DE102009055743A1 - MRI-training-and adjustment-device for positioning head of medical tool in living tissue for treatment of breast cancer of female patient, has frame with opening blocked by rail, where base plate, frame and rail are invisible in MRI - Google Patents

Abstract

The device has a phantom (15) containing target bodies (21) in an inner space, and a base plate attached below an MRI coil for living tissue to be examined. The base plate carries an attachment block (44) that is linear slidable opposite the tissue. The phantom and/or a tissue pressing frame (12) is detachably attached at the attachment block. The pressing frame has an opening that is blocked by an elongated pressing rail (13). The base plate, attachment block, tissue pressing frame and the pressing rail are invisible in the MRI. An independent claim is also included for a method for training hitting of an anomaly in living tissue.

Description

The The invention relates to an MRI training and adjustment device for positioning the tip of a medical tool in living tissue, consisting of a phantom in its interior Contains target body, which are imaging in the MRI and its remaining components are invisible on the MRI.

When Imaging procedures for a non-infringing investigation The interior of living beings have been around for about a century X-ray machines are known in principle. Because of her radioactive contamination were ultrasound-assisted, about three decades ago, Imaging procedures were introduced. The youngest Method is the magnetic resonance tomography, also magnetic resonance imaging, Nuclear magnetic resonance (NMR) tomography or magnetic resonance imaging Called (MRI). Just as the ultrasound procedure damages It does not, however, the living organism, but in contrast can Bone image and is therefore also for complete and large-scale cross-sectional images of the entire body suitable.

Of the body to be examined becomes a strong and homogeneous static magnetic field - the main magnetic field - into it driven, whereby in the body the nuclear spin of atomic nuclei, in particular of hydrogen-atom nuclei bound to water (protons) aligns. High-frequency excitation pulses stimulate these nuclei to a "precession movement". After the decay of such a high-frequency excitation pulse "preceded" the Atomic nuclei with the so-called "Larmor frequency" depending on the strength of the main magnetic field and swing after one tissue-dependent relaxation time again in the preferred direction a, which is given by the main magnetic field.

For Every body layer can be calculated by computational and metrological Analysis of the integral, high-frequency core signals from the distribution the spatial spin density in connection with the relaxation times an image will be generated. The result of the precession movement detectable nuclear magnetic resonance signal can be linear through the application Field gradients are assigned to the place of its formation. To corresponding gradient fields are superimposed on the main magnetic field and controlled so that only in a layer to be imaged the cores be stimulated. Both for RF excitation of the nuclear spins as well as for Detection of the response signals of the cores requires an RF coil.

So can z. B. to a female breast, the prone position of the patient hangs down, a breast coil to be laid around. Then abnormalities in the tissue, such as. As cancerous tumors, already be recognized when they are still very small.

With The MRI device can be diagnosed for abnormalities are present and at which position they are. The MRI device allows this diagnosis without any injury to the patient - what is a very important asset. If, however, anomalies have been detected are, then a physical access is required there.

Around to assess whether they are cancerous or other anomalies, It is a very safe method to extract tiny tissue sample (Biopsy), which are then laboratory-examined.

Or It should medicate to the site of anomaly as possible be injected exactly, so it must also for the Tip of a medical tool - such. B. one Hollow needle - brought to the location of the detected anomaly become.

The However, piercing this tool is within the MRI device as good as impossible: First, makes the big one Coil of the main magnetic field the mechanical access and the other can not magnetizable because of the strong magnetic field Materials, such. As steel can be used.

Therefore the patient must for the examination and / or treatment be moved out of the MRI device and the medical Position the tool based on the position data just determined become. To train this process and also for that used device to adjust known as "phantoms". These are not or barely visible objects in the MRI image which certain points are marked by matter in the MRI device are clearly visible.

Such a phantom describes the patent DE 10 2005 050 839 B3 , It consists of numerous MRI-visible spherical elements distributed in a uniform grid over the entire volume of the phantom. For orientation, a few of these spatial points visible in the MRI are deviating from the rest.

One such phantom is not quite correct for the correction correctly calculated position data of the MRI device in each Point of the room suitable. Due to the large number of im MRI visible targets, however, it is virtually impossible to exercise with it, like a medical tool with its tip can be directed to a specific point in space, because the way there is blocked by numerous other balls in space is.

The main disadvantage of this phantom however, leaving the user alone with how to arrange and secure the phantom in the MRI device, and how to ensure that after the phantom is moved out of the main magnetic field coil, the phantom is positioned so accurately with respect to the medical tool that the Position values of the point to be achieved in the phantom can also be achieved outside the MRI device in the MRI method.

Also is not described, such as the introduction of the medical tool, So z. As the piercing of a hollow needle, actually expires.

One Another disadvantage of the described phantom is that there is no Help for the planning of puncture site and puncture direction gives.

On this background, the invention has set itself the task a training and adjustment device for positioning to create the tip of a medical tool in living tissue with the on a phantom outside of an MRI device can be practiced, as detected in the MRI device and measured space point exactly and on one as possible reached short distance with the tip of a medical tool can be.

With The training facility will above all be the correct transmission metrologically in the MRI device on a virtual image determined position data on a real existing, medical tool practiced. In addition, the physician can also train, how he used his tool quickly and without errors in the Positioning, so with the least possible burden of the patient into which tissue is introduced.

When Solution teaches the invention that another ingredient the training device is a base plate, which is below a MRI coil for the living tissue to be examined attachable is that at least one, with respect to the tissue linearly displaceable Mounting block carries on which solvable either attachable the phantom and / or a Gewebeandrückrahmen is that has an opening of at least one elongated Andrückschiene is crossed, wherein Base plate, mounting block, fabric pressing frame and Andrückschiene in MRI are invisible.

One An essential feature of the invention is therefore the connection of a Device for mechanical fixation of soft body tissue with a phantom.

These Device consists of a tissue pressure frame, the on tissue, such as. B. a female breast is pressed. This frame is made by at least one Andrückschiene thwarted. Preferably, the opening in the Gewebeandrückrahmen from a grid-like structure of several Andrückschienen evenly filled. The entire fabric pressure frame is mounted on at least one mounting block opposite the base plate is linearly displaceable.

The The function of the tissue pressure frame is exemplified by a female breast will be explained. For this the patient becomes Lie in prone position so that her breasts through each one opening hang around, which is surrounded by each MRI coil. Below these MRI coils and at a distance to it is the base plate attached, which carries the Gewebeandrückrahmen. He can -. B. by a spindle drive - opposite The base plate are moved linearly and that until he on the hanging down chest and compresses them. It makes sense to do so on the fabric press frame opposite side of the breast a corresponding counterpart arranged, which is either fixed or even in opposite directions is shifted to the tissue pressing frame, so that the Gewebeandrückrahmen and its counterpart the breast similar to one Clamp vise.

Thereby the breast is brought into a defined shape, in the eventual Anomalies of the tissue are placed in a specific position. Also Breathing of the patient does not oppose the breast the device "postponed". In case of a whereabouts of the device on the chest, this position is reproducible accessible again.

The Special of the fabric pressing frame is that he is on almost the entire area the access of the medical tool into the living tissue allows. These have the Andrückschienen usually a very narrow profile, perpendicular to the surface is aligned with the living tissue and in this way only one very small proportion of the area blocked.

In In practice, the patient - as mentioned - on placed on the examination table of an MRI device in prone position, with her breasts hanging down by one MRI coil each. Even outside the main coil are the breasts compressed by linear displacement of the Gewebeandrückrahmens something and thereby brought into a defined position. Then the next Step the patient along with the tissue pressure frame and its fastening device moved into the MRI device and examined the breast.

When tissue anomalies are detected, their position is determined by the MRI device and made known to the examining physician. In the next step, the patient will be back moved out of the MRI device, so that the physician can reach the still compressed between the Gewebeandrückrahmen and its counterpart breast.

In In this position he can put his medical tool in the chest Insert so that the tip of the tool the tissue anomaly reached. There he can z. B. take a tissue sample (biopsy) or leave a mark, so that the tissue anomaly for later treatments, such. B. an operation clearly can be identified. A possibility of therapy is it through the medical tool through active ingredients in the area the anomaly.

Around This process for the patient so painless and so short as he possibly can, he can use the MRI training and adjustment device should be thoroughly practiced and the devices for introducing the needle can to be adjusted.

To is used instead of the tissue pressure frame or behind the Tissue pressure frame your so-called "phantom" in a certain position firmly mounted. Inside the phantom are Contain target bodies that are imaging in MRI. The remaining Components of the phantom, such as. B. his walls and his Filling in the MRI are not or only slightly visible, noticeable. Then, in the MRI device, the positions the target body are measured and their spatial coordinates be announced. The next step is the phantom together with its attachment and the base plate in exactly the position in which it has also been measured, from the MRI device drive out and the acting physician can in the next Step into the phantom.

It exercises It is his goal to reach the existing targets exactly just for those of the MRI device available used position data. If the case of the Phantoms and the phantom's filling are transparent, Thus, by inspection, he can see the result of his practice check.

If These exercises are always the same, reproducible Deviations result, it can be derived from a correction value be with whom the leadership of the medical tool must be acted upon.

Around not just the correct "aiming" with the tool to practice, but also a feeling to the physician for introducing the tool into the human tissue to procure, proposes the invention as an embodiment the phantom is a container whose opening the tissue pressing frame facing surface of a thin, elastic and skin-like membrane composed of the medical tool is penetrable. This simulates that the skin usually gives the tool a higher resistance opposite as the inner tissue.

Therefore will the membrane at the first touch through the medical tool does not open immediately, but a withdraw a little. Only when the pressure of the tool so great that the elasticity of the skin is exceeded is, she tears something, creating an inlet for opening the medical tool, through which it passes into the Tissue can penetrate.

In order to also within the phantom the behavior of the medical tool reproduced as accurately as possible when penetrating the tissue The invention proposes that it be low viscous, gelatinous gel or other human Tissue in its mechanical properties and its image close Material is filled. The biggest part this gel - about 80-93% - consists of Water, preservatives, crosslinkers and antibiotics. The remaining 7-20% are substantants (??). Another recipe would be 0.5-3.0 g NiSO4 × 6H2O, and 3.0-7.0 NaCl to one liter of distilled water.

When a meaningful, mechanical embodiment proposes the invention that on the base plate two mounting blocks are arranged at a distance from each other, each by means of a threaded spindle in the direction of the living tissue are displaceable and where attached the phantom and / or the tissue pressure frame can be.

When a possibility for attachment proposes the invention T-shaped grooves in front, in which complementary accordingly molded counterparts that engage the phantom and are integrally formed on the Gewebeandrückrahmen. Alternatively they are also dovetail joints, pins and holes, snap-in connections or screw connections conceivable.

A very useful combination for practicing and adjusting the device is when at the mounting blocks Both the tissue-pressing frame and the phantom are attached are. Then the user finds exactly the same boundary conditions as with the application to a patient.

The combination of tissue pressing frame and phantom is particularly interesting when the removal tool is to be manually inserted and orientation only the jewei lige field in the grid-shaped with horizontal and vertical Andrückschienen filled opening of the fabric frame and the angle of the tool to serve in the horizontal and vertical directions.

But even if the medical tool with a mechanical Tool holder is guided, it makes sense in addition to the phantom also the tissue pressure frame in the MRI training facility to assemble. Then it can be checked if actually no pressure rails hit by the medical tool become.

In order to the tissue pressure frame for both training and Adjustment as well as being usable on the patient, it is suggested that he can be separated from the phantom.

In order to the phantom alternatively directly with the mounting blocks can be connected, it makes sense to the front to form the same fastening devices, which also on the front of the tissue-pressing frame are present. In this case the fabric press frame must be at its back also have T-shaped grooves, the complementary thereto Record the counterpart of the phantom.

As an alternative to manual guidance of the medical tool, the invention proposes a mechanical tool holder. A suitable device is described in the patent DE 196 26 286 C5 described, which is hereby expressly declared part of this application.

in the However, the principle is also adjustable in only three degrees of freedom Holder for the tool conceivable. It would be useful one with respect to the tissue pressure frame horizontal and a subsequent vertical adjustment. Both Adjustments could be performed linearly. The third degree of freedom would be the penetration depth of the medical Tool in the living tissue. With such an adjustment in only three degrees of freedom, all points of the workspace can be reached.

One Problem could arise, however, if the medical Tool meets exactly on a pressure rail. At only low accuracy requirement might be attempted be through the elasticity of the medical tool and the elasticity of the Andrückschiene the medical tool but still past the Andrückschiene in the living tissue to push. However, the positioning accuracy would be suffer appreciably.

Around To avoid this disadvantage and also to a possible short distance from the outer skin of the human tissue to reach the target point, the invention proposes a further degree of freedom. For example, by at least a pivot axis or better still with two pivot axes selected from which direction in the room the medical tool in the living tissue is to be forced into it.

When another variant for the shortest possible Path of the medical tool from the skin to the target point in human tissue, the invention recommends an additional Pivot axis whose geometric center on the longitudinal axis the MRI coil is located.

If as an application example of an approximately hemispherical female Breast is thought to be at a tissue abnormality to be examined is located very close to the surface, then it makes sense, too to pivot this large pivot axis so far that the medical tool approximately perpendicular to the skin surface pushed into the tissue.

When a very interesting embodiment suggests the invention a tool holder of several orthogonal to each other aligned carriage and / or pivoting devices. These sledges and / or these pivoting devices can either manually adjusted and fixed by a clamping screw. alternative They can be moved with one motor each.

Your Each position can have a mechanical scale in it Immediately near the track of a sled be recorded or via electronic position actual value encoders become connected with the movement mechanics. You can z. B. be integrated into the drive motor or a spindle at the other, free end opposite the drive motor be flanged.

The Drive motors can be in a very simple variant be activated by simple buttons, each one only one Specify the speed range and a single direction of rotation. More comfortable are levers that have different speed levels can choose up to a stepless Specification of the speed, similar to the accelerator pedal (Accelerator pedal) of a motor vehicle.

at Such a control of the motors should possibly be present Position actual value transmitter connected in each case to a position actual value display become. Depending on the actual position value display Units used can be very quickly that of the MRI device specified position setpoint with the actually achieved Position actual value can be compared.

A Alternative is it, both the motors and the position actual value transmitter electrically connect to an electronic control. In a very simple case, all position setpoints for the respective Drive motors with the exception of the penetration specified. In the first Step, the thus fixed point of space is still outside of the tissue or outside the phantom approached. First when this point is reached and only the tool in the Tissue must be driven in the second step of the respective Drive activated to the tool exactly in the required depth to push.

For the arrangement of the target body in the interior of the phantom proposes the invention as a simple and clear Arrangement of a phantom body with several staircase-like Steps ahead. In each step a depression is formed, which ever receives a target body. In the simple case of a not exactly measured height of the different stages, serve they only for holding each of a target body.

If the exact distance of the steps to each other is known, then after successfully finding a first target body the relative accuracy of the actual position detection of the MRI device being checked. If not only the distance of the steps to each other, So her "chain measure" is known, but even the distance to a reference point of the phantom, so can even the absolute accuracy of the position actual value detection the MRI device will be checked.

A further use of such an accurately measured Phantoms is training accurate positioning without the prior expensive measurement in an MRI device.

When a useful method for training the exact meeting of a with the MRI found anomaly in living tissue the invention that in the first step, the base plate with the attached phantom is mounted below an MRI coil. In the second step, the position of the one contained in the phantom Measure the target body with an MRI device. Then in the third step, the baseplate with the phantom from the MRI coil and the MRI device separately and in the fourth step the medical Tool only on the basis of the position data determined in the second step guided with its tip into a target body. The fifth and last step is the result respectively checked visually through the wall of the phantom and through the gel.

Around to adjust a tool holder proposes the invention that the first three steps of the aforementioned procedure be repeated. The fourth step is the tip of the tool by means of the tool guide under visual control in a target body out. In the fifth Step then becomes the respective reference point and the respective travel path all movement axes of the tool holder detected and to those Positional data put into mathematical relationship with the MRI device have been determined in the second step. In future Examinations of existing, living tissue can be performed on this way determined computational relationship for the implementation the position data obtained with the MRI device into position setpoints be used for the axes of movement of the tool holder.

Around the manual tool guide for meeting a already anticipated with the MRI anomaly found in living tissue to practice on a phantom, the invention recommends a Cycle, the first four steps of which previously explained Sequence correspond. In the fifth step, the respective Quadrant between the nearest vertical and horizontal Andrückschienen the tissue pressure frame as well the angles of attack of the tool in two levels and recorded to those Positional data put into mathematical relationship with the MRI device previously determined in the second step. In future Investigations on real existing, living tissue can the computational relationships thus determined for the implementation of the position data determined with the MRI device in a correct manual guidance of the medical tool be used meaningfully.

in the Following are further details and features of the invention will be explained in more detail with reference to two examples. These are not intended to limit the invention, but just explain. It shows in a schematic representation:

1 Oblique image of an MRI training device with device pressure frame and phantom from the tool side

2 MRI training device like 1 , but side view

3 Horizontal section through an MRI exerciser like 1 and 2 , but with a different phantom with inserted staircase-like phantom body

In 1 perspective view of the tool side of an MRI training device is shown. In the center of the picture is the tissue pressure frame 12 to see, which has a large opening, through which several horizontal Andruckschienen 13 most of them are drawings and have a look at the phantom 15 free, that instead of the human tissue to the back of the tissue-pressing frame 12 is scheduled.

Not shown in figure that the phantom 15 during normal operation of the MRI training device in an MRI device is removed and the remaining, drawn arrangement is used directly below an MRI coil of the MRI device. Then z. B. by the MRI coil sagging, female breasts are brought for a diagnosis of tissue abnormalities in a precise measurable position by the Andrückrahmen 12 by means of the two threaded spindles 05 and 06 As far as the breast is moved until it rests on the entire surface, bringing the breast in a well-defined shape and position. The fabric press frame has this 12 in its large opening over numerous Andrückschienen 13 ,

Then the MRI device can detect abnormalities such as: As cancerous tumors are sought and the position of detected tumors are accurately measured. Such cancerous tumors correspond in the phantom 15 the target body 21 ,

The position data of the discovered tumors or the target body are read by the MRI device. Then there must be the tip of the medical tool 1 be guided.

In the simplest - in 1 not shown, but well understood - case of manual insertion of the medical tool 1 in the living tissue, the Andrückschienen 13 also serve as a condition or at least as a guide.

In most cases, this is the medical tool 1 a hollow needle that is pricked into human tissue. This puncture must be performed outside the MRI device and therefore without any control. After each puncture, the patient must be driven back into the MRI machine to check the direction and depth of penetration of the medical tool 1 are correct.

Since any errors in this positioning task are extremely painful for the patient, the physician can practice the correct insertion on the MRI training device according to the invention, which is described in US Pat 1 will be shown. For this purpose, instead of the human tissue, the phantom 15 used.

In 1 it can be seen that the phantom 15 in his interior some small target body 21 contains. They are from the gel 18 that is not or almost invisible on MRI. Likewise, in the MRI device are the walls of the phantom 15 invisible, so that the MRI device's target body 21 recognize and measure their position. Also visually are the walls and the gel 18 transparent, so that the result of the target search can always be optically controlled.

In 1 is also comprehensible, as with the training device and the feeling of the physician for the introduction of medi cal tool such. As the piercing with a needle-shaped medical tool 1 into the phantom 15 can be practiced. This is on the front of the phantom 15 a membrane 19 appropriate. It closes the tissue pressure frame 12 pointing opening of the phantom 15 and keeps that inside the phantom 15 gel 18 back. It is for the medical tool 1 penetrable but with a much higher resistance than the gel 18 , In figure is drawn as a medical tool 1 in the membrane 19 entry. It is not shown that this is the membrane 19 First, slightly deformed around the tool until it is slightly cut and the tool 1 through the incision enters. The elastic membrane prevents next to the injection site gel 18 emerges.

The embodiment in 1 shows a multi-adjustable tool holder for the medical tool 1 , It rests on the tool carrier plate 02 , which at each end at a footbridge 07 and 08 is attached. These bridges 07 . 08 are over tenons 09 . 10 with the fixing blocks 44 and 45 connected. These mounting blocks 44 . 45 in turn carry the tissue-pressing frame 12 ,

In the embodiment shown is on the tool carrier plate 02 a horizontal slide 03 to the left (L) and to the right (R) displaceable. In 1 it is good to see that the horizontal slide 03 at a mark on the front of the tool carrier plate 02 driving along. Its actual position value can be read off by a scale. Through in the middle of the horizontal slide 03 recognizable Randelschraube can the position of the horizontal slide 03 be fixed.

Similarly, on the horizontal carriage 03 the vertical slide 01 built, which takes over the movement of the medical tool in the vertical direction.

In addition, in the in 1 shown embodiment, the inclination of the medical tool by an unspecified, on the right edge of the depth slide 04 arranged pivot axis can be changed.

On top of the vertical slide 01 is another sled of the depth slide 04 positioned with the medical tool 1 on the membrane 19 can be pushed until the tension of the diaphragm 19 so big that she becomes the medical tool 1 pass through. It moves in the further course then with relatively little resistance through the gel 18 go through it (hopefully) to a target body 21 encounters.

As a result, the tool holder is always in a clear geometric relationship to the target bodies 21 ,

In 1 It is very understandable that a major effect of the MRI training device is that the tool 1 is not inserted into an absolutely opaque part of the body as in practice on living tissue, but over transparent walls of the phantom 15 and thanks to the transparency of the gel 18 , can also be visually accurately tracked, at which point the tip of the medical tool (hollow needle) is currently currently and which way she still has to travel to a target body 21 to hit successfully.

In 1 is in the two mounting blocks 44 and 45 drawn as a possible embodiment, that they each have a T-shaped guide 42 . 43 have, in each of which a complementary part on the Gewebeandrückrahmen 12 intervenes. This allows the tissue-pressing frame 12 from above into the mounting blocks 45 and 44 be inserted there and is well secured there over a longer period of operation.

In 1 it is understandable that instead of the tissue pressure frame 12 also the phantom 15 directly with the mounting blocks 44 . 45 can be connected, if it also has on its front fasteners in the guides 42 and 43 can be inserted.

In 2 is the same arrangement as in 1 shown in perspective from the side. Good to see is that in this embodiment, the phantom 15 consists of a cuboid housing, which are formed at its edges by a frame and whose surfaces are each transparent, so that they look at the target body 21 release. These are in an unspecified position within the also transparent gel 18 that fills the interior of the phantom.

In 2 it becomes clear that the cuboid phantom 15 with its front at the back of the fabric press frame 12 is attached.

2 makes it clear that the entire assembly of phantom 15 and tissue pressure frame 12 and the mounting blocks 44 and 45 as well as the attached webs 07 and 08 together with the attached tool holder over the mounting blocks 45 and 44 at one end in each case a threaded spindle 05 and 06 are attached. By turning the threaded spindles, the entire assembly relative to the base plate 30 be moved.

This shift is not relevant to training practice, but is the critical feature for using the MRI exerciser with the phantom removed 15 , Then by turning the two threaded spindles 05 and 06 the tissue pressing frame is pressed against the living tissue to be examined.

In 3 is a horizontal section through the same mechanical arrangement as in the 1 and 2 but with a slightly different phantom 15 in its interior, directly opposite the membrane 19 a phantom body 23 wearing. This phantom body 23 has the staircase-like steps 24 to 28 on, which are each removed by the same amount from its two neighbors in the illustrated embodiment. On each of the five levels 24 to 28 is ever a depression 54 mounted, in the illustrated embodiment hemispherical. This is a - not shown here - target body 21 placed.

If the exact distances of the steps 24 to 28 from the membrane 19 known and also the other coordinates of the sinkhole 54 , then it's in 3 comprehensible, as with such a configured MRI training device without the use of the costly previous measurement of the target body 21 by an MRI device the targeted piercing of the medical tool can be practiced.

Instead of the actual position values from the MRI device, the known positions of the depressions are used 54 worked. The result can be optically controlled in a simple manner.

Looking at 3 is easy to understand that the here in each case the same height subsidence 54 can be arranged in different positions vertically to the cutting plane, which makes the training more interesting and realistic. In 3 are for the sake of clarity, all five depressions 54 drawn at the same height.

01

vertical slide

02

Tool carrier plate

03

horizontal slide

04

deep slide

05

Threaded spindle, right for mounting block 44

06

Threaded spindle, left for mounting block 45

07

Dock, right; to mounting block 44 with cones 10 fixed

08

Dock, left; to mounting block 45 with cones 9 fixed

09, 10

Spigot, connection of the webs 07 . 08 with the fixing blocks 44 . 45

1

medical tool, grasps by tissue pressing frame 12 through into living tissue or into the phantom 15 one

12

Gewebeandrückrahmen, Pressurable to living tissue

13

Pressure rail, in opening in the fabric pressure frame 12

15

Phantom, alternative to living tissue at attachment block 44 . 45 or to tissue pressure frame 12 attachable

18

Gel, in the interior of the phantom 15

19

Membrane seals the tissue pressing frame 12 pointing opening of the phantom 15

21

Target body, visible in the MRI

23

Phantom body in the phantom 15

24-28

step-like stage of the phantom body 23

30

Base plate, carries fasteners for threaded spindles 05 . 06

42

Guide, left, to attach the phantom 15 or the tissue-pressing frame 12

43

Leadership, how 42 but right

44

Fortification block, right, wears phantom 15 or tissue pressure frame 12

45

Mounting block, like 44 but left,

54

Depression in steps 24 - 28 for target body 21

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - DE 102005050839 B3 [0011]
• - DE 19626286 C5 [0041]

Claims (14)

MRI training and adjustment device for positioning the tip of a medical tool ( 1 ) in living tissue, consisting of - a phantom ( 15 ), - in its interior target body ( 21 ), which are MRI-imaging and whose remaining components are invisible in the MRI, characterized in that a further component of the training device is a baseplate ( 30 ), which can be fastened beneath an MRI coil for the living tissue to be examined, and the at least one fastening block which can be displaced linearly relative to the tissue ( 44 . 45 ), on which solvable - either the phantom ( 15 ) and / or - a tissue pressure frame ( 12 ) is fastened, which has an opening which is formed by at least one elongate pressure rail ( 13 ) is crossed, wherein base plate ( 30 ), Mounting block ( 44 . 45 ), Tissue pressure frame ( 12 ) and pressure rail ( 13 ) are invisible in the MRI. MRI training device according to claim 1, characterized in that the phantom ( 15 ) is a container, the opening of the Gewebeandrückrahmens ( 12 ) facing surface of an elastic, skin-like membrane ( 19 ) of the medical tool ( 1 ) is penetrable. MRI training device according to claim 2, characterized in that the phantom ( 15 ) with a low-viscosity, gelatinous gel ( 18 ), such. Example, a mixture of 7-20% substanceatine, 80-93% water, preservatives, crosslinkers and antibiotics or another, the human tissue in its mechanical properties and in his image in MRI material coming close is filled. MRI training device according to one of the preceding claims, characterized in that on the base plate ( 30 ) two mounting blocks ( 44 . 45 ) are arranged spaced from each other, - by means of a respective threaded spindle ( 05 . 06 ) are displaceable in the direction of the living tissue and - at which by means of one guide ( 42 . 43 ) the Phantom ( 15 ) or the tissue pressure frame ( 12 ) are fastened. MRI training device according to one of the preceding claims, characterized in that the phantom ( 15 ) with the tissue pressure frame ( 12 ) connected to the guides ( 42 . 43 ) of the mounting blocks ( 44 . 45 ) is inserted. MRI training device according to one of the preceding claims, characterized in that the base plate ( 30 ) a, in at least three spatial degrees of freedom adjustable tool holder for the medical tool ( 1 ) wearing. MRI training device according to claim 6, characterized characterized in that the tool holder over several - orthogonal aligned carriage and / or - Swing devices adjustable is. MRI training device according to claim 7, characterized characterized in that the carriages and / or the pivoting devices - manually adjustable and fixed by a respective clamping screw or - With one motor each movable and - via a mechanical Scale the respective actual position value is readable or - ever an electronic Positionistwertgeber is attached. MRI training device according to claim 8, characterized marked that - the motors at the push of a button are movable and / or - the position actual value encoders are connected to a position actual value display and / or - Engines and position feedback are connected to a controller. MRI training device according to one of the preceding claims, characterized in that in the interior of the phantom ( 15 ) a phantom body ( 23 ) with step-like steps ( 24 . 25 . 26 . 27 ), wherein in each step a depression ( 54 ), each having a target body ( 21 ). MRI training device according to claim 10, characterized in that the depression ( 54 ) is spherical segment. Method for training the meeting of an MRI anomaly in living tissue with a medical tool according to one of the preceding claims, characterized in that - in the first step, the base plate ( 30 ) with the phantom attached to it ( 15 ) is attached below an MRI coil and - in the second step, the position of the phantom ( 15 ) contained target body ( 21 ) is measured with an MRI device and - in the third step, the base plate ( 30 ) with the phantom ( 15 ) from the MRI coil and the MRI-Ge is separated and - in the fourth step, the medical tool ( 1 ) only on the basis of the position data determined in the second step with its tip in a target body ( 21 ) and, in the fifth step, the result visually through the wall of the phantom and through the gel ( 18 ) is controlled through. Method for adjusting the tool holder of a medical tool for meeting an anomaly in living tissue found with the MRI according to claim 12, characterized in that the sequence from the first to the third step corresponds to claim 12 and - in the fourth step, the tip of the tool ( 1 ) by means of the tool guide under visual control into a target body ( 21 ) and - in the fifth step, the respective reference point and the respective travel path of all movement axes of the tool holder are recorded and put into mathematical relation to those position data which have been determined with the MRI device in the second step and - in future examinations on real existing ones living tissue, the computational relationship determined in this way for the implementation of the position data obtained with the MRI device are used in position target values for the movement axes of the tool holder. A method for training the manual tool guide of a medical tool for meeting an MRI-found anomaly in living tissue according to claim 13, characterized in that the sequence from the first to the fourth step corresponds to claim 13 and - in the fifth step of the respective quadrant between the nearest pressing rails of the fabric pressing frame and the angles of attack of the tool ( 1 ) are recorded in two levels and put into mathematical relation to those position data which have been determined with the MRI device in the second step and - in future investigations on actually existing, living tissue, the computational relationship thus determined for the implementation of The MRI device determined position data are used in the manual guidance of the medical tool.