ES2557152T3 - Representación de datos de formación de imágenes de diagnóstico en un mapa tridimensional - Google Patents

Representación de datos de formación de imágenes de diagnóstico en un mapa tridimensional Download PDF

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ES2557152T3
ES2557152T3 ES01307001.6T ES01307001T ES2557152T3 ES 2557152 T3 ES2557152 T3 ES 2557152T3 ES 01307001 T ES01307001 T ES 01307001T ES 2557152 T3 ES2557152 T3 ES 2557152T3
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image
map
catheter
portions
processor
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Yaron Keidar
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Biosense Webster Inc
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Biosense Webster Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5269—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving detection or reduction of artifacts
    • A61B8/5276—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving detection or reduction of artifacts due to motion
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T17/00—Three-dimensional [3D] modelling for computer graphics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; Determining position of diagnostic devices within or on the body of the patient
    • A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
    • A61B5/062—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1077—Measuring of profiles
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/30—Determination of transform parameters for the alignment of images, i.e. image registration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/352—Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A61B5/7207—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts
    • A61B5/721—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/503—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Clinical applications
    • A61B8/0883—Clinical applications for diagnosis of the heart
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30048—Heart; Cardiac

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Biophysics (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
  • Theoretical Computer Science (AREA)
  • General Physics & Mathematics (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Computer Graphics (AREA)
  • Geometry (AREA)
  • Software Systems (AREA)
  • Dentistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Human Computer Interaction (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)
  • Image Processing (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Processing Or Creating Images (AREA)
  • Image Generation (AREA)
  • Image Analysis (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

Aparato para mapear una estructura (24) en un cuerpo de un sujeto (26), que comprende: un dispositivo para formación de imágenes (48), adaptado para capturar una imagen tridimensional (3D) (90) de la estructura que comprende la información de diagnóstico; una sonda (30), adaptada para insertarse en la estructura (24), para generar un mapa geométrico en 3D (38) de la estructura; un procesador (34), acoplado a la sonda (30) y al dispositivo de formación de imágenes (48), y adaptado para registrar la imagen (90) con el mapa (38), de tal manera que cada uno de una pluralidad de puntos de imagen (82) en la imagen se identifique con un punto de mapa correspondiente en el mapa; y un monitor (36), acoplado para accionarse con un procesador (34) para mostrar el mapa (38), para que la información de diagnóstico asociada con cada uno de los puntos de imagen (82) se muestre en el punto de mapa correspondiente, donde el procesador (34) está adaptado para: registrar (54) la imagen (90) con el mapa (38) aplicando una transformación al menos a uno de la imagen y el mapa para que después de la transformación, la imagen y el mapa tengan un eje común (72) y una escala común, dividir la imagen en una pluralidad de porciones planas paralelas (92), perpendiculares al eje (72) y mutuamente separadas a lo largo del eje, donde la pluralidad de puntos de imagen (82) están situados en las porciones, y encontrar una coordenada axial de cada una de las porciones (92) y una coordenada angular de cada uno de los puntos de imagen (82) situados en cada una de las porciones, e identificar cada uno de los puntos de imagen con el punto de mapa que tenga las mismas coordenadas axiales y angulares.

Description

DESCRIPCIÓN
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desde el sensor electromagnético y las transmite a un ordenador alojado en una consola 34, de una forma comprensible para el ordenador. Debido a que el catéter está diseñado para un único uso, la placa base contiene preferentemente un chip de EPROM, que apaga la placa base después de haber usado el catéter. Esto evita que el catéter, o al menos el sensor electromagnético, se use dos veces.
Para usar el sensor electromagnético, el sujeto 26 se coloca en un campo magnético generado, por ejemplo, situando bajo el paciente una almohadilla que contiene bobinas de generador de campo 28 para generar un campo magnético, accionado por circuitos de impulso 32. Un sensor electromagnético de referencia (no mostrado) es preferentemente fijo en relación con el paciente, por ejemplo, pegado a la espalda del paciente, y el catéter 30 que contiene su sensor avanza al corazón 24. El sensor preferentemente comprende tres bobinas pequeñas en el campo magnético. Las señales generadas por el sensor de referencia fijo y por el sensor en el corazón se amplifican y transmiten a una consola 34, que analiza las señales y después muestra los resultados en un monitor 36. Con este método, puede determinarse y mostrarse visualmente la localización precisa del sensor en el catéter en relación con el sensor de referencia. Los sensores también pueden detectar el desplazamiento del catéter que es provocado por la contracción del músculo del corazón.
Los sensores electromagnéticos adecuados para los fines de la presente invención se describen, por ejemplo, en la patente de Estados Unidos anteriormente mencionada 5.391.199 y la publicación de patente PCT WO 96/05768. Biosense Ltd (Tirat Hacarmel, Israel) fabrica un sensor de mapeo electromagnético preferente y lo vende bajo la designación comercial NOGA. Algunas de las características de mapeo del catéter 30 y el sistema 20 están implementadas en el catéter NOGA-STAR vendido por Biosense Webster, Inc., y en el sistema Biosense-NOGA, también vendido por Biosense Webster, Inc. En EP-A-1 125 549 se describen de manera general más aspectos del diseño del catéter 30 y del sistema 20.
Usando tales sensores, el sistema 20 consigue una generación continua de seis dimensiones de información de posición y orientación con respecto al catéter 30. Alternativamente, los sensores usados en el catéter 20 pueden comprender otros tipos de sensores de posición y/o coordenadas, como se describe, por ejemplo, en la patente de Estados Unidos 5.391.199, 5.443.489 o 5.515.853 o en la publicación PCT WO 94/04938 o WO 99/05971, o sustancialmente cualquier otro tipo de dispositivo de detección de posición y/o coordenada conocido en la técnica.
Como se ha señalado anteriormente, el catéter 30 está acoplado a la consola 34, que permite al usuario observar y regular las funciones del catéter. La consola 34 incluye un procesador, preferentemente un ordenador con circuitos apropiados para el procesamiento de señales (que normalmente están contenidos en el interior de una caja del ordenador). El procesador está acoplado al monitor accionador 36. El usuario 22 pone la punta distal del catéter 30 en contacto con múltiples puntos en la superficie del endocardio del corazón 24, y las coordenadas de posición se registran en cada punto. La información derivada de este análisis se usa para reconstruir un mapa geométrico tridimensional 38 de la superficie del endocardio del corazón 24.
El sistema 20 también comprende una unidad de formación de imágenes de diagnóstico 48, tal como una unidad de Eco Doppler, TEFU, TEP, IRM, TC u otra unidad de formación de imágenes conocida en la técnica. La unidad 48 se usa para capturar una imagen de diagnóstico en 3D del corazón 24, preferentemente mientras el usuario 22 está mapeando el corazón usando el catéter 30. Alternativamente, la imagen de diagnóstico se captura antes de empezar el mapeo, y la unidad 48, en este caso, puede estar separada de los otros elementos del sistema
20. Los datos de diagnóstico de la imagen capturada por la unidad 48 se superponen en el mapa 38, usando métodos descritos más abajo. Dependiendo del tipo y la configuración de la unidad 48, una amplia variedad de diferentes datos de diagnóstico pueden estar representados en la imagen, tales como perfusión, factores metabólicos, uso de marcadores, movimiento o grosor de la pared del corazón y/u otras propiedades anatómicas o eléctricas, como se conoce en la técnica. La imagen también puede medirse para representar diferentes fases en el ciclo del corazón.
Típicamente, el sistema 20 incluye otros elementos, algunos de los cuales no se muestran en las figuras para simplificar. En la realización presente, el sistema incluye preferentemente una consola láser 49, que se usa para realizar revascularización miocárdica directa, como se describe, por ejemplo, en la solicitud de patente PCT PCT/IL97/00011 y en la solicitud de patente de Estados Unidos 09/109.820, que está publicada como US 6.171.303. La consola 49 inyecta energía láser a una guía de ondas adecuada (no mostrada) en el catéter 30. La guía de ondas transporta la energía a la punta distal del catéter, donde se aplica para revascularizar áreas del miocardio que sufren perfusión baja. Alternativamente, el sistema puede incluir otros elementos terapéuticos, como son conocidos en la técnica, particularmente elementos para administrar tratamiento local en el corazón, tal como un impulsor de radiofrecuencia acoplado aun electrodo de ablación en el catéter 30; un generador de ultrasonido acoplado a un transductor de alta potencia en el catéter, para ablación ultrasónica del endocardio; o un suministro de un agente terapéutico, tal como agentes del crecimiento para angiogénesis, acoplado a una aguja de inyección en el catéter. Aún más alternativamente, el sistema puede incluir elementos invasivos de diagnóstico, tales como fórceps de biopsia que funcionan a través del catéter 30.
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Claims (1)

  1. imagen1
ES01307001.6T 2000-08-18 2001-08-17 Representación de datos de formación de imágenes de diagnóstico en un mapa tridimensional Expired - Lifetime ES2557152T3 (es)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/643,666 US6650927B1 (en) 2000-08-18 2000-08-18 Rendering of diagnostic imaging data on a three-dimensional map
US643666 2000-08-18

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ES2557152T3 true ES2557152T3 (es) 2016-01-22

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US (1) US6650927B1 (es)
EP (2) EP1182619B1 (es)
JP (1) JP5088994B2 (es)
KR (1) KR100819717B1 (es)
AU (1) AU782242B2 (es)
CA (1) CA2355397C (es)
ES (1) ES2557152T3 (es)
HK (1) HK1042366A1 (es)
IL (1) IL144905A (es)

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IL144905A0 (en) 2002-06-30
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