WO2022153726A1 - Blood vessel location display device - Google Patents

Abstract

Provided is a blood vessel location display device with which a medical practitioner can perform paracentesis without averting the line of sight from the vicinity of the paracentesis location. A blood vessel location display device 10 comprises: a probe body 20 having, along one direction, a first imaging unit 22 for acquiring a cross-sectional image of a human body by contacting the skin surface; a control unit 30 for detecting a blood vessel location from the cross-sectional image; and a display unit 27 for displaying the blood vessel detected by the control unit 30 in at least one direction along which the first imaging unit 22 runs. Additionally, the display unit 27 is disposed in a location close to the first imaging unit 22 on the outer surface, of the probe body 20, along the same direction as said one direction along which the first imaging unit 22 runs.

Description

Blood vessel position indicator

The present invention relates to a blood vessel position indicator that detects the position of a blood vessel from an image acquired by an echo device and displays a puncture point based on the detected position of the blood vessel.

In order to secure an access site for drug administration and endovascular treatment, blood vessel puncture is performed by puncturing the human body with an injection needle. In vascular puncture, since the operator cannot visually recognize the blood vessel from the skin surface, the position of the blood vessel is estimated by the standard knowledge of blood vessel running and skill such as palpation of blood vessel pulsation. However, vascular puncture failures often occur, causing physical and mental distress to the patient.

In recent years, techniques for visualizing blood vessel positions such as near-infrared images, ultrasonic echoes, and optical reverberation imaging may be used to identify the puncture position. For example, as an ultrasonic echo device for displaying a cross-sectional image of an arm on a monitor, there is one as listed in Patent Document 1.

Republished Patent No. 2017/022073

The above-mentioned technique for visualizing the blood vessel position makes it possible to specify the blood vessel position at the time of puncture, but since the positional relationship between the visualized image and the skin surface is not always clear, it is necessary to grasp the puncture position. A certain amount of skill is required. In particular, in puncture using an ultrasonic echo device, a cross-sectional image acquired by the ultrasonic echo device is displayed on a monitor, and it is necessary for the operator to puncture while imagining the puncture position on the patient's arm from the cross-sectional image. be. In addition, the near-infrared image can project a blood vessel image on the skin surface, but since the near-infrared rays are reflected and attenuated in the body, the position accuracy is low and there is a possibility that the position may deviate from the actual blood vessel position. high.

The present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a blood vessel position indicator capable of puncturing from the vicinity of the puncture position without moving the line of sight.

The blood vessel position indicator according to the present invention that achieves the above object includes a probe body having a first imaging unit that comes into contact with the skin surface and acquires a cross-sectional image of the human body along one direction.
A control unit that detects the position of blood vessels from the cross-sectional image,
A display unit that displays the blood vessel position detected by the control unit in at least one direction along which the first imaging unit is aligned.
Have.

The blood vessel position indicator configured as described above identifies the blood vessel position with high accuracy from the cross-sectional image acquired by the first imaging unit, and the position of the puncture point is displayed in the vicinity of the puncture point of the probe body. However, it is not necessary to shift the line of sight to a monitor or the like, and the puncture operation can be concentrated, so that the puncture can be reliably performed regardless of the skill of the operator.

It is a front view of the blood vessel position indicator of this embodiment. It is a side view of the blood vessel position indicator. It is a figure which shows the skin contact surface of the blood vessel position indicator, and is the figure which showed the positional relationship with the arm which acquires the cross-sectional image. It is an enlarged side view of the state where the blood vessel position indicator is in contact with the arm and displays the blood vessel position. It is an enlarged view near the skin contact surface and the side surface of the probe body which is in contact with an arm. It is a block diagram of a blood vessel position indicator. It is a figure which showed the example of the image acquired by the imaging unit. It is a figure showing the positional relationship between the position of the center of gravity of a blood vessel, the imaging position, and the puncture point. It is an enlarged view of the position display part which displays a blood vessel position and a blood vessel diameter. It is a figure which shows the skin contact surface of the blood vessel position indicator which has a plurality of imaging parts, and is the figure which showed the positional relationship with the arm which acquires the cross-sectional image. It is an enlarged side view of the state in which the blood vessel position indicator having a plurality of imaging units is in contact with an arm and displays the blood vessel position. It is an enlarged view near the lower end of the probe main body which has the display part which concerns on the 1st modification. It is an enlarged view near the lower end of the probe main body which has the display part which concerns on the 2nd modification. It is an enlarged view near the lower end of the probe main body which has the display part which concerns on 3rd modification.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. The dimensional ratios in the drawings may be exaggerated and differ from the actual ratios for convenience of explanation.

The blood vessel position indicator according to the embodiment of the present invention is used when puncturing the arm of a human body, acquires a cross-sectional image of the arm, detects the blood vessel position, and displays the blood vessel position in the vicinity of the puncture position. It is a thing.

As shown in FIGS. 1 and 2, the blood vessel position indicator 10 has a probe main body 20 having an imaging unit 22 that comes into contact with the skin surface and acquires a cross-sectional image of the human body. The imaging unit 22 is provided on the skin contact surface 20a of the probe main body 20. A display unit 27 is provided on the side surface 20b, which is one of the outer surfaces of the probe main body 20.

The probe body 20 has a vertically long handle portion 24 that is gripped by the operator. The handle portion 24 may be fixed to the robot. When the handle portion 24 is fixed to the robot, the handle portion 24 may have a shape other than the vertically long shape. As shown in FIG. 3, the imaging unit 22 extends along one direction at the central portion of the skin contact surface 20a of the probe main body 20 and is provided so as to extend over substantially the entire width thereof. The imaging unit 22 is an echo device that has a vibrator that generates ultrasonic waves and obtains a cross-sectional image of the inside of the human body by detecting the reflected wave. In the present embodiment, since the cross-sectional image orthogonal to the axial direction of the blood vessel is acquired, the image pickup unit 22 is arranged so as to be orthogonal to the length direction of the arm H. The display unit 27 is provided on the side surface 20b extending along the same direction as the one direction in which the imaging unit 22 extends. The needle that punctures the arm is inserted from the side surface 20b side.

As shown in FIG. 4, the display unit 27 has a position display unit 28 arranged near the skin contact surface 20a on the side surface 21a, and a depth display unit 29 arranged above the position display unit 28. In the position display unit 28, a large number of display elements 28a are arranged along the horizontal direction, and each display element 28a can be switched between lighting and extinguishing. In FIG. 4, two display elements 28a slightly to the left of the center are lit, and the other display elements 28a are extinguished. The lit display element 28a represents the blood vessel position in the length direction of the imaging unit 22. Further, the position display unit 28 represents the blood vessel diameter by the number of display elements 28a that are lit at the same time. An LED can be used as the light source of the position display unit 28. However, other light sources may be used. The light from the LED is branched by the separator so that the display element 28a can be selectively turned on.

The depth display unit 29 is composed of a liquid crystal screen. The depth display unit 29 numerically displays the puncture depth, which is the depth at which the needle should be inserted. Here, the puncture depth is the distance from the puncture position to the position of the center of gravity of the blood vessel when puncturing at a constant angle (for example, 30 °) from the puncture position. However, as the puncture depth, the length obtained by projecting a straight line extending from the puncture position to the position of the center of gravity of the blood vessel on the skin surface may be displayed.

As shown in FIG. 5, the position display unit 28 is arranged in the vicinity of the skin contact surface 20a on the side surface 20b of the probe main body 20. The needle 60 is generally inserted at an angle of 30 ° with respect to the perpendicular line on the skin surface of the arm H. The lower end position of the position display unit 28 has a gap between it and the skin surface so as not to interfere with the inserted needle 60. This gap is set to 2 mm or less, preferably 2 mm or less in consideration of the diameter of the needle 60 being about 1 mm. Since the position display unit 28 is arranged near the lower end of the side surface 20b of the probe main body 20 into which the needle 60 is inserted, the operator grasps the position to be punctured without moving the line of sight from the puncture position and punctures. You can concentrate on the movement.

Next, a method for specifying the blood vessel position and the puncture depth will be described. As shown in FIG. 6, the blood vessel position indicator 10 is detected by an imaging unit 22 that contacts the skin surface and acquires a cross-sectional image of the human body, a control unit 30 that detects the blood vessel position from the cross-sectional image, and a control unit 30. It has a display unit 27 that displays the position of the blood vessel. The control unit 30 is connected to the image pickup unit 22 via the transmission unit 32 and the reception unit 34, and allows the image pickup unit 22 to acquire a cross-sectional image and receive the acquired cross-sectional image. The control unit 30 is connected to a power supply unit 37 composed of a rechargeable battery via a charging circuit 36.

The control unit 30 acquires a cross-sectional image as shown in FIG. 7 from the imaging unit 22. The horizontal direction in the cross-sectional image, that is, the width direction of the arm is the X direction, the vertical direction in the cross-sectional image, that is, the depth direction of the arm is the Y direction, and the direction orthogonal to the paper surface of the cross-sectional image, that is, the length direction of the arm is the Z direction. do. The coordinates of the upper left point in this cross-sectional image are set as the starting point (0, 0, 0).

The control unit 30 detects the position of a blood vessel in the image by performing image analysis on the acquired cross-sectional image. The control unit 30 detects a region recognized as a blood vessel in the image, and sets the position of the center of gravity 70 as the position of the blood vessel. In order to detect a region recognized as a blood vessel in an image, a large number of images of the same type can be prepared and machine learning or a deep running method can be used. Further, the imaging unit 22 can detect a region having blood flow by the Doppler method and recognize the region as a blood vessel region. When detecting the region of blood vessels from a cross-sectional image, it is necessary to distinguish between arteries and veins. Arteries and veins can be distinguished based on the position of the bone of the arm H appearing in the cross-sectional image. In addition, when a region with blood flow is detected by the Doppler method, arteries and veins can be distinguished by the direction of blood flow. Let the coordinates of the detected center of gravity position 70 of the blood vessel be (x, y, 0). The control unit 30 also detects the diameter of the blood vessel detected from the cross-sectional image.

Since the coordinate z in the Z direction of the side surface 20b of the probe main body 20 that is the puncture position is half the width W of the skin contact surface 20a of the probe main body 20, it is calculated by z = W / 2. The angle θ of the line from the position of the center of gravity of the blood vessel to the puncture position with respect to the perpendicular line on the skin surface is calculated by θ = arctan (z / y). The puncture depth a is calculated by a = y / cos θ. These define the coordinates of the puncture position in the x direction and the puncture depth a. The control unit 30 lights the display element 28a corresponding to the coordinate position in the x direction and the blood vessel diameter of the position display unit 28 of the display unit 27, and causes the depth display unit 29 to display the puncture depth.

As shown in FIGS. 9 (a) and 9 (b), the position display unit 28 changes the position and number of the display elements 28a to be lit according to the x-coordinate of the detected blood vessel position and the blood vessel diameter. Further, as shown in FIG. 9C, the display can be different between one display element 28a corresponding to the x-coordinate of the position of the center of gravity of the blood vessel and the other display element 28a within the range of the blood vessel diameter. .. The difference in display can be the shade of light, the difference in color, the presence or absence of blinking, and the like. As a result, the operator can easily grasp the position of the center of gravity of the blood vessel into which the tip of the needle should be inserted.

The control unit 30 may detect the position of the inner wall of the blood vessel in addition to the position of the center of gravity of the blood vessel in the image analysis of the acquired cross-sectional image. In this case, the display on the display element 28a can be different between the position of the center of gravity of the blood vessel, the position of the inner wall of the blood vessel, and the position of the center of gravity of the blood vessel and the position of the inner wall of the blood vessel. For example, the display element 28a corresponding to the position of the center of gravity of the blood vessel is red, the display element 28a corresponding to the position of the inner wall of the blood vessel is green, and the display element 28a corresponding to the position of the center of gravity of the blood vessel and the position of the inner wall of the blood vessel is blue. be able to. The difference in display may be in other modes as described above.

Next, a modified example of displaying the puncture direction in addition to the puncture position will be described. As shown in FIG. 10, the skin contact surface 20a of the probe main body 20 is provided with two parts, a first imaging unit 25 and a second imaging unit 26. The first imaging unit 25 and the second imaging unit 26 are arranged apart from each other in a direction orthogonal to one direction in which they extend. When the blood vessels are inclined with respect to the direction orthogonal to the extending direction of the first imaging unit 25 and the second imaging unit 26, the blood vessel positions detected by the first imaging unit 25 and the second imaging unit 26 are different.

The control unit 30 detects the blood vessel position at each position from the cross-sectional images acquired by the first imaging unit 25 and the second imaging unit 26. As shown in FIG. 11, on the side surface 20b of the probe main body 20, the first position display unit 40 and the second position display unit 41 correspond to the first imaging unit 25 and the second imaging unit 26, and the probe main body. The imaging unit 22 of 20 is arranged in two stages along the direction from the side on which the imaging unit 22 is provided to the side to be gripped. Further, a depth display unit 29 is arranged above the second position display unit 41.

Since the first position display unit 40 and the second position display unit 41 display the X-direction position of the blood vessel at the position of the first imaging unit 25 and the X-direction position of the blood vessel at the position of the second imaging unit 26. , The operator can visually recognize the traveling direction of the blood vessel. At the time of puncture, a more reliable puncture can be performed by inserting a needle along the traveling direction of the blood vessel.

Next, a modified example of the display unit will be described. As shown in FIG. 12, the display unit 42 is formed by arranging a large number of vertically long display elements 42a in the horizontal direction. The display unit 42 displays the display element 42a corresponding to the position of the detected blood vessel in the X direction with a length corresponding to the puncture depth. In this way, the puncture depth may be expressed by the length of the line on the display unit 42 instead of the numerical value. As a result, the operator can intuitively grasp the puncture depth.

As shown in FIG. 13, the display unit 43 may be configured by one liquid crystal screen. On the display unit 43, an arrow indicating the position of the detected blood vessel in the X direction and a numerical value of the puncture depth are displayed. As shown in FIG. 14, when the display unit 44 displays the puncture direction in addition to the puncture position, the arrow may be displayed in a perspective view so that these can be grasped three-dimensionally. In this way, the display on the display unit can be arbitrarily set.

As described above, the blood vessel position indicator 10 according to the present embodiment is based on the probe main body 20 having the first imaging unit 22 that comes into contact with the skin surface and acquires a cross-sectional image of the human body along one direction, and the cross-sectional image. It has a control unit 30 for detecting the blood vessel position, and a display unit 27 for displaying the blood vessel position detected by the control unit 30 in at least one direction along which the first imaging unit 22 is aligned. The blood vessel position display 10 configured in this way identifies the blood vessel position with high accuracy from the cross-sectional image acquired by the first imaging unit 22, and displays the position of the puncture point in the vicinity of the puncture point of the probe main body 20. Since it is not necessary for the operator to shift his / her eyes to a monitor or the like and he / she can concentrate on the puncture operation, the puncture can be reliably performed regardless of the skill of the operator.

Further, the display unit 27 may be arranged at a position near the first imaging unit 25 surface on the outer surface of the probe main body 20 along the same direction as the first imaging unit 22. As a result, since the display unit 27 is located at a position close to the puncture position, it is possible for the operator to more easily grasp the puncture position.

Further, the control unit 30 may calculate the puncture depth from the skin surface in addition to the blood vessel position from the cross-sectional image, and the display unit 27 may display the puncture depth together with the display of the blood vessel position. As a result, the operator can easily grasp the puncture depth.

Further, the display unit 27 may display the puncture depth as a numerical value or a line length. This allows the operator to intuitively grasp the puncture depth.

Further, the control unit 30 may detect the blood vessel diameter in addition to the blood vessel position from the cross-sectional image, and the display unit 27 may display the blood vessel diameter together with the display of the blood vessel position. This allows the operator to easily grasp the diameter of the blood vessel.

Further, the skin contact surface 20a of the probe main body 20 has a second imaging unit 26 arranged at a distance in a direction orthogonal to the first imaging unit 25 along one direction, and the control unit 30 is a first imaging unit. The blood vessel positions at the respective positions are detected from the cross-sectional images acquired by the 25 and the second imaging unit 26, and the display units 40 and 41 are the lengths of the blood vessels based on the blood vessel positions at the respective positions of the plurality of imaging units 25 and 26. The direction along the vertical direction may be displayed. As a result, the operator can grasp the puncture direction, so that even if the length direction of the blood vessel is inclined with respect to the direction orthogonal to the length direction of the first imaging unit 25 and the second imaging unit 26, the puncture is reliably performed. It can be performed.

Further, the display units 40 and 41 that display the blood vessel positions in one direction along which the first imaging unit 25 and the second imaging unit 26 are aligned are gripped or fixed from the side of the probe main body 20 where the first imaging unit 25 is provided. By arranging a plurality of blood vessels along the direction toward the blood vessel, the direction along the length direction of the blood vessel may be displayed. As a result, the operator can intuitively grasp the puncture direction.

The present invention is not limited to the above-described embodiment, and various modifications can be made by those skilled in the art within the technical idea of the present invention. For example, although the monitor that displays the cross-sectional image acquired in the present embodiment is not shown, the blood vessel position display 10 may be connected to the monitor so that the cross-sectional image can be visually recognized.

Further, in the present embodiment, the position of the center of gravity of the blood vessel to be punctured is detected from the cross-sectional image, but a position other than the position of the center of gravity of the blood vessel to be punctured may be detected and displayed on the display unit 27. For example, the control unit 30 detects the inner surface J of the blood vessel located between the blood vessel to be punctured and the imaging unit 22 and the position K in the membrane of the blood vessel from the cross-sectional image, and displays the position on the display unit 27. You may do so. Further, the control unit 30 detects the inner surface J of the blood vessel located between the blood vessel to be punctured and the imaging unit 22 and the position K in the membrane of the blood vessel from the cross-sectional image, and is separated from this position by a certain distance. The position may be displayed on the display unit 27. As a result, the distance between the position displayed on the display unit 27 and the blood vessel to be punctured can be lengthened, and after the blood vessel is punctured with the needle, it is possible to prevent the needle from being further inserted to penetrate the blood vessel. Positions separated by a certain distance are mainly positions separated in the axial direction of the blood vessel. The positions may be separated in the radial direction.

At the time of puncture, the position of the blood vessel may change by being pushed by the needle. In order to reliably puncture the target blood vessel, the direction and degree of the position change of the blood vessel can be displayed on the first position display unit 40 and the second position display unit 41.

The direction and degree of change in the position of the blood vessel is detected by the control unit 30 comparing the stored cross-sectional image before puncture with the cross-sectional image after puncture. Therefore, the control unit 30 can detect the direction and degree regardless of the direction in which the blood vessel changes position. When the direction and degree of the blood vessel position change are detected, the control unit 30 causes the first position display unit 40 and the second position display unit 41 to display the direction and degree of the blood vessel position change.

For example, when the blood vessel is moved to the back side with respect to the skin surface by the needle, the display of the first position display unit 40 located on the skin surface side changes. The display of the first position display unit 40 can be changed from a lighting state to a blinking state, or the display color can be changed. Further, in order to indicate the degree of change in the position of the blood vessel, the blinking speed of the first position display unit 40 or the shade of color changes.

When the blood vessel is moved in a direction parallel to the skin surface by the needle, the position of the display element for displaying the blood vessel position is changed by the movement in the first position display unit 40 or the second position display unit 41. .. Thereby, the direction and degree of the position change of the blood vessel can be represented. At this time, the display element displayed after the change may change the display mode, such as lighting or blinking in a color different from the display element displayed before the change.

Note that this application is based on Japanese Patent Application No. 20215-5614 filed on January 18, 2021, and the disclosure contents thereof are referred to and incorporated as a whole.

10 Blood vessel position indicator 20 Probe body 20a Skin contact surface 20b Side surface 22 Imaging unit 24 Handle 25 First imaging unit 26 Second imaging unit 27 Display unit 28 Position display unit 28a Display element 29 Depth display unit 30 Control unit 32 Transmitter 34 Receiver 36 Charging circuit 37 Power supply 40 1st position display 41 2nd position display 42 Display 42a Display element 60 Needle 70 Center of gravity position

Claims (7)

1. A probe body having a first imaging unit in one direction that contacts the skin surface and acquires a cross-sectional image of the human body.
   A control unit that detects the position of blood vessels from the cross-sectional image,
   A display unit that displays the blood vessel position detected by the control unit in at least one direction along which the first imaging unit is aligned.
   Blood vessel position indicator with.
2. The blood vessel position indicator according to claim 1, wherein the display unit is arranged at a position near the first imaging unit on an outer surface of the probe body along the same direction as the first imaging unit along the first imaging unit.
3. The control unit calculates the puncture depth from the skin surface in addition to the blood vessel position from the cross-sectional image.
   The blood vessel position indicator according to claim 1 or 2, wherein the display unit displays the puncture depth together with the display of the blood vessel position.
4. The blood vessel position indicator according to claim 3, wherein the display unit displays the puncture depth as a numerical value or a line length.
5. The control unit detects the blood vessel diameter in addition to the blood vessel position from the cross-sectional image.
   The blood vessel position indicator according to any one of claims 1 to 4, wherein the display unit displays the blood vessel diameter together with the display of the blood vessel position.
6. On the skin contact surface of the probe body, there is a second imaging unit arranged at a distance in a direction orthogonal to the first imaging unit along the one direction.
   The control unit detects the blood vessel position at each position from the cross-sectional images acquired by the first imaging unit and the second imaging unit.
   The blood vessel position indicator according to any one of claims 1 to 5, wherein the display unit displays a direction along the length direction of a blood vessel based on a blood vessel position at each position of the plurality of imaging units.
7. The direction in which the display unit that displays the blood vessel position in the one direction along which the first imaging unit and the second imaging unit are aligned is from the side of the probe body where the first imaging unit is provided to the side to be gripped or fixed. The blood vessel position indicator according to claim 6, wherein a plurality of blood vessels are arranged along the blood vessel to display a direction along the length direction of the blood vessel.

Images