CN101511276A - 介入置入和成像系统 - Google Patents

介入置入和成像系统 Download PDF

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CN101511276A
CN101511276A CNA2007800031417A CN200780003141A CN101511276A CN 101511276 A CN101511276 A CN 101511276A CN A2007800031417 A CNA2007800031417 A CN A2007800031417A CN 200780003141 A CN200780003141 A CN 200780003141A CN 101511276 A CN101511276 A CN 101511276A
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杰西卡·格罗斯曼
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Abstract

针置入和成像系统，包括护套、成像芯、以及介入芯。该成像芯和介入芯收纳在护套的第一和第二轴向通道中并且所述芯的至少一个在护套之内是可卸且可替换的。成像芯从护套延伸或密封在护套的第一轴向通道之内。介入芯通常从护套远端附近的位置侧向地或轴向前进。

Description

介入置入和成像系统
技术领域
本发明总体涉及医疗设备和方法。更具体地说，本发明涉及用于对护套中的成像芯和介入芯进行可卸式定位的系统以及使用该系统的方法。
背景技术
对女性生殖道功能失调性子宫出血和纤维瘤的治疗仍不能满足临床要求。纤维瘤是子宫肌层(肌肉)的良性肿瘤并且是女性骨盆的最常见肿瘤。高达30％的育龄妇女会感染纤维瘤并且会引起明显的症状，诸如不适、骨盆疼痛、月经过多(过量月经出血)、压迫、贫血、收缩、不育、以及流产。纤维瘤可位于子宫肌层(壁内)，与子宫内膜(粘膜下)相邻或者在子宫外层(浆膜下)中。最常见的纤维瘤是壁内发生的并且直径可长到若干厘米的平滑肌过度生长。
当前对纤维瘤的治疗包括药理治疗和外科介入。药理治疗包括施用药物，如NSAIDS、雌激素-孕酮组合物、以及GnRH类似物。所有药物是相对无效的并且是缓和而不是治愈。子宫切除术(外科切除子宫)是对纤维瘤的另一常见治疗。虽然有效，但是子宫切除有许多不利的副作用，如生育力丧失、需要开腹手术、性机能失调、以及恢复时间长。还存在与子宫切除相关的显著的发病率(败血病、失血、腹膜炎、肠与膀胱损伤)、死亡率、以及花费。切除纤维瘤的外科肌瘤切除术是需要剖腹术和全身麻醉的开腹外科程序。通常这些程序会引起重大失血并且切除了纤维瘤块的一部分。
为了克服与开腹外科程序相关的至少部分问题，在1990年代初首创了腹腔镜肌瘤切除术。然而，腹腔镜肌瘤切除术技术上仍有挑战，需要腹腔镜缝合，其实施仅局限于最熟练的腹腔镜妇科医生。对子宫纤维瘤的其他微创性治疗包括宫腔镜检查、子宫动脉消融、子宫内膜消融、以及肌溶解。
宫腔镜检查利用细纤维光学照相机来使子宫以及损坏组织的附件成像。宫腔镜切除术是利用各种设备(环、滚球、双极电极)以消融或切除子宫组织的外科技术。子宫必须充满液体以更好地观察并且因此具有液体过负荷的潜在副作用。宫腔镜消融受到其可视化技术的限制并且因此仅适合粘膜下和/或突出到子宫腔之中的那些纤维瘤。
子宫动脉栓塞术是在1990年代初引入的并且通过腹股沟切口将小颗粒注入到子宫动脉之中以选择性阻断纤维瘤的血液供给而执行。并发症包括骨盆感染、卵巢早衰、以及严重的骨盆疼痛。此外，长期MRI数据表明了不完全的纤维瘤梗塞会引起梗塞的纤维瘤组织再生长以及症状复发。
子宫内膜消融主要是功能失调性(或者异常)子宫出血的过程并且有时可用于纤维瘤。子宫内膜消融依赖于各种能源，诸如低温能量、微波能量、以及射频能量。子宫内膜消融损坏了子宫内层的子宫内膜组织，但是没有特定地治疗纤维瘤。该技术还不用于将来需要生育的女人。子宫内膜消融仍能极好治疗功能失调性子宫出血，但是其对纤维瘤的治疗能力有限。
肌溶解首次在1980年代执行，利用激光或RF能量结合腹腔镜显示，使组织凝固、蛋白质变性和子宫肌层坏死。腹腔镜肌溶解可以代替肌瘤切除术，因为使纤维瘤凝固并且此后产生凝固性坏死，导致尺寸急剧减小。与所有腹腔镜技术一样，肌溶解受到仅看得见(并因而治疗)浆膜下纤维瘤的事实的限制。
针刺肌溶解使用腹腔镜在视觉控制之下将一个或多个针引入到纤维瘤中。此后在两个相邻针之间传送双极射频(＂RF＂)电流，或者在单个针与附贴于大腿或背部的远距离离散电极之间传送单极电流。针刺肌溶解的目的在于使相当大体积的肿瘤凝固并且因此使它基本上收缩。传统技术利用凝固针来多次穿过肿瘤的不同区域以破坏异常组织的许多圆柱芯。然而，由于粘连形成的危险以及所需的操作时间和熟练技术减少了多次穿过的适宜性，所述粘连形成的危险被认为是随着损伤的子宫浆膜量的增加而增加。
为了克服当前技术的局限性，期望提供一种微创方法以选择性根除子宫之内的纤维瘤。尤其是期望提供一种将成像和消融组合到一个简单手提式单元或者组件中的治疗设备。进一步期望该方法和装置能够以对病人危险和不适最小的安全有效的方式，对子宫中所有类型的纤维瘤进行定位和治疗。更进一步期望该设备可采用多个可互换的组件，既允许设备的选择性杀菌或者再使用又允许该系统对具有不同解剖结构和需要的患者进行个体化配置。更进一步期望这种设备可用在除了子宫之外的解剖结构的其他部分的程序中或者为之所用。通过如下所述的发明可满足至少部分目的。
发明内容
本发明提供了一种针置入和成像系统，该系统可在通常实时的直接目视下将针置入到实质组织之中。通常从天然或人工的体腔或者体腔管内部置入针。示意性的体腔包括子宫、食管、胃、膀胱、结肠等等。示意性的体腔管包括尿管、尿道、输卵管等等。人工体腔包括腹部中的吹注(insufflated)区域、胸腔、关节周围区域(用于关节镜程序)等等。本发明通常没有在血管或者脉管系统的其他区域中的程序中的用途。因此，虽然以下描述具体针对在子宫内进行子宫纤维瘤的检测和治疗的程序，但是本发明的范围并不局限于此。
根据本发明的针置入和成像系统包括护套、成像芯、以及介入芯。护套具有近端、远端、第一轴向通道、以及优选与第一轴向通道分离的第二轴向通道。＂分离＂是指通道通过防止一个通道与另一通道交叉污染的内壁或者屏障而分离。轴向通道通常从近端到远端延伸护套的整个长度，并且可以至少在近端开口，通常是在两端均开口。然而，在有些情况下，通道可能较短和/或可能被塞住或者在一端被密封(通常远端)，使通道的端部与外界环境分离。护套通常是可弯曲的，有时是可偏转或者可转向的，但是在其他情况下沿着其整个或一部分长度可以是刚性的。在有些情况下，远端或者远端附近的至少一部分护套是开放的或者视觉透明的，可从第二轴向通道内成像。例如，至少一部分护套可以由超声半透明材料构成，可允许通过护套的壁进行超声或者光学相干断层(OCT)成像。在其他情况下，第二轴向通道可在其远端开口(例如设有开口端或者孔)以使成像芯前进到护套远端以外。典型地，第二轴向或通道将在其远端开口以使针或者其他介入元件前进穿过。然而，在其他情况下，第二轴向通道可以被可穿透的隔膜或者覆盖物封闭或覆盖。
成像芯可适合医学成像的任何传统形式，诸如超声成像、光学相干断层成像(OCT)、直接光学可视化(例如使用图像传输的光纤或者利用原位电荷耦合器件(CCD)或者用于原位可视化的其它成像元件)等等。成像芯位于第一轴向通道中，通常是可卸式布置以便在护套之内卸除和替换，使得可对成像芯消毒并再次使用。代替可转向的护套或者在可转向的护套之外，成像芯通常是可弯曲的并且在有些情况下是可偏转或可转向的。
介入芯是可更换、可转移、或者固定地配置在第二轴向通道中。在大多数情况下，介入芯通常可从护套前进的或以其他方式置入，以便实现所需的治疗或者诊断程序。在如下所述的特定实施例中，介入芯通常是针，其可在具有开口远端(和/或其他侧开口)的第二轴向通道内往复移动地布置，以置入并穿透到相邻实质组织中。在那些情况下，针可以是射频(RF)电极、微波天线、低温探针、或者用于消融或以其他方式治疗组织的其他能量传送或介导元件。在其它情况下，针可以是用于采样、活检、或以其他方式执行诊断程序、或者用于将治疗剂或药物传送到组织之中的空芯针。
在最通常的实施例中，成像芯是可卸和可替换的，并且治疗芯是不可卸或者至少不可替换地结合在第二通道之内(虽然上面描述了适于往复移动地置入)。在这种情况下，针置入和成像系统可用于治疗或诊断程序并且在该过程完成之后从患者上除去。此后取下可卸式成像芯并消毒。然后通常处理掉护套和介入芯，尽管在其他情况下可能对它们进行消毒并且再次使用。
在其他实施例中，成像芯可固定在第一轴向通道之内，同时介入芯在该护套内是可卸和可替换的。在那些情况下，在程序中已使用了针置入和成像系统之后，从患者取出该系统并且从护套除下介入芯。通常对可卸式介入芯进行杀菌以再次使用，同时处理掉护套与成像芯的组合或者单独杀菌以再次使用。
在更进一步的实施例中，成像芯和介入芯这两者在护套的各自轴向通道之内是可卸且可替换的。在使用了这种针置入和成像系统之后，从各自的轴向通道移走成像芯和介入芯两者。此后由那时的治疗内科医师或者医疗设备来确定对各护套、成像芯、以及介入芯可以处理掉和/或消毒以再次使用。最通常的，至少处理掉护套，同时对成像芯和介入芯的任一个或这两者进行消毒以再次使用。
成像芯和介入芯的几何形状根据针置入和成像系统的预期使用可变化。通常，成像芯适于侧位成像并且可位于第一轴向通道之内用于从护套的侧视。第一轴向通道可以对于外部而言完全封闭，并带有在护套壁中形成的超声、光学、或者其他视觉透明的窗来允许成像芯成像。密封的第一轴向通道的使用通常是优选的，因为它使成像芯与所治疗的或所诊断的体腔或腔管分离开来。或者，可在护套壁之内形成开口窗以允许成像芯成像。更进一步或者，成像芯适于向远端延伸到护套远端处第一轴向通道中的开口以外，以进行成像。在成像芯可向远延伸的情况下，至少成像芯的远端通常适于偏转或转向。
在本发明的进一步其他实施例中，成像芯可适于在向远侧端的方向中成像。与侧向成像实施例一样，护套至少部分由超声或以其他方式视觉透明的材料构成和/或可在护套中形成开口以允许通过那里成像。
在超声成像芯的优选情况下，超声转换器可排列成相控阵列，例如线性(通常轴向对准)相控阵列或环形相控阵列。或者超声成像元件可包括一个或多个独立元件，诸如抛物线形或者其他形状的成像元件。在更进一步实施例中，超声波成像转换器可安排成旋转机构以允许旋转式扫描。
本发明的具体优点是在所治疗或诊断的体腔或管腔之内选择性定位成像芯和介入芯的能力。该定位能力可来自护套、成像芯、和/或较少来自介入芯。在一些实施例中，该护套是可转向的或者可偏转的，通常利用用于使远端选择性偏转的单个或多个张引线。或者，该护套可作为包括多个护套的套件而提供，所述多个护套具有计划用于特定解剖结构和解剖通路的不同远端几何形状。在这种情况下，该系统至少包括第一和第二护套，通常包括第三、第四、第五、或者附加护套，其每一个具有唯一的远端几何形状。
在还有的其他系统中，成像芯本身是可转向的或者可偏转的，同样通常是通过一个或多个牵引线或张引线提供的。这种可转向或者可偏转的成像芯可在护套的第一轴向通道之内置入或者操纵，以便该芯的偏转又使护套的远部偏转。替代地或者另外地，成像芯可置入在护套的远端以外，使得该芯在护套的外部可偏转和重定向。可转向的成像芯的这种置入和作用与刚性的、不可弯结构的护套一起尤其有用，虽然它们也可用于具有转向机构的护套。
介入芯通常包括针或者其他组织穿透元件。通常，该介入芯在其远端或者远端附近具有组织穿透元件，诸如尖锐的远尖端、尖端上的RF切割元件、具有尖锐端的可卸管心针等等。在任何情况下，通常远端适合于它从护套前进时可自穿透到组织中。前进的方向与成像芯的成像野一致，以便医师通常可实时观察到介入芯穿透到组织中。在示例性实施例中，可以看到从护套前进的治疗针进入子宫壁治疗子宫纤维瘤。这种组织穿透元件适于往复通过护套中的侧孔而侧向延伸或者可以适于往复移动通过护套中的远端口以轴向延伸。
附图说明
图1是根据本发明的原理所构造的针置入和成像设备及系统的示例性图示。
图1A是设备沿着图1中的线1A—1A的剖视图。
图2A和2B示出了根据本发明的原理，可转向的成像芯插入到护套中的第一实施例。
图3示出了根据本发明的原理，护套之内不可转向的成像芯的替代实施例。
图4示出了根据本发明的原理，不可转向的护套内不可转向是成像芯的更进一步实施例。
图5A—5C示出了成像芯插入到护套中，在该护套中成像芯和介入芯都从护套的远端轴向延伸。
图6A—6D示出了具有计划用于子宫内治疗的预成形远端的护套。
图7A和7B示出了在其远端附近具有用于置入一对针型介入芯的开口窗的护套的更进一步实施例。
图8A—8C示出了根据本发明的原理，用于将阻塞元件输送到子宫动脉的针置入和成像系统的使用。
图9示出了利用图8A—8C的系统可观察到的图像。
具体实施方式
如图1所示，针置入和成像系统10包括护套12、成像芯14、以及介入芯16。护套12具有远端18、近端20、以及位于近端的手柄结构22。成像芯14还具有远端24、近端26和位于近端的手柄结构28.类似地，介入芯16具有远端30、近端32，并且通常在护套12上具有扳柄34或者其他置入机构以便使针从护套的近端18轴向往复移动。
如图1所示，介入芯16是组织穿透电极，其中远端30典型是尖锐的或以其他方式适于从护套12前进时可穿透或以其他方式进入实质组织。介入芯16可通过连接电缆42与RF电源40相连，所述连接电缆42通过护套12的手柄结构22而连接于介入芯上。开关、脚蹬、或者其他扳柄(未示出)位于RF电源40上或者具有RF电源40，以便按照通常的传统方式通过介入芯16来开始传送RF能量。如RF组织消融领域众所周知的，所提供的射频能量可以是单极的、双极的、或者其组合。另外，如本领域技术人员所众所周知的，芯16可具有用于盐水输注或者＂湿RF＂的管腔或者其他输送工具。
成像芯14典型包括其远端24附近的超声成像转换器或者转换器阵列46。超声转换器或阵列46通过可以与成像芯14的手柄结构28连接的电缆50而与以膝上型计算机形式所说明的图像监控器48相连。应该知道的是，在其他实施例中可将图像监控器48与RF电源40组合到为介入控制和图像监控所提供的单个单元中。
在图1的实施例中，如图1A所示，成像芯14可卸地放在通过护套12延伸的第一轴向通道56中。还如图1A所示，介入芯16布置在通常与护套体12平行形成的第二轴向通道58之内。在图1的实施例中，介入芯16可在第二轴向通道58之内往复移动以从护套12的远端轴向或者侧向延伸。通常，介入芯16的近端不可卸地与扳柄34或者护套的其他前进部件相耦合，因此介入芯不计划成可卸和可替换的。
现在参考图2A和2B，通过使成像芯前进穿过形成于手柄结构22中的托架60，将成像芯14加载到护套12的第一轴向通道56中。当完全插入时，手柄结构28完全收纳到托架60之中，如图2B所示。在该实施例中，第一轴向通道60在护套12之内密封了其整个长度，并且在护套的远端18附近形成了声学透明窗62。如图2A中的箭头66所示，通过旋转手柄结构22上的控制旋钮64，可以使护套12的远端18偏转。在其他实施例中，护套12是刚性的且不可转向。如图2B所示，通过拔出护套12手柄结构22上的扳柄68，可使介入芯16的远端30从护套的远端18前进。利用手柄结构28上的控制旋纽72，可任选偏转成像芯14的远端24，虽然在该图中未示出成像芯的偏转。
虽然通常期望在护套12和成像芯14中的至少一个中提供偏转或者转向能力，但是如图1的实施例所示的任一个或这两个护套和成像芯中，提供这种转向不是必需的。例如，如图3所示，手柄结构22可具有用于偏转护套12远端的控制旋纽64，同时手柄结构28可以没有控制旋钮并且成像芯14可以不可转向。或者，如图4所示。护套12不是可转向的，同时成像芯14是可转向的。在还有的其他实施例中，护套和成像芯均不是可转向的，例如，当护套具有永久偏转的远端或者提供为包括多个护套的套件时，如图6A—6D中所示出且在下面所详细描述。
可按照各种方式实现从护套12和/或在护套12内部置入成像芯14和介入芯16。在图1、2A、以及2B的实施例中，第一通道56密封(通常带有声学透明窗61)，以便成像芯14保持在该通道之内并且决不从该护套伸出。与此相反，最好如图2B所示，介入芯16在侧向上延伸穿过护套12侧面的端口63。
现在参考图5A和5B，本发明的针置入和成像系统的实施例100包括护套12、成像芯14、以及介入芯16，其通常与先前参考图1、2A、以及2B的描述相同，除了远端置入构造之外。如图5A所示，如上所述将成像芯14载入到护套12中，并且与在前实施例的显著不同仅在于护套12不必包括位于其远端的声学或光学透明窗。代之以最好如5B所示，介入芯16的远端30和成像芯14的远端24可延伸穿过护套12远端中的端口。此外，如虚线所示，利用手柄结构28的控制旋钮72，成像芯14的远端24是可偏转的。护套12的远端也是可转向的，并且针置入和成像系统100的实施例可使得通过护套的转向、成像芯的偏转、以及成像芯相对于护套的旋转而接近子宫或者其他体腔内的各种组织表面。
现在参考图6A—6D，护套套件包括多个单独的护套12A、12B、12C、12D、以及任选还有其他护套。每个护套12A—12D的远端具有永久设置在护套中的不同形状。虽然护套体仍可保持一定程度的灵活性，但是它们将具有足够的刚性以便保持预置的形状。如图6A所示，最简单的形状通常是线性的。图6B的护套12B具有平缓的曲线以便于接近子宫的前后。图6C中示出的护套12C的远尖端具有可接近子宫侧壁的通常L形的偏转。最后，图6D的护套12D具有介于护套12B与12C中间的曲线以可接近子宫的宫底。还有其他的几何形状可用于接近并介入子宫及其他体腔和管腔之内。
现在参考图7A和7B，应该知道的是可使用多种针几何形状和护套构造。例如，如图7A所示，护套112可具有其远端118附近的凹口样开口113，以使一个或多个组织穿透针116A和116B相对于接近护套而言前向地和侧向地前进。最好如图7B所示，针116A和116B可穿过护套112而往复移动地收纳在轴向通道158A和158B之内。为成像芯(未示出)提供了附加的轴向通道156，所述成像芯前进穿过护套112并且位于开放的凹口113之内，当针116A和116B置入实质组织中时使针116A和116B成像。
现在参考图8A—8C以及图9，本发明的针置入和成像系统可用于输送物质、能量、或者其他各种介入模式以治疗子宫U的壁中的子宫纤维瘤UF。如图8A所示，中空传送针200在阵列246所提供的超声成像之下，可从护套212的远端前进。针200可置入在用于向子宫纤维瘤F供血的动脉A中，并且将闭塞元件传送到动脉以便阻塞动脉以剥夺纤维瘤的血液。
如图8B和8C所示，针200还可构造成进入如图8B所示与纤维瘤UF相邻的组织之中，或者如图8C所示纤维瘤UF之内。使用这些任何示出构造的针，也可输送各种材料，诸如标记、染料、液体泡、空气泡、固体材料、生物可降解材料等等。如图9所示，可利用超声成像阵列246，可以实时观察针200在视野250内的位置。
虽然上述是对本发明的优选实施例的完整说明，但是可使用各种替换、修改、以及等同体。因此，不应将上述描述作为对所附权利要求所限定的本发明范围的限制。

Claims (43)

1.一种针置入和成像系统，包括：
护套，具有近端、远端、第一轴向通道、以及与第一轴向通道分离的第二轴向通道；
成像芯，位于第一轴向通道中；以及
介入芯，位于第二轴向通道中；
其中该成像芯和介入芯的至少一个在其各自的轴向通道中是可卸和可替换的。
2.如权利要求1所述的系统，其中该成像芯是可卸和可替换的，而治疗芯不可卸地位于第二轴向通道中。
3.如权利要求1所述的系统，其中该介入芯是可卸和可替换的，而成像芯是不可卸地固定于第一轴向通道中。
4.如权利要求1所述的系统，其中该第一轴向通道是对外部密封并且在护套中形成了透明窗以允许通过成像芯成像。
5.如权利要求1所述的系统，其中在护套中形成了开口窗以允许通过成像芯成像。
6.如权利要求1所述的系统，其中该成像芯向远延伸到护套的远端以外以允许通过成像芯成像。
7.如权利要求1所述的系统，其中该成像芯适于远侧前向成像。
8.如权利要求1所述的系统，其中成像芯适于侧向成像。
9.如权利要求1所述的系统，其中该护套具有固定的弯曲远端。
10.如权利要求9所述的系统，其中该远端是弯曲的，以便引导通过宫颈时接近子宫壁上的靶位置。
11.如权利要求10所述的系统，进一步至少包括第二护套，该第二护套具有固定的弯曲远端以接近子宫壁上的第二靶位置。
12.如权利要求1所述的系统，其中该护套具有可选择性偏转的远端。
13.如权利要求12所述的系统，其中该护套包括至少一个牵引线以实现偏转。
14.如权利要求1所述的系统，其中该成像芯包括适于成像的超声转换器。
15.如权利要求14所述的系统，其中该超声转换器包括转换器元件的相控阵列。
16.如权利要求1所述的系统，其中该成像芯可弯曲到至少其远端之上。
17.如权利要求1所述的系统，其中该成像芯具有固定的弯曲的远端。
18.如权利要求1所述的系统，其中该成像芯具有可选择性偏转的远端。
19.如权利要求18所述的系统，其中该成像芯包括至少一个牵引线以实现偏转。
20.如权利要求1所述的系统，其中该介入芯包括组织穿透元件，该组织穿透元件相对于护套可轴向往复移动。
21.如权利要求20所述的系统，其中该组织穿透元件适于通过侧端口往复移动以从护套侧向延伸。
22.如权利要求20所述的系统，其中该组织穿透元件适于通过远端口往复移动以从护套轴向延伸。
23.如权利要求20所述的系统，其中该组织穿透元件包括适于将电流传送到组织的电极。
24.如权利要求20所述的系统，其中该组织穿透元件是适于将物质传送到组织或相关脉管系统的空心针。
25.一种用于治疗子宫纤维瘤的系统，所述系统包括：
护套，具有近端、远端、第一轴向通道、以及与第一轴向通道分离的第二轴向通道，其中该护套适于经阴道导入以将远端位于子宫中；
超声成像芯，在第一轴向通道中是可卸和可替换的，并且当在适当位置时通过护套远端具有视野；以及
针，可往复移动定位于第二轴向通道中，并且具有可位于超声成像芯视野中的远端。
26.如权利要求所述25的系统，其中第一轴向通道是对外部密封的并且在护套中形成声学透明窗以允许成像。
27.如权利要求26所述的系统，其中超声成像芯适于在远侧前向方向上成像并且该声学透明窗位于护套的远端。
28.如权利要求27所述的系统，其中所述针轴向地往复移动。
29.如权利要求26所述的系统，其中该超声成像芯适于侧向成像并且该声学窗是护套侧面上的声学窗。
30.如权利要求29所述的系统，其中所述针侧向地往复移动。
31.如权利要求25所述的系统，其中所述针包括适于将电流传送到组织的电极。
32.如权利要求25所述的系统，其中所述针是适于将物质传送到组织或相关脉管系统的空心针。
33.如权利要求25所述的系统，其中该护套具有固定的弯曲的远端。
34.根据权利要求33的系统，其中该远端被弯曲，以便引导穿过宫颈时接近子宫壁上的靶位置。
35.如权利要求34所述的系统，进一步包括至少第二护套，该第二护套具有固定的弯曲远端以接近该子宫壁上的第二靶位置。
36.如权利要求25所述的系统，其中该护套具有可选择性偏转的远端。
37.如权利要求36所述的系统，其中该护套包括至少一个牵引线以实现偏转。
38.如权利要求25所述的系统，其中该超声成像芯包括相控阵列转换器。
39.如权利要求25所述的系统，其中该超声波成像芯可弯曲到至少其远端之上。
40.如权利要求25所述的系统，其中该超声成像芯具有固定的弯曲的远端。
41.如权利要求25所述的系统，其中该超声成像芯具有可选择性偏转的远端。
42.如权利要求41所述的系统，其中该超声成像芯包括至少一个牵引线以实现偏转。
43.一种用于准备针置入和成像系统的方法，所述方法包括：
(a)提供预先使用的系统，该系统包括：
护套，具有近端、远端、第一轴向通道、以及与第一轴向通道分离的第二轴向通道；
成像芯，位于第一轴向通道中；以及
治疗芯，位于第二轴向通道中；
(b)从护套移走该成像芯与治疗芯中的至少一个；
(c)对所移走的成像或治疗芯消毒；以及
(d)将已消毒的芯替换到未使用无菌护套中。
CNA2007800031417A 2006-01-12 2007-01-10 介入置入和成像系统 Pending CN101511276A (zh)

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EP1971267A4 (en) 2009-12-02
US20160249878A1 (en) 2016-09-01
CA2632841A1 (en) 2007-12-27
US9517047B2 (en) 2016-12-13
WO2007149595A2 (en) 2007-12-27
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WO2007149595A3 (en) 2009-04-16
US9357977B2 (en) 2016-06-07

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