PHOTOACOUSTIC GUIDE SUPPORT SYSTEM AND PHOTOACOUSTIC GUIDE SUPPORT METHOD
20190183458 ยท 2019-06-20
Assignee
Inventors
Cpc classification
A61B8/12
HUMAN NECESSITIES
A61B5/0095
HUMAN NECESSITIES
A61M2025/0293
HUMAN NECESSITIES
A61M2025/0037
HUMAN NECESSITIES
A61M25/0125
HUMAN NECESSITIES
International classification
A61B8/00
HUMAN NECESSITIES
A61B1/313
HUMAN NECESSITIES
A61B8/12
HUMAN NECESSITIES
Abstract
According to one embodiment, a photoacoustic guide support system includes: a wire portion that is used in a catheter and includes an optical fiber provided therein and emitting a measuring laser beam into a blood vessel and a photoacoustic wave detection element which detects a photoacoustic wave generated when a target is irradiated with the measuring laser beam; and a signal processing device that determines whether the wire portion is capable of advancing based on a detection signal obtained when the photoacoustic wave detection element detects the photoacoustic wave. When the detection signal shows a predetermined pattern, the signal processing device determines that the wire portion is capable of advancing forward and displays the determination result to a display device.
Claims
1. A photoacoustic guide support system comprising: a measuring laser beam generator that generates a measuring laser beam; a guide wire that includes an optical fiber for emitting the measuring laser beam to a target, and a detection portion for detecting a photoacoustic wave generated when the target is irradiated with the emitted measuring laser beam; and a signal processing portion that determines whether or not the guide wire is capable of advancing based on a detection signal obtained when the detection portion detects the photoacoustic wave, wherein when the detection signal shows a predetermined pattern, the signal processing portion determines that the guide wire is capable of advancing forward and outputs the determination result to an output portion.
2. The photoacoustic guide support system according to claim 1, wherein the measuring laser beam has an absorption spectrum corresponding to blood, and when a signal having a predetermined value or higher is detected in the detection signal obtained from a predetermined distance or longer, the signal processing portion determines that the guide wire is capable of advancing forward.
3. The photoacoustic guide support system according to claim 1, wherein the measuring laser beam has an absorption spectrum corresponding to a tissue of an occluded area of a blood vessel, and when a signal having a predetermined value or higher is detected in the detection signal, the signal processing portion determines that the guide wire is capable of advancing forward.
4. The photoacoustic guide support system according to claim 1, wherein a refraction portion that emits the measuring laser beam at a tilted angle with respect to a central axial direction of the optical fiber is provided in the optical fiber, the optical fiber includes a rotation controller that rotates the optical fiber, and a rotation angle detection portion that detects a rotation angle of the optical fiber, and the signal processing portion determines a rotation angle at which a signal showing a predetermined pattern is obtained among respective rotation angles as a direction in which the guide wire is to advance.
5. The photoacoustic guide support system according to claim 1, wherein the measuring laser beam has an absorption spectrum corresponding to blood, and when a signal having a predetermined value or higher is detected in the detection signal obtained from a predetermined distance or longer, the signal processing portion determines that the guide wire is capable of advancing to a rotation angle at which the detection signal is obtained.
6. The photoacoustic guide support system according to claim 1, wherein the measuring laser beam has an absorption spectrum corresponding to a tissue of an occluded area of a blood vessel, and when a signal having a predetermined value or higher is detected in the detection signal, the signal processing portion determines that the guide wire is capable of advancing to a rotation angle at which the detection signal is obtained.
7. The photoacoustic guide support system according to claim 1, wherein a laser beam having a higher intensity than the measuring laser beam is emitted in an advancing direction of the optical fiber.
8. The photoacoustic guide support system according to claim 1, wherein the detection portion is provided in the guide wire.
9. The photoacoustic guide support system according to claim 1, wherein the detection portion is provided in a region other than the guide wire where the optical fiber is provided.
10. The photoacoustic guide support system according to claim 9, wherein the detection portion is provided in a catheter where the guide wire is provided.
11. The photoacoustic guide support system according to claim 10, wherein the detection portion is provided at a tip of the catheter.
12. A photoacoustic guide support method using a photoacoustic guide support system that includes a measuring laser beam generator that generates a measuring laser beam, a guide wire that includes an optical fiber for emitting the measuring laser beam to a target, and a detection portion detecting a photoacoustic wave generated when the target is irradiated with the emitted measuring laser beam, and a signal processing portion that determines whether or not the guide wire is capable of advancing based on a detection signal obtained when the detection portion detects the photoacoustic wave, the method comprising: allowing the signal processing portion to determine that the guide wire is capable of advancing forward and to output the determination result to an output portion when a detection signal obtained by the detection portion detecting the photoacoustic wave shows a predetermined pattern.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DESCRIPTION OF EMBODIMENTS
[0037] Next, embodiments for implementing the present invention (referred to as embodiment) will be described in detail appropriately with reference to the drawings.
Conceptual Diagram
[0038]
[0039] Here, the photoacoustic guide wire 10 is used in a catheter, but the catheter is not illustrated in the drawings other than
[0040] As illustrated in
[0041] As illustrated in
[0042] In the embodiment, as illustrated in
[0043] When it is determined that the photoacoustic guide wire 10 can advance based on the result of the determination on the state of the tissue, a doctor advances the photoacoustic guide wire 10. However, when the forward occluded area C is hardened by calcification or the like, it may be difficult to advance the photoacoustic guide wire 10. In this case, a laser beam for crushing a forward tissue (crushing laser beam R2) is emitted from the optical fiber 3. As a result, the occluded area C such as thrombus is crushed such that the advancement of the photoacoustic guide wire 10 is assisted.
[0044] Hereinafter, a specific configuration or a specific operation of the photoacoustic guide wire 10 illustrated in
First Embodiment
System
[0045]
[0046] In the photoacoustic guide support system Z, the photoacoustic guide wire 10 includes the optical fiber 3 provided in the wire portion 1 that is the same as a guide wire used for catheterization and the photoacoustic wave detection element 2. As illustrated in
Signal Processing Device 100
[0047]
[0048] The signal processing device 100 includes a memory 110, a central processing unit (CPU) 120, and a storage device 130 such as a hard disk (HD). Further, the signal processing device 100 includes an input device 140, a communication device 150, and the display device 160.
[0049] On the memory 110, a program stored in the storage device 130 is loaded. The loaded program is executed by the CPU 120. As a result, a processing portion 111, and a measuring laser beam controller 112, a correction processing portion 113, a signal processing portion 114 and a crushing laser beam controller 115 that constitute the processing portion 111 are implemented.
[0050] The measuring laser beam controller 112 causes the measuring laser beam generator 11 to generate the measuring laser beam R1.
[0051] The correction processing portion 113 corrects a signal intensity using a method described below.
[0052] The signal processing portion 114 determines a direction in which the photoacoustic guide wire 10 is to advance using a method described below.
[0053] When the crushing laser beam emission button 171 (refer to
[0054] The input device 140 includes the crushing laser beam emission button 171 illustrated in
[0055] The communication device 150 receives the detection signal from the photoacoustic wave detection element 2. In addition, the communication device 150 transmits an instruction signal to the measuring laser beam generator 11 to generate the measuring laser beam R1, or transmits an instruction signal to the crushing laser beam generator 12 to generate the crushing laser beam R2.
[0056] The display device 160 has been described above with reference to
Procedure
[0057]
[0058] First, the process of
[0059] After the start of the operation, the measuring laser beam controller 112 causes the measuring laser beam generator 11 to generate the measuring laser beam R1. As a result, the measuring laser beam R1 is emitted from the tip of the optical fiber 3 (S101).
[0060] When a target is irradiated with the measuring laser beam R1, the photoacoustic wave W is generated from the target.
[0061] Next, the detection signal of the photoacoustic wave W is detected by the photoacoustic wave detection element 2 (S102).
[0062] Next, the correction processing portion 113 corrects an influence of light diffusion and absorption (intensity correction) (S103). The process of Step S103 will be described below.
[0063] Next, the signal processing portion 114 determines whether or not a specific peak value in the detection signal is a threshold or higher (predetermined pattern) (S104). The determination depending on whether the specific peak value is the threshold or higher will be described below.
[0064] When the specific peak value in the detection signal is lower than the threshold as a result of Step S104 (S104.fwdarw.No), the signal processing portion 114 displays an advancing direction change request screen on the display device 160 (S111). On the advancing direction change request screen, information indicating that it is necessary to change the advancing direction is displayed. Next, the processing portion 111 returns to the process of Step S101.
[0065] When the specific peak value in the detection signal is the threshold or higher as a result of Step S104 (S104.fwdarw.4 Yes), the signal processing portion 114 displays a crushing laser beam irradiation screen on the display device 160 (S112). The crushing laser beam irradiation screen displays information indicating that the crushing laser beam R2 can be irradiated in a direction where the photoacoustic guide wire 10 is currently facing.
[0066] Next, the crushing laser beam controller 115 determines whether or not the crushing laser beam emission button 171 (emission button) is pressed by the doctor (S121).
[0067] When the crushing laser beam emission button 171 is not pressed by the doctor (S121.fwdarw.No) as a result of Step S121, the processing portion 111 returns to the process of Step S101.
[0068] When the crushing laser beam emission button 171 is pressed by the doctor as a result of Step S121 (S121.fwdarw.Yes), the crushing laser beam controller 115 causes the crushing laser beam generator 12 to generate the crushing laser beam R2. As a result, the crushing laser beam R2 is emitted from the tip of the optical fiber 3 (S122).
[0069] Next, the measuring laser beam controller 112 causes the measuring laser beam R1 to be emitted from the tip of the optical fiber 3. After the processing portion 111 performs the same processes as those of Steps S102 and S103, the signal processing portion 114 determines whether or not the occluded area C is penetrated based on the detection signal (S123).
[0070] When the occluded area C is not penetrated as a result of Step S123 (S123.fwdarw.No), the processing portion 111 returns to the process of Step S101.
[0071] When the occluded area C is penetrated as a result of Step S123 (S123.fwdarw.Yes), the processing portion 111 ends the process.
[0072] When the tip portion of the photoacoustic guide wire 10 is inserted again by the doctor up to the position where the tip portion of the photoacoustic guide wire 10 cannot advance easily, the photoacoustic guide support system Z performs the processes from Step S101 again.
Intensity Correction Process: S103 of FIG. 4
[0073] When the photoacoustic wave W is detected by the photoacoustic wave detection element 2, a time-series detection signal is generated. The elapsed time from when the measuring laser beam R1 is emitted corresponds to the distance from the tip portion of the photoacoustic guide wire 10. The distance L from the tip portion of the photoacoustic guide wire 10 to the target that is irradiated with the measuring laser beam R1 is represented by the following Expression (1).
L=(tvL.sub.0)/2(1)
[0074] Here, t represents the elapsed time from when the measuring laser beam R1 is emitted from the tip of the optical fiber 3. In addition, v represents a sound velocity in the body, and L.sub.0 represents the distance from the tip of the photoacoustic guide wire 10 to the photoacoustic wave detection element 2. After the emission from the optical fiber 3, the measuring laser beam R1 is diffused and absorbed such that the signal intensity thereof decreases. Therefore, it is necessary to correct the detection signal using a correction function with respect to t, that is, the distance from the tip of the optical fiber 3.
[0075] That is, as illustrated in
[0076]
[0077] Here,
[0078] In
[0079] As illustrated in
[0080] Therefore, the correction processing portion 113 amplifies the signal intensity of the signal obtained from a long distance using the correction curve illustrated in
[0081] When the intensity correction using the correction function is performed on the detection signal illustrated
Determination on Advancing Direction: S104 of FIG. 4
[0082] A method of performing the determination on whether or not the photoacoustic guide wire 10 can advance and the determination on the advancing direction will be described with reference to
[0083] First, it is assumed that the process of the determination on the advancing direction according to the embodiment is performed only when it is difficult to advance the photoacoustic guide wire 10 due to a hardened area of the occluded area C in the blood vessel V. That is, as illustrated in
[0084]
[0085] In the photoacoustic guide wire 10 according to the embodiment, it is desirable that the wavelength of the measuring laser beam R1 matches with a characteristic absorption wavelength in the tissue of the occluded area C. In this case, when the occluded area C is positioned in front of the photoacoustic guide wire 10, the photoacoustic wave W having a strong peak as illustrated in
[0086] In addition, when vascular wall (or the blood B) is positioned in front of the photoacoustic guide wire 10, the photoacoustic wave W having a weak peak as illustrated in
[0087] That is, when the peak value of the detection signal after the intensity correction in Step S103 of
[0088] In this case, for example, the doctor rotates the photoacoustic guide wire 10 in various ways such that the signal processing portion 114 determines a direction in which the peak value illustrated in
[0089] A case where the detection signal after the intensity correction is higher than the predetermined threshold as illustrated in
[0090] As such, by using the measuring laser beam R1 having a wavelength in the absorption spectrum of the tissue of occluded area C, a direction in which the occluded area C is present, that is, the advancing direction of the photoacoustic guide wire 10 is determined.
[0091]
[0092] As illustrated in
[0093] In this case, the detection signal derived from the blood B remaining in the occluded area C or the blood B positioned behind the occluded area C can be obtained. Even in this case, when the detection signal is a predetermined value or higher, crushing is performed.
[0094] Here,
[0095] In
[0096] On the other hand,
[0097] That is,
[0098] In
[0099] In this case, the signal processing portion 114 determines a direction in which the pattern illustrated in
[0100] That is, the specific peak value in Step S104 of
[0101] When the photoacoustic guide wire 10 does not still penetrate the inside of the occluded area C, it is necessary to distinguish the detection signal of the blood B present on the near side of the occluded area C (refer to
[0102] The measuring laser beam R1 having the absorption spectrum of the blood B may be used when whether or not the occluded area C is present near the photoacoustic guide wire 10 is not clear. As such, by using the measuring laser beam R1 having the absorption spectrum of the blood B, a guide of the advancing direction can be obtained even when whether or not the occluded area C is present near the photoacoustic guide wire 10 is not clear. In addition, by using the measuring laser beam R1 having the absorption spectrum of a biological body, in particular, the blood B having strong light absorption, the advancing direction can be determined with high accuracy.
[0103] The measuring laser beam R1 having the absorption spectrum of the blood B and the measuring laser beam R1 having the absorption spectrum of the tissue of the occluded area C can be selectively used according to the circumstances.
[0104] It is known that, regarding the photoacoustic wave W generated by the irradiation of the measuring laser beam R1, the signal intensity and the waveform vary depending on optical characteristics of the tissue of the irradiated portion. By recognizing the forward state of the photoacoustic guide wire 10 based on the information of the photoacoustic wave W, the advancement of the photoacoustic guide wire 10 in a direction that is not the advancing direction can be avoided. In addition, even when the photoacoustic guide wire 10 enters a false lumen, a guide for returning the photoacoustic guide wire 10 to the inside of the original blood vessel V (true lumen) can be obtained. Further, when a calcified portion is present in front of the photoacoustic guide wire 10, the calcified portion is crushed by the crushing laser beam R2 such that the photoacoustic guide wire 10 can easily advance.
[0105] In a hole that is formed in the occluded area C by the photoacoustic guide wire 10 according to the embodiment, for example, a balloon or a stent is provided. That is, by emitting the crushing laser beam R2 in a direction that is determined as the advancing direction, the hole for providing a balloon or a stent can be obtained.
[0106] In addition, since the photoacoustic wave detection element 2 is provided on the wire portion 1, the advancing direction can be determined based on the detection signal obtained by the photoacoustic guide wire 10 itself.
Second Embodiment
[0107] Next, a second embodiment of the present invention will be described with reference to
[0108] In the first embodiment, whether or not the photoacoustic guide wire 10 can advance forward is determined. On the other hand, in the second embodiment, the advancing direction is indicated.
Photoacoustic Guide Support System Za
[0109]
[0110] Differences between the signal processing device 100 illustrated in
[0111] (1) A photoacoustic guide wire 10a includes a refraction portion 4 that is configured such that a laser beam R is emitted in an oblique direction with respect to a central axis of an optical fiber 3a. Here, the laser beam R includes the measuring laser beam R1 and the crushing laser beam R2. The refraction portion 4 may have a configuration in which a tip of the optical fiber 3a (and a wire portion 1a) is cut obliquely as illustrated in
[0112] (2) A rotation control device (rotation controller, rotation angle detection portion) 20 that controls rotation of the photoacoustic guide wire 10a and measures a rotation angle of the photoacoustic guide wire 10a is provided in the photoacoustic guide wire 10a.
[0113] (3) A signal processing device 100a controls the rotation of the photoacoustic guide wire 10a.
[0114] Since the other configurations are the same as those of the photoacoustic guide support system Z illustrated in
Signal Processing Device 100a
[0115]
[0116] A difference of the signal processing device 100a from the signal processing device 100 illustrated in
[0117] The rotation processing portion 116 causes the rotation control device 20 to rotate the photoacoustic guide wire 10a and obtains the rotation angle of the photoacoustic guide wire 10a transmitted from the rotation control device 20.
[0118]
[0119] In the second embodiment, as in the first embodiment, it is assumed that the photoacoustic guide wire 10a advances up to a position where the photoacoustic guide wire 10a cannot advance easily.
[0120] Here, an appropriate advancing direction is determined by rotating the photoacoustic guide wire 10a. It is desirable that the photoacoustic guide wire 10a is automatically rotated by the rotation control device 20. However, the photoacoustic guide wire 10a may be manually rotated. During the rotation of the photoacoustic guide wire 10a, the measuring laser beam R1 is emitted from the tip of the optical fiber 3a (indicated by a white arrow in
[0121] Detection signals are detected from respective rotation angles. The detected detection signals are associated with each other by the signal processing device 100a. This configuration will be described below.
[0122] It is assumed that the blood vessel V, the occluded area C, the blood B, and the photoacoustic guide wire 10a have a positional relationship illustrated in
Procedure
[0123]
[0124] In Step S103, after the intensity correction, the rotation processing portion 116 rotates the photoacoustic guide wire 10a at a predetermined angle (S201). The processes of Steps S101 to S103 are processes of obtaining the detection signal corresponding to one rotation angle.
[0125] The rotation processing portion 116 determines whether or not the rotation ends (S202). That is, the rotation processing portion 116 determines whether or not the photoacoustic guide wire 10a is rotated by 360 degrees based on the rotation angle obtained from the rotation control device 20.
[0126] When the rotation does not end as a result of Step S202 (S202.fwdarw.No), the processing portion 111a returns to the process of Step S101.
[0127] When the rotation ends as a result of Step S202 (S202.fwdarw.Yes), the rotation processing portion 116 determines the rotation angle (S203). A method of determining the rotation angle will be described below. At this time, the determined rotation angle may be displayed on the display device 160.
[0128] The rotation processing portion 116 rotates the photoacoustic guide wire 10a to the rotation angle determined in Step S203 (S204).
[0129] Next, the crushing laser beam controller 115 determines whether or not the crushing laser beam emission button 171 (emission button) is pressed by the doctor (S121a).
[0130] When the crushing laser beam emission button 171 is not pressed by the doctor as a result of Step S121a (S121a.fwdarw.No), the processing portion 111a returns to the process of Step S121a.
[0131] When the crushing laser beam emission button 171 is pressed by the doctor as a result of Step S121a (S121a.fwdarw.Yes), the crushing laser beam controller 115 causes the crushing laser beam R2 to be emitted (S122). Then, the processing portion 111a performs the process of Step S123.
Determination on Rotation Angle: S203 of FIG. 13
[0132] Here, the process (S203) of determining the rotation angle in
[0133]
[0134] In
[0135] The detection signal becomes weak as the measuring laser beam faces in a direction of the vascular wall, and the detection signal becomes strong as the measuring laser beam faces in a direction of the occluded area C. Accordingly, a direction in which the peak of the detection signal is the highest is the advancing direction. In the example of
[0136] As such, by using the measuring laser beam R1 having a wavelength in the absorption spectrum of the tissue of occluded area C, a direction in which the occluded area C is present, that is, the advancing direction of the photoacoustic guide wire 10 is determined.
[0137]
[0138]
[0139] In
[0140] Referring to
[0141] As such, by using the measuring laser beam R1 having the absorption spectrum of the blood B, a guide of the advancing direction can be obtained even when whether or not the occluded area C is present near the photoacoustic guide wire 10 is not clear. In addition, by using the measuring laser beam R1 having the absorption spectrum of a biological body, in particular, the blood B having strong light absorption, the advancing direction can be determined with high accuracy.
[0142] When the advancing direction is determined, the rotation processing portion 116 operates the photoacoustic guide wire 10a to face the advancing direction. Next, the crushing laser beam R2 is emitted.
[0143] When the peaks of the detection signals obtained at individual rotation angles are the same, the signal processing portion 114 determines that the photoacoustic guide wire 10a can advance forward.
[0144] According to the second embodiment, the advancing direction of the photoacoustic guide wire 10a can be determined more easily than in the first embodiment.
Third Embodiment
[0145] Next, the third embodiment of the present invention will be described with reference to
[0146] In the third embodiment, unlike the first and second embodiments, the photoacoustic wave detection element 2 is not provided in the photoacoustic guide wire 10 (refer to
System
[0147]
[0148] In the photoacoustic guide support system Zb illustrated in
[0149] The catheter 30 has a tubular configuration, in which the photoacoustic guide wire 10b is movable (capable of advancing and retreating in an axial direction of the catheter 30).
[0150] In addition, in the example of
[0151] An operation of the photoacoustic guide support system Zb according to the third embodiment is the same as the photoacoustic guide wire 10b according to the first embodiment, and thus the description thereof will not be repeated.
[0152] In addition, the photoacoustic guide wire 10b according to the third embodiment may have a configuration in which the measuring laser beam R1 and the crushing laser beam R2 are emitted in an oblique direction with respect to the central axis of the photoacoustic guide wire 10b and the rotation control device 20 is provided. That is, the photoacoustic guide support system Zb according to the third embodiment may have the same configuration as that of the second embodiment, except for the photoacoustic wave detection element 2b.
[0153] When the photoacoustic wave detection element 2 is provided on the side surface of the photoacoustic guide wire 10 or 10a as in the first and second embodiments, the thickness of the photoacoustic guide wire 10 or 10a increases by the thickness of the photoacoustic wave detection element 2. By providing the photoacoustic wave detection element 2b in the separate catheter 30 provided separately from the photoacoustic guide wire 10 as in the third embodiment, the diameter of the photoacoustic guide wire 10b that enters the occluded area C can be reduced. In particular, by providing the photoacoustic wave detection element 2b at the tip portion of the catheter 30, the photoacoustic wave detection element 2b can be provided to face a direction in which the photoacoustic wave W is incident. As a result, the detection ability of the photoacoustic wave W can be improved.
[0154] When the use of the photoacoustic guide wire 10b ends, the photoacoustic guide wire 10b is accommodated in the catheter 30.
[0155] When the photoacoustic wave W propagates not only due to the tissue of the occluded area C but also due to the blood B flowing into the crushed occluded area C. Accordingly, the photoacoustic guide wire 10b enters the tissue of the occluded area C, and even when the catheter 30 is present outside the occluded area C, the photoacoustic wave detection element 2b can receive the photoacoustic wave W.
[0156] The present invention is not limited to the embodiments and includes various modification examples. For example, the embodiments have been described in detail in order to easily describe the present invention, and the present invention is not necessarily to include all the configurations described above. In addition, a part of the configuration of one embodiment can be replaced with the configuration of another embodiment. Further, the configuration of one embodiment can be added to the configuration of another embodiment. Also, addition, deletion, and replacement of another configuration can be made for a part of the configuration each of the embodiments.
[0157] In addition, some or all of the above-described configurations, functions, portions 111 to 116 and 111a, the storage device 130, and the like may be realized by hardware, for example, by designing an integrated circuit. Also, as illustrated in
[0158] In addition, in each of the embodiments, the drawings illustrate control lines and information lines as considered necessary for explanations but do not illustrate all control lines or information lines in the products. It can be considered that almost of all components are actually interconnected.