DE3205915A1 - Device for puncturing intracorporeal organs - Google Patents

Abstract

The invention relates to a device for puncturing intracorporeal organs comprising a puncture cannula absorbing radiated energy, a circular arc with graduation and needle and cannula holding device runners movable along this circular arc and with a centre of rotation of the needle holding device on the runners, the deviation, in degrees, of the needle direction from the vertical axis of the needle holder directed toward the centre of the circle being adjustable and readable, the deviation, in degrees, being readable or calculable from the computed tomogram and the circular arc which includes an examination table being mounted concentrically relative to the recording apparatus.

Description

Device for puncturing

internal organs The invention relates to a Device for puncturing internal organs, vessels or the like, in particular with the help of computed tomography, angiography, sonography, including Shock waves, nuclear magnetic resonance, electromagnetic waves, in particular Microwaves, or the like, a biopsy needle tip locator.

It is known to puncture using suitable puncture cannulas perform and tissue or body fluids from internal organs, e.g.

Liver or kidneys taken for diagnostic or other purposes. Likewise, for the purpose of a nerve block, high-percentage alcohol can also be poured into the To be brought near a nerve, which has a therapeutic elimination of the same evokes.

Furthermore, instead of the puncture cannula or through the puncture cannula Electrodes or thin catheters are inserted.

In all of these cases it is extremely important to know the exact location to know the puncture cannula in relation to the organs or vessels to be punctured, to avoid unnecessary injuries to areas at risk, e.g.

to prevent larger blood vessels or nerves and also an erroneous one Tissue removal from undesired areas of the body as well as incorrect injections in a Avoid injection.

DE-OS 24 43 558 describes a device for puncturing internal organs, vessels or the like using an ultrasound well reflecting pnction cannula and an ultrasonic echo cross-sectional image scanning system for area-wise ultrasound scanning of the punctured Body area and a viewing device for making the echo sectional images visible, wherein on the viewing device an aiming aid for aiming at any puncture point in the echo sectional image and on the ultrasound applicator at least one on the target direction of the aiming aid Adjustable guide for inserting the puncture cannula into the puncture Body area is provided.

In the literature there is a computer tomographically targeted needle puncture described (P. Vock, Radiologe, 19 (1979), 182-186, "Computertomographisch targeted Needle puncture11), but even with proven correct localization the needle a single fine needle puncture very often a negative cytological one Result and thus generally 3-5 punctures are required, with a hit rate of 60-85% is achieved.

Computed tomography controlled biopsies with reduced radiation exposure Bolus injection technique is also described (John R. Haaga, AJR 133, October 1979, pages 633-641, "New Techniques for OT-guided Biopsies").

Additional biopsies using computed tomography are described (John R. Haaga, Ralph J. Alfidi, Radiology, 118 (March 1976) pp. 603-607, "Precise Biopsy Localization by Computed Tomography, John R. Haaga et al, Radiologic Clinics of North America, Volume XV, No. 3, December 1977, pp. 449-456, "Interventional OT Scanningtl).

The use of ultrasound is also mentioned in the literature (J. Triller, Radiologist 19 (1979), Pages 173-181, ~ Ultrasound Targeted Abdominal Punctures ").

These known methods have the disadvantages that they are insufficient are precise and require multiple samples to be taken (e.g. P. Vock, Loc. cit.

Page 184, column 1) and by observing the biopsy process bring about a longer lasting energy input into the body tissues.

Another disadvantage with freehand punctures is the necessity multiple punctures and possibly multiple recordings to represent the Needle in full line and especially the tip of the needle.

In contrast, the present invention is based on the object of a To deliver a device for puncturing internal organs or the like, with the use of which a precise localization of the biopsy needle tip is possible, with low radiation exposure or with low energy exposure of the Body.

According to the invention, this object is achieved with a device of the above-mentioned type mentioned genus in that it consists of an X-ray or other Puncture cannula that absorbs energy radiation well, an arc of a circle (1) with graduation and needle or cannula holding device runner movable along this circular arc (4), this needle holding device having a pivot point (3) on the runner, wherein the degree of deviation (# of the direction of the needle from that to the center of the circle (M) aligned vertical axis of the needle holder (2) is adjustable and readable, whereby this degree deviation (# from the computed tomogram, angiogram or the like the rules of geometry can be read or calculated, whereby the Ereisbogén, the an examination table (7) and, if necessary, a patient pad (5) and possibly includes a table holder, exactly concentric to the receiving apparatus is mounted to the arrangement of the body in the circular arc in an identical relative Position as in the recording apparatus.

This results, together with the one from the computed tomogram, angiograrnin or the like needle exactly the puncture point in the body, with only the calibration factor or the scale (reduction factor) between real size and Computed tomogram, angiogram or similar size (e.g. 3: 1) must be taken into account is.

A device of the type mentioned enables the precise definition the puncture route to a destination previously specified on the monitor image. Included the depth of the puncture from the skin surface is shown on the selected layer image to the target location and the puncture angle measured from the horizontal. the Measurement data are transferred to the puncture device and puncture cannula. the the exact position of the puncture cannula is determined on a subsequent layer controlled and documented. The puncture cannula is not in place during the puncture visible. However, this is not absolutely necessary, as the The tip of the cannula must be exactly at the target location.

However, e.g. by adding an ultrasonic head penetration of the needle when wishes without interference Tissue or air overlay can be observed.

A particular embodiment of the present invention is thereby characterized in that the degree of deviation (g) of the direction of the needle from that to the Center of the circle directed vertical axis of the needle holder (2) from the angle (-) between the line from the pivot point (3) to the intended target point and the through the horizontal line running through the target point and the angle (ß) between the line from the fulcrum (3) to the center of the system and the one passing through the center Horizontal is calculable.

Further particular embodiments are characterized in that the degree of deviation (g) of the direction of the needle from the iron perpendicular to the center of the circle Axis of the needle holder (2) can be determined from the coordinates of the target point that a plurality of holding device runners (4) are attached to the circular arc (1), wherein Energy entered by one or more devices and by one or more Devices a position control is carried out that the table bracket is off Feet (6) exist, and that the movable on the arc (1) with graduation Needle or cannula holding device runner (4) can be locked.

In the case of punctuation, deviations can occur because the puncture cannula bends. This can be done by keeping the cannula long enough and avoid using suitable cannulas.

The puncture was so far either under X-ray fluoroscopy, by means of Ultrasound control or under CT control mostly carried out by hand. Many are under fluoroscopy Organs and structures not recognizable and therefore not puncturable. The ultra-sectional image recording-after In contrast, the B-scan only reproduces a small section of the body for computed tomography, which shows a sectional image of the whole body. In order to it is possible to recognize tumors or certain body structures on the monitor image and to measure, using a computer tomograph with an X-ray tube detector unit for extensive X-ray scanning of the area of the body to be punctured and an evaluation console with playback monitor to make the X-ray cross-sectional images visible.

The needle tip holder can be made of contrasting material, so that the angle can be seen on the control image without a remaining needle will.

The system accuracy of the device according to the invention can be checked through a solid, rigid, contrasting tip that has been created by the The circular arc hev is centered on the center point, and the system accuracy remains unchanged can be checked by taking a sample and thus aiming at the center of the circle power.

The needle holder can be different for reasons of apparatus or handling To be long.

The target point, for example a tumor, can with the device according to the invention lie anywhere within the test and puncture field.

The needle holder is shaped like a point and can also be used at the back be angled, which means that it sits directly on the skin, even if it is inclined Surface possible list, the device according to the invention explained in more detail in FIG.

1 denotes the circular arc with scaling, 2 the needle holder with the needle holder pivot point 3, the runner 4, the patient support 5, the feet 6 and the examination table 7.

In FIG. 1, the graduation of the circular arc is also indicated with the horizontal (00), vertical position equal to 9o °, as well as the diameter of the circular arc with e.g. 550 mm and the radius of the circle on which the pivot point is (3) Moved on the carriage with e.g. 210 mm.

The angles measured from the horizontal are also given g r, and the angle that can be calculated from this is calculated as follows: 5 a 1800 ß + γ + (180 - α) = 180 ° B + γ + 180 - α = 180 - α 1800 Blank page

Claims (6)

P a t e n t a n s p r ü c h e 1. Device for puncturing internal parts of the body Organs, vessels or the like, especially with the help of computed tomography, Angiography, ultrasound, sonography, including shock waves, nuclear magnetic Resonance, electromagnetic waves, especially microwaves, or the like, Biopsy needle tip localizer, 1 characterized in that it consists of an X-ray or other energy radiation well absorbing puncture cannula, an arc of a circle (1) with graduation and needle or needle points that can be moved along this arc. Cannula holding device runner (4), this needle holding device has a turntable (3) at the house, where the degree deviation (g) is the direction of the Needle from the vertical axis of the needle holder directed to the center of the circle (M) (2) is adjustable and readable, this degree deviation (g) from the computed tomogram, gangiogram or the like can be read or calculated according to the rules of geometry, # ~ 7 wherein the arc of a circle, an examination table (7) and possibly a Patient pad (5) and, if applicable, a table holder included, exactly is mounted concentrically to the AuSnaheapparatur for the arrangement of the body in the Circular arc in the same relative position as in the recording apparatus. 2. Apparatus according to claim 1, characterized in that the degree deviation (g) the direction of the needle from the perpendicular to the center of the circle Axis of the needle holder (2) from the angle (oi) between the line from the pivot point (3) to the intended target point (Z) and the one passing through the target point (Z) Horizontal and the angle (ß) between the line from the pivot point (3) to the center (M) of the system and the horizontal line running through the center point can be calculated is. 3. Device according to claims 1 and 2, characterized in that that the degree of deviation (g) of the direction of the needle from that to the center of the circle directed vertical axis of the needle holder (2) from the coordinates of the target point is determinable. 4. Device according to claims 1 to 3, characterized in that that on the circular arc (1) several holding device-LäuSer (4) are attached, whereby energy is entered by one or more devices and by one or several devices a position control is carried out. 5. Device according to claims 1 to 4, characterized in that that the table holder consists of feet (6). 6. Device according to claims 1 to 5, characterized in that that the needle or cannula holding device runner movable on the circular arc (1) with graduation R) can be locked.