The characteristics of the invention and the advantages derived therefrom will appear more clearly from the following description of a few non limiting embodiments, illustrated in the annexed drawings, in which:
Particularly referring to
The construction of magnetic resonance imaging apparatus has been long known. The magnet structure has the function of delimiting a space for receiving a patient or a part of the patient's body and of generating a magnetic field which permeates at least partly the volume of the patient receiving space. The magnet structure is also associated to so-called gradient coils for generating time dependent magnetic fields as well as coils for transmitting matter excitation pulses, which are generally radio frequency pulses, as well as at least one coil for receiving the radio frequency signals resulting from matter response to the excitation pulses.
A general introduction to the principles of operation of MRI apparatus is contained in: “Quaderni di RM, Basi Fisiche della Risonanza Magnetica” A. Desgrez, J. Bittoun, I. Idy-Peretti, Edizione Franco Milani 1992 Masson.
The means for generating the static field that permeates at least partly the patient receiving space may include permanent magnets and/or resistive magnets and/or superconducting magnets.
The type of field generating means has a minor incidence upon the operation principle of MRI apparatus. Construction variants are mainly associated to the means for controlling the resistive or superconducting magnets which require power in coils combined with cores and the corresponding drivers and power supplies. Temperature control is generally always provided even in permanent magnets, however in superconducting magnets in addition to reducing or compensating for thermal drifts of magnetic fields, this control also allows to maintain the conditions in which the coils have a superconducting behavior.
The MRI apparatus has many more components in addition to the magnet structure and the above mentioned operating units, however these components are known parts, which are not related to the present concepts.
As shown in
Regarding the size, the cavity and the at least one access opening have such a width as to allow the patient to access it by walking and/or remain in such cavity in a position in which the axis that joins his/her shoulders is parallel to the width of the cavity.
In particular conditions, the cavity and the at least one access opening, particularly the two opposite access openings have such a width as to allow access by a wheelchair or similar device, either driven by the person sitting thereon or pushed by third parties.
The patient may be also introduced in the cavity 2 using a patient table, a convertible armchair and/or an armchair or the like, instead of the wheelchair, after laying the patient thereon outside the magnet structure. The patient table, armchair and/or other similar devices may also have means for adjusting the height and/or tilt of the patient support plane about one or more axes so that the patient may be tilted with different orientations in space.
The two opposite field generating pole pieces form or are supported by two opposite vertical walls which are spaced to such an extent as to form the above mentioned patient receiving space and at least one access opening at least at one end side. The means for excitation of the body under examination or a part thereof for emission of resonance signals (not shown in detail and generally consisting of at least one transmitting coil) are integrated in or supported by said walls or are combined with said pole pieces 101.
In this example, the wall that connects the two pole pieces 101 and/or the walls supporting such two pole pieces 101 is the support base for the magnet structure and the walking surface for the patient when he/she is within the patient receiving space.
A number of variants of the magnet structure may be provided, such as different rotations of the structure as shown in
The base 201 that, in the specific non-limiting example of the figures, acts as a connection wall between the two opposite walls that form or support the pole pieces 101 of the magnet structure, may have one, two or more steps on the opening side, for access to the imaging space. Otherwise, to allow access by disabled people and/or by carriage-mounted means of transport, such as patient tables, armchairs or the like, there are provided at least two parallel climbing ramps at the at least one access opening, along parallel strips disposed at the same distance from each other as the wheels of a wheelchair, a patient table, an armchair, or the like, or one climbing ramp whose width corresponds to the total width of the base.
A balustrade and/or lateral gripping and retainer means may be further provided at least in the area of the steps and/or ramps and at least on one side or on both sides thereof, for assisting the patient in sliding into the space 2.
While
Furthermore, while
In a first example, as shown in
According to an improvement, the platform has a modular construction, i.e. is composed of multiple platform elements 105, each having a predetermined height, e.g. a minimum unit height. Also, one or more platform elements may be diminished or increased in height, allowing height adjustment in a range from a minimum value to a maximum value. By this arrangement, coarse patient position adjustment with respect to the imaging volume, for the above purpose of centering the organ and/or anatomic region with the imaging volume, is performed using the modular elements, whereas fine position adjustment occurs thanks to the height or thickness adjustable element. In a variant thereof, this element is provided as a common base element which has additional carriage characteristics, so that only one module of the set is adjustable in thickness or height, whereas all the others are stationary, hence simpler and less expensive.
The platform elements 105 may be mounted in superimposed arrangements for making platforms 5 of various heights. They may be also arranged in laterally staggered position with respect to vertical alignment, to form a stepped access side.
A further example of the means for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof, that may be provided separately or in combination with other positioning means consists of one or more gripping handles 6 or other gripping means, which may be either permanently or removably fixed in several different positions with respect to the walls that form and/or support the pole pieces 101 and/or with respect to the base 201 and/or with respect to the platform 5 and to other means for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof, such as those that will be described in the following embodiments.
In
In
A great number of variants for fixation of the gripping means 106 may be envisaged, including any type of brackets or support elements, such as rods, posts and/or beams, each of which may be removably fixed in one or more predetermined positions to the base and/or the walls or the pole pieces of the magnet structure and/or the platform/s or the modular platform elements.
The elements for supporting the gripping means and/or the handles are formed by multiple elements, that can be removably coupled together and/or extended or shortened or anyway have an adjustable size.
Referring to Figure, the gripping or retaining means 6 consist of at least one handle, preferably a pair of laterally aligned or misaligned handles 6, which are spaced in such a position as to provide support for forward bending of the standing patient body P, i.e. in a prone position thereof. In this case, the gripping element/s 106 of each handle are mounted to a vertical post 206. This post may be provided in several different lengths or be continuously adjustable in length.
As shown in
The seat element may be provided in combination with one or more of the means 5 or 6 for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof may be provided as described above. Like the bases 5, the base 307 of the seat element may have a carriage-mounted design and/or be provided with means for adjusting the seat height position and/or means for tilt adjustment along one or more different axes of the seating surface 107 and/or the backrest 207. The seat 7 has at least one seating surface part 107 which is allowed to tilt along at least one axis, preferably along two perpendicular axes, and especially along at least one transverse axis, i.e. oriented in the seat width and/or magnetic field B0 direction (see
The seat 7 may be also provided in combination with footrest elements (not shown) that may be removable and/or adjustable in tilt along at least one transverse axis, i.e. oriented in the backrest width direction, and/or along two perpendicular axes and/or possibly additionally or alternatively adjustable in height.
Referring to
In accordance with a further improvement or alternative arrangement, the patient table 8 may have a carriage-mounted base like the one designated by numeral 408 in
The patient may access the patient receiving space by simply walking therein and only lie on the table when he/she is in such patient receiving space, or he/she may be placed on the table outside the patient receiving space 2 of the magnet structure and be carried into said space on the table 8.
Any other device, such as an armchair and/or a convertible armchair may be provided instead of the patient table.
Besides allowing the patient to assume various postures, the means for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof act at least partly as guides or cases for receiving several different devices or means, such as the resonance signal receiving means and the cables for connecting the outputs of such means to an electronic processor unit of the apparatus, associated to the magnet structure and located outside the latter.
Regarding the resonance signal receiving means, typically receiving coils, the invention proposes two solutions, which many be used separately or in combination. One of such solutions consists in integrating the receiving coils and/or the resonance signal receiving means in the walls 101 that form or support the pole pieces. The receiving coils may be held in such walls or supported thereby and be integrated in the pole pieces.
According to the second solution, the resonance signal receiving means may be removably fixed directly to the body under examination or a part thereof. These resonance signal receiving means, i.e. receiving coils are removably fixable directly to the patient body in the area of one or more separate anatomic regions to be imaged.
According to an advantageous feature of this invention, these receiving means comprise an electromagnetic (RF) signal receiving antenna, composed of one or more conductors 9, which are permanently or removably fitted in or on a garment-like and/or wearable support element. Referring to
The antenna element and/or the conductors 9 that form it are coupled to the garment-like or wearable support element 10 by receiving means, such as loops, waistbands, pockets or combinations thereof, or by permanent or removable fastener means, as shown in
The removable fastener means 12 may advantageously consist of Velcro strap elements. For a single wearable element 10 to be used for several different coils or receiving means having different structures or shapes and particularly formed of conductors that extend in different predetermined paths, the garment-like or wearable element has a certain number of fastener elements 12 arranged on its surface in a predetermined pattern or order The fastener elements 12, in the form of connecting strap elements, cooperate with complementary elements of such connecting strap, that are attached to the rigid or flexible conductors and/or to structural elements of the coils or receiving means in general.
Alternatively or additionally, the garment-like or wearable support element has loops and/or waistbands for receiving rigid or flexible conductors and/or segments of rigid or flexible conductors that form the antenna element or parts of the receiving means or receiving coils.
According to a further variant embodiment, the removable fastener means for rigid or flexible conductors and/or segments of rigid or flexible conductors and/or loops and/or the waistbands for receiving rigid or flexible conductors and/or segments of rigid or flexible conductors are formed and/or fixed to the garment-like and/or wearable support element and/or to the rigid or flexible conductors and/or segments of rigid or flexible conductors by means such as elastically extensible and/or deformable bridges of material and/or fabric.
As mentioned above and shown in
In order that the patient may be allowed to assume several different postures using a single receiving means, in addition to the use of elastically or inelastically flexible conductors, the invention provides, as shown in
The elastically or inelastically flexible and/or extensible conductors 9 or said one or more segments 9′ of rigid and/or elastically or inelastically flexible and/or extensible conductors, that may be connected together by removable electric connection bridges 13, which in turn can be rigid and/or elastically or inelastically flexible and/or extensible, have means for removable attachment to cooperating removable fastener elements 12 on the garment-like or wearable support element 10, which removable fastener means 12 and which cooperating attachment means are respectively arranged along the corresponding elastically or inelastically flexible and/or extensible conductors 9 or the one or more segments 9′ of rigid and/or elastically or inelastically flexible and/or extensible conductors and along the surface of the garment-like and/or wearable support element 10. The above is provided in such a manner that, as each removable attachment means is coupled with each corresponding removable fastener element, the flexible conductors 9 and/or the segments 9′ of rigid and/or flexible conductors are automatically shaped and/or positioned relative to each other in a predetermined three-dimensional path pattern of said conductors to obtain the shape of the antenna or the receiving coil.
Therefore, the receiving coil is formed of a plurality of segments 9′ of rigid or flexible conductors that may be removably attached to the garment-like and/or wearable support element 10, and may be electrically connected together by removable electric connection bridges 13, a set of such segments 9′ of conductors being provided, which comprises pieces of different lengths and/or shapes for modular construction of conductors of different lengths and shapes, such as rectilinear segments of different lengths and/or curved segments having different lengths and/or different curvatures.
According to a further feature allowing to use elastically and/or inelastically conductor segments 9′ or conductors 9, the wires, straps or tracks 109 of conductive material have high-density portions arranged along part or all of their length, such as zigzag, wavy and/or spiral sections, or the like. These sections, designated by numeral 609 in
In a further variant, the attachment means 13, like the Velcro elements, are attached to the wearable element 10 using bridges of elastically deformable and/or extensible material.
According to another feature of the invention, to be used separately or in addition to those described above, the apparatus is provided in combination with means for adjusting gravity stresses on the body under examination, a non limiting example thereof being shown in
Particularly referring to the example of
Advantageously, the garment-like and/or wearable element is the same element as the one that is used for supporting the antenna or coil element, suitably having connections, pockets or the like for holding one or more ballast elements.
The method of use of the inventive apparatus is apparent from the above description. In the MRI imaging method with the apparatus of the invention, the patient
For a better and more effective patient placement, shapes and/or positioning marks may be drawn, possibly in different colors, on the walking surface of the patient receiving space 2, here corresponding to the base 201 and/or on one or more of the walls of the magnet structure which delimit such patient receiving space 2, here corresponding to the vertical walls 101 and/or to the magnetic field generating means 3, such shapes being provided for use by the operating personnel as patient positioning examples. Therefore, in this case, the patient may be asked to place his/her feet in the feet positioning shapes on the floor of the space 2, which have a predetermined color, and to assume a posture as indicated by a body shape, a silhouette or the like, having a predetermined color or defined by an outline of a predetermined color on one or both vertical walls 101 or on the means 3.
When the receiving means are integrated in the magnet structure, the patient may avoid to wear or have one or more receiving coils associated thereto.
In the previous case, especially when the magnet structure has no receiving coils integrated therein, before entering the patient receiving space 2 and/or possibly simply before assuming the posture required for the examination and before being submitted to imaging, the patient has to wear one or more receiving coils as described above and/or have a possibly different receiving coil associated thereto, which coil is supported by support means associated to the magnet structure and may be displaceable to the operating position, in which it is coupled with the patient body, and to an idle position, in which it is far from the patient body.
When an examination requires means for assisting the patient in assuming a certain posture, then the examination includes the steps of:
Alternatively, when the means for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof have a carriage-mounted base and when such means for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof can access the patient receiving space 2 through the access opening, then, as an alternative to the above, the patient sits or lies on said means for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof when such means are outside the patient receiving space as delimited by the magnet structure and then accesses such patient receiving space on such means for positioning and/or bearing and/or retaining and/or supporting the patient or for assisting placement thereof, driven or pushed by external means, which may be manual and patient-driven or motor-driven under the control of the patient or third parties.
As patient placement means a platform is provided on which the patient is asked to climb, which platform has an access side with one or more steps, the patient being positioned with both legs on a step or on the top of the platform or with one leg resting on the first or on one of the next steps, and the other leg resting on the base of the imaging space and/or on the top of the base.
Alternatively or additionally, as placement means, a chair element is provided, having a seating surface, a backrest and possibly a footrest, one or more of such seating, backrest and/or footrest surfaces being adjustable in position and/or tilt and/or orientation.
Once the patient is in the sitting position, either inside the patient receiving space or outside it, as provided by the above alternative methods, the seating surface and/or the backrest and/or the footrest may be adjusted in position and/or tilt or orientation.
Then, with the patient sitting and positioned within the patient receiving space, MR imaging is performed.
The position and/or tilt or orientation of the seating surface and/or the backrest and/or the footrest may be changed a first time and/or one or more additional times, and MR imaging may be repeated each time.
Once imaging is completed, the patient is either asked to stand up while still in the patient receiving space and to leave the space by autonomous walking, or carried out of the space on the chair, using the latter as a means of transport.
When using patient bearing and/or retaining means that may be set in various positions within the imaging space, the imaging method includes the steps of:
Imaging may also be performed by one or more successive imaging steps, the patient being asked, before at least one of such steps or some of such steps, to wear a garment or a wearable and removably fastenable element, which acts as a ballast element 14.
In one embodiment, a sequence of successive MR imaging operations is performed, the weight of the ballast element being increased or decreased before each imaging operation, from a predetermined initial value and/or according to predetermined variation functions.
According to yet another feature of the invention, the patient performs a predetermined movement during MR imaging, such as a walking and/or climbing movement, the base being provided in the form of a tilting treadmill and/or a step-up or step-down movement and/or a sitting movement or a passage from the sitting position to the standing position, or a forward bending movement or a backward and/or sideward arching movement, while a time-dependent sequence of MR imaging operations on at least one or more anatomic regions is performed during such movements.
Number | Date | Country | Kind |
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06121574.5 | Sep 2006 | EP | regional |