PREPARING AND MAPPING A TUBE-SHAPED STRUCTURE

Abstract

In order to improve the detectability of a structure that is tube-shaped in an imaging method, a method for preparing the structure is specified. A first channel is formed inside an inner wall of an auxiliary device, and a second channel is formed between the inner wall and an outer wall. A first fluid that contains a material for contrast amplification is poured into the structure via the first channel. The first channel is then closed by a swelling element of the auxiliary device being enlarged by pouring a second fluid into the second channel.

Claims

1. A method for preparing a structure that is tube-shaped before an imaging method, wherein an auxiliary device has previously been introduced into the structure, the method comprising: forming a first channel within an inner wall of the auxiliary device and forming a second channel between the inner and an outer wall of the auxiliary device; pouring a first fluid, which contains a material for contrast enhancement, into the structure through the first channel; and closing the first channel, the closing of the first channel comprising enlarging a swelling element of the auxiliary device, the enlarging of the swelling element comprising pouring a second fluid into the second channel.

2. The method of claim 1, wherein a liquid or gaseous contrast agent, a fluorogenic material, or a salt solution is used as the material for contrast enhancement.

3. The method of claim 1, wherein the structure is closed through enlarging the swelling element by pouring the second fluid into the second channel such that the outer wall of the auxiliary device fits against an inner wall of the structure.

4. The method of claim 3, wherein closing the structure prevents the first fluid from flowing from one closed part of the structure into another part of the structure.

5. The method of claim 1, wherein at least one bronchus, at least one bronchiole, or at least one bronchus and at least one bronchiole are prepared by the method.

6. A method for mapping a tube-shaped structure, wherein an auxiliary device has previously been introduced into the tube-shaped structure, the method comprising: preparing the tube-shaped structure before an imaging method, the preparing of the tube-shaped structure comprising: forming a first channel within an inner wall of the auxiliary device and forming a second channel between the inner and an outer wall of the auxiliary device; pouring a first fluid, which contains a material for contrast enhancement, into the tube-shaped structure through the first channel; and closing the first channel, the closing of the first channel comprising enlarging a swelling element of the auxiliary device, the enlarging of the swelling element comprising pouring a second fluid into the second channel; and performing the imaging method for mapping the tube-shaped structure using the contrast enhancement by the material of the first fluid.

7. The method of claim 6, further comprising at least partially removing the first fluid from the tube-shaped structure via the first channel after carrying out the imaging method.

8. The method of claim 6, wherein the imaging method comprises a computer tomography method, a cone beam computer tomography method, a fluorescence-based computer tomography method, a digital subtraction angiography method, or a magnetic resonance tomography method.

9. An auxiliary device for preparing at least one tube-shaped structure before an imaging method, wherein the auxiliary device has an inner wall, an outer wall, and a first channel formed within the inner wall, the auxiliary device comprising: a second channel formed between the inner wall and the outer wall, wherein a first fluid is pourable into the first channel when the auxiliary device has been introduced into the at least one tube-shaped structure; and a swelling element that is enlargeable when a second fluid is poured into the second channel, wherein the first channel is closeable by enlarging the swelling element.

10. The auxiliary device of claim 9, wherein the swelling element includes a Fogarty balloon.

11. The auxiliary device of claim 9, further comprising an expandable membrane that is fastened to the inner wall and the outer wall such that a balloon is formed as the swelling element.

12. The auxiliary device of claim 9, further comprising a pump configured to: pump the first fluid for pouring into the first channel; pump the second fluid for pouring into the second channel; or pump the first fluid for pouring into the first channel and pump the second fluid for pouring into the second channel.

13. The auxiliary device of claim 9, further comprising a pump configured to at least partially remove the first fluid from the tube-shaped structure via the first channel.

14. A system for mapping at least one tube-shaped structure, the system comprising: a device for carrying out an imaging method; and an auxiliary device for preparing the at least one tube-shaped structure before the imaging method, wherein the auxiliary device has an inner wall, an outer wall, and a first channel formed within the inner wall, the auxiliary device comprising: a second channel formed between the inner wall and the outer wall, wherein a first fluid is pourable into the first channel when the auxiliary device has been introduced into the at least one tube-shaped structure; and a swelling element that is enlargeable when a second fluid is poured into the second channel, wherein the first channel is closeable by enlarging the swelling element.

15. The system of claim 14, wherein the swelling element includes a Fogarty balloon.

16. The system of claim 14, wherein the auxiliary device further comprises an expandable membrane that is fastened to the inner wall and the outer wall such that a balloon is formed as the swelling element.

17. The system of claim 14, wherein the auxiliary device further comprises a pump configured to: pump the first fluid for pouring into the first channel; pump the second fluid for pouring into the second channel; or pump the first fluid for pouring into the first channel and pump the second fluid for pouring into the second channel.

18. The system of claim 14, wherein the auxiliary device further comprises a pump configured to at least partially remove the first fluid from the tube-shaped structure via the first channel.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0074] In the figures, same or functionally same elements are provided with the same reference symbols.

[0075] The description of same or functionally same elements is, if appropriate, not necessarily repeated in different figures. The diagrams show:

[0076] FIG. 1 is a diagrammatic view of an exemplary embodiment of an auxiliary device;

[0077] FIG. 2 is a diagrammatic view of a further exemplary embodiment of an auxiliary device for use in a method for preparing at least one tube-shaped structure; and

[0078] FIG. 3 is a diagrammatic view of an exemplary embodiment of a system for mapping at least one tube-shaped structure.

DETAILED DESCRIPTION

[0079] FIG. 1 shows a diagrammatic view (e.g., a longitudinal section) of an exemplary embodiment of an auxiliary device H for preparing at least one tube-shaped structure before an imaging method according to one or more of the present embodiments.

[0080] The auxiliary device H is, for example, tube-shaped, pipe-shaped, or channel-shaped and, for example, double-walled. For example, the auxiliary device H has an outer wall WA and an inner wall WI. The outer wall and the inner wall may each contain a pipe-shaped material (e.g., plastic material) that is, for example, a flexible or deformable material.

[0081] The inner wall WI forms a first channel K1 of the auxiliary device H inside the inner wall WI. An area between the inner wall WI and the outer wall WA is, for example, empty. As a result, a second channel K2 is formed between the inner wall and the outer wall WI, WA. A first opening O1 of the inner channel WI and the auxiliary device H are located at a first end of the auxiliary device H. A second opening O2 of the inner channel WI and the auxiliary device H is located at an opposite end of the auxiliary device H.

[0082] The auxiliary device H also has a swelling element SE. The swelling element SE includes, for example, an expandable membrane M that is attached and fastened to the inner wall WI and the outer wall WA such that a balloon (e.g., an annular balloon) is formed.

[0083] The membrane M is, for example, configured as an annular strip. A first edge (e.g., a circular edge) of the membrane M faces the first opening O1 and, for example, is fastened (e.g., in a fluid-impermeable manner) to the outer wall WA. On a second edge opposite the first edge (e.g., an annular edge), the membrane M is fastened (e.g., in a fluid-impermeable manner) to the inner wall WI. The attachment of the membrane M to the inner wall WI is, for example, at a location closer to the second opening O2 than an attachment point of the membrane M to the first wall WI. For example, the second edge of the membrane M faces the second opening O2.

[0084] In an area between the attachment points of the membrane M to the inner and the outer wall WI, WA, the outer wall WA and the second channel K2 are continued through the membrane M. In other words, the membrane M forms part of the outer wall WA in this area. For example, the auxiliary device H does not have an outer wall in an area between the second opening O2 and the attachment point of the membrane M to the inner wall WI, apart from the membrane M, and is therefore, for example, not double-walled, except for the membrane M.

[0085] The swelling body SE thus forms a balloon that may be enlarged (e.g., inflated) by pouring a second fluid into the second channel K2. As a result, the annular balloon is enlarged outwards and inwards. For example, with sufficient enlargement, the first channel K1 may be completely closed, as indicated by dashed lines.

[0086] FIG. 2 shows an exemplary embodiment of an auxiliary device H (e.g., the auxiliary device H from FIG. 1) in use (e.g., in the preparation of a tube-shaped structure S) according to an exemplary embodiment of a method.

[0087] The tube-shaped structure S may be, for example, part of a bronchial system of a human being. The bronchial system may have, for example, a first bronchus B1, a second bronchus B2 branching therefrom, and a bronchus B3 branching off from the first bronchus B1 at another location.

[0088] The structure of the bronchus or the bronchial system or the tube-shaped structure shown is not meant to be restrictive and is purely for illustrative purposes.

[0089] Before the start of the method for preparation, the auxiliary device H was already introduced into the tube-shaped structure S. This may have been done, for example, in order to be able to perform a method for preparing or mapping the tube-shaped structure S according to one or more of the present embodiments during intraoperative imaging and/or to be able to introduce a tool (e.g., a bronchoscope) through the auxiliary device H into the bronchial system.

[0090] The swelling body SE of the auxiliary device H is positioned by introduction into the tube-shaped structure S, for example, such that the swelling body SE is located at a level between a branch of the bronchus B3 and a branch of the bronchus B2 from the bronchus B1.

[0091] After the auxiliary device H has been introduced into the tube-shaped structure S, a first fluid F1 (e.g., a liquid contrast agent or a salt solution) is poured into the tube-shaped structure S via the first channel of the auxiliary device H when the swelling element is not or not substantially enlarged (e.g., when the balloon was not inflated), which is illustrated by hatching in Figure. 2. As a result, both areas of the bronchus B1 below the swelling element SE and the bronchus B3 or parts of the bronchus B3 are filled with the first fluid.

[0092] After the introduction of the first fluid F1, a second fluid F2 is poured into the balloon via the second channel of the auxiliary device H. As a result, the balloon is enlarged to such an extent that opposite parts of the inner wall WI are pressed together so that the first channel is closed; further, the membrane M is pressed against an inner wall of the structure WS so that the membrane M fits closely against the inner wall WS.

[0093] As a result of the enlargement of the swelling element SE, the part of the bronchus B1 and of the bronchus B3 filled by the first fluid F1 is consequently separated from other parts of the bronchus B1 and, for example, from the bronchus B2. The corresponding part in the tube-shaped structure S is therefore closed.

[0094] In the state shown in FIG. 2, for example, an imaging method (e.g., computer tomography, cone beam computer tomography, or fluorescence-assisted computed tomography) may be carried out in order to obtain an image of the tube-shaped structure S in the areas filled by the first fluid F1. The first fluid F1, the contrast agent, or the salt solution leads to enhanced contrasts in a result of the imaging method.

[0095] For this purpose, contrast enhancement by a liquid contrast agent (e.g., a standard contrast agent used in imaging methods) may be particularly high (e.g., higher than in the case of a salt solution). In the case of a salt solution, an advantage may be that the salt solution is harmless to the health of the patient. The corresponding advantages and disadvantages may be balanced with respect to one another according to the present embodiments.

[0096] FIG. 3 shows a diagrammatic view of one embodiment of a system.

[0097] The system includes an auxiliary device H and a device V for carrying out an imaging method. The device V may be, for example, a computer tomography device or a magnetic resonance tomography device.

[0098] The system optionally includes a pump unit P (e.g., a pump) and an optional connection device A. The pump unit P may be fastened to the first opening O1 of the auxiliary device H by the connection device A. For example, the connection device A may be configured such that the first fluid may be pumped or poured into the first channel of the auxiliary device H and thus into the tube-shaped structure by the pump unit P. Alternatively or additionally, after carrying out the imaging method, the first fluid may be removed at least partially by the pump unit P via the first channel from the tube-shaped structure (e.g., drained or aspirated).

[0099] After performing the imaging method, the swelling element (e.g., the balloon) may be vented or deflated to cancel the closure of the first channel and the tube-shaped structure S. Thereafter, for example, the first fluid may be removed completely or partially via the first channel (e.g., drained).

[0100] According to one or more of the present embodiments, using, for example, an auxiliary device or a method according to one or more of the present embodiments, the visibility (e.g., of small tube-shaped structures; of peripheral bronchi or bronchioles) may be improved or even enabled in an imaging method. This may considerably simplify contrast-enhanced navigation (e.g., during an operation).

[0101] The improved concept enables real-time recording by the imaging method during the operation. Changes that occur shortly before or during the operation may thus be taken into account. In addition, the influence of possibly limited resolution in imaging methods is of less importance.

[0102] Various embodiments of the auxiliary device and the method use the first channel as a working channel by which, for example, tools such as, for example, a bronchoscope, to which an inflatable or fillable balloon is fastened, may be introduced into the structure. When the balloon is filled, an outer side of the balloon is placed against the tissue or the interior of the tube-shaped structure, while an inner side of the balloon closes the working channel.

[0103] For example, according to the present embodiments, structures such as airways of the lungs, which in conventional approaches, are too small to be visible in an imaging process, may still be mapped. The airways are only made visible in accordance with the present embodiments. The airways may, for example, also be segmented as part of the imaging method and used for further processing.

[0104] Another advantage of one or more of the present embodiments is that during an operation a doctor may more quickly ascertain along which airways the doctor is to navigate the bronchoscope or other tool as a result of the improved detectability.

[0105] The elements and features recited in the appended claims may be combined in different ways to produce new claims that likewise fall within the scope of the present invention. Thus, whereas the dependent claims appended below depend from only a single independent or dependent claim, it is to be understood that these dependent claims may, alternatively, be made to depend in the alternative from any preceding or following claim, whether independent or dependent. Such new combinations are to be understood as forming a part of the present specification.

[0106] While the present invention has been described above by reference to various embodiments, it should be understood that many changes and modifications can be made to the described embodiments. It is therefore intended that the foregoing description be regarded as illustrative rather than limiting, and that it be understood that all equivalents and/or combinations of embodiments are intended to be included in this description.