CA2078536C - Externally moveable intracavity probe for mri imaging and spectroscopy - Google Patents
Externally moveable intracavity probe for mri imaging and spectroscopyInfo
- Publication number
- CA2078536C CA2078536C CA002078536A CA2078536A CA2078536C CA 2078536 C CA2078536 C CA 2078536C CA 002078536 A CA002078536 A CA 002078536A CA 2078536 A CA2078536 A CA 2078536A CA 2078536 C CA2078536 C CA 2078536C
- Authority
- CA
- Canada
- Prior art keywords
- coil
- mandrel
- shaft
- balloon
- probe
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Classifications
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
- G01R33/00—Arrangements or instruments for measuring magnetic variables
- G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
- G01R33/28—Details of apparatus provided for in groups G01R33/44 - G01R33/64
- G01R33/32—Excitation or detection systems, e.g. using radio frequency signals
- G01R33/34—Constructional details, e.g. resonators, specially adapted to MR
- G01R33/341—Constructional details, e.g. resonators, specially adapted to MR comprising surface coils
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
- A61B5/4222—Evaluating particular parts, e.g. particular organs
- A61B5/4255—Intestines, colon or appendix
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
- G01R33/00—Arrangements or instruments for measuring magnetic variables
- G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
- G01R33/28—Details of apparatus provided for in groups G01R33/44 - G01R33/64
- G01R33/285—Invasive instruments, e.g. catheters or biopsy needles, specially adapted for tracking, guiding or visualization by NMR
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
- G01R33/00—Arrangements or instruments for measuring magnetic variables
- G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
- G01R33/28—Details of apparatus provided for in groups G01R33/44 - G01R33/64
- G01R33/32—Excitation or detection systems, e.g. using radio frequency signals
- G01R33/34—Constructional details, e.g. resonators, specially adapted to MR
- G01R33/34084—Constructional details, e.g. resonators, specially adapted to MR implantable coils or coils being geometrically adaptable to the sample, e.g. flexible coils or coils comprising mutually movable parts
Abstract
An insertable intracavity probe for use in magnetic resonance imaging of an area of interest in a body cavity particularly the colon, has an elongate shaft with a handle at its proximal end and an inflatable balloon structure at its distal end.
The balloon structure has an outer balloon containing a loop-type pickup coil for connection to an interfacing network. The coil is sandwiched between two internal separately inflatable balloons, and when the probe is inserted, the coil can be optimally positioned relative to the area of interest by controlled differential inflation of the balloons. The probe also has an insertable rod-like mandrel for providing twisting orbital-type movement of the balloon structure on the shaft, by rotation of the mandrel, useful to steer the probe along curves or bends in the body cavity when it is being inserted. In a modified form of the probe, the mandrel can be used to rotate the coil and the internal balloons as a unit within the outer balloon for optimal in situ angular positioning of the coil.
The balloon structure has an outer balloon containing a loop-type pickup coil for connection to an interfacing network. The coil is sandwiched between two internal separately inflatable balloons, and when the probe is inserted, the coil can be optimally positioned relative to the area of interest by controlled differential inflation of the balloons. The probe also has an insertable rod-like mandrel for providing twisting orbital-type movement of the balloon structure on the shaft, by rotation of the mandrel, useful to steer the probe along curves or bends in the body cavity when it is being inserted. In a modified form of the probe, the mandrel can be used to rotate the coil and the internal balloons as a unit within the outer balloon for optimal in situ angular positioning of the coil.
Description
--r 1 2 0 7 8 5 3 ~5 ~;Xl~;KNALLY MOVABLE INTRACAVlIY PROBE FOR
MRI IMAGING AND SPECTROSCOPY
r-rl~vu~ld of the Invention This invention relates to a receiving device in the form of an intracavity probe for use in m~gnetic resonance im~ging (MRI) and spectroscopy systems to enhance the im~ging pelrol-~.allce and spectroscopy sensitivity of such instruments when ev~ ting allal~,..ical regions small in size relative to the body, and deep within 10 the body, but proximate a location where an insertable pickup probe can be used.
Specifically, the present invention relates to an intracavity pickup probe especially useful to image the colon region by rectal introduction, but which may also be useful for in~pecting other regions of the body by suitable intracavity insertion.
In the field of MRI systems, also commonly known as NMR im~ging systems, external pickup probes are typically used for receiving radio frequencysignals from the region of interest. For optimum pelrolmance when im~gin~ certain select parts of the body, the pickup probe should be insertable for intracavity use and include a radio frequency receiving coil, to be positioned as close to the region of interest as possible. In addition, the insertable pickup probe should also have a sensitive volume equaling the desired field of view of the region of interest. This allows optimi7~tion of the "filling factor" and "coupling coefficient" for the specific MRI system, thereby improving signal to noise ratio in MR im~ging.
Furthermore, for optimum sensitivity, the receiving coil should have a loaded coil quality factor (Q) which is as great as possible and should be adjusted to ~esonale at the exact I~rmour frequency of the scanner of the MRI system. It also sometim~ is desired that the insertable, intracavity pickup probe be disposable, and hence the cost of the probe should be minimi7ed as much as possible. At the sametime, it is important that in red~lcing the cost of the probe, the ability to impedance match and tune the receiving coil to the scanner of the MRI system not be colllprolllised. Therefore, there is a need to provide a disposable pickup probe at minim~l cost for use in a MRI system which is capable of automatic or manual tuning and impedance matching of the receiving coil to the scanner of the MRI system.
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, .
MRI IMAGING AND SPECTROSCOPY
r-rl~vu~ld of the Invention This invention relates to a receiving device in the form of an intracavity probe for use in m~gnetic resonance im~ging (MRI) and spectroscopy systems to enhance the im~ging pelrol-~.allce and spectroscopy sensitivity of such instruments when ev~ ting allal~,..ical regions small in size relative to the body, and deep within 10 the body, but proximate a location where an insertable pickup probe can be used.
Specifically, the present invention relates to an intracavity pickup probe especially useful to image the colon region by rectal introduction, but which may also be useful for in~pecting other regions of the body by suitable intracavity insertion.
In the field of MRI systems, also commonly known as NMR im~ging systems, external pickup probes are typically used for receiving radio frequencysignals from the region of interest. For optimum pelrolmance when im~gin~ certain select parts of the body, the pickup probe should be insertable for intracavity use and include a radio frequency receiving coil, to be positioned as close to the region of interest as possible. In addition, the insertable pickup probe should also have a sensitive volume equaling the desired field of view of the region of interest. This allows optimi7~tion of the "filling factor" and "coupling coefficient" for the specific MRI system, thereby improving signal to noise ratio in MR im~ging.
Furthermore, for optimum sensitivity, the receiving coil should have a loaded coil quality factor (Q) which is as great as possible and should be adjusted to ~esonale at the exact I~rmour frequency of the scanner of the MRI system. It also sometim~ is desired that the insertable, intracavity pickup probe be disposable, and hence the cost of the probe should be minimi7ed as much as possible. At the sametime, it is important that in red~lcing the cost of the probe, the ability to impedance match and tune the receiving coil to the scanner of the MRI system not be colllprolllised. Therefore, there is a need to provide a disposable pickup probe at minim~l cost for use in a MRI system which is capable of automatic or manual tuning and impedance matching of the receiving coil to the scanner of the MRI system.
~ ., *
, .
Summary of the Invention It is an object of the present invention to provide an insertable, intracavity pickup probe capable of being placed in close proximity to a region of 5 interest, particularly in the colonS to improve the quality of a magnetic resonance image or spectrum.
It is a further object of the present invention to provide an insertable MRI pickup probe capable of being manipulated by a clinici~n during insertion of the 10 probe in a manner accommodating shape variations, curves, bends and the like in a body passage through which the probe is inserted.
Another object of the invention is to provide an insertable MRI pickup probe which when inserted at a site of interest in a body cavity can be manipulated so as to optimize the positioning of the pickup coil in relation to the particular area of interest.
The invention in a specific embodiment relates to an insertable, intracavity pickup probe, and more specifically an intrarectal pickup probe for high 20 sensitivity and high resolution im~ging of the colon and associated area. Although the pickup probe is described hereinafter as principally to image or obtain spectra from the area of the colon, it should be understood that the concepts outlined herein are equally appropliate for other regions of interest such as the rectum, vagina, stomach, and mouth. Additionally, the principles described herein may be applied25 to MRI or NMR application involving the arteries, veins, and other similar regions of the body reachable by an insertable or implantable pickup probe.
The insertable pickup probe of the present invention greatly improves the signal-to-noise ratio of an image or spectrum acquisition over signal pickup30 devices commonly used with MRI and NMR scanner systems. In addition, the restricted field of view of the probe reduces or elimin~tes image distortion caused by motion, blood flow, patient breathing, and signal ~ ing when conducting an image~r acquisition using multi-limen~ional fast Fourier transform techniques.
The insertable pickup probe of the present invention comprises a shaft which supports an outer patient interface balloon structure at its distal end. In a specific embo limpnt~ the interface balloon structure contains a receiving coil in the form of a closed substantially planar loop with anterior and posterior faces. Two internal indepen(lently inflatable balloons are positioned within the structure on the anterior and posterior sides of the coil, respectively, effectively sandwiching the coil therebetween. The intern~l balloons have sepaldte inflation tubes which extend through the shaft exiting at the proximal handle end thereof. Each tube has a stopcock or like inflation controller, and each tube is separately connectable to an inflation cuff or the like. The coil is provided with an electrical lead which also extends through the shaft, exiting at the proximal handle end and being provided with a connector for ~tt~hing the coil to an interface network to receive signals from the coil.
When the probe is inserted in a body cavity with the balloon structure positioned ~ cent an area of interest to be investig~ted by NMR or MRI im~gin~, the provision of the sepal~tely inflatable internal balloons allows the coil to be more effectively positioned relative to the area of interest by selective and differential inflation. For example, if the area of interest is located on the anterior side of the coil, the posterior-side internal balloon may be infl~ted to a higher inflation volume than the anterior-side balloon to move the coil toward the anterior.
In accordance with another aspect of the invention, the probe may include st~ring and locator means to assist a clinician when inserting the probe in a body cavity to accommodate bends or curves in the cavity and to provide a visualindication as to the orientation of the coil. To this end, the probe may include a stiffener tube extending axially through the outer balloon from the proximal end of the shaft, and a removable steering mandrel which can be inserted into the shaft from the ploAilllal end so as to extend through the shaft and stiffener tube substantially up to the distal end of the balloon structure. The mandrel, which may be in the form , .
~ ~;
-. 2078536 of a stiff plastic or like rod may have a curved distal end. The effect of the curved end of the mandrel is to provide a type of orbital movement of-the balloon structure and coil when the proA~mal end of the mandrel is axially rotated relative to the shaft during insertion of the probe, useful to provide st~ring of the probe through curves S and the like in a body cavity.
According to a further feature of the invention, the mandrel may be used to rotate the coil along with the anterior and posterior balloons within the outer balloon structure. To this end, proximal and distal end rotary bearings are provided 10 within the outer balloon to receive the mandrel, and the coil along with the anterior and posterior balloons are taped together to form, with the mandrel, a rotary unit which can be rotated within the outer balloon by rotation of a knob or the like at the p~ al end of the mandrel. Thus, a c linici~n can angularly position the coil in situ within a patient without rotation of the probe as a whole. The mandrel can be formed 15 with indicator means to display the angular position of the coil.
To provide an indication of the orientation of the coil, the shaft may include a longit~1-1in~1 sight line or stripe aligned with the coil. Also the mandrel may have a proximal end knob with an arrow or other mark to indicate the direction of the 20 curve of the mandrel to aid in steering.
The above and other objects and advantages of the present invention will become more readily apparellt when reference is made to the following dcscliption, taken in conjunction with the acco~llpanying drawings.
Brief Description of the Drawi~
Figure 1 is a perspective view of an insertable pickup probe in accordance with the present invention and an associated interface network.
Figure 2 is a cross-sectional plan view of the distal balloon portion of the insertable pickup probe illustrated in Figure 1.
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Figure 3 is a cross-sectional elevational view of the distal end balloon portion of the probe.
Figure 4 is a sectional view taken on line 4-4 of Figure 3.
s Figure S is an elevational view of a steering mandrel for the probe.
Figure 6 is a plan view of the steering mandrel.
Figure 7 is a view similar to Figure 2 showing the distal balloon portion of a modified pickup probe according to the invention.
Figure 8 is an elevational view of a mandrel used in the probe shown in Figure 7.
Figures 9 and 10 are views showing ~ltern~tive cross-sectional shapes for the mandrel.
Figure 11 is a cross-section view on line XI-XI of Figure 7.
Des~ tion of Preferred Embodin~enl Referring first to Figure 1, an insertable colon pickup probe is shown in an assembled form at 10, and an interface network to which the probe connects is shown at 12. The pickup probe 10 is an MRI or NMR receiving device capable of im~ing or g~thering spectra from the human colon and surrounding tissue, but mayalso be used as the transmit coil for RF excitation. The probe 10 is used with the interface network 12 which provides the tuning, impedance matching, and decoupling functions.
The probe 10 includes a shaft 14 which supports a patient interface balloon structure 16 at its distal end and a handle 18 located at the proximal end of ~ .~
the shaft 14. As will be described in more detail later, assembly 16 includes aninternal pickup coil 20 and intern~l anterior and posterior inflation balloons 22 and 24, none of which are shown in Figure 1. The coil and internal balloons are accommodated, as will be described, in an outer balloon 26. Tubes 28, 30 for 5 infl~tin~ the intern~l balloons extend from the respective balloons through shaft 14 and exit at the pro~hl.al end of handle 18. The tubes have respective inflation control stopcocks 32, 34 and connections 36, 38 for attaching same to an inflator device 40 such as a syringe or cuff.
The receiving coil contained within the patient interface balloon structure 16 can be electrically connected to the interface 12 by an insulated interconnecting cable 42 which has a plug 44 at its proximal end for connection to terminal 46 located on the front of the interface network 12.
The interface network 12 also includes a terminal 48 for providing a co,~le~lion to a MRI scanner. Furthermore, the interface network 12 may include a switch S0 capable of being moved b~lwæll an o~l~Ling position and a tuning position or be ~esigned such that it functions fully autom~tic~lly. To display to the operator the mode of operation, indicator lights 52 or an LED readout are provided on thefront of the interface network 12. In addition, a light 54 or an LED readout forintli~ting the occurrence of a probe failure is provided on the front of the interface network 12.
A removable elc)ng~ rod-like steering mandrel 56 extends through the balloon structure 16 and shaft 14. The mandrel has an operating knob 58 at its proximal end.
R~f~rring now to Figures 2 to 4, the patient interface balloon structure 16 of the insertable pickup probe 10 is illustrated in more detail. Extending through the shaft 14 and axially through balloon structure 16 is a stiffener tube 60 which is a ~ll--ane ~l part of ~e structure and which may, ~or example, be supported in shaf~
14 by an end plate 62 and a like end plate (not shown) at the proximal end of the ~~ 7 2078536 shaft. The lead 42 for the pickup coil 20 extends through a lumen of the tube 60 and exits the tube through an apel~ule 64 ~ ent the distal end of shaft 14. Outside of the ap~llule, lead 42 connects to coil 20 which is in the form of a loop occupying a substantial cross-sectional area of the outer balloon 26.
s The intPrn~l inflation balloons 22 and 24 embrace the coil 20 on its anterior and posterior sides and also occupy substantial areas of the outer balloon as shown in Figure 3. The inner balloons are connected at their distal inlet ends to the infiation tubes 28 and 30 which are shown diagr~mm~tic~lly only in Figure 2. Theinfl~ticn tubes pass through apertures in end plate 62 and thence through the shaft 14.
The inner balloons and coil 20 may be loosely held together as a sandwich-type p~c~ge by an encircling cuff 66 shown dotted in Figures 2 and 3.
The mandrel 56, which is of a stiff plastic or other material, also fits 15 through the lumen of the stiffening tube 60. As shown in Figures S and 6, themandrel is line~r in plan view but has a J-like bend 68 at its distal end in elevational view. Also, the mandrel O~ld~ g knob 58 has an indicator mark 70 to show a clinician inserting the probe the ~lignmPnt of the mandrel. Further, as shown inFigure 1, the shaft has a lengthwise int~ic~tor stripe 72 (shown dotted for convenience 20 only) subst~nti~lly aligned with the plane of coil 20.
Other constructional details and m~teri~l~ of the various components of the probe are generally known per se and for such details, reference may be made to Euro~ Patent Application EP 0385367. Details of the interface network are 25 also shown and described in the copending patent application.
For insertion of the probe by way of a patient's rectum, the internal balloons 22 and 24 would be deflated to minimi7e the size of the structure 16, it being noted that outer balloon 26 is not infl~ted. During insertion of the probe, the 30 balloon structure may be given an orbital type twisting movement by rotation of the mandrel, should it be n~Pi~ to "steer" the probe along curves or bends in the anal tract or other intercavity passageway.
~ - 8 - 2078536 When the balloon structure is sihl~tecl at a site to be investig~te~ by MRI or NMR im~in~, the probe is manipulated in order to orientate the coil ~ub~ lially face on to an area of interest. Then, for optimal positioning of the coil relative to said area, the internal balloons may be differentially infl~te~ with the 5 balloon on that side of the coil which is further from the area of interest being inflated to a higher volume than the balloon which is on the side of the coil facing the area of interest. DirÇe~ lial inflation of the balloons is effected, for example, by opening and closing the respective stopcocks 32 and 34 to allow controlled quantities of air to be delivered to the respective balloons from the inflator device 40.
10 Differential inflation of the balloons as described has the effect of locating the coil in closer proximity to the area of interest than is possible with known forms ofinflatable probe devices. Typical infl~ti-m volume for the balloons may, for example, be 40cc in each balloon for a center lumen position of the coil and lOcc in the anterior balloon and 50cc in the posterior balloon for an anterior position of the coil.
Figures 7-11 show a modified probe structure in which the coil along with the internal balloons may be rotated within the outer balloon so as to allow in situ angular positioning of the coil when in position in a body cavity without having to rotate the probe as a whole when positi~n~ within a patient. Equivalent reference 20 numerals are used to denote parts which are equivalent to those in the previous embodiment.
Thus, in the modified arrangement, a proximal rotary bearing 80 is provided at the dist~l end of shaft 14 and a similar distal rotary bearing 82 is provided 25 in a bearing support 83 within the outer balloon 16 at its distal end. Stiffener tube 60' is ~u~ ed for rotation within the bearings 80 and 82, and a relatively stiffmandrel 56' with a proximal end o~l~ling knob 58' extends through shaft 14 and tube 60'. The pickup coil 20 and the int~rn~l anterior and posterior balloons 22 and 24 are constructed in like manner to the previous embodiment, but in this case they 30 are taped together and also taped to the mandrel by tapes 66' so as to rotate together with the mandrel and stiffener tube as a unit within the outer balloon. The mandrel may have alternative cruciform cross-sectional shapes as shown in Figures g and 10 ~F.~-g received in a co~ sl~ondingly shaped lumen in the stiffener tube so that rotation of the mandrel by knob 58' when the probe is in situ in a body cavity is effective to rotate the internal balloon assembly within the outer balloon 16. The cruciform shape of the mandrel is also useful for in-lic~ting the angular position of the coil relative to S the outer balloon along with indicator 70'.
The rem~inder of the structure of the probe including the handle is similar to that described in connection with Figures 1-6.
In all emb~im~nts of the invention the outer balloon 16 may be disposable or covered by a disposable sheath or the like to allow for repeated use of the probe.
While only a pl~r~red embodiment of the invention has been described 15 herein in detail, the invention is not limited thereby and modifications can be made within the scope of the attached claims. Just as a few examples, the mandrel need not be curved, and with an alternate mechanism for ~ligning the coil, the stiffening tube need not be provided.
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It is a further object of the present invention to provide an insertable MRI pickup probe capable of being manipulated by a clinici~n during insertion of the 10 probe in a manner accommodating shape variations, curves, bends and the like in a body passage through which the probe is inserted.
Another object of the invention is to provide an insertable MRI pickup probe which when inserted at a site of interest in a body cavity can be manipulated so as to optimize the positioning of the pickup coil in relation to the particular area of interest.
The invention in a specific embodiment relates to an insertable, intracavity pickup probe, and more specifically an intrarectal pickup probe for high 20 sensitivity and high resolution im~ging of the colon and associated area. Although the pickup probe is described hereinafter as principally to image or obtain spectra from the area of the colon, it should be understood that the concepts outlined herein are equally appropliate for other regions of interest such as the rectum, vagina, stomach, and mouth. Additionally, the principles described herein may be applied25 to MRI or NMR application involving the arteries, veins, and other similar regions of the body reachable by an insertable or implantable pickup probe.
The insertable pickup probe of the present invention greatly improves the signal-to-noise ratio of an image or spectrum acquisition over signal pickup30 devices commonly used with MRI and NMR scanner systems. In addition, the restricted field of view of the probe reduces or elimin~tes image distortion caused by motion, blood flow, patient breathing, and signal ~ ing when conducting an image~r acquisition using multi-limen~ional fast Fourier transform techniques.
The insertable pickup probe of the present invention comprises a shaft which supports an outer patient interface balloon structure at its distal end. In a specific embo limpnt~ the interface balloon structure contains a receiving coil in the form of a closed substantially planar loop with anterior and posterior faces. Two internal indepen(lently inflatable balloons are positioned within the structure on the anterior and posterior sides of the coil, respectively, effectively sandwiching the coil therebetween. The intern~l balloons have sepaldte inflation tubes which extend through the shaft exiting at the proximal handle end thereof. Each tube has a stopcock or like inflation controller, and each tube is separately connectable to an inflation cuff or the like. The coil is provided with an electrical lead which also extends through the shaft, exiting at the proximal handle end and being provided with a connector for ~tt~hing the coil to an interface network to receive signals from the coil.
When the probe is inserted in a body cavity with the balloon structure positioned ~ cent an area of interest to be investig~ted by NMR or MRI im~gin~, the provision of the sepal~tely inflatable internal balloons allows the coil to be more effectively positioned relative to the area of interest by selective and differential inflation. For example, if the area of interest is located on the anterior side of the coil, the posterior-side internal balloon may be infl~ted to a higher inflation volume than the anterior-side balloon to move the coil toward the anterior.
In accordance with another aspect of the invention, the probe may include st~ring and locator means to assist a clinician when inserting the probe in a body cavity to accommodate bends or curves in the cavity and to provide a visualindication as to the orientation of the coil. To this end, the probe may include a stiffener tube extending axially through the outer balloon from the proximal end of the shaft, and a removable steering mandrel which can be inserted into the shaft from the ploAilllal end so as to extend through the shaft and stiffener tube substantially up to the distal end of the balloon structure. The mandrel, which may be in the form , .
~ ~;
-. 2078536 of a stiff plastic or like rod may have a curved distal end. The effect of the curved end of the mandrel is to provide a type of orbital movement of-the balloon structure and coil when the proA~mal end of the mandrel is axially rotated relative to the shaft during insertion of the probe, useful to provide st~ring of the probe through curves S and the like in a body cavity.
According to a further feature of the invention, the mandrel may be used to rotate the coil along with the anterior and posterior balloons within the outer balloon structure. To this end, proximal and distal end rotary bearings are provided 10 within the outer balloon to receive the mandrel, and the coil along with the anterior and posterior balloons are taped together to form, with the mandrel, a rotary unit which can be rotated within the outer balloon by rotation of a knob or the like at the p~ al end of the mandrel. Thus, a c linici~n can angularly position the coil in situ within a patient without rotation of the probe as a whole. The mandrel can be formed 15 with indicator means to display the angular position of the coil.
To provide an indication of the orientation of the coil, the shaft may include a longit~1-1in~1 sight line or stripe aligned with the coil. Also the mandrel may have a proximal end knob with an arrow or other mark to indicate the direction of the 20 curve of the mandrel to aid in steering.
The above and other objects and advantages of the present invention will become more readily apparellt when reference is made to the following dcscliption, taken in conjunction with the acco~llpanying drawings.
Brief Description of the Drawi~
Figure 1 is a perspective view of an insertable pickup probe in accordance with the present invention and an associated interface network.
Figure 2 is a cross-sectional plan view of the distal balloon portion of the insertable pickup probe illustrated in Figure 1.
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Figure 3 is a cross-sectional elevational view of the distal end balloon portion of the probe.
Figure 4 is a sectional view taken on line 4-4 of Figure 3.
s Figure S is an elevational view of a steering mandrel for the probe.
Figure 6 is a plan view of the steering mandrel.
Figure 7 is a view similar to Figure 2 showing the distal balloon portion of a modified pickup probe according to the invention.
Figure 8 is an elevational view of a mandrel used in the probe shown in Figure 7.
Figures 9 and 10 are views showing ~ltern~tive cross-sectional shapes for the mandrel.
Figure 11 is a cross-section view on line XI-XI of Figure 7.
Des~ tion of Preferred Embodin~enl Referring first to Figure 1, an insertable colon pickup probe is shown in an assembled form at 10, and an interface network to which the probe connects is shown at 12. The pickup probe 10 is an MRI or NMR receiving device capable of im~ing or g~thering spectra from the human colon and surrounding tissue, but mayalso be used as the transmit coil for RF excitation. The probe 10 is used with the interface network 12 which provides the tuning, impedance matching, and decoupling functions.
The probe 10 includes a shaft 14 which supports a patient interface balloon structure 16 at its distal end and a handle 18 located at the proximal end of ~ .~
the shaft 14. As will be described in more detail later, assembly 16 includes aninternal pickup coil 20 and intern~l anterior and posterior inflation balloons 22 and 24, none of which are shown in Figure 1. The coil and internal balloons are accommodated, as will be described, in an outer balloon 26. Tubes 28, 30 for 5 infl~tin~ the intern~l balloons extend from the respective balloons through shaft 14 and exit at the pro~hl.al end of handle 18. The tubes have respective inflation control stopcocks 32, 34 and connections 36, 38 for attaching same to an inflator device 40 such as a syringe or cuff.
The receiving coil contained within the patient interface balloon structure 16 can be electrically connected to the interface 12 by an insulated interconnecting cable 42 which has a plug 44 at its proximal end for connection to terminal 46 located on the front of the interface network 12.
The interface network 12 also includes a terminal 48 for providing a co,~le~lion to a MRI scanner. Furthermore, the interface network 12 may include a switch S0 capable of being moved b~lwæll an o~l~Ling position and a tuning position or be ~esigned such that it functions fully autom~tic~lly. To display to the operator the mode of operation, indicator lights 52 or an LED readout are provided on thefront of the interface network 12. In addition, a light 54 or an LED readout forintli~ting the occurrence of a probe failure is provided on the front of the interface network 12.
A removable elc)ng~ rod-like steering mandrel 56 extends through the balloon structure 16 and shaft 14. The mandrel has an operating knob 58 at its proximal end.
R~f~rring now to Figures 2 to 4, the patient interface balloon structure 16 of the insertable pickup probe 10 is illustrated in more detail. Extending through the shaft 14 and axially through balloon structure 16 is a stiffener tube 60 which is a ~ll--ane ~l part of ~e structure and which may, ~or example, be supported in shaf~
14 by an end plate 62 and a like end plate (not shown) at the proximal end of the ~~ 7 2078536 shaft. The lead 42 for the pickup coil 20 extends through a lumen of the tube 60 and exits the tube through an apel~ule 64 ~ ent the distal end of shaft 14. Outside of the ap~llule, lead 42 connects to coil 20 which is in the form of a loop occupying a substantial cross-sectional area of the outer balloon 26.
s The intPrn~l inflation balloons 22 and 24 embrace the coil 20 on its anterior and posterior sides and also occupy substantial areas of the outer balloon as shown in Figure 3. The inner balloons are connected at their distal inlet ends to the infiation tubes 28 and 30 which are shown diagr~mm~tic~lly only in Figure 2. Theinfl~ticn tubes pass through apertures in end plate 62 and thence through the shaft 14.
The inner balloons and coil 20 may be loosely held together as a sandwich-type p~c~ge by an encircling cuff 66 shown dotted in Figures 2 and 3.
The mandrel 56, which is of a stiff plastic or other material, also fits 15 through the lumen of the stiffening tube 60. As shown in Figures S and 6, themandrel is line~r in plan view but has a J-like bend 68 at its distal end in elevational view. Also, the mandrel O~ld~ g knob 58 has an indicator mark 70 to show a clinician inserting the probe the ~lignmPnt of the mandrel. Further, as shown inFigure 1, the shaft has a lengthwise int~ic~tor stripe 72 (shown dotted for convenience 20 only) subst~nti~lly aligned with the plane of coil 20.
Other constructional details and m~teri~l~ of the various components of the probe are generally known per se and for such details, reference may be made to Euro~ Patent Application EP 0385367. Details of the interface network are 25 also shown and described in the copending patent application.
For insertion of the probe by way of a patient's rectum, the internal balloons 22 and 24 would be deflated to minimi7e the size of the structure 16, it being noted that outer balloon 26 is not infl~ted. During insertion of the probe, the 30 balloon structure may be given an orbital type twisting movement by rotation of the mandrel, should it be n~Pi~ to "steer" the probe along curves or bends in the anal tract or other intercavity passageway.
~ - 8 - 2078536 When the balloon structure is sihl~tecl at a site to be investig~te~ by MRI or NMR im~in~, the probe is manipulated in order to orientate the coil ~ub~ lially face on to an area of interest. Then, for optimal positioning of the coil relative to said area, the internal balloons may be differentially infl~te~ with the 5 balloon on that side of the coil which is further from the area of interest being inflated to a higher volume than the balloon which is on the side of the coil facing the area of interest. DirÇe~ lial inflation of the balloons is effected, for example, by opening and closing the respective stopcocks 32 and 34 to allow controlled quantities of air to be delivered to the respective balloons from the inflator device 40.
10 Differential inflation of the balloons as described has the effect of locating the coil in closer proximity to the area of interest than is possible with known forms ofinflatable probe devices. Typical infl~ti-m volume for the balloons may, for example, be 40cc in each balloon for a center lumen position of the coil and lOcc in the anterior balloon and 50cc in the posterior balloon for an anterior position of the coil.
Figures 7-11 show a modified probe structure in which the coil along with the internal balloons may be rotated within the outer balloon so as to allow in situ angular positioning of the coil when in position in a body cavity without having to rotate the probe as a whole when positi~n~ within a patient. Equivalent reference 20 numerals are used to denote parts which are equivalent to those in the previous embodiment.
Thus, in the modified arrangement, a proximal rotary bearing 80 is provided at the dist~l end of shaft 14 and a similar distal rotary bearing 82 is provided 25 in a bearing support 83 within the outer balloon 16 at its distal end. Stiffener tube 60' is ~u~ ed for rotation within the bearings 80 and 82, and a relatively stiffmandrel 56' with a proximal end o~l~ling knob 58' extends through shaft 14 and tube 60'. The pickup coil 20 and the int~rn~l anterior and posterior balloons 22 and 24 are constructed in like manner to the previous embodiment, but in this case they 30 are taped together and also taped to the mandrel by tapes 66' so as to rotate together with the mandrel and stiffener tube as a unit within the outer balloon. The mandrel may have alternative cruciform cross-sectional shapes as shown in Figures g and 10 ~F.~-g received in a co~ sl~ondingly shaped lumen in the stiffener tube so that rotation of the mandrel by knob 58' when the probe is in situ in a body cavity is effective to rotate the internal balloon assembly within the outer balloon 16. The cruciform shape of the mandrel is also useful for in-lic~ting the angular position of the coil relative to S the outer balloon along with indicator 70'.
The rem~inder of the structure of the probe including the handle is similar to that described in connection with Figures 1-6.
In all emb~im~nts of the invention the outer balloon 16 may be disposable or covered by a disposable sheath or the like to allow for repeated use of the probe.
While only a pl~r~red embodiment of the invention has been described 15 herein in detail, the invention is not limited thereby and modifications can be made within the scope of the attached claims. Just as a few examples, the mandrel need not be curved, and with an alternate mechanism for ~ligning the coil, the stiffening tube need not be provided.
~,, ,,~ ~
Claims (29)
1. An insertable intracavity probe for use in magnetic resonance imagingof a region of interest within a cavity of a patient comprising an elongate shaft having a proximal end and a distal end, a handle on the proximal end of the shaft, and a balloon structure on the distal end of the shaft, the balloon structure including an outer balloon, a pick-up coil in the outer balloon, the coil having an electrical lead extending through the shaft for connecting the coil to an interface network, first and second inflatable inner balloons within the outer balloon, the inner balloons being located on first and second sides of the coil, respectively, sandwiching the coil therebetween, and respective inflation tubes for inflating the inner balloons extending through the shaft.
2. The invention as defined in claim 1 including control means for selectively and individually controlling inflation pressure for the respective inner balloons.
3. The invention as defined in claim 2 wherein the control means includes a stopcock on each inflation tube and connector means for attaching the tube to an inflation source.
4. The invention as defined in claim 1 which includes a stiffener tube extending from the shaft through the balloon structure.
5. The invention as defined in claim 1 which includes a rod-like mandrelfor insertion into the elongate shaft from the proximal end of the handle, the mandrel having a length to extend; when inserted substantially from a distal end of the balloon structure out of the proximal end of the handle.
6. The invention as defined in claim 5 wherein the mandrel has a curved distal end portion for providing orbital twisting movement of the balloon structure on the shaft when the mandrel is rotated in the shaft.
7. The invention as defined in claim 6 wherein the mandrel has a proximal end with a mark for indicating alignment of the curved distal end portion of themandrel.
8. The invention as defined in claim 7 wherein the mandrel has a knob at the proximal end and said mark is on the knob.
9. The invention as defined in claim 1 wherein the shaft includes identifying means for indicating alignment of the coil.
10. The invention as defined in claim 9 wherein the identifying means is a longitudinal stripe or like mark on the shaft.
11. An insertable intracavity probe for use in magnetic resonance imagingof a region of interest within a cavity of a patient comprising an elongate shaft having a proximal end and a distal end, a handle on the proximal end of the shaft, a balloon structure on the distal end of the shaft including therein a pickup coil having a lead extending through the shaft for connection to an interfacing network and an elongate rod-like mandrel insertable into the balloon structure from a proximal end of the handle, for providing guidance of the balloon structure during insertion into the cavity.
12. The invention as defined in claim 11 which includes a stiffener tube extending from the shaft through the balloon structure and wherein the mandrel fits in a lumen in the stiffener tube.
13. The invention as defined in claim 11 or 12 wherein the mandrel has a curved distal end.
14. The invention as defined in claim 13 wherein the mandrel has a proximal end provided with a knob and a mark for indicating orientation of the mandrel in the shaft.
15. The invention as defined in claim 12 wherein the stiffener tube is rotatably mounted in distal and proximal bearings in the balloon structure whereby rotation of the mandrel effects rotation of the stiffener tube and coil.
16. The invention as defined in claim 15 wherein the coil is embraced by first and second inflatable inner balloons for providing selective positioning of the coil.
17. The invention defined in claim 15 or 16 wherein the mandrel has a curved distal end.
18. An insertable intracavity probe for use in magnetic resonance imagingof a region of interest within a cavity of a patient comprising an elongate shaft having a longitudinal axis, a proximal end and a distal end, a handle on the proximal end of the shaft, a balloon on the distal end of the shaft including therein a pickup coil having a lead extending through the shaft for connection to an interfacing network, a rotatable stiffener tube extending from the shaft through the balloon, bearing means rotatably mounting the stiffener tube within the balloon, and elongate mandrel extending substantially coaxially through the handle, the shaft and a lumen in the stiffener tube whereby rotation of the mandrel effects rotation of the stiffener tube, the mandrel having a proximal end portion extending outwardly from the handle, and attachment means within the balloon securing the coil to the stiffener tube and mandrel for rotation therewith whereby the coil can be angularly rotated and positioned within the balloon by rotation of said proximal end portion of the mandrel.
19. The invention as defined in claim 18 including first and second inflatable inner balloons within the outer balloon, the inner balloons being located on first and second sides of the coil, respectively, sandwiching the coil therebetween; and respective inflation tubes for inflating the inner balloons extending through the shaft wherein the attachment means also secures the inner balloons to the stiffener tube and mandrel for rotation therewith.
20. The invention as defined in claim 18 wherein the bearing means includes a proximal rotary bearing at a proximal end of the balloon, and a distal rotary bearing at a distal end of the balloon.
21. The invention as defined in claim 18 wherein the mandrel includes indicator means for indicating angular orientation of the coil within the balloon.
22. The invention as defined in claim 21 wherein the mandrel has a cross-sectional shape for aligning the indicator means with the position of the coil.
23. The invention as defined in claim 22 wherein a mandrel has a cruciform cross-sectional shape.
24. A method of magnetic resonance imaging of a region of interest withina cavity of a patient from a pickup probe inserted into said cavity, the probe having a distal and balloon structure including a pickup coil and first and second internal inflatable balloons within said structure embracing the coil on opposite sides of the coil, respectively, the method including the steps of positioning the balloon structure proximate said area of interest, providing selective and independent inflation of the internal balloons to influence positioning of the coil within said structure so as to optimally position the coil in relation to said area of interest, and using the coil for said imaging.
25. A method as defined in claim 24 which further includes rotating the coil and inner balloons with said balloon structure to obtain optimal positioning of the coil.
26. In a method of magnetic resonance imaging of a region of interest within a cavity of a patient using an inserted pickup probe having an elongate shaft with a balloon structure at a distal end thereof including a pickup coil therein the improvement which comprises using an elongate mandrel inserted into the shaft and balloon structure to assist in manipulation of the balloon structure during insertion of the probe by rotation of the mandrel about an axis of the shaft.
27. The method defined in claim 26 wherein the mandrel has a bowed distal end and the method further comprises providing orbital movement of the balloon structure about the shaft by rotation of the mandrel.
28. A method of magnetic resonance imaging a region of interest within a cavity of a patient by means of a pickup probe inserted into said cavity, the probe having a distal end balloon structure including a pickup coil therein, positioning the balloon structure proximate said area of interest, the method including the steps of selectively rotating the coil within said balloon structure to optimally position the coil with respect to said area of interest and using the coil for said imaging.
29. A method as defined in claim 28 further including the step of influencing the coil laterally within the balloon structure to obtain optimum positioning of the coil in relation to said area of interest.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/760,463 US5307814A (en) | 1991-09-17 | 1991-09-17 | Externally moveable intracavity probe for MRI imaging and spectroscopy |
| US07/760,463 | 1991-09-17 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2078536A1 CA2078536A1 (en) | 1993-03-18 |
| CA2078536C true CA2078536C (en) | 1996-07-02 |
Family
ID=25059185
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002078536A Expired - Fee Related CA2078536C (en) | 1991-09-17 | 1992-09-17 | Externally moveable intracavity probe for mri imaging and spectroscopy |
Country Status (6)
| Country | Link |
|---|---|
| US (1) | US5307814A (en) |
| EP (2) | EP0848931A3 (en) |
| JP (1) | JP2655940B2 (en) |
| CA (1) | CA2078536C (en) |
| DE (1) | DE69227912T2 (en) |
| WO (1) | WO1993005706A1 (en) |
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-
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- 1991-09-17 US US07/760,463 patent/US5307814A/en not_active Expired - Lifetime
-
1992
- 1992-09-17 CA CA002078536A patent/CA2078536C/en not_active Expired - Fee Related
- 1992-09-17 DE DE69227912T patent/DE69227912T2/en not_active Expired - Lifetime
- 1992-09-17 EP EP98104302A patent/EP0848931A3/en not_active Withdrawn
- 1992-09-17 JP JP5506236A patent/JP2655940B2/en not_active Expired - Lifetime
- 1992-09-17 WO PCT/US1992/007891 patent/WO1993005706A1/en active IP Right Grant
- 1992-09-17 EP EP92921089A patent/EP0604587B1/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| WO1993005706A1 (en) | 1993-04-01 |
| US5307814A (en) | 1994-05-03 |
| EP0604587A4 (en) | 1994-08-10 |
| CA2078536A1 (en) | 1993-03-18 |
| DE69227912T2 (en) | 1999-07-01 |
| EP0848931A3 (en) | 1998-10-21 |
| EP0848931A2 (en) | 1998-06-24 |
| EP0604587B1 (en) | 1998-12-16 |
| DE69227912D1 (en) | 1999-01-28 |
| JPH07502909A (en) | 1995-03-30 |
| EP0604587A1 (en) | 1994-07-06 |
| JP2655940B2 (en) | 1997-09-24 |
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