Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/41—Detecting, measuring or recording for evaluating the immune or lymphatic systems
  • A61B5/411—Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/08—Measuring devices for evaluating the respiratory organs
  • A61B5/0813—Measurement of pulmonary parameters by tracers, e.g. radioactive tracers

Definitions

• This invention relates to the diagnosis of respira ⁇ tory diseases and more specifically to a novel and im ⁇ proved method and apparatus utilizing an aerosolized radioactive isotope for ventilation of the lungs to en ⁇ able the production of multiple images of relatively high resolution and contrast to facilitate location of e boli, tumors and the like as well as other diseases affecting the respiratory tract without the danger of hyperdeposition and loss of image clarity.
• radioactive gases such as xenon and krypton are generally relied upon notwithstanding the relative ⁇ ly high cost entailed in producing the gas, patient in ⁇ convenience, extremely limited time in which to obtain even one image of the lung and the need for containment and disposition of the exhaled gas.
• This invention overcomes the problems heretofore entailed in the diagnosis of lung diseases and provides a method and apparatus utilizing a radioactive mist which avoids the difficulties entailed with gases as well as the problems heretofore encountered with aero ⁇ sols. More specifically, it has been found that with the utilization of aerosols wherein the particle size is maintained below approximately 1.2 microns with by far the major portion of the particles being well below 1 micron, the mist behaves much the same as a gas and does not produce material rainout or hyperdeposition in the upper respiratory tract, pharynx or trachea. Moreover, there is substantially uniform deposition throughout the entire lung without accumulation at airway branching points and the patient can be in any position and is not required to hold his breath during the scanning opera- tion and ample time is available for multiple scans.
• the isotope being in aerosol form can, upon being exhaled, be filtered out and safely stored until the radioactivity reaches a safe level for convenient disposition. Radioactive gases however cannot be fil- tered and great care is required for containment and storage, the latter requiring extended periods of time as compared to aerosols.
• Another object of the invention resides in the pro ⁇ vision of a novel and improved method and apparatus for the diagnosis of lung diseases characterized by its sim ⁇ plicity, reliability, ease of operation and relatively low cost.
• Still another object of the invention resides in the provision of novel and improved diagnostic apparatus which enables multiple photographic views of the lung to be recorded with little if any patient inconvenience.
• a still further object of the invention resides in the provision of a novel and improved method and appa ⁇ ratus for making image ventilation studies of the lung which affords greatly improved resolution and contrast.
• the invention utilizes a nebulizer wherein the maximum particle size is essentially limited to 1.2 ic- rons with a negligible quantity of particles larger than 1.2 microns.
• a unidirectional air inlet is coupled to the output of the nebulizer and the output is also cou ⁇ pled through a unidirectional flow valve and a T- or Y- connector to a mouthpiece or face mask through which the patient inhales the mist produced by the nebulizer.
• the third or discharge opening on the connector includes a unidirectional flow valve for the discharge of mist and air exhaled by the patient and a filter for the removal of the radioactive mist.
• the output from the filter is preferably fed to a suitable container for storage until the radioactivity decays to a safe level for disposal. Since the nebulizer is usually operated continuously by a compressed air supply, means are also provided at the output of the nebulizer to prevent the development of excess pressure during the exhaling periods.
• Figure 1 is a side elevational view in partially diagrammatic form of one embodiment of apparatus in accordance with the invention.
• particle sizes not only should not ex- ceed 1.2 microns but that the particles of the aerosol should be in the range of about .056 microns to about 1.2 microns with approximately 90% of the particles be ⁇ ing under 1 micron. Under these conditions, the aerosol behaves as a gas and the desired objectives can be achieved.
• the radioactive technetium compounds referred to above are generally available in Nuclear Medicine De ⁇ partments for routine clinical diagnostic procedures and accordingly constitute a relatively inexpensive and available aerosol for the conduct of ventilation scans.
• the nebulizer is gener ⁇ ally denoted by the numeral 10 and includes a compressed gas inlet 11 and an outlet 12.
• the nebulizer may take any desired form though in the illustrated embodiment, the housing would include a suitable reservoir, an aspi ⁇ rator for producing the mist and the gas such as oxygen or air should be supplied at the rate of the order of 6 to 10 liters per minute.
• a four-way connector generally denoted by the numeral 13 is coupled to the outlet 12 of the nebu ⁇ lizer 10 by the tubular leg 14.
• a unidirectional air inlet valve 15 is connected to a second tubular leg 16 of the four-way connector 13
• a second unidirectional outlet valve 17 and particle filter 18 are connected to a third leg 19 of the four-way connector 13 and a fourth leg 20 of the connector 13 is connected to flexible tub- ing 21 having a bellows configuration for delivery of the aerosol to the patient.
• the outlet end of the tubing 21 is connected to a third unidirectional valve 23 which may be contained within a second container 24 also formed of lead or other radiation shielding material.
• the outlet of the one-way valve 23 is coupled to one leg 25 of a Y- con ⁇ nector 26 disposed within the container 24 and the sec ⁇ ond leg 27 of the Y- connector is coupled to a flexible tube 28 similar to that of the tube 21.
• a mouthpiece 29 for the patient is secured to the end of the tube 28 so that the patient can conveniently inhale the mist generated by the nebulizer 10 together with air entering the one-way valve 15. While a simple mouthpiece 29 has been illustrated, a suitable facemask may replace the mouthpiece if so desired.
• the unidirectional flow valve 23 may take any desired form and may preferably be ad ⁇ justed to prevent flow during the presence of atmos ⁇ pheric pressure on the downstream side of the valve and provide for free flow when the downstream pressure is reduced during the time the patient is in the process of inhaling.
• the patient When utilizing aerosols for ventilation scans, the patient may inhale and exhale several times in order to be certain that the radioactive mist has been uniformly deposited throughout the entire lung. During the exhal ⁇ ing periods, the patient will exhale through the mouth ⁇ piece or face ask, as the case may be, and through the tube 28. Since the one-way valve 23 will prevent re ⁇ verse flow of mist, the exhaled aerosol will pass out ⁇ wardly through the leg 30 of the Y- connector 26, a one ⁇ way valve 31 and a filter 32 and the exhaled air and/or gas will be discharged through the tube 33.
• the filter 32 retains the aerosol exhaled by the patient and con ⁇ tains the filtered aerosol until the level of radio ⁇ activity has decreased to a safe level for convenient disposal.
• the valve 23 will remain closed and it is therefore desirable to prevent development of excessive pressure within the tube 21 caused by compressed air entering the inlet 11 of the nebulizer 10.
• the tubing 21. being in the form of a bellows, will tend to expand and thus limit the pressure.
• the one-way valve 17 may be utilized and adjusted to act as a relief valve to limit the maximum pressure in the tube 21.
• an aerosol filter 18 is pro ⁇ vided to filter out and contain the aerosol and the re ⁇ maining gas is discharged through the pipe 34. If de- sired, pipes 33 and 34 may be coupled together and fed to a holding container which will retain the gaseous material until the radioactivity has decreased to a level permitting normal disposal.
• the nebulizer 10 may take any desired form pro- vided however that the aerosol particles generated thereby are within the ranges set forth above.
• One such nebulizer which will generate a mist meeting the requirements outlined above is illustrated and described in.United States Patent No. 4,116,387.
• Figure 2 illustrates a modified embodiment of the invention wherein a large particle trap is included in the event the specific nebulizer 10 utilized may have an excess number of large particles.
• leg 20 extending from the four-way connector 13 is curved up ⁇ wardly and receives the vertical leg of an elbow 35 hav ⁇ ing a plurality of inclined baffles 36.
• the horizontal output leg of the elbow 35 is then coupled to the bel ⁇ lows-shaped tubing 21 for delivery of the mist to a patient.
• the baffle arrangement contained within the. albowget 35 provides a circuitous path for the mist with the re ⁇ sult that the larger particles which because of their greater mass will tend to collide with one of the baf- fles and be removed from the remainder of the aerosol. These larger particles upon reconversion to a liquid will automatically drain back into the nebulizer and enter the liquid reservoir therein. If desired, a sep ⁇ arate drain may be employed for returning this liquid directly to the reservoir or to an individual receiver.
• the method and apparatus for the production of lung scans utilizing an aerosol has been found to be exceedingly effective not only from the standpoint of reduced costs and convenience for the patient but vast- ly improved image scans have been obtainable which greatly facilitate diagnosis of precise difficulties in ⁇ volving the entire lung.
• the invention is particularly useful for the production of image scans of the lung, it is of course useful for medication of the lung in the treatment of disease.
• the method and apparatus would be useful for treatment of the lung with antimicrobials, antifungals, tagged anticancer drugs and the like.
• the method and apparatus is also useful for provocative al- lergy testing to determine the body reaction, for in ⁇ stance, to histamines and antigens such as ragweed and the like.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Medical Informatics (AREA)
• Animal Behavior & Ethology (AREA)
• Veterinary Medicine (AREA)
• Biophysics (AREA)
• Pathology (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Pulmonology (AREA)
• Molecular Biology (AREA)
• Surgery (AREA)
• Physics & Mathematics (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Physiology (AREA)
• Immunology (AREA)
• Vascular Medicine (AREA)
• Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
• Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
• Nuclear Medicine (AREA)
• Medicinal Preparation (AREA)

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• 1983
  • 1983-03-22 NL NL8320128A patent/NL8320128A/nl unknown
  • 1983-03-22 GB GB08330116A patent/GB2128095B/en not_active Expired
  • 1983-03-22 AU AU15108/83A patent/AU561747B2/en not_active Ceased
  • 1983-03-22 AT AT0901483A patent/AT396423B/de not_active IP Right Cessation
  • 1983-03-22 WO PCT/US1983/000389 patent/WO1983003342A1/fr not_active Ceased
  • 1983-03-22 DE DE19833338525 patent/DE3338525T/de not_active Ceased
  • 1983-03-22 JP JP58501477A patent/JPS59500431A/ja active Granted
  • 1983-03-22 CH CH6337/83A patent/CH660118A5/fr not_active IP Right Cessation
  • 1983-03-22 EP EP19830901486 patent/EP0105332A4/fr not_active Ceased
  • 1983-03-23 NZ NZ203664A patent/NZ203664A/en unknown
  • 1983-03-23 PT PT76434A patent/PT76434B/pt not_active IP Right Cessation
  • 1983-03-23 CA CA000424287A patent/CA1245929A/fr not_active Expired
  • 1983-03-24 ES ES520954A patent/ES520954A0/es active Granted
  • 1983-03-24 IE IE659/83A patent/IE54016B1/en not_active IP Right Cessation
  • 1983-03-25 ZA ZA832117A patent/ZA832117B/xx unknown
  • 1983-03-25 IT IT48001/83A patent/IT1168853B/it active
  • 1983-11-23 SE SE8306464A patent/SE449698B/sv not_active IP Right Cessation

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