CN101099684A - Mri活组织检查装置 - Google Patents

Mri活组织检查装置 Download PDF

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CN101099684A
CN101099684A CNA2007101266290A CN200710126629A CN101099684A CN 101099684 A CN101099684 A CN 101099684A CN A2007101266290 A CNA2007101266290 A CN A2007101266290A CN 200710126629 A CN200710126629 A CN 200710126629A CN 101099684 A CN101099684 A CN 101099684A
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biopsy device
sickle
inner tubular
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mri
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CN101099684B (zh
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W·D·哈伯斯蒂奇
R·G·拉格黑文德兰
J·A·希布纳
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Devicor Medical Products Inc
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Ethicon Endo Surgery Inc
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Abstract

一种磁共振成像(MRI)相容的针芯活检系统，采用具有直观图形显示器和可拆卸的遥控键盘的活检装置，即使是在安装在乳房线圈内的定位夹具提供的封闭区域内其有利地准许便利的控制并相对于定位的乳房引导活检装置的探头。用于交互控制和电力产生的控制模块远距离定位并且通过铠装缆线连通和传递旋转机械能。

Description

MRI活组织检查装置
相关申请的交叉引用
本申请是Hughes等人于2005年4月12日提交的序列号为11/103,959的美国专利申请“MRI BIOPSY DEVICE LOCALIZATION FIXTURE”的部分继续申请，该文献的全部公开内容在这里作为参考被引入。
技术领域
本发明主要涉及一种辅助组织取样的成像方法，尤其是涉及一种为了获得皮下活组织检查和为了去除病变而相对于磁共振成像(MRI)乳房线圈定位活检探头的改进方法。
背景技术
针芯活检装置已经与成像技术结合以更好的瞄准乳腺组织中的`变。这样一种可在市场上购买到的产品由Ethicon Endo-Surgery公司以MAMMOTOMETM的商标名称在市场上销售。1996年6月18日授权给Burbank等人的美国专利No.5,526,822中描述了这样一种装置的一个实施例，并且其在此通过参考结合入本文。它的手柄接收机械和电子能量以及来自与磁共振成像(MRI)仪的强磁场隔开的远程定位控制模块的真空辅助。
如从该参考文献所看到的，该仪器是一种图像引导式、经皮针芯乳腺活组织检查仪器。该仪器是真空辅助的，并且用于取回组织样本的一些步骤已经被自动化。在将组织从身体切除之前，医生使用这种装置(利用真空)捕获“活”组织。这允许采集不同硬度的组织样本。另外，使用一种侧开口孔，避免了必须插入病变，而这种插入病变会造成将肿块推开，引起轨迹转移，或者引起血肿，该血肿与其中循环的剩余造影剂一起可能导致可疑病变中的伪像增强。侧孔可以围绕探头的纵向轴线旋转，从而允许采集多个组织样本而不必以其它方式重新定位探头。这些特征允许对大病变的大量采样并完全去除小病变。
真空辅助针芯活检装置已经被改进，其安全并且与包括磁共振成像(MRI)在内的各种成像方式相容。尤其是，安放在磁共振成像仪磁心附近的活检系统部分需要对强磁场不敏感，以避免被吸引到磁心或发生故障。并且，磁共振成像仪依赖于感应组织被磁场内的强变化激发后发出的极微弱的射频(RF)信号。放在射频屏蔽的磁共振成像仪房间内的组件需要避免产生电磁干扰(EMI)并且需要避免具有足以使射频信号歪曲而在磁共振成像扫描数据中产生假象的材料。
一种成功的方法是隔离原动力发电、图形用户界面、真空辅助和控制模块中的闭环控制，该控制模块一般距离磁心约6英尺安放，以减少与其强磁场和/或灵敏射频(RF)信号检测天线的有害相互作用。直观图形用户界面(GUI)提供了大量结合入控制模块的既定程序功能以有效利用在磁共振成像房间内的时间采集组织样品。
例如，在美国专利No.6,752,768(其公开的全部内容在这里通过参考被引入)中，可以按下控制按钮改变针芯活检装置的操作模式，并且该模式远程显示在显示屏上。
尽管全功能图形用户界面具有许多临床益处，但医生会发现在手术的手动过程中控制模块很不便地位于远程。另外，一些磁共振成像仪具有这种提高的灵敏度和/或增强的磁场强度，其对于增加控制监测器与磁共振成像仪之间的距离(例如，30英尺)是理想的。并且，即使控制监测器足够近，一些医生更喜欢简化的用户界面以简化训练熟悉。
因此，非常需要一种在磁共振成像仪房间中相容使用的活检系统，该系统具有更方便和直观的活检控制器。
发明内容
本发明通过提供一种磁共振成像(MRI)相容的针芯活检系统的手持件克服了现有技术的上述不足及其它缺点，该手持件包括一个图形用户界面，即使是在真空、电力产生以及控制处理组件相对于磁共振成像磁体和敏感射频(RF)接收组件远距离安放的情况下也能便于用户控制。由此，医生可以具备真空辅助针芯活检系统的所有功能而不会由于与远距离安放的控制模块的距离产生不便。
具体而言，本发明涉及如下内容：
(1)、一种活检装置，包括：
具有侧面组织接收孔的外部套管；
设置用于在该套管内移动的内部管状切割器；
对所述内部管状切割器的移动位置敏感的传感器；
在近侧连接到该外部套管上并且可操作地设置成响应于传感器表示移动位置的图形显示器。
(2)、如第(1)项所述的活检装置，其中图形显示器包括一个条形图，该条形图用相对于指示的内部管状切割器的移动位置侧面组织接收孔的纵向范围注释。
(3)、如第(1)项所述的活检装置，进一步包括与内部管状切割器连通以使组织脱垂进入侧面组织接收孔的真空源，图形显示器进一步可操作地设置成描绘出对应于真空源的运行模式。
(4)、如第(3)项所述的活检装置，进一步包括响应于控制模式的用户激励在多种运行模式之间切换的模式控制器和控制电路，图形显示器包括多个指示器，其对应于目前的运行模式而发光。
(5)、如第(4)项所述的活检装置，进一步包括示出多种运行模式中的每一种的多个图形指示标记。
(6)、如第(3)项所述的活检装置，进一步包括一个侧腔，该侧腔固定到外部套管并在远端连通于侧面组织接收孔且在近端连通于大气。
(7)、如第(1)项所述的活检装置，进一步包括：
探头组件部分，该部分包含内部管状切割器、固定到内部管状切割器的切割器架和被接合以相对于切割器架纵向移动的移动轴；和
包括可接合到移动轴的旋转部件的机架组件。
(8)、如第(7)项所述的活检装置，其中探头组件进一步包括在近侧固定到内部管状切割器的切割器齿轮、具有设置成接合齿轮切割器而将旋转传递给内部管状切割器的圆柱形齿轮部分的旋转轴。
(9)、如第(8)项所述的活检装置，其中机架进一步包括定比传动机构，该定比传动机构具有可连接到移动轴的一个旋转输出端和可连接到旋转轴的另一个旋转输出端。
(10)、如第(9)项所述的活检装置，进一步包括通过机械传动缆线固定到机架的远距离定位的切割器移动马达。
(11)、如第(10)项所述的活检装置，其中机械传动缆线固定到机架的下表面，以减少外部套管上的转矩负载。
(12)、如第(8)项所述的活检装置，其中当整个内部管状切割器向近侧相对于侧面组织接收孔缩回时，圆柱形齿轮部分的纵向尺寸被设置成与切割器齿轮脱离接合。
(13)、如第(1)项所述的活检装置，其中传感器包括连接于内部管状切割器的编码器。
(14)、一种外科活检系统，包括：
手持件，该手持件包括细长中空套管以及相对于该中空套管可旋转并可轴向定位的切割器，该空心套管具有一个侧孔，用于将组织样品接收进入中空套管；
电源，该电源离手持件远距离设置并且可操作地通过机械传动缆线连接到切割器，以旋转和移动该切割器；
可操作地与手持件相连的控制单元；和
固定到手持件并可操作地配置有控制单元的显示器，其中该显示器提供了外科活检系统的运行模式的图形显示。
(15)、如第(14)项所述的外科活检系统，手持件进一步包括至少一个可操作以选择外科活检系统的运行模式的控制按钮。
(16)、如第(15)项所述的外科活检系统，其中所述至少一个控制按钮设置在可拆卸的键盘上。
(17)、如第(14)项所述的外科活检系统，其中手持件可操作地与真空源相连。
根据附图和其描述将会明白本发明的这些和其它目的和优点。
附图说明
结合入本发明的说明书中并组成该说明书的一部分的附图示出了本发明的实施方式，并且其与上文给出的本发明的总体描述以及下文给出的实施方式的详细描述一起用于解释本发明的原理。
图1是磁共振成像(MRI)活检系统的分解透视图，该系统包括具有与本发明的各方面一致的直观图形控制器的手持件(“活检装置”)；
图2是图1中MRI活检系统的定位夹具的侧面支架和基座的等轴测图；
图3是安装在图2的右侧第一靶标导轨上的导向组件的等轴测图；
图4是图3的导向组件与图1的套筒套管针和导引器闭塞器的分解等轴测图；
图5是插入图1和4的套筒套管针的导引器闭塞器的等轴测图；
图6是具有一次性探头组件和与可重复利用机架部分脱离接合的键盘控制器的图1的MRI活检装置的从右后侧看的等轴测图；
图7是具有一次性探头组件和与可重复利用机架部分脱离接合的键盘控制器的图1的MRI活检装置的从左前侧看的等轴测图；
图8是图7的可重复利用机架部分的从左前侧看的分解等轴测图；
图9是顶盖被移除以暴露托架腔内部组件的图7的一次性探头组件的俯视图；
图10是图7的一次性探头组件的从左前侧看的分解等轴测图；
图11是安装入图1的乳房线圈中的定位夹具和导向组件的从左后侧看的等轴测图；
图12是进入图11的导向组件的图7的MRI活检装置的从后侧看的等轴测图；
图13是图7的MRI活检装置的显示部分的详细俯视图；
图14是图12的MRI活检装置、定位夹具和乳房线圈的从右后侧看的等轴测图，同时标记配置仪器插入通过一次性探头组件的探头。
具体实施方式
磁共振成像活检装置有利地包括为了无菌目的一部分是一次性的和为了节约可重复利用的部分。减少了与由于磁共振成像仪的强磁场和敏感射频接收组件而必需远距离安放的控制部分的机械、电和气动连接的不便。首先，甚至在插入定位和导向结构后磁共振成像活检装置上的近端的可拆分直观控制和显示设备提供了交互式控制。其次，在设备损坏或功能障碍之前感应与MRI活检装置的机械连接的束缚。第三，移动机械连接器更接近于MRI活检装置和导向结构之间的结合点以减少转矩负载，尤其是通过其远端探头转换的那些。第四，单根机械驱动缆线驱动一个定比传动机构，该传动机构移动和旋转远端探头的切割器，以实现有效的定比移动/旋转采样切割，而不需要两根机械驱动缆线。
参照附图，其中相同的附图标记在几个图中均表示相同的构件，在图1至3中，磁共振成像(MRI)相容的活检系统10具有一个控制模块12，控制模块12通常放置在装有磁共振成像仪(未示出)的屏蔽间外或者至少隔开放置，以减少与其强磁场和/或敏感射频(RF)信号检测天线的有害相互作用。如同在美国专利No.6,752,768中描述的，该专利的全部内容在这里作为参考被引入，将预编程范围的功能结合入控制模块12以帮助采集这些组织样品。控制模块12控制并驱动MRI活检装置(“手持件”)14，MRI活检装置14由连接到乳房线圈18的定位夹具16定位和引导，而乳房线圈18安放在磁共振成像仪的台架(未示出)上。
缆线管理线轴20安放在缆线管理固定鞍架22上，鞍架22从控制模块12的一侧突出。缠在缆线管理线轴20上的是一对电气缆线24和机械缆线26，它们被捆扎成铠装缆线27，用于分别传递控制信号和切割器的旋转/前进动作。具体地，每根电气和机械缆线24、26都具有连接到位于控制模块12中的相应电气和机械端口28、30上的一端和连接到MRI活检装置14的可重复利用机架部分32的另一端。磁共振成像对接杯座34通过对接工位安装托架36钩到控制模块12上，当不使用时该磁共振成像对接杯座34可以容纳机架部分32。
安装到墙上的界面锁定盒38为控制模块12上的锁定端口42提供了一个系缆40。系缆40有利地、独特地终止，并且仅为一小段，以避免无意中将控制模块12过份靠近磁共振成像仪。串联封套44可以有利地将系缆40、电气缆线24和机械缆线26与控制模块12上的它们各自的端口42、28、30分别对准。
通过第一真空管线46提供真空辅助，该第一真空管线46连接在控制模块12与截留液体和固体残留物的真空罐50的出口48之间。管道组件52完成控制模块12和MRI活检装置14之间的气动连通。特别是，将第二真空管线54连接到真空罐50的入口56上。第二真空管线54分成连接到MRI活检装置14上的两个真空管线58、60。利用安装在机架部分32中的MRI活检装置14，控制模块12进行功能检查。将盐水手工注入活检装置14中，以用作润滑剂并有助于实现真空密封。控制模块12致动MRI活检装置14中的切割器机构(未示出)，监控全部行程。通过参考施加用于转动机械缆线26的电动力和/或由比较在机械缆线26的每个端部的转速或位置检测的机械缆线26内的扭转量来监控机械缆线26内或活检装置14内的束缚。
正好在邻近于可重复利用的机架部分32上的显示区域61，遥控键盘62(其可相对于可重复利用的机架部分32拆卸)通过电气缆线24与控制模块12通信，以增强对MRI活检装置14的临床控制，尤其是当插入定位夹具16后控制装置自身处于MRI活检装置14上而不易得到时，和/或当控制模块12的放置遥远(例如，距离30英尺)不方便时。在插入后也容易到达可重复利用的机架部分32上的尾端指轮63，以旋转将要采集组织样品的侧面。
在平行的左右上部轨道70、72内分别可横向调整地容纳定位框架68的左右上导向器64、66，平行的左右上部轨道70、72固定到乳房线圈18的患者支承台78的下侧74和形成在乳房线圈18的患者支承台78内的选定的乳房开口76的每个侧面。乳房线圈18的基座80由中线柱82连接，中线柱82在乳房开口76之间固定到患者支承台78。并且，位于每侧上且间隔约一个相应的乳房开口76的一对外侧立式支承柱84、86限定一个横向凹槽88，定位夹具16位于横向凹槽88内。
在图1至2中，中间板90沿内(中间)侧挤压选择的乳房，所述中间板90向下进入定位框架68的中间三侧框架92内。横向栅94从乳房的外侧(横向侧)挤压乳房，所述横向栅94向下进入定位框架68的侧面三侧框架96内，限定X-Y平面。相对于站立的患者X轴为垂直的(直的)并且相当于医生面对定位夹具16的外部暴露部分所看到的从左至右的轴线。
垂直于这个延伸到乳房中间侧面的X-Y平面的是Z轴，Z轴一般对应于MRI活检装置14的一次性探头组件100的探头98的插入方向和深度，或套筒套管针102插入导引器闭塞器104的方向和深度。为了清楚起见，术语Z轴可以与“穿刺轴线”交换使用，尽管后者可以垂直于或不垂直于用于定位患者上的插入点的空间坐标。这里描述的定位夹具16的变型允许相对于X-Y轴线的非正交穿刺轴线，以便利或临床有益的角度到达病变。空间坐标的原点可以是横向栅94给予组织的凹痕的成像。可选择地，基准夹持器108夹持的一次性基准指针106充满了MRI可成像物质(例如，KY凝胶、盐水、钆)并且用盖110密封。
探头98、套筒套管针102和基准指针106由定位夹具16引导。特别参照图2，横向栅支承托架120在空间上定位左右第一靶标导轨121、122，靶标导轨121、122又引导活检装置14的基准指针106、套筒/套管针102或探头98(图1)。每个第一靶标导轨121、122都包括一个连接轴124，连接轴124安放在(Y轴)高度叉臂架(height yoke)126的左侧或右侧轴套125内，高度叉臂架126在托架主体128上是垂直可调节的，托架主体128在横向栅94上是横向可调节的。可选择地，为了向中线接近乳房线圈可以使托架主体安放在中板90上。可托架主体128包括一个近端直立矩形柱132，矩形柱132具有一个从其远侧面突出的较薄壁134，远侧面作为托架140的一部分横向向外张开(限定左右垂直矩形槽136、138)，托架140具有顶和底悬臂144、146，悬臂144、146分别在形成在横向栅94中的顶部轨道148和近端开放下部轨道150上滑动。当横向调节杆151根据横向测量引导器145重新定位到预定位置的左侧或右侧时，可以提升横向(X轴)调节杆151，以提升其远端149，脱离与形成在横向栅94中的底部轨道147的接合。
高度叉臂架126为在远侧中部中断的矩形箍，形成左右锁定臂152，左右锁定臂152分别垂直骑在左右垂直矩形槽136、138中。左右锁定臂152具有各自的凸脊状近侧表面(未示出)，高度锁定杆156选择性地向近侧移动该凸脊状近侧表面，与每个垂直矩形槽136、138的近侧面上的凸脊状表面158接合。当高度叉臂架126垂直重新定位时，提升高度锁定杆156使高度叉臂架126脱离与托架主体128的锁定接合。对于高度调节，高度叉臂架126的近端顶表面作为视准线160以读取提供在高度锁定杆156的近端表面上的高度测量标尺162。
固定轴124允许旋转使得穿刺轴可以包括一个向上或向下的轨迹。在说明性方案中，高度叉臂架126的近侧角部包括角度定位槽164(例如，-15°、0°、+15°)，角度定位槽164由角度锁定杆166选择。第一靶标导轨122包括一个远端定位槽167，其作为基准夹持器108(图1)起始位置参照。
在图3至4中，导向组件200(其可以连接到图2的横向栅支承托架102)包括一个托架202，托架202的上部外侧面202a向上外展，以与第一靶标导轨122的底槽203接合。下部横向侧面202b水平外展，以提供一个机架导引轨道204，机架导引轨道204位于穿刺轴的下面。为了对MRI活检装置14(图1)提供附加引导，第二靶际导轨206包括一个侧槽208，侧槽208沿第一靶标导轨122的纵向导向突出部210被引导。当在其上完全接合时，在爪簧214的促使下在绕侧面窗218中的垂直爪销216旋转的制动爪212落入在近侧设置在第一靶标导轨122上的邻近定位槽220中，侧面窗218邻近设置在第二靶标导轨206中。爪簧214可以使制动爪212保持在中间位置，这在第二靶标导轨206的组装和随后的拆除中都起作用或者包括一对用于该目的的相对爪簧(未示出)。
在图4至5中，套筒套管针102包括一个空心轴(或套管)223，空心轴223邻近附着于圆柱形毂224并具有一个邻近于开放末端228的侧面开口226。圆柱形毂224具有一个存在于外部的指轮230用于旋转侧面开口226。圆柱形毂224具有一个内侧凹槽232，内侧凹槽232环绕鸭嘴形闭塞器234、弹性密封件236和密封件保持器238，以当轴223变空并且用于密封插入的导引器闭塞器104时提供流体密封。
导引器闭塞器104有利地结合许多具有相应特性的组件。空心轴242包括一个流体腔管244，流体腔管244在可成像的侧面凹口246和邻近端口248之间连通。当完全与延伸到套筒套管针102的末端228之外的穿刺尖端249接合时，空心轴242纵向定尺寸延伸。闭塞器手柄250环绕近端的端口248并包括一个锁定元件252，其包括一个可视角度指示器254，锁定元件252接合套筒指轮230，以确保可成像的侧面凹口246与套筒套管针102的侧面开口226对准。闭塞器密封盖256可以从近端接合闭塞器手柄250以关闭流体管腔244。闭塞器密封盖256包括一个锁定或定位元件258，锁定或定位元件258包括一个可视角度指示器259，可视角度指示器259对应于闭塞器指轮盖230上的可视角度指示器254。闭塞器密封盖256可以由刚性、柔软或弹性体材料制成。
返回到图3、4，在刺入组织的过程中，具有套筒毂262的套筒座260引导套筒套管针102，套筒毂262容纳套筒套管针102的圆柱形毂224。套筒座260具有一个侧面套筒毂导槽264，侧面套筒毂导槽264沿第二靶标导轨206的顶和底导向凸缘266、268滑动，每个导向凸缘266、268都具有一个对准的、且带有凹槽和凸脊的棘齿表面270，表面270与相应顶和底导轨锁定摇杆制动销276、278上的相应顶和底棘齿元件272、274相互作用，套筒座260相应侧面内的相应顶和底制动销插脚280、282接合相应制动销276、278内。棘齿元件272、274近端倾斜能够允许远端的移动。每个导轨锁定摇杆制动销276、278的远侧部通过各自的导轨锁定压缩弹簧284、286偏移离开套筒座260，以偏移棘齿元件272、274成与导向凸缘266、268的凸纹表面270接触。同时阻抑导轨锁定摇杆制动销276、278使得套筒座260被近端牵引，回退其中支持的套筒套管针102，直到套筒座260到达第二靶标导轨206的近端，于是当第二靶标导轨206从第一靶标导轨122分离时套筒座260顺时针(从顶部观察)旋转制动爪212并且因此接合第二靶标导轨206，利用连续近端移动造成从那里移除。
首先在将第二靶标导轨206安放在第一靶标导轨122之前，套筒座260有利地可调节地设置在第二靶标导轨206上，以设定一个预定的穿刺深度。尤其是，深度导引器290由新月形的深度指示器292形成，深度指示器292具有一个形成用于接合顶和底导向凸缘266、268的侧面槽296。设置在侧面槽296的顶和底上的向前倾斜的表面298以与第二靶标导轨206上的凸纹棘齿表面270接合，通过从第二靶标导轨206的远端插入深度指示器292进行组装。此后摩擦接合阻止进一步的近端移动和强烈阻止任何远端移动，尤其是从深度导引器290的深度导螺杆300，当深度启动杆305用于旋转并且在其中纵向定位深度导螺杆300时，深度导螺杆300的远端302在深度指示器292的外侧孔304内旋转，并且其近端横向偏转。深度导螺杆300的中部容纳在形成于其侧沟208外侧的套筒座260内的纵向通孔306内。对于粗略深度调整，深度导螺杆300的外层铅线307选择性地与套筒座260接合直到顶和底部粗调按钮308、310被向内下压入套筒座260，压缩相应的顶和底部粗调压缩弹簧312、314。粗调按钮308、310中的每一个都包括一个各自的垂直细长开口316、318，垂直细长开口316、318的内表面存在一个螺旋齿轮部分320、322，当回缩的粗调压缩螺钉312、314促使其接合时其与深度导螺杆300上的外层铅线307接合。
返回图3，指轮230被描述为与套筒座260的套筒毂262接合，而套筒套管针102的其它部分被省去。根据本发明的应用可以包括MRI活检装置的探头，该探头包括一个穿刺尖端或不穿过空心轴(管腔)223以其它方式使用。同样，具有类似密封部件的指轮可以结合入套筒座260。
在图6至7中，MRI活检装置14具有一次性的探头组件100，探头组件100被描述为从可重复利用的机架部分32上拆下并具有从可重复利用的机架部分32松开的遥控键盘62。铠装缆线27连接到指轮63后端远端的可重复利用机架部分32的下面，以增强可重复利用机架部分的平衡和支持，缆线27又通过I形梁形状的机架导轨324与机架轨道204(图4)接合，机架导轨324的上表面326与机架底板330的底槽328接合。在接合过程中，机架底板330上的凸脊状构件331引导一次性探头组件100。机架导轨324的狭窄上部远侧面332也与向下的夹持凸缘334接合，夹持凸缘334在一次性探头组件100的远端指轮336近侧向下延伸。下部吊挂的壳体337固定于机架底板330的近侧下表面部分。
一次性探头组件100还具有一个下表面，其向后滑动进入与可重复利用机架部分32的接合。尤其是，一个狭窄近端338形成为顶盖340，顶盖340具有一个远端锁臂342，除了在顶盖340的暴露表面346上近端地存在一个解锁按钮344外，远端锁臂342在每个侧面都与顶盖340分开，下压解锁按钮344以使锁定表面348(图6)从机架底板330的可重复利用机架部分32内的远端开放接收孔352的远端唇缘350脱离。
形成可重复利用机架部分32的邻近顶盖356的上部近侧面内的凹入面板354以接收遥控键盘62。下部壳体358匹配近侧顶盖356。近侧顶盖356还限定接收孔352的上部。凹入面板354具有一个前部导向孔360和一个后锁定孔362，对准前部导向孔360和后锁定孔362以分别接收前齿363和遥控键盘62后端的挠曲解锁接头片364，以选择性地使键盘62与可重复利用机架部分32接合和分离。键盘62还包括一个移动摇杆按钮366，按钮366具有向远端前进、缺省中间和后侧回退命令位置。后部按钮368可被程序化，用于模式功能，例如盐水冲洗。
尤其参照图6，一次性探头组件100具有多个提供在尾部对接端370上的互连部件。设置向右倾斜的真空软管接头372以安装真空导管(未示出)，该软管将由从其下部和尾部延伸的摩擦夹片373夹紧以避免意外泄漏。右侧狭槽374远端开口并且形成在机架底板330和近侧顶盖356之间，当一次性探头组件100与可重复利用机架部分32接合时以接收这种真空导管。中心带键槽传动轴375接合尾端指轮63并与远端指轮336连接以旋转探头98中的侧孔376到预定侧面，如同远端指轮336上的箭头指示378在视觉上确认的。右侧带键槽传动轴380影响切割器移动，而左侧带键槽传动轴382影响切割器旋转。
远端指轮336和探头98都固定到圆柱形毂384上，圆柱形毂384是下部壳体358的远端部分，下部壳体358超过与顶盖340的匹配延伸。样品通孔386通过圆柱形毂384连通用于接收进入探头98的旋转和移动的切割器管388(图9)并接收由回退的切割器管388放置的组织样品(未示出)。当切割器管388完全回退入形成在顶盖340和下部壳体358的近端部分之间的托架腔390中时，由切割器管388环绕的真空管394的远端延伸尖端392移动取回的组织样品到样品回收台396上，样品回收台396为顶盖340和圆柱形毂384之间的凹陷区域。
在图8中，应当明白，铠装缆线27连接到机架底板330并将单个机械传动旋转传送到位于机架底板330上的定比传动机构398，并且电连接到与接收孔352的定比传动机构398后部连接的编码器400。铠装缆线27还通过导线束(未示出)与显示区域61进行电通信并且通过缆线组件402与键盘62进行电通信，缆线组件402包括夹持键盘缆线406并且在近侧紧固到铠装缆线27的应变消除支架404。定比传动机构398具有贯穿端口408，用以容纳中心带键槽传动轴375(图6)的远端，以旋转地接合近端接收的由后端指轮63在远端提供并且由O型环412密封的锥形轴410。通过定比传动机构398在远侧提供的右侧端口414，接合用于旋转一次性探头组件100的右侧带键槽传动轴380以推进和回退(“移动”)切割器管388。在定比传动机构398远端提供的左侧端口416，当切割器管388的远侧刀口滑过探头98的侧孔376时，接合用于旋转一次性探头组件100的左侧带键槽传动轴382，用以旋转切割器管388。
在图9至10中，一次性探头组件100的托架腔390包括具有带螺纹的纵向孔420的切割器架418，带螺纹的纵向孔420环绕细长移动轴422，移动轴422的近端是由尾部的右侧圆柱形轴承424支承的右侧带键槽传动轴380，该右侧圆柱形轴承424位于下壳体358后壁425中。在圆柱形轴承424的外周长周围的轴承座圈容纳有一O型环426。带螺纹的移动轴422的末端428在接合到下壳体358前壁432远端右侧圆柱形轴承430内部进行旋转。在圆柱形轴承430的外周长周围的轴承座圈容纳有一O型环434。细长移动轴422的带螺纹的中央部436位于非螺纹远端多余延伸(over-run)部分438和非螺纹近端多余延伸部分440之间，两者的尺寸允许切割器架418的带螺纹的纵向孔420从带螺纹的中央部分436脱离。
远端压力弹簧442和近端压力弹簧444分别位于非螺纹远端和近端多余延伸部分438、440上，当细长移动轴422反向旋转时，促使切割器架418的带螺纹的纵向孔420返回到与螺纹中央部436接合。特别地，切割器架418包括滑动接合顶盖340(未示出)下表面的顶部纵向通道446以及接合下壳体358的上表面的纵向轨道450的底部纵向导向装置448。由此旋转性地限制细长移动轴422的旋转引起切割器架418的相应纵向移动，同时远端和后部的一对夹持凸缘452、454横向地保持到左侧以分别接合形成在切割器圆柱齿轮462的齿轮部分460的每个侧面上的远端和近端轴承座圈456、458，该切割器圆柱齿轮462具有施加真空的纵向孔。
为此，真空软管接头372连接到支架结构464，该支架结构464在顶盖340和下壳体358之间夹紧以提供托架腔390内的孔466，孔466与切割器齿轮462的纵向孔成一条直线并且与真空软管接头372流体连通。
尤其参考图10，真空管394的近端容纳在孔466中。矩形导管467支撑着真空管394的远端延伸尖端392并且在顶盖340和下壳体358之间进行接合。切割器管388环绕并相对于真空管394移动。连接到齿轮切割器462近端的密封盖468动态密封于真空管394的外周，使得邻近提供给远端延伸尖端392的负压不在托架腔390内释放。切割器管388在真空管394的开放远端周围推进，经过样品回收台396以抵靠后部密封垫470密封，后部密封垫470基本上将近端开口472封闭在在圆柱形毂384内旋转的套筒接头474内。套筒接头474具有一个接合用于与远端指轮336一起旋转的远端476。远端和近端O形环478、480分别安装在远端和近端轴承座圈482、484内，其跨坐套筒接头474的侧面通道486以提供一定程度的摩擦阻力，防止无意中的旋转并且有利地密封侧面通道486用于真空辅助以脱出组织和回收样品。非圆形开口488置于远端指轮336的远侧面的中心。探头98的取样管490的近端延伸通过非圆形开口488以接收切割器管388的远端。沿其长度固定到取样管490的侧管492与套筒接头474的侧面通道486连通。侧管492限定一个侧腔，其通过腔孔494(图9)与由取样管490/切割器管388在侧孔376下限定的切割器腔连通。
后端指轮63转动中心带键槽传动轴375，中心带键槽传动轴375又旋转轴496，轴496的键控远端498又接合并旋转小齿轮500，小齿轮500与近侧圆柱齿轮502齿轮接合，圆柱齿轮502形成套筒接头474的外部近侧环状面。键控远端498的圆柱形远端尖端504在下部壳体358内的轴孔(未示出)内旋转。后端指轮63的旋转由此使探头98旋转。
在下部壳体358内支承远端弯管气动接头506以具有一个与套筒接头474的侧面通道486相通的顶端508和一个与下部壳体358支持的通风气动管道512连接的尾端510。通风气动管道512的另一端连接于近侧弯管气动接头516的远端514，弯管气动接头516的外侧端518与大气连通。从外侧端518通过管腔孔494排放气压的各种组件的尺寸可以通过取样管490取出组织样品。然而在切割组织样品之前通过真空软管接头372气动放掉更多空气在侧孔376产生一个足够低的压力，以脱垂用于切割的组织。
细长旋转轴520近侧终止于左侧带键槽传动轴382内，左侧带键槽传动轴382由左侧尾部圆柱形轴承522支承用于旋转，圆柱形轴承522具有一个在外周周围的轴承垫圈，其容纳O形环524并容纳在下部壳体358的后部壁425内。细长旋转轴520的远端526容纳在左侧尾部圆柱形轴承528内用于旋转，左侧尾部圆柱形轴承528具有一个在外周周围的轴承垫圈，其容纳O形环530并容纳在下部壳体358的前部壁425内。当切割器架418前进以定位切割器管388滑过侧孔376时，切割器圆柱形齿轮460与细长旋转轴520的圆柱形齿轮部分532接合。与旋转传动比的量成比例的旋转切割器管388保证了组织的有效切割。当不能有利切割时去除旋转将增加组织样品收回的收回。
在使用中，在图11中，定位夹具16已经安装入乳房线圈18。导向组件200已经预先设置了预定插入点、预定穿刺轴和预定穿刺深度。如图12中描述的，已经插入套筒套管针102/导引器闭塞器104并形成图像以确定放置后，移除导引器闭塞器104并且插入活检装置14的探头98。套筒套管针102的形状匹配探头98，通过调整远端指轮336上的箭头指示器378和套筒套管针102的指轮230上的可视角度指示器来进行视觉上的帮助。在参照显示区域61上的活检装置14的状态信息时，医生可以通过按压键盘62上的移动摇杆按钮366和尾部按钮368影响活检装置14的运行。在图13中，显示区61有利地包括一个具有远端和近端指示标记536、538的切割器位置条形图534，远端和近端指示标记536、538可以与已经闪亮的灯部分540数相比表示切割器管388相对于侧孔376的进程。可以通过三种模式切换尾部按钮368以循环活检装置14，通过具有相应标记的位置发光二极管指示器542、采样发光二极管指示器544和清除发光二极管指示器546进行指示，其图示描绘在所述模式中活检装置的运行。尤其是，位置模式表示图548示出切割器管388可以前进和后退，例如，在将探头98插入套筒套管针102之前关闭侧孔376。在采样方式表示图550中，实施真空辅助，引出足够的空气通过切割器管388以脱垂组织进入开放侧孔376，在移动切割器管388时其被保持着。在清除模式表示图552中，当完全回退切割器管388以取回组织样品时保持真空。在图14中，在样品通过圆柱形毂388的孔386的过程中配置了标示装置548。
应当明白任何据称在这里作为参考被引入的专利、发行物或其它公开材料(全部或部分)在这里仅到引入的事物不与在本公开中阐述的现存定义、陈述、或其它公开事物矛盾的程度。同样，并且到必需程度，这里明确描述的公开取代作为参考在这里引入的任何矛盾事物。据称在这里作为参考被引入、但其与这里阐述的现存定义、陈述、或其它公开事物矛盾的任何事物、或其部分，都将仅仅被引入到在引入事物和现存公开事物之间没有矛盾产生的程度。
尽管已经通过几种实施方式的描述阐述了本发明并且尽管已经相当详细地描述了该说明性实施方式，但本申请的意图不是将附属权利要求的范围限定或以任何方式限制到这种细节。本领域的技术人员很容易看到其它优点和变型。
例如，尽管与切割器管定位相关的组件的闭环反馈传感具有各种优点，但是可以以与本发明一致的其它方式实现切割器位置的确定。例如，可以在完全前进和/或完全回退时感应驱动组件上的负载，其可以用于根据移动命令的持续时间测定估计切割器位置。
作为另一种实例，取代离散的发光二极管指示器和加标记的表示图，按照本发明的特征的应用可以包括图形显示器(例如，有机液晶显示)，图形显示器能够交互显示直观的仪器状态信息。可选择地或另外，可以结合触摸屏性能以允许仪表控制和显示。
作为又一种实例，按照本发明的方面一致的应用可以与不同诊断图像形式(例如，超声波、计算机断层照相法(CT))结合使用。

Claims (10)

1.一种活检装置，包括：
具有侧面组织接收孔的外部套管；
设置用于在该套管内移动的内部管状切割器；
对所述内部管状切割器的移动位置敏感的传感器；
在近侧连接到该外部套管上并且可操作地设置成响应于传感器表示移动位置的图形显示器。
2.如权利要求1所述的活检装置，其中图形显示器包括一个条形图，该条形图用侧面组织接收孔的相对于指示的内部管状切割器的移动位置的纵向范围注释。
3.如权利要求1所述的活检装置，进一步包括与内部管状切割器连通以使组织脱垂进入侧面组织接收孔的真空源，图形显示器进一步可操作地设置成描绘出对应于真空源的运行模式。
4.如权利要求3所述的活检装置，进一步包括响应于控制模式的用户激励在多种运行模式之间切换的模式控制器和控制电路，图形显示器包括多个指示器，其对应于目前的运行模式而发光。
5.如权利要求4所述的活检装置，进一步包括示出多种运行模式中的每一种的多个图形指示标记。
6.如权利要求3所述的活检装置，进一步包括一个侧腔，该侧腔固定到外部套管并在远端连通于侧面组织接收孔且在近端连通于大气。
7.如权利要求1所述的活检装置，进一步包括：
探头组件部分，该部分包含内部管状切割器、固定到内部管状切割器的切割器架和被接合以相对于切割器架纵向移动的移动轴；和
包括可接合到移动轴的旋转部件的机架组件。
8.如权利要求7所述的活检装置，其中探头组件进一步包括在近侧固定到内部管状切割器的切割器齿轮、具有设置成接合齿轮切割器而将旋转传递给内部管状切割器的圆柱形齿轮部分的旋转轴。
9.如权利要求8所述的活检装置，其中机架进一步包括定比传动机构，该定比传动机构具有可连接到移动轴的一个旋转输出端和可连接到旋转轴的另一个旋转输出端。
10.如权利要求9所述的活检装置，进一步包括通过机械传动缆线固定到机架的远距离定位的切割器移动马达。
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CA2589569C (en) 2016-11-08
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US20100160818A1 (en) 2010-06-24
US20150201916A1 (en) 2015-07-23
JP5101165B2 (ja) 2012-12-19
US20160296213A1 (en) 2016-10-13
JP5456865B2 (ja) 2014-04-02
US9392999B2 (en) 2016-07-19
US9504453B2 (en) 2016-11-29
AU2007202271A1 (en) 2007-12-06
CA2589569A1 (en) 2007-11-22
US20060258956A1 (en) 2006-11-16
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EP1859742A1 (en) 2007-11-28
AU2007202271B2 (en) 2012-08-02

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