1. Field of the Invention
The invention relates to methods, ultrasound probes, and instrumentation for real time 2D imaging from the tip of an ultrasound probe that can be inserted into the body, either through natural openings or through surgical wounds.
2. Description of the Related Art
Real time (Rt) two-dimensional (2D) ultrasound imaging around the tip of an ultrasound probe that can be inserted into the body, is in many situations a sought after tool, both for diagnosis and for guidance of procedures. Examples of such procedures are placement of devices in vessels, heart ventricles and atria, guidance of electrophysiology ablation, or guidance in minimal invasive surgery. In these cases, the ultrasound probe gets in direct contact with the blood path, and it is then a great advantage to use factory-sterilized, disposable probes. This requires that the manufacturing cost of the probes can be kept low.
There is further a need for the probe to be flexible, for example for insertion into the vessels and the heart as a catheter. In this situation one could also want to control flexing of the tip from the external instrument. In other situations, like endoscopic surgery, one would like to have a stiff probe. A limited diameter puts a limit to the number of signal wires that can run along the probe.
The present invention provides a solution to these problems by using mechanical scanning of the ultrasound beam from a single element transducer with fixed focus, or an annular transducer array with depth steered focus. For the annular array, one can conveniently use solutions as described in U.S. Pat. No. 6,540,677, to increase the sensitivity and reduce the number of wires connecting between the probe tip and the external imaging instrument. Two embodiments for mechanical scanning of the probe is proposed:
1. In the first embodiment, the transducer array is mounted at the tip of a rotating wire, and the beam is pointed at an acute angle to the rotation axis so that the beam is scanned along a conic surface in the forwards direction from the probe tip. The conic image is then divided into sub sectors and visualized as several plane sectors on the image screen. In a variation of embodiment a second transducer is mounted at close to right angle to the rotating probe tip, for additional imaging at a close to cross sectional plane of the probe.
2. In a second embodiment, the transducer array is mounted at a wobbling structure at the tip of the array, so that the ultrasound beam is scanned within a plane 2D sector. The wobbling is conveniently driven by hydraulic means. The 2D scan plane can be directed both in the forwards direction from the probe tip and at an angle to the probe tip.
Sensors to measure the angular position of the array, both in relation to the probe tip, and in relation to the external world, can be mounted at the array to be used in a feedback loop to control the scanning speed of the beam, and/or to trigger the image beams so that they are spread over the image with adequate angular distance, or the angle is used in the reconstruction of the image if the angular distance between the image beams varies over the image.
For limited movement velocity of the imaging object, one can obtain dynamic focusing of the ultrasound beam in the 2D azimuth scan plane by linear combination of the received RF signal from neighboring receive beams. Dynamic focusing in the elevation direction is best done with annular arrays, which then also would give dynamic focusing in the azimuth plane also.
The probes can be made both flexible and stiff, for best adaption to the application. The tip of the flexible probe can be direction steered (flexed) through wires along the periphery of the probe that are stretched/released through handles at the outside instrument.
Other objects and features of the present invention will become apparent from the following detailed description considered in conjunction with the accompanying drawings. It is to be understood, however, that the drawings are designed solely for purposes of illustration and not as a definition of the limits of the invention, for which reference should be made to the appended claims. It should be further understood that the drawings are not necessarily drawn to scale and that, unless otherwise indicated, they are merely intended to conceptually illustrate the structures and procedures described herein.
In the drawings:
The invention relates to an ultrasound real time 2D imaging system, which in a typical embodiment is composed of the components shown in
In this particular embodiment, the imaging probe 100 is a particularly flexible catheter probe for example allowing double curving of the probe, which has advantages for imaging inside tortuous vessels and the heart cavities. For these applications one would also want the region close to the tip to be more flexible than the proximal region of the probe, as the tortuous flexing is mainly necessary in the distal region, while less flexibility of the proximal region helps in manipulation of the probe. In other applications, the probe can be much less flexible, close to stiff, for example in minimally invasive surgery where the probes would be inserted through a trocar. For the flexible probe, one can in some embodiments stretch wires along the periphery of the probe, where the wires can systematically be stretched and released by control organs 108 at the utility interface 103 for flexing the tip of the probe in one or two directions.
When the imaging object has limited movement velocity, the number of wires between the imaging tip and the external imaging instrument can also be reduced with synthetic focusing techniques, for example where one in a sequence image with the different elements in the probe, and combine these signals into a beam that is focused at all depths with focus width determined by the active aperture of the array. Synthetic focusing in the azimuth direction can also be obtained by linear combination (filtering) of the RF-signal of neighboring, fixed focus or unfocused azimuth beams.
The array 201 and the circuit 203 are mounted in an array holder unit 204 that is connected to a flexible rotation cable 205 typically made of double helix spun wires, like a speedometer wire. The rotation cable 205 has a core of electric cable wires 206 that connects the array and circuit to the external utility console 103, as shown in
For accurate sensing of the angular direction of the array, a position sensor 210 would typically be mounted at the probe tip to measure the rotation ψ, indicated as 211, of the array holder 204 and array 201 in relation to the catheter sheath 209 . This position sensor could typically be of optical types like described in
An example of visualization of the 2D conic image data on a flat screen, is shown in
For various applications, for example for measurement of a vessel cross section or observations of the cardiac valves, it is advantageous in addition to the forward cone to show a cross sectional image around the probe tip. This can be achieved as shown in
Another embodiment for 2D scanning of the ultrasound beam according to the invention, is shown in
The probe contains in this example embodiment two hydraulic channels 509 and 510 that can inject or remove fluid from the chambers 507 and 508, that are separated by the flexing member 504. In normal scanning operation, the interior compartments 502, 507, and 508 are filled with a fluid, preferable water with physiological composition. Injecting fluid through the tube 509 into compartment 507 while removing similar amounts of fluid through tube 510 from compartment 508 causes the array/circuit assembly 501 to rotate in the clockwise direction indicated by the arrow 512. The opposite rotation is obtained by injecting fluid through tube 510 into chamber 508 while removing a similar amount of fluid through tube 509 from chamber 507.
For simplified filling of the chambers 502, 507, and 508 with fluid, without introducing air bubbles, a continuous forward filling with fluid is obtained by the channels 514 that feeds fluid from the compartments 507 and 508 into the compartment 502, while the channel 515 feeds fluid from the compartment 502 to the outside front of the probe dome. This continuous flow of fluid to the front of the dome, improves acoustic contact between the dome and the object contact surface, or can spill into the blood when the probe is inserted into a blood-filled region. In other embodiments, the draining of the fluid from compartment 502 can in addition or instead be done through the probe to its proximal, outside end, by an additional specific channel through the probe from the distal to the proximal end.
The probe is on its proximal end connected electrically and hydraulically to the utility console 103 of
To avoid geometric distortions of the image in the direction of the mechanical scan, one can conveniently use an angular position sensor of the moving array/circuit assembly at the tip of the probe. Such position sensors can be based on optical or electromagnetic principles according to known methods, and for sake of example
a shows the rotating array holder 104 with the rotating drive cable 105, that rotates the array in the direction indicated by 604. The rotating drive cable contains in this example embodiment also an optical fiber 601 that feeds light into a transparent sub-part 602 of the array holder. The surface of the sub-part 602 is partly covered with a light inhibiting film at the end face and also at grating lines 603 in a periodic pattern along the circumference of 602 that inhibits light to shine out through the circumference, while between the grating lines the light is allowed to shine through. The distance between the grating lines is equal to the width of the grating lines within the accuracy of the manufacturing.
Two optical fibers 605 and 606 picks up light that shines through the circumference of 602 and feeds the light back to the instrument where it is converted to electrical analog signals by for example photo transistors and subsequently converted to digital form for processing to accurately detect the rotational angle of the array holder 104. Example signals after the phototransistors for the two fibers are shown in
ψ(t)=F{x(t), y(t)} (1)
where for many applications F{ } can be approximated by the inverse tangent as
ψ(t)=F{x(t), y(t)}=tan−1{y(t)/x(t)} (2)
A similar optical position sensor for the wobbling system in
In
With two fibers that collects light that is 90 deg out of phase with each other (quadrature phase) one is able to resolve the direction of rotation. If one knows the rotation direction, it would be sufficient to have a single fiber for the reflected light, however, the conversion from light intensity to angle would be simplified by the use of two light signals with quadrature phase relationship.
The same fiber can also be used for transmitted and reflected light using for example a transmitting mirror as shown in
Other methods of angular position sensing can be based on electromagnetic methods where many such methods are known.
Using wide band or multi-band transducers based on ceramic films, for example as described in U.S. Pat. No. 6,671,692, one can operate the ultrasound transducer both in a low frequency band for an overview image with large penetration, and in a high frequency band for a short range image with improved resolution. The overview image could for example be used to guide ones way in the cardiac chambers to move the probe tip close to an electrophysiology ablation scar, and then evaluate the scar with the high resolution short range image. Similarly could the long range image be used to get an overview of the movement of native heart valves to evaluate best procedure for valve repair or valve replacement, while the short range image can be used to evaluate details in valve morphology.
It is also expressly intended that all combinations of those elements and/or method steps which perform substantially the same function in substantially the same way to achieve the same results are within the scope of the invention. Moreover, it should be recognized that structures and/or elements and/or method steps shown and/or described in connection with any disclosed form or embodiment as a general matter of design choice. It is the intention, therefore, to be limited only as indicated by the scope of the claims appended hereto.
Thus, while there have shown and described and pointed out fundamental novel features of the invention as applied to a preferred embodiment thereof, it will be understood that various omissions and substitutions and changes in the form and details of the devices illustrated, and in their operation, may be made by those skilled in the art without departing from the spirit of the invention. For example, it is expressly intended that all combinations of those elements and/or method steps which perform substantially the same function in substantially the same way to achieve the same results are within the scope of the invention. Moreover, it should be recognized that structures and/or elements and/or method steps shown and/or described in connection with any disclosed form or embodiment of the invention may be incorporated in any other disclosed or described or suggested form or embodiment as a general matter of design choice. It is the intention, therefore, to be limited only as indicated by the scope of the claims appended hereto.
This application claims priority from U.S. Provisional Patent Application Ser. No. 60/551,736 which was filed on Mar. 10, 2004.
| Number | Date | Country | |
|---|---|---|---|
| 60551736 | Mar 2004 | US |