The method of determining the position of the needle tip in biological tissues and device for its implementation

 

The invention relates to medical technology, and is intended to identify the location of the needle tip in biological tissues, for example when performing epidural anesthesia. In the cavity of the needle insert the fiber, polished distal end of which is combined with the end of the needle, through which the biological tissue is supplied and discharged reflected radiation and measure the intensity or spectral characteristics of the radiation, or the structure and color of the image reflected from consistently passable by the end of the needle biological tissues, by comparing the measured characteristics with the known, and the nature of changes in these values identify the biological tissue. Device for identification of biological tissue contains optically connected to the radiation source, a beam splitter, an optical fiber having distal and proximal ends and a photosensor, the output of which is connected to a video monitor, while the distal end of the optical fiber is installed in the pavilion of the medical needle can remove it, and polished end face of the distal end of the optical fiber is aligned with the end of the needle. The invention improves the accuracy and reliability of identification of the location of the needle tip in ische:always;">

The invention relates to medical technology, and is intended to determine the location of the needle tip of the syringe in biological tissues, for example when performing epidural anesthesia, percutaneous puncture of the heart cavities, diagnostic manipulation in tissues of the lung, the diagnosis and subsequent treatment of thrombotic diseases arteriovenous system, and so on

The known method for the endoscopic identification of cancerous tissue (German Patent (DE) No. 4110228, IPC 5 And 61 In 1/06, H 04 N 7/18, R.J. IMS 7-05-94), based on the fluorescence of a labeled substance in cancer tissue under the influence of modulated light supplied by the optical fiber placed in the endoscopic probe, and the observation image generated by the outgoing fiber fluorescein radiation, on a television monitor.

The drawback of this method to identify the location of the working end of the probe into biological tissue is low identification accuracy due to the lack of certainty of the location of the fiber relative to the working end of the probe and tissue, as well as the need for the use of marker substances, fluorescing under the action of light, which for most biological tissues have macradenia the location of the needle tip in the biological tissue, located in the epidural space of the spinal canal that is described in the training manual for doctors: Morgan Jr. D. E., Magid S. Michael. Clinical anesthesiology - M/SPb., Binom / Nevsky dialect, 1998 (S. 303-304).

This method is based on the tactile sensations of the fingers of the hand of the doctor to the resistance when passing through the biological tissue of the end of the needle and the pressure on the plunger of the syringe (the "loss of resistance") or fixation point disappearance drops of isotonic sodium chloride from the pavilion needle under the action of negative pressure in the epidural space (the way of "hanging drops").

The disadvantage of this method is the subjectivity of the perception of the physician, leading to errors of determination of the moment of occurrence of the end of the needle of the syringe into identifiable tissue, especially in case, when the needle is obturated (the hole in the needle is clogged), and possible perforation (damage) of the Dura mater of the spinal cord, causing danger and complications associated with epidural analgesia (see Svetlov C. A., Kozlov, S. P. the risks and complications of Central segmental analgesia. Anesthesiology and resuscitation. 2000, No. 5, S. 86).

A device that can be used to determine okamurai, U.S. patent No. 5172685, 5 And 61 In 1/06, R.J. IMS 7-14-94).

The device includes a source of optical radiation, an optical fiber, which is supplied and discharged optical radiation, probe, which is inserted the optical fiber, a beam splitter mounted on the optical path for the light to biological tissue and direction of the reflected radiation on the photosensor generates a signal proportional to the amount of light, a video display, an input connected to the photosensor.

A disadvantage of the known device is that it is not possible to accurately determine the distance between the desired fabric and working end of the probe, because the location of the working end of the fiber relative to the working end of the probe and the desired biological tissue is not sufficiently specific, and does not allow to use instead of the standard probe disposable needles, as the working end of the fiber permanently installed in the endoscopic probe.

Also known needle sighting needle biopsy of the thyroid gland (patent RU 2033758 C1, 30.04.1995), which essential features are closest to the invention and is selected as a prototype.

The needle is made in the form of a tube with a specially arranged resp is brilliant mandrel, made in the form of a cylinder whose diameter corresponds to the inner diameter of the needle and the angle of cut of the working end of the mandrel is equal to the angle of the cut needle containing a device for fixing the position of the mandrel, ultrasonic device, on the screen which is displayed on the location of the working end of the needle relative to the biological tissue.

A disadvantage of the known device is the low accuracy of determination of the moment of occurrence of the end of the needle in the desired tissue due to the fact that the openings in the side walls of the needle to create ultrasonic position sensors of the working end of the needle is located at some distance from her work cut, ambiguity and variability of the relationships between the measured density and type of biological tissue, as well as the inability to use standard disposable needles, medical needles and waiver marking fabric substance.

Provided by the invention the technical result is to increase the accuracy and simplify the positioning of the needle tip in biological tissues due to the unambiguous determination of the moment of occurrence of the end of the needle in the fabric, use standard disposable medical needle and the refusal to use marking t is x tissues is solved as follows.

Pavilion medical needle place the working end of the fiber with the possibility of its subsequent removal, combine the polished end face of the working end of the fiber with work cut end of the needle, inject the needle into the fabric, produce irradiation of tissue optical radiation through the optical fiber, converts reflected from the tissue optical signal into an electrical signal, record the radiation reflected from consistently passable by the end of the needle biological tissues, see the signal in the form of a graph on a video monitor, analyze the characteristics of the reflected radiation, comparing the changes of the measured values with the known nature of the changes reflected radiation from various tissues, and the nature of changes in these values determine the position of the end of the needle, and analyze the intensity of the reflected radiation and its spectral characteristics, or the structure and color of the image to be created.

Device for determining the position of the needle tip in biological tissues, characterized in that it contains optically connected to the optical radiation source, a beam splitter, an optical fiber and a photodetector, the output of which is connected to the video monitor, and the end sweetwood combined with the end of the needle.

Since different biological tissues have different coefficients of absorption, reflection and other spectral characteristics of the optical radiation of certain wavelengths, the intensity and spectral composition of the reflected radiation will be different for different biological tissues (see, for example, Khairullina A. J. and others, "Bank data on optical and biophysical properties of blood, tissues and biological liquids in the visible and near IR regions of the spectrum, Optical journal, No. 3, 1997). Image created reflected from various biological tissues radiation, also have a different structure and color.

Changes in the intensity and spectral composition of radiation on biological tissues in their sequential passage of the end of the needle is registered by the photo-sensor (sensor(s)), is converted into an electrical signal in the form of a graph or image of the monitoring object is displayed on a video monitor or a computer monitor.

Based on the results of practical experiments measure the relative change in such schedule or structure and color images during the passage of the needle of various tissues, for example, when epidural anesthesia tissue of the skin, gerovo is prostranstva, tissue of the Dura and spinal-cord tissue. The combination of polished working end of the fiber with the end of the needle produces a video display signal corresponding to the optical radiation reflected from the biological tissue through which at this time is end of the needle with fiber that uniquely identifies the time of occurrence of needle in identifiable tissue and improves the accuracy of identification of biological tissue.

After identifying the tissue of the working end of the fiber is removed (pulled out) from the pavilion needle that allows the use of standard disposable needle.

The essence of the proposed invention is illustrated in Fig.1, where the example shows the experimental graphs of relative changes in the electrical signal from the photo-sensor sequential passage of the end of the needle biological tissues of the animal, obtained for three wavelengths: red, yellow b blue (here, for example, adipose tissue is in the range of location of the needle tip at a depth of 10-20 mm, fabric yellow ligament in the range of 40-50 mm, the fabric of the epidural space is in the range of 52-58 mm), and Fig.2 and 3, which shows a schematic circuit ustrust working end of the light guide 2 and the device 3 for attaching and fixing the position of the polished end face of the working end of the fiber with the end of the needle. The end of the working end of the fiber 2, combined with the end of needle 1 can be bevel performed at an angle less than the angle defined by the numerical aperture of the fiber, which allows you to receive reflected radiation from the tissue, and the second end of the optical fiber 2 is placed in the case 4, which are optically connected to the beam splitter 5, the light source 6, the photosensor 7, the output of which is connected to the video monitor of the computer 8.

The device 3 for attaching and fixing the position of the polished end face of the working end of the fiber with the end of the needle may be made in the form of a collet clamp or removable ring having a slot for clamp screw (see Reference constructor accurate instrumentation. /Under the editorship of Litvin, F. L., M-L, engineering, 1964, pp. 414-416). A beam splitter 5 can be performed in a semi-transparent mirror, and the radiation source 6 can be controlled LEDs with different wavelengths or broadband light sources - incandescent lamp, white led. The photo sensor 7 may be made in the form of a receiver of optical radiation type photodiode or CCD array, if the monitor is transmitted to the image fabric. To improve conversion reflected from the biological tissue of the beam in the electric shall priemnik. When used as a light source of an incandescent lamp or a white led for operation in the most sensitive range of wavelengths of light can be used filter(s) 10.

The signal from the photodetector is fed to the controller (computer) 11, where it is processed and graphically transmitted to the monitor (display unit) 8. The controller may also control the switching of the LEDs.

After determining the position of the end of the needle in the desired tissue (e.g., tissue epidural space), the fiber is removed (pulled out) from the pavilion of the needle to the needle to connect the syringe to either install a catheter, etc., This allows the use of disposable needles. The light guide 2 can also be disposable.

The device (Fig.3) contains the needle 1, the light guide 2, inserted a working end of the needle, the polished end face which are aligned with the end of the needle and fixed using tool 3. The second end of the optical fiber 2 is located in building 4, which is a beam splitter 5, is made in the form of a splitter to two of the loom, one of which is illuminated by a radiation source of a wide range of wavelengths of light 6, and the other reflected radiation enters the photosensor 7, made in the form of spectrophotome the tion, reflected from the biological tissue adjacent to the end of the needle and combined with it the working end face of the light guide. The results of spectral analysis are processed using a computer program and go on the computer display 8. The photo sensor 7 can also be carried out in the form of a video camera, which converts the image of the tissue from the second end of the optical fiber into an electrical signal with subsequent transfer it to a video monitor.

After determining the location of the needle tip in the desired tissue fiber optic harness is pulled out from the pavilion needle.

The proposed method is implemented using the proposed device (Fig.2) in the following way.

Inserted into the cavity of a standard needle 1 working end of the fiber 2, combine it polished the working face with the end of the needle and fix them relative to each other by the device 3. Include a radiation source 6, the needle in the skin tissue of the patient and then promote it in the tissues, measuring by means of a receiver 7, the intensity of the reflected radiation, the measurement results which are observed in the form of a graph on the monitor 8. Comparing the changes of the measured values with the known nature of the changes in the intensity of the reflected Isla space. For more accurate and reliable identification of the source of radiation can be switched LEDs with different wavelengths (e.g. visible and near-infrared), or before a switched light receiver has various filters. If the receiver uses a CCD sensor, the monitor see the image of the tissue and its structure and color identify the position of end of needle, as the tissue adjacent to the end of the needle and combined with her polerowanie the end of the working end of the fiber is transferred by the fiber at the end face of the second end of the light guide.

According to the variant of the device of Fig.3 the proposed method is implemented as follows.

Inserted into the cavity of the needle 1 working end of the fiber 2, combine it polished the working face with the end of the needle and record their mutual arrangement device 3. Include a radiation source 6, the needle in the skin tissue of the patient and then promote it in the tissues, measuring 7 spectrophotometer spectral characteristics of the reflected from the tissue radiation transmitted on a computer monitor 8. Since the spectra of absorption, reflection and other spectral characteristics of each substance rasley needle see on the monitor image adjacent to its end fabrics and are known for their structure and colour identify the desired fabric.

The proposed method and device for determining the position of the needle tip in biological tissues allow you to move from the methods currently in practice, based on the subjective tactile and visual sensations doctor to objective measurements based on the well-known law about the different spectra of emission and absorption of optical radiation of different substances, or to observe directly the fabric, which increases the accuracy of determining the time of occurrence of the end of the needle in identifiable tissue.

In comparison with the known methods and prototype increases the accuracy of determining the position of the needle, because the working end of the needle combined with a polished end face of the working end of the fiber in contact with the desired biological tissue reflecting optical radiation and containing information about the type of fabric, eliminating the need to use marking fabric substance. Unambiguous determination of the moment of occurrence of the end of the needle with the light guide, for example, in the fabric of the epidural space reduces (eliminates) the possibility of puncture of the Dura mater of the spinal cord, causing danger and complications associated with epidural analgesia, which increases the quality of treatment. Vozmozhnostyu standard medical needle, in particular, when performing epidural anesthesia, which makes it easy to identify, eliminate possible infection and also increases the quality of treatment.

Claims

1. The method of determining the position of the needle tip in biological tissues, characterized in that the pavilion medical needle place the distal end of the optical fiber with the possibility of its subsequent removal, combine the polished end face of the distal end of the optical fiber with the end of the needle, inject the needle into the fabric, produce irradiation of tissue optical radiation through the optical fiber, converts reflected from the tissue optical signal into an electrical signal, record the radiation reflected from consistently passable by the end of the needle tissue, see it on the video monitor, analyze the characteristics of the reflected radiation, comparing the changes of the measured values with the known nature of the changes reflected radiation from various tissues, and the nature of changes in these values determine the position of the end of the needle.

2. The method according to p. 1, wherein analyzing the intensity values of the reflected radiation.

3. The method according to p. 1, wherein analyzing the spectral features what about the reflected radiation image.

5. Device for determining the position of the needle tip in biological tissues, characterized in that it contains optically connected to the optical radiation source, a beam splitter, an optical fiber and a photodetector, the output of which is connected to the video monitor, and the distal end of the optical fiber is installed in the pavilion of the medical needle can remove it, and polished end face of the distal end of the optical fiber is aligned with the end of the needle.



 

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