WO2022208741A1 - 血管病変モデル - Google Patents
血管病変モデル Download PDFInfo
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- WO2022208741A1 WO2022208741A1 PCT/JP2021/013871 JP2021013871W WO2022208741A1 WO 2022208741 A1 WO2022208741 A1 WO 2022208741A1 JP 2021013871 W JP2021013871 W JP 2021013871W WO 2022208741 A1 WO2022208741 A1 WO 2022208741A1
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- lesion
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- vascular lesion
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Definitions
- This disclosure relates to a vascular lesion model.
- Patent Literature 1 discloses a technique for producing a three-dimensional model of a blood vessel by lamination modeling using a material such as a photocurable resin with reference to three-dimensional image data of the blood vessel. By using three-dimensional image data, a three-dimensional model having a three-dimensional shape in which a lesion such as plaque is formed in a blood vessel can be produced.
- the three-dimensional model described above was not suitable for observation under ultrasound guidance.
- methods using medical devices such as catheters, such as percutaneous transluminal angioplasty (PTA) have been performed as methods for treating stenosis and occlusion of blood vessels.
- diagnosis may be made by observation under ultrasound guidance.
- patients who are allergic to contrast media are desired to undergo treatment such as percutaneous angioplasty under ultrasound guidance.
- a vascular lesion model has been desired that can obtain an image simulating an actual ultrasound image of a lesion under ultrasound guidance, for example, for the training of operators who perform the diagnosis and treatment described above.
- no model that satisfies such requirements has been known in the past.
- a vascular lesion model is provided.
- This vascular lesion model is provided in contact with a first lesion formed of a polymer material and the first lesion, and a site including a surface in contact with the first lesion is larger than the first lesion.
- a second lesion formed of a material having a large acoustic impedance and simulating a calcified lesion in an ultrasound image.
- the second lesion is made of a material having a higher acoustic impedance than the first lesion, and the second lesion simulates a calcified lesion in the ultrasonic image. Therefore, if such a vascular lesion model is used, it is possible to obtain an image simulating an actual lesion area under ultrasound guidance for the purpose of treatment such as percutaneous angioplasty or diagnosis. Training such as observation of blood vessels can be performed.
- the second lesion may contain calcium sulfate.
- the second lesion may contain granular calcium sulfate.
- the second lesion contains granular calcium sulfate, the hardness of the second lesion can be easily approximated to that of an actual calcified lesion.
- the second lesion contains granular calcium sulfate, ultrasonic waves are attenuated due to being reflected by the second lesion, suppressing darkening of the ultrasonic image, Images can be clarified.
- the second lesion may contain paraffin.
- the second lesion may include particles of a polymer material coated with paraffin.
- the second lesion contains particles of a polymer material coated with paraffin, ultrasonic waves are attenuated due to reflection from the second lesion, and the ultrasonic image becomes black. It can be suppressed and the ultrasound image can be clarified.
- the second lesion may comprise a paraffin slice.
- the first lesion may be made of hydrogel. With such a configuration, it becomes easy to suppress the acoustic impedance of the first lesion and ensure the difference in acoustic impedance between the first lesion and the second lesion. In addition, it becomes easy to bring the hardness of the first lesion closer to the hardness of plaque lesions other than calcified lesions.
- the hydrogel may contain a polysaccharide hydrogel.
- the polysaccharide hydrogel may be agarose gel.
- the vascular lesion model of the above aspect further comprises a tubular vascular portion, and the first lesion and the second lesion are arranged inside the vascular portion to constrict or occlude the vascular portion. You can do it. With such a configuration, it is possible to enhance the sense of immersion in training by using the above-described vascular lesion model when performing training related to treatment or diagnosis under ultrasound guidance.
- the present disclosure can be realized in various forms other than the above, for example, it can be realized in the form of a manufacturing method of a vascular lesion model, an organ model including a vascular lesion model, a human body simulation apparatus including a vascular lesion model, and the like. is.
- FIG. 2 is a cross-sectional view schematically showing the schematic configuration of the vascular lesion model of the first embodiment;
- 4 is a flow chart showing a method for manufacturing a second lesion according to the first embodiment;
- FIG. 4 is an explanatory diagram showing how the appearance of the vascular lesion model of the first embodiment is captured.
- FIG. 4 is an explanatory diagram showing an ultrasound image of the vascular lesion model of the first embodiment; 4 is a flow chart showing another example of a method for producing a vascular lesion model.
- FIG. 5 is a cross-sectional view schematically showing the schematic configuration of a vascular lesion model of the second embodiment
- 9 is a flow chart showing a method for manufacturing a second lesion according to the second embodiment
- FIG. 11 is an explanatory diagram showing how the appearance of the vascular lesion model of the second embodiment is captured.
- FIG. 10 is an explanatory diagram showing an ultrasound image of a vascular lesion model according to the second embodiment
- FIG. 11 is a cross-sectional view schematically showing the schematic configuration of a vascular lesion model of the third embodiment
- 10 is a flow chart showing a method for manufacturing a second lesion according to the third embodiment
- FIG. 11 is an explanatory diagram showing an ultrasound image of a vascular lesion model according to the third embodiment
- FIG. 11 is an explanatory diagram showing an ultrasound image of a vascular lesion model according to the third embodiment;
- FIG. 11 is a cross-sectional view schematically showing the schematic configuration of a vascular lesion model of the fourth embodiment;
- 10 is a flow chart showing a method for manufacturing a vascular lesion model according to the fourth embodiment;
- FIG. 11 is an explanatory diagram showing how the appearance of the vascular lesion model of the fourth embodiment is captured.
- FIG. 11 is an explanatory diagram showing an ultrasound image of a vascular lesion model according to the fourth embodiment;
- FIG. 11 is an explanatory diagram showing how the appearance of the vascular lesion model of the fourth embodiment is captured.
- FIG. 11 is an explanatory diagram showing an ultrasound image of a vascular lesion model according to the fourth embodiment;
- FIG. 11 is a cross-sectional view schematically showing the schematic configuration of a vascular lesion model of a modified example of the fourth embodiment;
- FIG. 1 is a cross-sectional view schematically showing the schematic configuration of a vascular lesion model 10 of the first embodiment.
- the vascular lesion model 10 of the present embodiment is used to simulate treatment or examination procedures for blood vessels using medical devices under ultrasound guidance.
- the vascular lesion model 10 includes a first lesion 20, a second lesion 30, and a blood vessel 40 in which the first lesion 20 and the second lesion 30 are arranged.
- the first lesion 20 is made of a polymer material, and simulates a lesion excluding a calcified site in an ultrasonic image including plaque, which is a lesion in a blood vessel. Specifically, as described later, the first lesion 20 has a smaller acoustic impedance than the second lesion 30, and is observed relatively dark in the ultrasonic image, thereby simulating the lesion excluding the calcified lesion. do. It is desirable that the polymer material forming the first lesion 20 is easily permeable to ultrasonic waves. As a result, when performing training using a medical device such as a catheter or a guide wire together with the vascular lesion model 10 under ultrasound guidance, the medical device inserted into the vascular lesion model can be observed with an ultrasound image. becomes easier.
- hydrogel containing a large amount of water As the polymer material forming the first lesion 20, it is desirable to use, for example, hydrogel containing a large amount of water, from the viewpoint that the acoustic impedance is relatively small and ultrasonic waves can pass relatively easily.
- hydrogels used to configure the first lesion 20 include polysaccharide hydrogels such as agarose gel, methylcellulose gel, hyaluronic acid hydrogel, alginate hydrogel, carboxymethylcellulose gel, and xanthan gum.
- the first lesion 20 may be made of a polymeric material other than hydrogel, such as urethane gel.
- the first lesion 20 may be configured by combining a plurality of arbitrary polymer materials among various polymer materials as described above.
- polysaccharide hydrogels and polyvinyl alcohol are preferable because they are easy to handle, and agarose is particularly preferable because it is easy to adjust the softness.
- concentration of the polymer material in the first lesion 20 may be appropriately set according to desired physical properties such as hardness desired to be achieved in the first lesion 20 .
- the first lesion 20 may further contain microparticles or nanofibers of reflectors that reflect ultrasonic waves.
- the reflector may be made of a material having an acoustic impedance higher than that of the polymeric material forming the first lesion 20 .
- the size is about the same as that of the nanofiber, for example, about 10 nm to several hundred nm. It is desirable to use microparticles with a particle size.
- the second lesion 30 is provided in contact with the first lesion 20, is formed of a material having a larger acoustic impedance than the first lesion 20, and simulates a calcified lesion in an ultrasonic image.
- the second lesion 30 is formed into granules using calcium sulfate (hemihydrate, dihydrate, or anhydrous). Calcium sulfate is readily available as a powdered element.
- the second lesion 30 having an arbitrary shape for example, water or a gel material (agarose gel, gelatin gel, polyvinyl alcohol (PVA) gel, urethane gel, silicon
- a gel material agarose gel, gelatin gel, polyvinyl alcohol (PVA) gel, urethane gel, silicon
- the calcium sulfate may be formed into a desired shape, such as granules, by mixing a material that can be used as a solvent, such as a gel.
- the blood vessel part 40 is a part simulating a human blood vessel and has a hollow tubular shape.
- the vascular portion 40 may be made of a material that sufficiently transmits ultrasonic waves so that the first lesion 20 and the second lesion 30 placed in the vascular portion 40 can be observed under ultrasonic irradiation.
- the first lesion 20 and the second lesion 30 arranged inside be made of a transparent or translucent material so that the states of the lesion 20 and the second lesion 30 can be visually recognized from the outside.
- Examples of materials that can be used for the vascular portion 40 include polyvinyl alcohol (PVA), agarose, sodium alginate, cellulose, starch, glycogen, silicon, latex, and polyurethane.
- PVA polyvinyl alcohol
- agarose sodium alginate
- cellulose cellulose
- starch glycogen
- silicon silicon
- polyurethane polyurethane
- polyvinyl alcohol (PVA) is desirable because its lubricity and elasticity are similar to those of human blood vessels.
- the vascular lesion model 10 is used to enhance the sense of immersion of the operator when training for procedures related to treatment and diagnosis. can be done.
- the inner and outer diameters of the blood vessel part 40 and the length in the longitudinal direction of the blood vessel part 40 can be arbitrarily set according to the type of blood vessel to be simulated, the type of procedure to be trained, and the like. .
- the second lesion 30, which is an aggregate of granular calcium sulfate, is embedded in the first lesion 20, so that the first lesion 20 and the second lesion 30 are provided in contact with each other. ing.
- the first lesion 20 and the second lesion 30 are arranged in the blood vessel 40 so as to imitate how the lesion narrows or blocks the blood vessel.
- FIG. 1 shows how the first lesion 20 and the second lesion 30 are arranged so as to block the inside of the blood vessel 40 .
- FIG. 2 is a flow chart showing the manufacturing method of the vascular lesion model 10.
- a polymer material for forming the first lesion 20 is prepared (step T100). Specifically, for example, when agarose is used as a polymer material, agarose, which is a polymer material, and, if necessary, a reflector such as cellulose nanofiber (CNF) are mixed in a solvent such as water. to obtain an aqueous agarose solution, which is a solution of the polymeric material. In step T100, heating may be performed as necessary in order to obtain a polymer material solution.
- the second lesion 30 is prepared separately from the polymer material (step T110). A method for manufacturing the second lesion 30 prepared in step T110 will be described below.
- FIG. 3 is a flow chart showing the manufacturing method of the second lesion 30.
- step T200 calcium sulfate is prepared (step T200).
- step T200 for example, powdered calcium sulfate may be prepared.
- step T210 the calcium sulfate prepared in step T200 is mixed with the above-described solvent (step T210), and formed into an arbitrary size and shape (step T220) to obtain the second lesion 30.
- any of the hemihydrate, dihydrate, and anhydrous calcium sulfate may be used as described above.
- step T200 hemihydrate calcium sulfate is prepared, When mixed with water as a solvent in step T210, calcium sulfate becomes a dihydrate and easily solidifies. After solidification, the granular second lesion 30 can be obtained by cutting or crushing to an arbitrary size.
- PVA polyvinyl alcohol
- step T210 calcium sulfate anhydride is insoluble in PVA and is difficult to sufficiently mix with PVA. It is desirable to use hydrates. If the effect of the vascular lesion model 10 on the ultrasonic image is within an allowable range, the material of the second lesion 30 prepared in step T200 may contain a material other than calcium sulfate.
- step T120 a tubular member that will become the blood vessel portion 40 is prepared (step T120). Then, the blood vessel portion 40 is filled with the polymer material solution prepared in step T100 and the second lesioned portion 30 manufactured in step T110 (step T130). Thereafter, the polymer material is cured (step T140) to complete the vascular lesion model 10.
- step T140 the polymer material is cured (step T140) to complete the vascular lesion model 10.
- step T140 for example, when an aqueous agarose solution is prepared as the polymeric material in step T100, the aqueous agarose solution and the granular second lesion 30 are mixed and filled into the blood vessel 40 in step T130. Then, in step T140, the agarose solution is cured into an agarose gel. In step T140, cooling may be performed as necessary.
- the vascular lesion model 10 may be used as it is for training under ultrasound guidance, or may be used while immersed in a fluid (for example, simulated blood such as physiological saline). Alternatively, if the lesion does not occlude the vascular part 40 in the vascular lesion model 10, a flow path of fluid (for example, simulated blood such as physiological saline) is connected to the vascular lesion model 10, and the vascular part 40 is The fluid may be circulated within a channel including the inside.
- the vascular lesion model 10 may be incorporated into an organ model imitating an organ such as the heart, liver, and brain together with a vascular model that does not have a lesion. Alternatively, it may be incorporated into a human body simulation device that simulates at least a part of a human body, together with a blood vessel model and an organ model that do not have lesions.
- the second lesion 30 is configured using calcium sulfate, which is an inorganic material, it is configured with a polymer material such as hydrogel.
- the second lesion 30 can have a larger acoustic impedance than the first lesion 20 .
- the second lesion 30 provided in contact with the first lesion 20 is made of a material having a larger acoustic impedance than the first lesion 20, so that the second lesion 30 is sensitive to ultrasonic waves. This will simulate a calcified lesion in the image.
- the first lesion with a smaller acoustic impedance appears relatively dark in the ultrasound image, simulating a plaque lesion excluding a calcified site.
- the second lesion 30 made of calcium sulfate reflects the ultrasonic waves due to the difference in acoustic impedance between the second lesion 30 and the first lesion 20 arranged in contact with the second lesion 30. It is observed white in the ultrasound image and simulates a calcified lesion in the ultrasound image. Therefore, if the vascular lesion model 10 of the present embodiment is used, treatment such as percutaneous angioplasty, diagnosis, etc. can be performed while obtaining an image simulating an ultrasonic image of an actual lesion under ultrasound guidance. It is possible to perform training such as observation of blood vessels for the purpose of
- the second lesion 30 since the second lesion 30 is formed using calcium sulfate, a difference in acoustic impedance between the second lesion 30 and the first lesion 20 is ensured, The second lesion 30 facilitates simulating a calcified lesion in the acoustic image. Further, by forming the second lesion 30 using calcium sulfate, it becomes easy to bring the hardness of the second lesion 30 closer to the hardness of an actual calcified lesion. At this time, the hardness of the second lesion 30 can be adjusted by appropriately using a hemihydrate, a dihydrate, and an anhydrate as the calcium sulfate constituting the second lesion 30 .
- the hardness of the second lesion 30 can be softened compared to using a hemihydrate.
- the second lesion 30 can be formed by mixing water with calcium sulfate hemihydrate and solidifying it. can be easily molded.
- the acoustic impedance is a specific acoustic impedance, and can be obtained by multiplying the density of an object by the sound velocity (the sound velocity of sound waves propagating in the object).
- the sound velocity of the object can be obtained by, for example, the pulse echo method.
- the second lesion 30 when the second lesion 30 is an aggregate of granular materials formed using calcium sulfate, the hardness of the second lesion 30 should be brought closer to the actual calcified lesion. becomes easier. Therefore, when performing training using a medical device such as a guide wire together with the vascular lesion model 10, the feeling when the wire or the like comes into contact with the second lesion 30 and the feeling when the wire is pushed into the second lesion 30 It becomes easy to make the feeling that the second lesion 30 is crushed sometimes closer to the actual calcified lesion, and it is possible to enhance the operator's sense of immersion during training.
- the second lesion 30 is an aggregate of granular materials formed using calcium sulfate
- part of the ultrasonic wave is not reflected on the surface of the second lesion 30, and the second lesion 30 It can pass through between the grains that make up the lesion 30 . Therefore, it is possible to prevent the ultrasound image from becoming black due to attenuation of the ultrasound due to reflection from the second lesion 30 .
- the ultrasonic image becomes clear and the medical device inserted into the vascular lesion model becomes clear. It becomes easier to observe the device in ultrasound images.
- the second lesion 30 is an aggregate of granules formed using calcium sulfate
- calcified lesions of any size can be placed at any position within the blood vessel 40.
- the calcified lesion can be easily simulated because the portion can be placed and embedded in the first lesion portion 20 .
- the process for manufacturing such a vascular lesion model 10 can be shortened, and the vascular lesion model 10 can be easily mass-produced.
- the particle diameter (maximum value of the distance between the outer circumferences of the particles in the particle cross section) varies depending on the inner diameter of the blood vessel 40 and when the medical device is brought into contact with the second lesion 30. It can be appropriately set according to the desired feel, the degree of attenuation of ultrasonic waves in an ultrasonic image, and the like.
- the particle size of the calcium sulfate particles is desirably 1 mm or more, more desirably 2 mm or more, for example, from the viewpoint of suppressing attenuation of ultrasonic waves.
- the particle size of the calcium sulfate particles is preferably 8 mm or less, for example, from the viewpoint of bringing the feeling when the medical device is brought into contact with the second lesion 30 closer to that of an actual calcified lesion. 6 mm or less is more desirable.
- the shape of the second lesion 30 may be a shape other than the granular shape described above. 20 may be dispersed.
- FIG. 4 is an explanatory diagram showing the appearance of the vascular lesion model 10 having the granular second lesion 30 manufactured by the manufacturing method shown in FIGS. 2 and 3.
- FIG. FIG. 5 is an explanatory diagram showing an ultrasonic image of the vascular lesion model 10 similar to FIG. FIG. 5 shows how a wire as a medical device is inserted into the vascular lesion model 10 .
- agarose gel mixed with cellulose nanofibers (CNF) is used as the polymer material forming the first lesion 20 .
- CNF cellulose nanofibers
- the second lesion 30, which has a larger acoustic impedance than the first lesion 20 and looks white by reflecting the ultrasonic waves, is formed in granules, so that the ultrasonic waves pass through the gaps between the granules. As a result, observation of the surroundings of the second lesion 30 is facilitated.
- FIG. 2 a method for producing a vascular lesion model having a lesion that obstructs a blood vessel has been described. It may be in a state where As a modified example, an example of a manufacturing method of a vascular lesion model in which a lesioned part narrows the vascular part 40 without occluding it will be described below.
- FIG. 6 is a flow chart showing another example of the method for manufacturing the vascular lesion model 10 of the first embodiment.
- a polymer material for forming the first lesion 20, the second lesion 30, and the blood vessel 40 are prepared (steps T100 to T120).
- a core material is placed inside the blood vessel portion 40 (step T125).
- the core material used in step T125 is for forming a space that is not occluded by the lesion in the vascular lesion model, and is composed of a rod-like member having a smaller diameter than the inner diameter of the vascular part 40.
- the core material can be made of metal, for example, from the viewpoint of having rigidity to hold the position for forming the space in the blood vessel part 40 .
- the space around the core material in the blood vessel part 40 is filled with the solution of the polymer material and the second lesion 30 (step T130), thereby increasing the height.
- the molecular material is cured (step T140).
- the core material is removed from the vascular part 40 (step T145), and the vascular lesion model 10 is completed.
- the vascular lesion model 10 that is constricted by the lesion can be obtained.
- it is also desirable that the core material is subjected to a surface treatment for enhancing releasability.
- FIG. 7 is a cross-sectional view schematically showing the schematic configuration of the vascular lesion model 110 of the second embodiment.
- the vascular lesion model 110 of the second embodiment parts common to the vascular lesion model 10 of the first embodiment are given the same reference numerals.
- FIG. 7 shows a state in which the blood vessel 40 is occluded by a lesion, but a model in which the blood vessel is constricted without being occluded may also be used.
- a vascular lesion model 110 includes a first lesion 20 and a vascular section 40 in the same manner as the vascular lesion model 10 of the first embodiment, but includes a second lesion 130 instead of the second lesion 30 .
- the second lesion 130 includes a granular portion 132 made of a polymeric material, and a coat layer 134 made of paraffin and provided to cover the surface of the granular portion 132 .
- the granular part 132 can be made of the same polymeric material as the first lesion 20 . That is, as the polymeric material constituting the granular portion 132 , for example, hydrogels such as polysaccharide hydrogel, protein hydrogel, synthetic polymer hydrogel, polyvinyl alcohol (PVA) hydrogel, and silicone hydrogel, and urethane gel. etc. can be used. In addition to the polymer material as described above, the particulate portion 132 may further contain microparticles or nanofibers of reflectors that reflect ultrasonic waves. The granular portion 132 may be made of a material having the same composition as that of the first lesion 20, or may be made of a material having a different composition.
- hydrogels such as polysaccharide hydrogel, protein hydrogel, synthetic polymer hydrogel, polyvinyl alcohol (PVA) hydrogel, and silicone hydrogel, and urethane gel. etc.
- PVA polyvinyl alcohol
- silicone hydrogel silicone hydrogel
- urethane gel
- the coating layer 134 can be formed from paraffin alone or paraffin to which stearic acid has been added. By adding about 3 to 10% of stearic acid, the generation of air bubbles in paraffin can be suppressed, or the hardness of paraffin can be increased.
- the coating layer may be a mixture of paraffin and other materials other than stearic acid as long as the influence on the acoustic impedance is within an allowable range.
- FIG. 8 is a flow chart showing a method for manufacturing the second lesion 130 of the second embodiment.
- the vascular lesion model 110 of the second embodiment can be manufactured by the method shown in FIG. 2 or FIG. 6 as in the first embodiment, but FIG. 8 corresponds to step T110 in FIG. 2 or FIG. Show the process.
- a gel for forming the granular part 132 is produced (step T300).
- agarose is used as the polymer material and cellulose nanofibers (CNF) are used as the reflector
- CNF cellulose nanofibers
- the agarose is mixed with water and the cellulose nanofibers to dissolve the agarose in the water, and then the agarose is cured.
- An agarose gel may be prepared.
- the gel produced in step T300 is shaped into granules to form granular portions 132 (step T310).
- the gel produced in step T300 may be cut into a desired size such as 5 mm or less.
- a paraffin-containing material for forming the coat layer 134 is prepared and mixed, and the paraffin in this material is melted (step T320). Paraffin can be easily melted by heating to 60° C. or higher. In step T320, materials other than paraffin may not be melted, and may be dispersed in molten paraffin. Then, the granular portion 132 obtained in step T310 is coated with paraffin (step T330) to complete the second lesion .
- the paraffin coating in step T330 can be performed, for example, by immersing the granular part 132 in molten paraffin and then solidifying the molten paraffin adhering to the surface of the granular part 132 at, for example, room temperature. During paraffin coating, cooling may be performed as necessary.
- the coat layer 134 which is a portion including the surface in contact with the first lesion 20, is configured using paraffin. Therefore, the acoustic impedance of the coat layer 134 is higher than that of the first lesion 20 made of polymer material such as hydrogel. As described above, the coating layer 134 provided in contact with the first lesion 20 is made of a material having an acoustic impedance higher than that of the first lesion 20, so that the second lesion 30 appears as It simulates a calcified lesion.
- the first lesion with a smaller acoustic impedance appears relatively dark in the ultrasound image, simulating a plaque lesion excluding a calcified site.
- the second lesion 130 coated with the coating layer 134 made of paraffin transmits ultrasonic waves due to the difference in acoustic impedance between the second lesion 130 and the first lesion 20 arranged in contact with the second lesion 130. Because of the reflection, it appears white in the ultrasound image and simulates a calcified lesion in the ultrasound image. Therefore, if the vascular lesion model 110 of the present embodiment is used, treatment such as percutaneous angioplasty, diagnosis, etc., can be performed while obtaining an image simulating an ultrasound image of an actual lesion under ultrasound guidance. It is possible to perform training such as observation of blood vessels for the purpose of
- the coat layer 134 of the second lesion 130 is made of paraffin, the difference in acoustic impedance between the second lesion 130 and the first lesion 20 is ensured, and the second lesion 130 is observed in the ultrasonic image.
- 2-lesion 130 facilitates simulating a calcified lesion.
- the aggregation of the second lesion 130 of the granular material in the first lesion 20 formed of the polymer material the actual lesion formed as part of the lesion in the ultrasonic image can be obtained. It becomes easier to obtain images close to calcified lesions.
- the second lesion 130 is an aggregate of particles coated with paraffin, the hardness of the second lesion 130 can be easily approximated to that of an actual calcified lesion. Therefore, when performing training using a medical device such as a guide wire together with the vascular lesion model 110, the feeling when the wire or the like comes into contact with the second lesion 130 and the feeling when the wire is pushed into the second lesion 130 The feeling of the second lesion 130 sometimes crumbling can be easily approximated to that of an actual calcified lesion, and the operator's sense of immersion during training can be enhanced.
- the second lesion 130 is an aggregate of particles, a part of the ultrasonic wave is not reflected on the surface of the second lesion 130, and the particles forming the second lesion 130 are not reflected. can pass between Therefore, it is possible to suppress the attenuation of the ultrasonic waves caused by being reflected by the second lesion 130, and when performing training using the medical device under ultrasonic guidance, the medical device inserted into the vascular lesion model can be used. It becomes easier to observe the device for use in ultrasound images.
- the second lesion 30 as an aggregate of granular materials, a calcified lesion of an arbitrary size can be arranged at an arbitrary position in the blood vessel 40 and embedded in the first lesion 20. can do.
- the paraffin forming the surface of the second lesion 130 in this embodiment is insoluble in water. Therefore, even when the first lesion 20 and the granular portion 132 are formed using a gel such as agarose that uses water as a solvent, the second lesion 130 is prevented from being changed by the water in the gel. be able to.
- the coating layer 134 including the surface is the only part of the second lesion 130 that is formed using paraffin.
- Paraffin has a relatively large acoustic impedance, and the surface that contacts the first lesion 20 reflects a relatively large amount of ultrasonic waves.
- the degree of reflection of ultrasonic waves on the surface of the second lesion 130 can be suppressed. As a result, it is possible to suppress the attenuation of the ultrasonic waves caused by the reflection of the ultrasonic waves on the surface of the second lesion 130 and clarify the ultrasonic image.
- FIG. 9 is an explanatory diagram showing the appearance of the vascular lesion model 110 having the granular second lesion 130 manufactured by the manufacturing method shown in FIGS. 2 and 8.
- FIG. 10 is an explanatory diagram showing an ultrasonic image of a vascular lesion model 110 similar to FIG.
- agarose gel mixed with cellulose nanofibers (CNF) is used as the polymer material forming the first lesion 20 and the granular part 132 .
- CNF cellulose nanofibers
- the second lesion 130 which has a larger acoustic impedance than the first lesion 20 and looks white by reflecting the ultrasonic waves, is formed in a granular shape, so that the ultrasonic waves pass through the gaps between the particles. As a result, observation of the surroundings of the second lesion 130 is facilitated.
- FIG. 11 is a cross-sectional view schematically showing the schematic configuration of the vascular lesion model 210 of the third embodiment.
- the vascular lesion model 210 of the third embodiment parts common to the vascular lesion model 10 of the first embodiment are given the same reference numerals.
- FIG. 11 shows a state in which the blood vessel 40 is constricted without being blocked by the lesion, but a model in which the blood vessel is blocked may also be used.
- a vascular lesion model 210 includes a first lesion 20 and a vascular section 40 in the same manner as the vascular lesion model 10 of the first embodiment, but includes a second lesion 230 instead of the second lesion 30 .
- the second lesion 230 is formed by a slice made of paraffin.
- the slice which is the second lesion 230, can be formed from paraffin alone or paraffin to which stearic acid has been added.
- FIG. 12 is a flow chart showing a method for manufacturing the second lesion 130 of the second embodiment.
- the vascular lesion model 110 of the second embodiment can be manufactured by the method shown in FIG. 2 or FIG. 6 as in the first embodiment, but FIG. 8 corresponds to step T110 in FIG. 2 or FIG. Show the process.
- step T400 When manufacturing the second lesion 230, first, a material containing paraffin for forming the second lesion 230 is prepared and the paraffin is melted (step T400). Then, a thin film is formed using the paraffin melted in step T400 (step T410).
- the thin film formation in step T410 may be performed, for example, by applying molten paraffin onto a substrate such as polytetrafluoroethylene (PTFE).
- Application of molten paraffin can be performed by, for example, a doctor blade method, a spray method, a dip coating method, or the like.
- the thickness of the paraffin thin film is desirably 10 nm or more, more desirably 50 nm or more, and even more desirably 100 nm or more. From the viewpoint of suppressing attenuation of ultrasonic waves by the paraffin thin film, the thickness of the paraffin thin film is preferably 1 mm or less, more preferably 800 nm or less, and even more preferably 500 nm or less.
- the same effect as the second embodiment can be obtained since the second lesion 230 is configured using paraffin. For example, it becomes easy to bring the hardness of the second lesion 130 closer to the actual calcified lesion. Alternatively, it becomes easy to simulate randomly formed calcified lesions in relatively long and thick blood vessels such as arteries of the lower extremities.
- the second lesion 230 is provided with paraffin slices, by ensuring the difference in acoustic impedance between the first lesion 20 and the second lesion 230 in the ultrasonic image, Attenuation of ultrasonic waves caused by the second lesion 230 can be suppressed while simulating a calcified lesion.
- a thin film is produced using molten paraffin to produce the flaky second lesion 230 .
- the thickness of the paraffin forming the second lesion can be reduced compared to the case where the granular part 132 is coated with molten paraffin as in the second embodiment. is easier to adjust.
- FIGS. 13 and 14 are explanatory diagrams showing ultrasonic images of a vascular lesion model 210 having a flaky second lesion 230 manufactured by the manufacturing method shown in FIGS. 6 and 12.
- FIG. FIG. 13 is an ultrasound image of a vascular lesion model 210 having a second lesion 230 with a slice diameter (maximum distance between outer peripheries of the slice) of 3 to 5 mm
- FIG. 4 is an ultrasound image of a vascular lesion model 210 with a second lesion 230 of 3 mm or less.
- agarose gel mixed with cellulose nanofibers (CNF) is used as the polymer material forming the first lesion 20 .
- CNF cellulose nanofibers
- the second lesion 230 which has a larger acoustic impedance than the first lesion 20 and looks white by reflecting ultrasonic waves, is formed in the form of flakes, thereby allowing the space between the flakes to pass through. Acoustic waves pass through and observation of the surroundings of the second lesion 230 is facilitated. Further, as can be seen by comparing FIG. 13 and FIG. 14, the smaller the diameter of the flakes, the shorter the distance between the flakes and the easier it is for the ultrasonic waves to attenuate. From the above, it is understood that by appropriately adjusting the diameter of the slice, the ultrasonic image can be brought closer to the desired image representing the calcified lesion.
- FIG. 15 is a cross-sectional view schematically showing the schematic configuration of the vascular lesion model 310 of the fourth embodiment.
- the vascular lesion model 310 of the fourth embodiment parts common to the vascular lesion model 10 of the first embodiment are given the same reference numerals.
- FIG. 15 shows a state in which the blood vessel 40 is occluded by a lesioned portion, as in FIG.
- a vascular lesion model 310 includes a first lesion 20 and a vascular section 40 in the same manner as the vascular lesion model 10 of the first embodiment, but includes a second lesion 330 instead of the second lesion 30 .
- the second lesion 330 is formed by fine particles of paraffin dispersed in the first lesion 20 made of polymeric material.
- the structure in which the second lesion 330 is dispersed in the first lesion 20 is also called a mixed lesion 335 .
- FIG. 16 is a flow chart showing the manufacturing method of the vascular lesion model 310 of the fourth embodiment.
- a method for manufacturing a vascular lesion model 310 having a lesion that obstructs a blood vessel is shown.
- a polymeric material for forming first lesion 20 is prepared (step T500). This step is similar to step T100 in FIG.
- paraffin for forming second lesion 330 is melted (step T510) in the same manner as step T400 in FIG.
- the paraffin melted in step T510 can be, for example, paraffin alone or paraffin to which stearic acid has been added.
- step T520 a tubular member that will become the blood vessel portion 40 is prepared (step T520).
- step T530 the polymer material solution prepared in step T500 and the paraffin melted in step T510 are mixed and filled in blood vessel section 40 (step T530).
- step T540 the polymer material and paraffin are hardened (step T540), and the vascular lesion model 310 is completed.
- step T530 when agarose is used as the polymer material, in step T530, the agarose aqueous solution and molten paraffin are mixed and filled into the blood vessel section 40 . At this time, since the aqueous agarose solution and the molten paraffin do not mix, in step T530, the blood vessel part 40 is filled with a mixed liquid in which the molten paraffin is dispersed in the form of fine particles in the aqueous agarose solution. Then, in step T540, the agarose and paraffin are cured separately due to the difference in freezing point between the agarose and paraffin, and a vascular lesion model 310 is obtained in which paraffin is precipitated in the agarose gel.
- paraffin has a higher freezing point than agarose, so fine particles of molten paraffin that are dispersed in the form of fine particles solidify and precipitate in an aqueous solution of agarose before gelation. After that, the agarose aqueous solution gels.
- the second lesion 330 made of paraffin is the same as the first lesion 20 arranged in contact with the second lesion 330. Due to the difference in acoustic impedance between the two, ultrasonic waves are reflected and observed white in the ultrasonic image, simulating a calcified lesion in the ultrasonic image.
- the second lesion 330 is formed by fine particles of paraffin dispersed in the first lesion 20, depending on the amount of molten paraffin added to the polymer material solution in step T530, , the appearance (whiteness of the image) of the second lesion 330 in the ultrasound image can be adjusted.
- FIGS. 17 and 19 are explanatory diagrams showing how the appearance of the vascular lesion model 310 manufactured by the manufacturing method shown in FIG. 16 is captured.
- 18 and 20 are explanatory diagrams showing ultrasonic images of a vascular lesion model 310 similar to FIGS. 17 and 19.
- FIG. Here, agarose gel mixed with cellulose nanofibers (CNF) is used as the polymer material forming the first lesion 20 .
- FIGS. 17 and 18 show images of a vascular lesion model 310 produced by mixing molten paraffin at a rate of 15 wt % with respect to the agarose aqueous solution in step T530, and FIGS.
- CNF cellulose nanofibers
- FIGS. 18 and 20 shows an image of a vascular lesion model 310 manufactured by mixing melted paraffin at a rate of 30 wt% with respect to an aqueous agarose solution.
- paraffin microparticles dispersed in the agarose gel make the entire lesion whiter in the ultrasonic image, and the smaller the amount of molten paraffin added, the more the paraffin reflects ultrasonic waves. It was confirmed that the attenuation of ultrasonic waves was reduced.
- a step of removing the core material may be performed in the same manner as step T145 in FIG.
- the second lesion 330 which is paraffin microparticles, is dispersed in the first lesion 20 in the entire lesion, but a different configuration may be used.
- the vascular part 40 is filled with the material for the lesion, it is possible to provide a portion filled only with a polymeric material and a portion filled with a polymeric material mixed with molten paraffin.
- at least one of the second lesions of the first to third embodiments may be further combined.
- FIG. 21 is a cross-sectional view schematically showing the schematic configuration of a vascular lesion model 410 as a modified example of the fourth embodiment.
- the vascular lesion model 410 includes, in the first lesion 20, a site where the second lesion 330 of the fourth embodiment is placed and a site where the second lesion 230 of the third embodiment is placed.
- the second lesion 230 formed of paraffin slices reflects ultrasonic waves to a greater extent than the second lesion 330 formed of paraffin microparticles, thereby improving the ultrasonic image. becomes whiter.
- the appearance (whiteness of the image) of the second lesion in the ultrasonic image and the effect of inserting the medical device into the vascular lesion model can be improved.
- the hardness of the affected area, which is related to feel, can be arbitrarily changed for each site.
- the second lesion may be configured using materials other than calcium sulfate and paraffin.
- the second lesion may be formed using an inorganic material such as glass or ceramic.
- the first and second lesions are placed inside the vascular part 40 and used, but they may be configured differently.
- the vascular part 40 is not essential, and a vascular lesion model having the first lesion 20 and the second lesion without the vascular part 40 may be subjected to training including observation under ultrasound guidance.
- the present disclosure is not limited to the above-described embodiments and the like, and can be implemented in various configurations without departing from the scope of the present disclosure.
- the technical features in the embodiments corresponding to the technical features in the respective modes described in the Summary of the Invention column may be used to solve some or all of the above problems, or Substitutions and combinations may be made as appropriate to achieve part or all.
- the technical features are not described as essential in this specification, they can be deleted as appropriate.
- Vascular lesion model 20 First lesion part 30, 130, 230, 330... Second lesion part 40... Vascular part 132... Granular part 134... Coat layer 335... Mixed lesion part
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Abstract
Description
(1)本開示の一形態によれば、血管病変モデルが提供される。この血管病変モデルは、高分子材料によって形成された第1病変部と、前記第1病変部に接して設けられ、前記第1病変部と接する表面を含む部位が、前記第1病変部よりも音響インピーダンスが大きい材料により形成されており、超音波画像において石灰化病変を模擬する第2病変部と、を備える。
この形態の血管病変モデルによれば、第2病変部を、第1病変部よりも音響インピーダンスが大きい材料により形成して、超音波画像において第2病変部によって石灰化病変を模擬している。そのため、このような血管病変モデルを用いるならば、超音波ガイド下において、実際の病変部の超音波画像を模した像を得つつ、経皮的血管形成術等の治療や、診断等を目的とした血管の観察等のトレーニングを行うことができる。
図1は、第1実施形態の血管病変モデル10の概略構成を模式的に表す断面図である。本実施形態の血管病変モデル10は、超音波ガイド下において、血管に対する、医療用デバイスを用いた治療または検査の手技を模擬するために使用される。血管病変モデル10は、第1病変部20と、第2病変部30と、第1病変部20および第2病変部30が内部に配置された血管部40と、を備える。
図7は、第2実施形態の血管病変モデル110の概略構成を模式的に表す断面図である。第2実施形態の血管病変モデル110において、第1実施形態の血管病変モデル10と共通する部分には同じ参照番号を付す。図7では、図1と同様に、病変部によって血管部40が閉塞される様子を示しているが、閉塞されることなく狭窄されるモデルとしてもよい。
図11は、第3実施形態の血管病変モデル210の概略構成を模式的に表す断面図である。第3実施形態の血管病変モデル210において、第1実施形態の血管病変モデル10と共通する部分には同じ参照番号を付す。図11では、病変部によって血管部40が閉塞されことなく狭窄される様子を示しているが、閉塞されるモデルとしてもよい。
図15は、第4実施形態の血管病変モデル310の概略構成を模式的に表す断面図である。第4実施形態の血管病変モデル310において、第1実施形態の血管病変モデル10と共通する部分には同じ参照番号を付す。図15では、図1と同様に、病変部によって血管部40が閉塞される様子を示しているが、閉塞されることなく狭窄されるモデルとしてもよい。
第2病変部は、硫酸カルシウムやパラフィン以外の材料を用いて構成してもよい。第1病変部20を構成する高分子材料よりも音響インピーダンスが大きい材料であって、第1病変部20と接する第2病変部の表面を含む部位を構成することにより、超音波画像において、石灰化病変を模擬する第2病変部とすることができればよい。例えば、ガラスやセラミック等の無機物を用いて第2病変部を形成してもよい。
20…第1病変部
30,130,230,330…第2病変部
40…血管部
132…粒状部
134…コート層
335…混合病変部
Claims (10)
- 血管病変モデルであって、
高分子材料によって形成された第1病変部と、
前記第1病変部に接して設けられ、前記第1病変部と接する表面を含む部位が、前記第1病変部よりも音響インピーダンスが大きい材料により形成されており、超音波画像において石灰化病変を模擬する第2病変部と、
を備える血管病変モデル。 - 請求項1に記載の血管病変モデルであって、
前記第2病変部は、硫酸カルシウムを含む
血管病変モデル。 - 請求項2に記載の血管病変モデルであって、
前記第2病変部は、粒状に成形した硫酸カルシウムを含む
血管病変モデル。 - 請求項1に記載の血管病変モデルであって、
前記第2病変部は、パラフィンを含む
血管病変モデル。 - 請求項4に記載の血管病変モデルであって、
前記第2病変部は、パラフィンでコートした高分子材料の粒状体を含む
血管病変モデル。 - 請求項4に記載の血管病変モデルであって、
前記第2病変部は、パラフィンの薄片を備える
血管病変モデル。 - 請求項1から6までのいずれか一項に記載の血管病変モデルであって、
前記第1病変部は、ハイドロゲルによって形成される
血管病変モデル。 - 請求項7に記載の血管病変モデルであって、
前記ハイドロゲルは、多糖類ハイドロゲルを含む
血管病変モデル。 - 請求項8に記載の血管病変モデルであって、
前記多糖類ハイドロゲルは、アガロースゲルである
血管病変モデル。 - 請求項1から9までのいずれか一項に記載の血管病変モデルであって、さらに、
管状の血管部を備え、
前記第1病変部および前記第2病変部は、前記血管部の内部に配置され、前記血管部を狭窄あるいは閉塞する
血管病変モデル。
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CN202180095968.5A CN116982098A (zh) | 2021-03-31 | 2021-03-31 | 血管病变模型 |
PCT/JP2021/013871 WO2022208741A1 (ja) | 2021-03-31 | 2021-03-31 | 血管病変モデル |
JP2023510033A JPWO2022208741A1 (ja) | 2021-03-31 | 2021-03-31 | |
US18/370,093 US20240029586A1 (en) | 2021-03-31 | 2023-09-19 | Vascular lesion model |
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Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2010007801A1 (ja) * | 2008-07-16 | 2010-01-21 | 学校法人早稲田大学 | 模擬血管製造用のモールド、模擬血管の製造方法、及び模擬血管 |
WO2010016353A1 (ja) * | 2008-08-08 | 2010-02-11 | テルモ株式会社 | 超音波検査用生体モデル |
JP2010533025A (ja) * | 2007-07-13 | 2010-10-21 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | 超音波ガイド下のニードル挿入用のファントム及び該ファントムの製法 |
US20200126449A1 (en) * | 2017-04-18 | 2020-04-23 | Teleflex Medical Incorporated | Vascular Access Training Simulator System and Transparent Anatomical Model |
-
2021
- 2021-03-31 WO PCT/JP2021/013871 patent/WO2022208741A1/ja active Application Filing
- 2021-03-31 CN CN202180095968.5A patent/CN116982098A/zh active Pending
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Publication number | Priority date | Publication date | Assignee | Title |
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JP2010533025A (ja) * | 2007-07-13 | 2010-10-21 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | 超音波ガイド下のニードル挿入用のファントム及び該ファントムの製法 |
WO2010007801A1 (ja) * | 2008-07-16 | 2010-01-21 | 学校法人早稲田大学 | 模擬血管製造用のモールド、模擬血管の製造方法、及び模擬血管 |
WO2010016353A1 (ja) * | 2008-08-08 | 2010-02-11 | テルモ株式会社 | 超音波検査用生体モデル |
US20200126449A1 (en) * | 2017-04-18 | 2020-04-23 | Teleflex Medical Incorporated | Vascular Access Training Simulator System and Transparent Anatomical Model |
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US20240029586A1 (en) | 2024-01-25 |
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