1) to the surface-before (39) of the compression plate (2) is thus sealed by the arranged on the longitudinal sides of the housing rollers (49) and arranged on the transverse sides of the sealing pieces (51) toward liquid-tight. The ultrasonic applicator (14) is not shown in FIG 9, but it is similar within the housing (13) is installed, is as already described with reference to FIG. 7 In FIGS 10 and 11 of the ultrasound applicator additionally comprising a wiping member (52) and means is provided for drying (53). The wiping element (52) is arranged on one longitudinal side of the housing (13) over its entire length and removed even on the surface after the examination (39) remaining remnants of the coupling liquid. A complete drying is achieved with the means for drying (53). The means for drying (53) mainly consist of an absorbent material, for example a textile material in the form of a felt or an elastic foam material.

During the implementation of ultrasonic scanning of both the wiping element (52) and the means for drying (53) from the surface (39) is pivoted away, as shown in Fig. 10 The movement during the scanning is symbolized by an arrow (61). If the ultrasound applicator moved back to its starting position, indicated by an arrow (62), the wiping element (52) and the means for drying (53) are lowered onto the surface (39) to obtain (after the examination remaining coupling means from the surface 39) of the compression plate (2) are removed. The activated position of the wiping member (52) and the means for drying (53) are shown in Figure 1. 1 After prolonged use, the means for drying (53) are gen vollgeso- with coupling liquid. Therefore, the absorbent material on a support member (54) is easily replaceable fastened. Alternatively, a heating element (55) on the carrier element (54) can be fastened, whereby the soaked absorbent material to the means for drying (53) can be re-dried. FIG 12 shows a perspective view of a further embodiment of the inventive SEN ultrasound applicator, which is provided for coupling with a vertically standing compression plate. An ultrasonic applicator (14) in an interior (9) of up to the opening (11) and the opening (65) sealed housing (13). Here, the ultrasound applicator (14) is fixedly connected to the housing (13), which has not been represented for reasons of clarity here. The opening (11) in the sound harbors one of the ultrasonic applicator in the transmission case (14) generated or received in a case of the ultrasonic applicator (14) for receiving sound wave. The ultrasonic applicator (14) comprises a plurality of transducer elements arranged in a row (15) are individually activatable. The housing (13) is designed in the form of a rectangular box open on two sides. To which the opening (11) delimiting three edges of the housing (13) is circumferentially a seal (37) on an outer surface (39) of a compression plate (2) is placed, here has the opening (11) in the application sideways, while the opening (65) facing upward. A double arrow (58) indicates the direction of movement of the ultrasound applicator (14). Upon movement of the ultrasound applicator (14) of the imaging area before performing an X-ray examination can residues of the coupling fluid in analogy to Figures 10 and 11 by activated wiping elements (52) and means for drying (53), which are located in the region of the opening (65) were not shown and for the sake of clarity, be removed. In a likewise possible horizontal guide of the Ultraschallapplika- gate (14) on the vertical compression plate (2), which is not shown here, is the opening (65) formed by omitting one of the narrow walls of the housing. Openings for fluid filling or venting may be dispensed in any case, because the housing can be filled via the opening (65) and vented.

LIST OF REFERENCE NUMBERS

1 human mammary gland

3 seal

2,4 compression body in the form of a compression plate

5 ultrasonic transducer array

6 double arrow

7 hollow rod

7A rack

8 X-ray source

9 housing interior

10 movie

11 opening

12 interior

12A.12B part of interior

13 housing

14 ultrasound applicator

15 ultrasonic transducer element

16 left side wall

17 pages wall

18 Right Side wall

19 holder

20 double arrow ultrasound-transmitting side

double arrow

Ultrasonic coupling fluid

linkage

drive

electric motor

engine

signal lines

electronics unit

double arrow

Display device electrical leads

liquid line

Ausweiteeinheit

pump

monitor

reservoir

poetry

Vent hole outer surface

pusher

guide

poetry

layer

arrow

Flüssigkeitsfüllöffhung

wall

Vent curved double arrow

Role tubular guide

sealing pieces

wiping element

Means for drying

Carrier element heater 57 double-headed arrow 59 double-headed arrow

Arrow 62 arrow

gear

radiating

opening

Claims

Patentanspr├╝che
1. Ultraschallger├ñt and / or combined ultrasonic R├╢ntgenger├ñt for investigation of the human breast with at least one movably arranged compression plate by DA in da├ƒ in and / or on at least one compression plate of a ultrasonic Koppelfl ├╝ssigkeit fl├╝ssigkeitsdicht surrounded ultrasound applicator along a path is movably arranged, whereby for the Durchf├╝hrung R├╢ntgenuntersuchung unabh├ñngig from the projection direction of the R├╢ntgenstrahlung with respect to the human chest bez├╝ resembled the layer thickness v├╢llig uniformly distributed ultrasonic Koppelfl├╝ssigkeit is at a maximum layer thickness of the H├╢he the ultrasonic transducer elements in the beam path and / or the ultrasonic Koppelfl├╝ssigkeit to Durchf├╝hrung the R├ ╢ntgenuntersuchung is vollst├ñndig removed from the beam path.
2. Geräte according to claim 1, characterized in daß 2.1. in a combined ultrasonic-Röntgen Untersuchungsgerät least one of the movably arranged a compression plates gefüllten with ultrasonic Koppelflüssigkeit flüssigkeitsdichten interior (12) (15) of the sound elements Höhe of the ultrasonic applicator has, wherein the ultrasonic applicator is located, which is connected to a with a drive (25) connected to the rod (7), in which the electrical cable of the ultrasonic transducer elements (15) from flüssigkeitsdicht the hmenraum be geführt and daß the ultrasonic applicator according to the ultrasonic examination vollständig from the beam path can be removed
2.2. comprising in a combined ultrasonic-Röntgen Untersuchungsgerät with two gegenüberliegend and relative to each other movably arranged Kompressionskörpern (2, 4), between which an examination room is located, one of the compression plates a hmenraum (12) wherein said a drive (25) connected to the ultrasound applicator (14) is arranged daß means (32, 34, 36, 40) for Füllen of the interior with ultrasonic Koppelflüssigkeit (23) and are present for removing ultrasonic Koppelflüssigkeit from the interior and daß the ultrasonic applicator (14) according to the chung Ultraschalluntersu- vollständig can be removed from the beam path
2.3. the ultrasonic Koppelfl├╝ssigkeit (23) and the ultrasound applicator (14) in a Geh├ñuse (13) on the side facing away from a patient handels├╝blichen compression plate (2) are located, one ├ûffnung (11) area of ​​the sound path enth├ñlt that of Fl├╝ssigkeitsdichtmitteln (37, 49, 50, 51) for sealing the Geh├ñuse-interior (9) gegen├╝ber egg ner ultraschallm├ñ├ƒig to be coupled Oberfl├ñche ( 39) is surrounded, wherein the sealing means simultaneously Fl├╝ssigkeits- vollst├ñndigen a movement of the ultrasound applicator (14) and on the Geh├ñuse ultraschallm├ñ├ƒig to be coupled Oberfl├ñche (39) for kontinuierlichen_Erstellung of ultrasonic sectional images and allow removal of the transducer and Geh├ñuse to Durchf├╝hrung the R├╢ntgenuntersuchung.
3. Untersuchungsgerät according to Ansprüchen 1 and 2, Paragraph 2.1, characterized in that daß
3.1. to minimize the R├╢ntgenabsorption H├╢he of the interior (12) of the compression plate (2) on the H├╢he of ultrasound transducer elements (15) of the ultrasound applicator (14) is bounded by vertical F├╝hrung the electric cable of the ultrasonic transducer (15) in relation to the sound path
3.2. the rod (7) and the ultrasound applicator (14) are arranged substantially in a plane and
3.3. (7) the rod
3.3.1. is designed as a hollow rod and daß with the ultrasound transducer assembly (15) comparable Thematic electrical lines (31) through the hollow rod from the compression plate (2) are herausgeführt
3.3.2. is straight and rigidly formed
3.4. is formed of the ultrasound applicator (14) as an ultrasonic array (5) having a plurality arranged in a series of ultrasonic transducer elements (15) 3.5. the ultrasonic array (5) transversely to the straight path to the interior (12) ausf├╝llt
3.6. the compression plate (2) and the interior (12) are rectangular
3.7. the drive device (25) for movement of the ultrasound applicator (14)
3.7.1. located inside the double-walled compression plate amid the Koppelflüssigkeit 3.7.2. außerhalb the double compression plate and the Koppelflüssigkeit is
3.8. be used as Koppelfl├╝ssigkeiten with a small R├╢ntgenabsorption
3.8.1. Öle as Mineralöl or light Mineralöl
3.8.2. Alcohols such as ethyl or propyl
3.9. the H├╢he of the interior (12) of the compression plate (2), which is limited to the H├╢he of ultrasound transducer elements (15), a smooth movement of the ultrasonic applicator (14) and a smooth redistribution of Koppelfl├╝ssigkeit allowed (23) by the ultrasonic applicator (14) is not ausf├╝llt the cross section of the interior seal.
4. Untersuchungsgerät according to Ansprüchen 1 and 2, Paragraph 2.2, characterized in that daß 4.1. the compression plate (2) is equipped with an interior space (12), in which the ultrasound applicator (14) moves
4.2. the Koppelfl├╝ssigkeit (23) is removed vollst├ñndig after the examination, whereby in addition to pumping zus├ñtzliche means (32, 34, 36, 40) to remove also the last Fl├╝ssigkeitsreste be used 4.3. the interior (12) of the compression plate (2) ge├╢ffnet and one of the interior forming panels - the patient facing away from second plate which is the same as the actual compression plate gro├ƒ - be removed after removal of the Koppelfl├╝ssigkeit from the beam path 4.4 lives. the double-walled compression plate (2) is perpendicular in lying Mammografieger├ñt is gef├╝llt from below with Fl├╝ssigkeit, wherein the ultrasonic applicator (14) and moves with the Fl├╝ssigkeitsspiegel up the upwardly open interior (12) facilitates the Abklappung of the second part of the compression plate after removal of the transducer (14) and the Koppelfl├╝ssigkeit (23), after the ultrasound applicator has zur├╝ckbewegt to the starting position and the Koppelfl├╝ssigkeit vollst├ was ñndig Located at 4.5. the Antriebsvo╬╣╧äichtung (25) for movement of the ultrasound applicator (14) inside the double-walled compression plate (2) in the middle of Koppelfl├╝ssigkeit (23) and containing the electrical leads (31) of the ultrasound applicator rod (7) during a movement fl├╝ssigkeitsdicht from the interior (12) and is challenges hereingef├╝hrt 4.6. the drive (25) of the double au├ƒerhalb compression plate (2) is 4.7. Means (32, 34, 36, 40) for F├╝llen of the interior (12) with ultrasonic Koppelfl├╝ssigkeit (23) and for removing ultrasonic Koppelfl├╝ssigkeit from the interior are present
4.8. the Kompressionskörper (2, 4) are formed as flat plates which are arranged parallel to each other 4.9. the ultrasound applicator (14) umfaßt a plurality of arrayed in a row ultrasound transducer elements (15)
10.4. a slider (40) with the ultrasound applicator (14) is
11.4. the interior (12)
4.11.1. a Belüftungsöffnung (38) 4.11.2. is in the direction of movement of the ultrasound applicator (14) has a cross-sectional gleichförmigen, daß with the ultrasonic applicator (14), a slider (40), which rests sealingly against the cross-section limiting Innenwänden
12.4. the means for emptying and a Füllen Vorratsbehälter (36) having a Flüssigkeitstransportvorrichtung which Vorratsbehälter (36) über Flüssigkeitslei- a device (32) to the interior (12) is connected and
13.4. a space remote from the examination and the interior (12) restricting wall (46) of the compression plate (2) is designed to be removable or can be folded away.
5. Untersuchungsgerät according to Ansprüchen 1 and 2, Paragraph 2.3, characterized in that daß 5.1. having Gehäuse (13) emanating in a from the ultrasound applicator (14) a sound path Öffnung (11)
5.2. the releasing the sound path of the ultrasound applicator Öffnung of Gehäuses of Flüssigkeitsdichtmitteln (49, 51, 37) for sealing the Gehäuse-Irmenraums (9) of the ultrasound applicator-containing Gehäuses gegenüber a ultraschallmäßig anzukop- pelnden Oberfläche (39) is bordered
5.3. the ultrasound applicator (14) is in a Gehäuse and is moved together with this on the patient side facing away from the compression plate
5.4. between the sound path of the applicator and the compression plate, only the Koppelflüssigkeit is 5.5. the design of the Gehäuses in the region which is in direct contact with the compression plate gewährleistet,
5.5.1. on the one hand a seal (37) hält the Koppelflüssigkeit within the Gehäuses
5.5.2. the Möglichkeit the movement of ultrasonic applicator and Gehäuse on the compression plate and 5.5.3. On the other hand vollständige distance of the coupling means of the compression plate in the areas über which the ultrasound applicator has been moved.
6. Untersuchungsgerät with ultrasound applicator (14) according to Ansprüchen 1 and 2, numeral
2.3 and claim 5, characterized in that daß 6.1. the Flüssigkeitsdichtmittel (49,51, 37)
6.1.1. are constructed for coupling to a flat Oberfläche (39)
6.1.2. zusätzlich include a textile-like material
6.1.3. comprise rollers (49) of a resilient material
6.2. the Geh├ñuse (13) has two parallel L├ñngsseiten and L├ñngsseiten umfa├ƒt connecting transverse sides, the Fl├╝ssigkeitsdichtmittel da├ƒ two rollers (49) comprise, arranged at the L├ñngsseiten and da├ include ƒ the Fl├╝ssigkeitsdichtmittel arranged on the transverse sides between the rollers Dichtst├╝cke (51)
6.3. daß the Dichtstücke (51) laterally covering the rollers (49) sealingly
6.4. daß to the Gehäuse (13), a wiping element (52) is attached, which 6.4.1. in a first movement direction of the ultrasound applicator (14) can be activated
6.4.2. deactivated in a second direction of movement and
6.4.3. is disposed at a Längsseite
6.5. daß to the Gehäuse (13) means for drying (53) of Oberfläche (39) are arranged, which 6.5.1. in a first movement direction of the ultrasound applicator (14) can be activated
6.5.2. deactivated in a second direction of movement and
6.5.
3. are disposed at a Längsseite
6.5.
4. comprise a material saugfähiges
6.5.5. a textile material include 6.5.6. comprise a resilient foam material
6.5.7. is comprise a Trägerelement (54) and the daß Trägerelement for replacing the saugfähigen material formed and
6th
5.8. comprise a heating element (55)
6.6. daß in the Gehäuse (13) a sealing verschließbare 6.6.1. Flüssigkeitsfüllöffhung (45) is arranged
6.6.2. Entl├╝ftungs├╢ffnung (47) is arranged
6.7. daß means for Andrücken (41, 44, 50) of the Öffnung (1: 1) sealing Flüssigkeitsdichtmittel (49, 51) to be coupled Oberfläche (39) with the Gehäuse (13 ) are connected.
7. Untersuchungsgerät with ultrasound applicator (14) according to Ansprüchen 1, 2, Paragraph 2.3 and the Ansprüchen 5 and 6, characterized in that the daß Gehäuse (13) with horizontal Abstrahlungs- and receiving direction of the ultrasonic waves outgoing from an ultrasonic applicator in (14) has a sound path Öffnung (1: 1) in the direction of the sound path and a Öffnung (65).
8. ultrasound applicator of a medical ultrasound Untersuchungsger├ñtes with compression plates (2, 4) and ultrasonic Koppelfl├╝ssigkeit (23), wherein the ultrasonic applicator (14) in a Geh├ñuse (13) on a compression plate is and the Geh├ñuse a ├ûffnung (11) in the region of a sound path enth├ñlt that ├ûffnung of Fl├╝ssigkeitsdichtmitteln (49, 51, 37) for sealing a Geh├ñuse-interior (9) gegen├ is surrounded ╝ber a ultraschallm├ñ├ƒig to be coupled Oberfl├ñche (39).
9. Ultrasonic applicator according to claim 8, characterized in that daß 9.1. it is located in a Gehäuse (13) and together with this on the patientenabge- facing side of the compression plate (2) is moved
9.2. between the sound path of the applicator (14) and the compression plate (2), only the Koppelfl├╝ssigkeit (23)
9.3. the design of the Gehäuses (13) in the region which is in direct contact with the compression plate (2) gewährleistet,
9.3.1. on the one hand a seal (37) hält the Koppelflüssigkeit (23) within the Gehäuses (13)
9.3.2. the Möglichkeit the movement of the ultrasound applicator (14) and Gehäuse (13) on the compression plate (2) and 9.3.3. On the other hand vollständige distance of the coupling means of the compression plate in the areas über which the ultrasound applicator has been moved.
10. Ultrasonic applicator according to Ansprüchen 8 and 9, characterized in that daß
10.1. the Flüssigkeitsdichtmittel (49, 51, 37) 10.1.1. are constructed for coupling to a flat Oberfläche (39)
10.1.2. zusätzlich include a textile-like material
10.1.3. comprise rollers (49) of a resilient material
10.2. the Geh├ñuse (13) has two parallel L├ñngsseiten and L├ñngsseiten umfa├ƒt connecting transverse sides, the Fl├╝ssigkeitsdichtmittel da├ƒ two rollers (49) comprise, arranged at the L├ñngsseiten and da├ include ƒ the arranged Fl├╝ssigkeitsdichtmittel on the transverse sides between the rollers (49) Dichtst├╝cke (51)
10.3. daß the Dichtstücke (51) laterally covering the rollers (49) sealingly
10.4. daß to the Gehäuse (13), a wiping element (52) is attached, the
10.4.1. in a first movement direction of the ultrasound applicator (14) activated 10.4.2. deactivated in a second direction of movement and 10.4.3. is disposed at a Längsseite
10.5. daß to the Gehäuse (13) means for drying (53) of Oberfläche (39) are arranged, which 10.5.1. in a first movement direction of the ultrasound applicator (14) activated 10.5.2. deactivated in a second direction of movement and
10.5.3. are arranged on a Längsseite
10.5.4. comprise a material saugfähiges
10.5.5. comprise a textile material
10.5.6. an elastic foam material include 10.5.7. comprise a Trägerelement (54) and the daß Trägerelement is designed to replace the saugfähigen material and 10.5.8. comprise a heating element (55)
10.6. daß in the Gehäuse (13) a sealing verschließbare 10.6.1. Flüssigkeitsfüllöffhung (45) is arranged 10.6.2. is arranged Entlüftungsöff ung (47)
10.7. daß means for Andrücken (41, 44, 50) of the Öffnung (1: 1) sealing Flüssigkeitsdichtmittel (49, 51) to be coupled Oberfläche (39) with the Gehäuse (13 ) are connected.
11. Ultrasonic applicator according to Ansprüchen 8 to 10, which is provided in a further Ausführung for coupling with a vertically standing compression plate and characterized in daß
11.1. it is placed in an inner space (9) of up to the Öffnung (11) and the Öffnung (65) tight Gehäuses (13) and fixed to the Gehäuse (13) 11.2. the Öffnung (11) to be received acoustic wave generated in the sound path of an ultrasonic applicator in the transmission case (14) or in the case of receiving one of the ultrasound applicator (14)
11.3. the ultrasound applicator (14) includes a plurality of arrayed in a row of transducer elements (15) are individually activatable umfaßt 11.4. the Gehäuse (13) is designed in the form of a rectangular box open on two sides
11.5. to which the Öffnung (1: 1) delimiting three edges of the Gehäuses (13) encircling a seal (37) to a äußere Oberfläche (39) of a compression plate (2) is mounted and in this case (the Öffnung 11) seitwärts has in the application, the während Öffnung (65) faces upwardly, and wherein a double arrow (58) indicates a vertical direction of movement of the ultrasonic applicator (14)
11.6. upon movement of the ultrasound applicator (14) of the imaging area before conducting a R├╢ntgenuntersuchung radicals of Koppelfl├╝ssigkeit by activated wiping elements are located (52) and means for drying (53) located in the area of ​​├ûffnung (65) are removed and 11.7. In a likewise m├╢glichen horizontal F├╝hrung of the ultrasound applicator (14) on the vertical compression plate (2) the ├ûffnung (65) is formed by omitting one of the narrow W├ñnde of Geh├ñuses.
12. Use of the medical Ultraschallgerätes and / or combined ultrasonic Röntgengerätes according to Ansprüchen 1 to 7 for investigation of the human breast.
13. Use of the ultrasound applicators in accordance with the Ansprüchen 8 to 11 in medical Ultraschallgeräten and / or combined ultrasonic Röntgengeräten.
PCT/EP1999/005917 1998-08-17 1999-08-16 Combined ultrasound-radiography apparatuses WO2000009014A1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
DE19837264.7 1998-08-17
DE19837262.0 1998-08-17
DE19837262A DE19837262A1 (en) 1998-08-17 1998-08-17 Combined ultrasound and X-ray device for breast examination; has maximum ultrasonic coupling liquid depth at ultrasonic transducer height, where liquid may be remove for X-ray investigation
DE19837259A DE19837259A1 (en) 1998-08-17 1998-08-17 Combined ultrasound and X-ray device for breast examination; has maximum ultrasonic coupling liquid depth at ultrasonic transducer height, where liquid may be remove for X-ray investigation
DE19837259.0 1998-08-17
DE1998137264 DE19837264A1 (en) 1998-08-17 1998-08-17 Combined ultrasound and X-ray device for breast examination; has maximum ultrasonic coupling liquid depth at ultrasonic transducer height, where liquid may be remove for X-ray investigation

Publications (1)

Publication Number Publication Date
WO2000009014A1 true WO2000009014A1 (en) 2000-02-24

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Application Number Title Priority Date Filing Date
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Country Link
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