WO2005013822A1 - Procede et appareil d'evaluation de proprietes biomecaniques au moyen d'ultrasons - Google Patents

Procede et appareil d'evaluation de proprietes biomecaniques au moyen d'ultrasons Download PDF

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Publication number
WO2005013822A1
WO2005013822A1 PCT/EP2004/007576 EP2004007576W WO2005013822A1 WO 2005013822 A1 WO2005013822 A1 WO 2005013822A1 EP 2004007576 W EP2004007576 W EP 2004007576W WO 2005013822 A1 WO2005013822 A1 WO 2005013822A1
Authority
WO
WIPO (PCT)
Prior art keywords
movement
ultrasound
induced
signals
target structure
Prior art date
Application number
PCT/EP2004/007576
Other languages
English (en)
Inventor
Ayache Bouakaz
Nicolaas De Jong
Christiaan Johannes Snijders
Ester Vlaanderen
Original Assignee
Stichting Voor De Technische Wetenschappen
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Stichting Voor De Technische Wetenschappen filed Critical Stichting Voor De Technische Wetenschappen
Priority to EP04740857A priority Critical patent/EP1656066A1/fr
Publication of WO2005013822A1 publication Critical patent/WO2005013822A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528—Joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0048—Detecting, measuring or recording by applying mechanical forces or stimuli
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0048—Detecting, measuring or recording by applying mechanical forces or stimuli
    • A61B5/0051—Detecting, measuring or recording by applying mechanical forces or stimuli by applying vibrations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6843—Monitoring or controlling sensor contact pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0875—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of bone
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N29/00—Investigating or analysing materials by the use of ultrasonic, sonic or infrasonic waves; Visualisation of the interior of objects by transmitting ultrasonic or sonic waves through the object
    • G01N29/04—Analysing solids
    • G01N29/07—Analysing solids by measuring propagation velocity or propagation time of acoustic waves
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N29/00—Investigating or analysing materials by the use of ultrasonic, sonic or infrasonic waves; Visualisation of the interior of objects by transmitting ultrasonic or sonic waves through the object
    • G01N29/04—Analysing solids
    • G01N29/12—Analysing solids by measuring frequency or resonance of acoustic waves
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N29/00—Investigating or analysing materials by the use of ultrasonic, sonic or infrasonic waves; Visualisation of the interior of objects by transmitting ultrasonic or sonic waves through the object
    • G01N29/34—Generating the ultrasonic, sonic or infrasonic waves, e.g. electronic circuits specially adapted therefor
    • G01N29/348—Generating the ultrasonic, sonic or infrasonic waves, e.g. electronic circuits specially adapted therefor with frequency characteristics, e.g. single frequency signals, chirp signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/44—Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441—Skin evaluation, e.g. for skin disorder diagnosis
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N2291/00—Indexing codes associated with group G01N29/00
    • G01N2291/02—Indexing codes associated with the analysed material
    • G01N2291/024—Mixtures
    • G01N2291/02483—Other human or animal parts, e.g. bones
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N2291/00—Indexing codes associated with group G01N29/00
    • G01N2291/02—Indexing codes associated with the analysed material
    • G01N2291/028—Material parameters
    • G01N2291/02836—Flow rate, liquid level

Definitions

  • the present invention relates particularly, though not exclusively, to methods and apparatus for assessing biomechanical properties of joints and other movable structures ofthe human and animal body.
  • Mobility tests, provocation tests and palpation are techniques that are frequently used in physiotherapy to obtain information on the hy ermobility or hypomobility of joints.
  • specific joints such as the sacroiliac, carpal and tarsal joints, these clinical examinations are impaired by limited excursion of the joints and by restricted accessibility to the region of interest.
  • radio-opaque markers can be inserted into the sacrum and ilium, and displacement of the markers after joint manipulation is measured on x-ray photographs.
  • rotations and translations of the ilium in relation to the sacrum can be measured using either of these techniques.
  • the positioning of markers for assessment of range of motion in joints with limited accessibility requires at least minimally invasive procedures, which increase the costs and risks ofthe procedures and discomfort to the patient.
  • Ultrasound techniques have proven to be suitable for such measurements for medical diagnostic purposes.
  • the underlying principle of ultrasound displacement measurements is based on time delay estimation of ultrasound waves.
  • time delay estimation is one of the common operations in ultrasound signal and image processing and can be performed by different algorithms. Examples are normalized and non-normalized cross correlation, normalized covariance, polarity-coincidence correlation and hybrid-sign correlation. For instance sophisticated signal processing is used to improve image quality or to extract information usually not available in the grey scale B-Mode image.
  • time delay is used for estimating displacement.
  • measurement of blood flow velocity using Doppler ultrasound is well lcnown, where the time delay is estimated by cross-correlation of subsequent echoes.
  • a packet of short ultrasound 'detection' pulses is transmitted into the vessel or heart, and reflected signals are received sequentially after a certain delay. Due to movement of ultrasound scattering entities in the blood, the time between the transmitted detection pulse and the returning echo will change, and can be used to estimate the velocity.
  • stationary (vessel wall) and non-stationary (blood) structures can be distinguished by correlating their signals throughout sequential image frames.
  • a recent technology that takes advantage of time delay estimations is intravascular ultrasound elastography.
  • local strain in the artery wall and plaques are assessed by looking at the deformation of the tissue.
  • time delay estimation is used for on-line measurements of the density of ceramic tiles.
  • the time of flight of the ultrasonic waves is measured in transmission mode using cross- correlation algorithms between transmitted and received signals.
  • ultrasound cross-correlation- based flow metering systems Other devices that use a similar approach are ultrasound cross-correlation- based flow metering systems. These systems, used as non-destructive testing systems, indicate the value of the convection velocity of turbulent structures in pipe flows.
  • the expression 'system under investigation' is intended to encompass exemplary systems such as the musculoskeletal system including the bones, muscles, ligaments etc.
  • exemplary systems such as the musculoskeletal system including the bones, muscles, ligaments etc.
  • An example of such a system is the pelvic musculoskeletal system.
  • the system under investigation includes multiple component parts which have differing ultrasound reflection / transmission properties and whose relative spatial relationship can vary due to the resilience, plasticity and or elasticity of at least one ofthe component parts.
  • the dynamic response of the target structures (e.g. bones) within the system can be measured with the ultrasound signals and the biomechanical properties of the system under investigation (e.g. joints) can be deduced therefrom.
  • the present invention provides a method for measuring mechanical properties of a system under investigation, comprising the steps of: inducing movement in a target structure in the system over a predetermined period of time; directing ultrasound detection signals into the system at times such that at least some induced movement has occurred in the target structure between a first detection signal and a second detection signal; and receiving ultrasound echo signals from the target structure.
  • the present invention provides an apparatus for the measurement of mechanical properties of a system under investigation, comprising: a mechanical stimulator for inducing movement in a target structure in the system over a predetermined period of time; and an ultrasound transducer for directing ultrasound detection signals into the system at times such that at least some induced movement has occurred in the target structure between a first detection signal and a second detection signal and for receiving echo signals therefrom.
  • Figure 1 is a schematic block diagram of the components of an apparatus for assessment of the dynamic response of a target structure to a time-dependent external stimulus
  • Figure 2 is a graph illustrating a packet of ultrasound detection pulses together with corresponding echo pulses
  • Figure 3 is a graph illustrating a first and a second ultrasound echo from a target structure in which movement is induced in the structure between first and second detection pulses
  • Figure 4 is a schematic block diagram of the components of apparatus for assessment of the dynamic response of a target structure to a time dependent external stimulus, according to a second embodiment of the present invention
  • Figures 5a and 5b are graphs depicting (a) the time delay between two echoes returned from the target structure and (b) the displacement-time plot of a component within the target structure.
  • FIG. 1 there is shown a first arrangement of apparatus 10 for the measurement of the dynamic response of a target structure 11 within a system under investigation 3, e.g. a human or animal joint 12.
  • the system 12 incorporates one or more ultrasound reflecting surfaces or components, such as bones 11, 13 within one or more resilient or otherwise deformable softer components such as tissue, cartilage, synovial fluid and the like. It will be understood that the more rigid bone components are relatively displaceable under physical displacement stimulus, as a result of the softer components therebetween.
  • a pulse generator or emitting source 1 is adapted to produce a series of ultrasound detection pulses to be directed onto the target structure 11, 13 in the system under investigation.
  • the pulse generator 1 is connected to a transducer 2 for generating ultrasound detection signals that are directed into the system 3, 12.
  • Ultrasound echo signals received from the system 3 are sensed by transducer 2 and received at receiver 6 connected thereto.
  • the received echo signals are analysed and processed by post-processing circuits 7.
  • a mechanical stimulator 4 is provided for inducing movement in the system 3, driven by a driving source 5.
  • the mechanical stimulator 4 may be of an electromagnetic type adapted to generate a continuous or impulsive / transient physical displacement in a drive head portion of the stimulator. The physical displacement is communicated to the system 3 under investigation by contact with the drive head of the stimulator 4.
  • the mechanical stimulator may comprise a vibrator for inducing periodic aperiodic or impulsive motion; or an impact device for inducing an impulsive motion.
  • the impact device could include a hammer action device.
  • the mechanical stimulation may be continuous or transient / impulsive.
  • the stimulation may be random or dete ⁇ ninistic in frequency and/or amplitude.
  • the deterministic stimulation may be periodic or non- periodic.
  • the periodic stimulation may have any particular profile, and may have a single frequency component or multiple frequency components (referred to herein as 'harmonic').
  • the mechanical stimulator 4 will impart physical displacement forces into the system under investigation. More rigid components, or target structures of the system, such as bones 11, 13, will be displaced according to forces transmitted to them through the surrounding soft tissue, which will generally exhibit resilient elastic or plastic properties. The rigid components will reflect any ultrasound pulses directed at them, which provides detailed information regarding their precise displacement as a function of time. In turn, this will reveal information regarding the surrounding medium through which the externally generated physical displacement excitation has been transmitted.
  • the profile of the physical displacement excitation i.e. its shape and its continuous or impulsive character
  • its force and the exact location of any input or contact point with the system depends upon a number of factors such as the type of target structure and system under investigation and on the type of data being sought.
  • the profile of the physical displacement excitation is sinusoidal (for a periodic waveform) or random.
  • the magnitude of the displacement is of the order of microns, (e.g. 1 to 1000 microns).
  • the frequency of any periodic physical displacement excitation wavefo ⁇ n is in the range 5 to 500 Hz.
  • the physical displacement excitation is applied at any suitable location for effective coupling of the motion into the system.
  • the mechanical stimulator could be positioned at the spina iliaca superior anterior.
  • the mechanical stimulator would be positioned at the medial side of the head of the first metatarsal, near the metatarsophalageal joint.
  • a number of short ultrasound detection pulses 20 is transmitted into the system by the pulse generator 1 and transducer 2.
  • the number N of pulses and the pulse repetition frequency are preferably such that at least a whole cycle of vibration is covered by a plurality of ultrasound pulses 20.
  • the number of pulses per cycle is at least 30.
  • the target structure (e.g. bone 11) beneath the surrounding soft tissue acts as a reflector and echoes 21 are returned to the transducer 2.
  • the pulse repetition frequency is preferably tuned so that for a given distance of the bone from the transducer and the speed of sound within the intervening medium, each echo 21 is returned to the transducer 2 before the transmission of the next pulse 22.
  • the apparatus may be expanded with a second transducer (not shown) and accompanying pulse generator (not shown) in similar manner.
  • the time for the transmitted pulses 20, 22 to travel to the bone 11 and back to the transducer 2 varies.
  • the echoes 21 are recorded subsequently by post-processing circuits 7 and analysed.
  • two successive echoes n and n+1, separated by time At will vary according to the difference in time of flight arising from the movement of the ultrasound reflecting part of the structure caused by the mechanical stimulator 4 in at least the period intervening the successive detection pulses that caused the two successive echoes n abd n+1.
  • Information about the difference in time of flight can be obtained by a number of possible mathematical algorithms, such as correlation algorithms. Other techniques are available to the person skilled in the art.
  • the variations in bone displacement as a function of time are dependent upon the waveform of the movement induced by the mechanical stimulator 4 and upon the physical attributes of the surrounding soft tissue. For example, any elasticity or resilience in the surrounding tissue determines the movement profile of rigid structures such as the bone and contribute to the significance of inertia and damping forces in the measured response.
  • apparatus 40 comprises a trigger source 41 that is comiected to a pulse generator 42 for producing a series of ultrasound pulses to be directed into the system 45 under analysis.
  • the pulse generator 42 is comiected, by way of switch 43, to a transducer 44 for generating ultrasound detection signals that are directed into the system under investigation 45 and onto a target structure therein.
  • Ultrasound echo signals 21 received from the target structure in the system 45 are sensed by transducer 44 and passed, via switch 43 to an amplifier and filter 48.
  • the switch 43 acts as a directional filter in which output signals for generating ultrasound output pulses 20 having a magnitude greater than a predetermined threshold level (eg. 0.5 V) are passed to the transducer 44, while echo pulses 21 having a magnitude less than the predetermined threshold level are passed through to the receiver circuits of amplifier and filter 48.
  • a predetermined threshold level eg. 0.5 V
  • the output of the amplifier and filter 48 is fed to an analysis or post-processing circuit comprising a digitising oscilloscope 49 and thence to a computer system 50 for storage and analysis ofthe data.
  • a mechanical stimulator 46 is provided for inducing movement in the system 45, driven by a driving source 47.
  • the mechanical stimulator 46 may be of any suitable type adapted to generate a continuous or impulsive physical displacement. The physical displacement is communicated to the system 45 under investigation by interfacing with the mechanical stimulator 46.
  • the trigger source 41 provides a trigger pulse 51 to both the pulse generator 42 and the oscilloscope 49.
  • This is amplified and possibly shaped by the pulse generator 42 and directed to the transducer 44 by the switch 43.
  • the transducer directs a resulting series of ultrasound detection signals into the system 45 during one or more cycles of the physical displacement waveform of the vibrator 46. These ultrasound signals are reflected from certain components 11, 13 in the system 12 and received at transducer 44.
  • the switch 43 directs the received echo signals to the amplifier and filter 48.
  • the amplifier and filter 48 removes noise and improves the signal to noise ratio and the output therefrom is directed to the oscilloscope 49.
  • the oscilloscope 49 also receives the trigger pulse 51 that generated the ultrasound detection signals and therefore provides a reference against which the time delays between successive output pulses 20 and echoes 21 can be measured.
  • the oscilloscope in sequence mode, displays and stores the echo signals after a preset delay.
  • a digital output from the oscilloscope 49 enables the storage of results to the computer system 50 for subsequent analysis.
  • an electromagnetic stimulator 46 was covered with a gel pad representing soft tissue and vibrating structure beneath and operated to give a periodic physical displacement excitation of 200 Hz, having a sinusoidal waveform at a constant amplitude.
  • the experiment was performed for different vibration amplitudes of 0.6, 1.2, 2.4, 3.7, 4.9 and 6.2 microns. Good agreement was found between the estimated vibration amplitude and the measured displacements. The measured values differed at maximum by 5% for displacements as low as 0.6 ⁇ .
  • a pilot in vivo experiment was performed in order to assess the protocol and the detectability of the bone vibration in the pelvic girdle system.
  • the physical displacement excitation was introduced into the pelvic system by means of an electromagnetic stimulator placed in direct contact with the spina iliaca superior anterior.
  • Sinusoidal vibrations were applied at 100 and 200 Hz with amplitudes ranging from 6.2 to 200 microns. The vibrations were detected in the ilium and on the sacrum on the dorsal side ofthe patient. The ultrasound technique was able to detect the induced vibrations of the pelvic bones ranging from 50 nm to 2 microns.
  • the mechanical stimulator 46 may be of any suitable size having a driving surface suitable for making sufficient contact with an external surface of the body or system under examination. It may be also designed to support a body or part of a body in question. The contact between the body and the mechanical stimulator may be continuous in the case of a periodic or aperiodic stimulus, or transient in the case of an impulsive stimulus.
  • the stimulator is preferably adapted for coupling to the body at a location of minimal distance from the bone and joint under examination, eg. at a location where the thinnest soft tissue layer intervenes.
  • the stimulator may also be adapted to include means for ensuring optimal position and/or orientation, such as a shaped surface or engagement structure for attachment to the body.
  • the position and orientation of ultrasound transducers for transmitting detection pulses and receiving echoes is preferably optimised with respect to the motion induced by the mechanical stimulator, so as to detect maximum vibration amplitude.
  • the direction of the ultrasound beam is orthogonal to the surface of the reflecting structure for receiving maximum echo signal.
  • the subject is placed in a prone position on a bed.
  • the pelvis is unilaterally supported by a mechanical stimulator or shaker.
  • the support preferably protrudes through an aperture in the bed surface, located at the SIAS (spina iliaca anterior superior).
  • SIAS spina iliaca anterior superior
  • the ultrasound transducer is preferably positioned respectively at the posterior superior iliac spine (SIPS) and on the line through the left and right SIPS near the procesus spinosus of S2.
  • the ultrasound transducer may be manipulated until a clear echo is observed on an oscilloscope, then the subsequently received signals stored.
  • the mechanical stimulator 46 is adapted to operate at frequencies within the range 5 Hz to 500 Hz, and more preferably in the range 5 Hz and 300 Hz.
  • the pulse generator 42 is adapted to produce ultrasound detection signals of frequency in the range 1 MHz to 30 MHz, and with pulse repetition rates of between 150 and 125,000 per second, or between 30 and 250 per cycle ofthe stimulator frequencies.

Abstract

L'invention concerne un procédé et un appareil permettant de mesurer les propriétés mécaniques d'un système à examiner, telles que les propriétés biomécaniques et les caractéristiques dynamiques d'un système musculo-squelettique dans le corps humain. Le système à examiner comprend des parties constituantes multiples (les os, les muscles, les ligaments, par exemple) présentant des propriétés de réflexion/transmission d'ultrasons différentes, et dont la relation relative dans l'espace peut varier en fonction de la souplesse, de la plasticité ou de l'élasticité d'au moins une de ces parties constituantes. Un mouvement dans le système est induit au moyen d'un simulateur mécanique. Des signaux de détection d'ultrasons sont introduits dans le système à des moments tels qu'au moins un certain mouvement induit se produit dans des structures cibles à l'intérieur du système, entre un premier signal de détection et un deuxième signal de détection. Des signaux d'écho ultrasons sont utilisés pour déterminer les propriétés mécaniques du système.
PCT/EP2004/007576 2003-07-17 2004-07-06 Procede et appareil d'evaluation de proprietes biomecaniques au moyen d'ultrasons WO2005013822A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP04740857A EP1656066A1 (fr) 2003-07-17 2004-07-06 Procede et appareil d'evaluation de proprietes biomecaniques au moyen d'ultrasons

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0316722.8 2003-07-17
GB0316722A GB2404024A (en) 2003-07-17 2003-07-17 Measuring biomechanical properties of joints using ultrasound

Publications (1)

Publication Number Publication Date
WO2005013822A1 true WO2005013822A1 (fr) 2005-02-17

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EP (1) EP1656066A1 (fr)
GB (1) GB2404024A (fr)
WO (1) WO2005013822A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101869490A (zh) * 2010-06-01 2010-10-27 深圳市一体医疗科技有限公司 一种振荡装置及应用该振荡装置的检测系统
US8197413B2 (en) 2008-06-06 2012-06-12 Boston Scientific Scimed, Inc. Transducers, devices and systems containing the transducers, and methods of manufacture

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1739455A1 (fr) 2005-06-23 2007-01-03 I.N.S.E.R.M. Institut National de la Sante et de la Recherche Medicale Imagerie ultrasonore d'agents de contrast utilisant des rampes de fréquences inversées

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992021023A1 (fr) * 1991-05-10 1992-11-26 Board Of Regents, The University Of Texas System Procede et appareil de mesure et d'imagerie elastographique
US20020068870A1 (en) * 2000-07-20 2002-06-06 Alam Sheikh Kaisar Hand held mechanical compression device for inducing tissue strain
US6569098B2 (en) * 2001-01-31 2003-05-27 University Technologies International Inc. Non-invasive diagnostic method and apparatus for musculoskeletal systems

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992021023A1 (fr) * 1991-05-10 1992-11-26 Board Of Regents, The University Of Texas System Procede et appareil de mesure et d'imagerie elastographique
US20020068870A1 (en) * 2000-07-20 2002-06-06 Alam Sheikh Kaisar Hand held mechanical compression device for inducing tissue strain
US6569098B2 (en) * 2001-01-31 2003-05-27 University Technologies International Inc. Non-invasive diagnostic method and apparatus for musculoskeletal systems

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8197413B2 (en) 2008-06-06 2012-06-12 Boston Scientific Scimed, Inc. Transducers, devices and systems containing the transducers, and methods of manufacture
CN101869490A (zh) * 2010-06-01 2010-10-27 深圳市一体医疗科技有限公司 一种振荡装置及应用该振荡装置的检测系统

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GB2404024A (en) 2005-01-19
GB0316722D0 (en) 2003-08-20
EP1656066A1 (fr) 2006-05-17

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