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The present invention relates generally to electronic patient monitors and, in particular, to patient monitors suitable for use in the severe electromagnetic environment of a magnetic resonance imaging machine.
Magnetic resonance imaging (MRI) allows images to be created of soft tissue from faint electrical resonance (NMR) signals emitted by nuclei of the tissue. The resonance signals are generated when the tissue is subjected to a strong magnetic field and excited by a radiofrequency pulse.
The quality of the MRI image is in part dependent on the quality of the magnetic field, which must be strong and extremely homogenous. Ferromagnetic materials are normally excluded from the MRI environment to prevent unwanted magnetic forces on these materials and distortion of the homogenous field by these materials.
A patient undergoing an MRI “scan” may be received into a relatively narrow bore, or cavity, in the MRI magnet. During this time, the patient may be remotely monitored to determine, for example, heartbeat, respiration, temperature, and blood oxygen. A typical remote monitoring system provides “in-bore” sensors on the patient connected by electrical or optical cables to a monitoring unit outside of the bore.
Connecting an in-bore sensor to a monitoring unit may be done with long runs of electrical or optical cables. Such cables can be a problem because they are cumbersome and can interfere with access to the patient and free movement of personnel about the magnet itself.
One solution to these problems of cabling is described in co-pending U.S. patent application Ser. Nos. 11/080,958, filed Mar. 15, 2005, and 11/080,743, filed Mar. 15, 2005, assigned to the assignee of the present invention and hereby incorporated by reference. This patent application describes a wireless patient monitor that may be positioned near the patient to provide real-time monitoring of patient physiological signals during the MRI examination.
The electrical environment of the MRI system produces a considerable amount of electrical noise that may interfere with the collection of physiological signals by in-bore sensors. The noise may include that generated by radio frequency pulses used to stimulate the protons of the patient's tissue into precession and noise induced by rapidly switched gradient magnetic fields. The character of the electrical noise produced by the MRI machine may change depending on the machine and on the particular scan protocols.
In order to reduce the effect of the electrical noise on the acquired physiological signals obtained by in-bore sensors, it is known to provide different types of signal filters, appropriate for different imaging situations, at the monitoring unit outside the bore. An operator observing the physiological signals may select among the different filters to choose a filter that provides a physiological signal with the lowest noise.
When wireless in-bore sensors are used, the transmitted signal must generally be pre-filtered before transmission to limit the bandwidth of the transmitted signal. This pre-filtering is not intended to separate all noise from the physiological signal and generally will not provide the entire optimum filter for this purpose. Nevertheless, to the extent that the pre-filter necessarily modifies the transmitted signal, it limits the ability of the operator to fully assess the amount of noise on the physiological signal and/or to fully control the filtration of the physiological signal.
The present invention provides improved filtration of a wirelessly transmitted physiological signal by providing a set of different electrical and/or firmware pre-filters at the transmitting unit that provide filtering of the physiological signal before or instead of the pre-filtering of the transmitter. In this way, more sophisticated filtration may be performed uncompromised by the pre-filter of the transmitter. The particular signal filter can be selected automatically or by wireless command.
Specifically then, the present invention provides an MRI compatible wireless system for monitoring patient physiological signals including a transmitting unit positionable proximate to the patient during the MRI examination. The transmitting unit includes at least one sensor input for receiving a physiological signal from a sensor communicating with the patient, and a set of electrical and/or firmware filters having different characteristics adapted to provide for signal filtering of MRI electrical interference from the physiological signal. A filter selector within the transmitting unit receives a selection signal during an MRI scan to select one or more of the electrical and/or firmware filters for filtering the physiological signal, and provides this signal to a wireless transmitter which transmits to an external monitoring unit in a manner compatible with the MRI examination.
It is thus one feature of at least one embodiment of the invention that it allows wireless transmission of reduced bandwidth data compatible with filtration optimized for removing MRI-induced noise.
The transmitting unit may include a receiver receiving commands from the external monitor and the selection signal may be a command received from the external monitor.
It is thus another aspect of at least one embodiment of the invention to permit manual selection of a transmitter-based pre-filter.
Alternatively, the transmitting unit may include a noise analyzer monitoring noise in the physiological signal to automatically provide the selection signal.
It is thus another aspect of at least one embodiment of the invention to allow filter selection at the transmitter using an analysis of the unfiltered signal before modification by transmission.
The noise analyzer may monitor the physiological signal as filtered by each of the pre-filters to select the pre-filter providing an output with best characteristics.
It is thus an aspect of at least one embodiment of the invention to provide a simple automatic assessment of signal quality.
The set of electrical and/or firmware pre-filters may be a field programmable gate array and/or a digital signal processor.
It is thus another feature of at least one embodiment of the invention to provide for an extremely compact yet versatile filter implementation.
The set of electrical and/or firmware filters may be tuned to different modes of interference caused by interference from the MRI examination selected from the sources of: magnetic gradient coil interference and radiofrequency coil interference.
It is thus another feature of at least one embodiment of the invention to allow filtration using ex ante knowledge about the MRI process.
The physiological signal is selected from the group consisting of: heart beat, respiration, body temperature, and blood oxygen.
It is an aspect of the present invention that it may provide for different filter types based on the type of physiological signal being transmitted.
The invention also provides a power source for wireless patient monitors using so called “super capacitors”, generally capacitors that are one Farad or more in size and thereby avoiding problems of using batteries in the confined and intense magnetic environment of the MRI machine.
More specifically, this aspect of the invention provides a wireless patient sensor for monitoring a patient during an MRI examination having a housing positionable near the patient during the MRI examination and an input circuit for receiving a physiological signal from the patient. The sensor further provides a transmitter for transmitting the physiological signal wirelessly to an external station in a manner compatible with operation of the MRI machine. The sensor is powered by a power source employing capacitor storage without chemical batteries.
It is thus one feature of at least one embodiment of the invention to eliminate the need for costly battery systems that may adversely affect the imaging process through the incorporation of magnetic elements.
The capacitor storage may provide a capacitance of at least one Farad.
It is thus another feature of at least one embodiment of the invention to employ so-called super capacitors as a convenient short-term energy storage system.
The sensor may further include a display displaying a charge on the capacitor storage.
It is thus another feature of at least one embodiment of the invention to provide a simple and accurate assessment of the readiness the sensor.
The display may show one or both of a voltage of the capacitor storage and/or an operating time of the physiological monitor when using the capacitor storage at a given voltage.
It is thus another feature of at least one embodiment of the invention to provide an accurate reading of the charge on the capacitors which may be derived directly from their output voltage.
The sensor may further include a DC-to-DC converter for providing constant voltage output as the capacitor storage voltage drops.
It is thus another aspect of at least one embodiment of the invention to provide a power system that accommodates the steady drop in voltage of a capacitor as power is used.
The DC-to-DC converter may be a boost converter.
It is thus another feature of at least one embodiment of the invention to provide a power system that maximizes the time at which the voltage is at a usable level.
The sensor may be used with a charging station providing receptacles for removable capacitor power sources to receive and charge the removable capacitor power sources when they are held in the receptacles.
It is thus a feature of at least one embodiment of the invention to provide for a simple rapid charging station at the site of use of the portable systems.
The charging station may provide a constant current source for charging the capacitor power sources.
It is another aspect of at least one embodiment of the invention to provide for high-speed charging of the capacitor storage without damage.
The charging station may further include an indicator showing a degree of completion of the charging of each capacitor power source in a receptacle.
It is thus another feature of at least one embodiment of the invention to allow quick determination of the state of charge of the capacitor storage systems prior to use.
The capacitor power sources may be constructed of non-ferromagnetic materials.
It is thus an aspect of at least one embodiment of the invention to provide a power source with improved compatibility with the MRI environment.
These particular features and advantages may apply to only some embodiments falling within the claims and thus do not define the scope of at least one embodiment of the invention.
Referring now to
A patient 14, supported on a movable table 17, may be positioned outside the bore of the magnet 12 to receive a wireless patient monitor 16 receiving signals from the patient 14 by leads 18. The patient 14 may then be moved into the bore of the magnet 12 with the wireless patient monitor 16 allowing for continuous monitoring of the patient 14. The wireless patient monitor 16 may incorporate its own power supply to transmit the monitored signals from the patient 14 via radio transmitted signal 19 or the like to a base station 24 positioned near the magnet 12 but outside of the bore.
Methods of supporting a wireless transmitter of this kind on a patient are described, for example, in co-pending U.S. patent application 2006/0247512 entitled “Patient Supported In-Bore Monitor For MRI”, assigned to the assignee of the present invention and hereby incorporated by reference.
Referring now to
The display 28 may further be used to associate the wireless patient monitor 16 with a given transmission channel. In this latter regard, the microcontroller 26 may communicate with a transmitter/receiver 30 connected to antenna 32 for transmitting and receiving data with the base station 24 on the channel selected by operating controls 29 to select a transmission channel that is then displayed on the display 28.
Wireless transmission of physiological data in the electrically noisy environment of the MRI suite 10, the noise caused by switched radio frequency and magnetic gradient fields of the MRI machine, without interference by the noise to the transmission and without interference by the transmission to the sensitive receiver electronics of the MRI machine, requires specialized transmission techniques such as those taught in U.S. patent application 2006/0206024 entitled: “Wireless In Bore Patient Monitor For MRI”, assigned to the same assignee as the present invention and hereby incorporated by reference.
The microcontroller 26 may also communicate with a field programmable gate array (FPGA) 34 that provides various features of a digital signal processor (DSP) to implement multiple gradient filters used in an automatic gradient filter selection algorithm as will be described further below.
In a preferred embodiment, the circuitry of the signal conditioning circuitry 25, the microcontroller 26, the transmitter/receiver 30, and the FPGA 34 are powered by a supercapacitor 36, being one or multiple discrete capacitors wired together in series or parallel having a capacitance of at least one Farad, contained by the patient monitor 16. In the application of the patient monitor 16, the supercapacitor 36 offers sufficient power density for operating the patient monitor 16 during a normal MRI scan, and avoids ferromagnetic materials or hazardous materials often found in batteries. Ferromagnetic materials can be a problem in the vicinity of the magnet 12 because such materials can be affected by strong forces of attraction of the polarizing magnetic field and/or interfere with the homogeneity of the magnetic field within the magnet bore, homogeneity that is critical to accurate imaging.
Referring now to
Referring now to
In either case, the charging stand 38 may provide for a series of charging pockets 40 holding either the supercapacitors 36 or the entire patient monitor 16 so that terminals 49 connected to the supercapacitors 36 are exposed to connect to corresponding terminals 42 in the pockets 40. Once placed in the pocket 40, the ground terminal of each supercapacitor 36 may be connected to a ground of a power supply 44 of the charging stand 38, and the positive terminal of each supercapacitor 36 may be connected to an independent current source 46 implemented in the power supply 44. Each current source 46 provides a controlled (and typically constant) current preset to a percentage of the maximum permissible charging current of each supercapacitor 36. The use of the current sources 46 ensure the maximum charging speed of the supercapacitor 36 by changing the charging voltage as necessary to provide a consistent current for charging.
The power supply 44 may also provide voltage signals 50 indicating the voltage on the supercapacitors 36 to indicator gauges 52 each being, in one embodiment, an LED bar gauge showing percentage of total charge on the supercapacitors 36 being a simple function of the voltage on the individual supercapacitors 36. Typically, the supercapacitors 36 will recharge in only a fraction of the time required for comparable batteries and will have a many times higher recharging number than batteries.
Referring again to
Referring now to
A filter 64, for example, a slew filter, conventional bandpass, lowpass or highpass filter, or other filters well known in the art of digital signal processing, may be applied to physiological signal 22 to produce a clean signal 22′ better reflecting the underlying physiological signals 22, with reduced electrical interference 60. Generally, the clean signal 22′ will have a smaller variance 62′ relative to variance 62 of signal 22.
Referring to
The variance analyzer 66 automatically selects through a switch array 68, implemented in software, one filter 64a, 64b and 64c providing the best filtration without the need for operation intervention. Alternatively, and referring to
It is specifically intended that the present invention not be limited to the embodiments and illustrations contained herein and the claims should be understood to include modified forms of those embodiments including portions of the embodiments and combinations of elements of different embodiments as come within the scope of the following claims.
This application claims the benefit of U.S. Provisional Application 60/799,884 filed May 12, 2006 and hereby incorporated by reference.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US07/68624 | 5/10/2007 | WO | 00 | 3/5/2009 |
Number | Date | Country | |
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60799884 | May 2006 | US |