DE102007016674A1 - Catheter system for use in magnetic resonance tomography system, has end piece, intermediate piece and section, whose materials are selected from insulating materials e.g. polyurethane, or conducting material e.g. precious metal - Google Patents

Abstract

The system has an end piece (1) such as plier, shear and needle, intermediate piece (2) and a section (3), whose materials are selected from insulating materials e.g. polyurethane (PE), polyethylene (PE), polymer and glass fibers, or from conducting materials e.g. metals such as precious metal and nickel titanium alloy, which have high paramagnetic or high diamagnetic characteristics. The elements are stuck together, welded or bolted with one another. A hollow body (4a) is utilized as an operating channel. An independent claim is also included for a method for providing a catheter for applications in body cavity i.e. blood vessel.

Description

The The present invention relates to a system and method for a Catheter with at least one channel for applications in body cavities in particular in blood vessels on MRI System, characterized in that it has both a negative, as well as creating a positive contrast in the MRI image and also an execution that does not cause any warming of the catheter by the dynamic and pulsed magnetic fields or the high frequency fields of the MRI leads. The different contrasts can thereby by the choice and arrangement of the materials (isolators and electrical conductors), as well as by one or more with corresponding Gel or liquid filled hollow body be generated.

Description - Stand of the technique

The Imaging diagnostics, for example, magnetic resonance imaging (MRI), Computed Tomography (CT), Positron Emission Tomography (PET), the ultrasound technology (US), or combination of these Procedure under possible additional The use of radiographic procedures (X-ray images) are also increasing to use the gained information immediately therapeutically. Examples of this are the so-called minimally invasive procedures in which the Patient treated promptly after diagnostic imaging will, without additional stationary Stay. Method of treating spinal injuries, tumor treatment or for the removal of tissue (biopsies) are meanwhile in the clinical use.

One additional Advantage could be arise when the therapeutic procedures are completely under constant diagnostic Control could take place on MRI or CT. That would be the surgeon constantly over the Informed progress of therapeutic use.

there just got the MRI big Advantages in the field of soft tissue differentiation and by the fact that the MRI is neither for the patient nor for the therapist to health damages to lead can, as the z. B. in X-ray based Procedure is the case. It would be so of great Advantage if the MRI for a subsequent minimally invasive or other therapy used could be.

For cardiovascular applications be for the therapeutic processes z. As catheters and guide wires used. In this case, a guidewire is first passed through a corresponding body cavity (z. B. leg vein) led to the therapy site (eg, vena cava) and subsequently pushed over the guidewire a catheter at the end of which a corresponding therapy tool is mounted. Such a tool can, for. B. a balloon for the expansion of stenoses (so-called balloon dilatation) and setting of vascular supports (called "stents") or one Biopsy needle for taking tissue samples or a needle for Injection of drugs or stem cells. Most diverse other therapeutic Procedures are conceivable.

all the same is the need to safely determine the place of therapy can and reach it safely with the therapy tool under MRI control to be able to. It is extremely important to constantly control the course or position of the therapy tool to be able to.

Just in MRT, however, due to the very high magnetic fields (currently in the rule 1.5 T-3.0 T = 30,000-60,000 multiple geomagnetic field) and the associated magnetic attraction forces, as well the disturbances Imaging by local and external magnetic fields biggest problems to perform such procedures directly on MRI.

In usually the therapy tools are made of materials which have more or less strong ferromagnetic properties and thus due to the strong magnetic forces in the magnetic field of the MRI system can not be used. Also materials, on the strong magnet of the MRT does not exert any attraction (eg stainless steel or CobaltChrom), can through high susceptibility artifacts for the safe MRI imaging will not be used.

One additional Problem arises due to the The MRI imaging needed high dynamic magnetic fields and High frequency fields, which are very often high in electrical conductors cause and therefore for safe use in the patient is out of the question (can cause severe burns).

Description - Task

What is needed is a system and method that can be easily identified in the MRI image, preferably by means of corresponding contrast differences (see 6 .), so that a safe and fast guidance to the place of therapy is possible. In addition, it should be safe for use in patient operation and accordingly do not have continuous or longer electrically conductive materials, so that heating by exposure to dynamic magnetic fields (induction of currents) or high-frequency energy is not possible and thus safe use in patients is possible.

By the alternating contrasts, which ideally depends on the signal intensity of the human Tissue either clearly positive (signal-enhancing) or negative (signal-reducing or signal-extinguishing) Ideally, the catheter can be lifted with the help of appropriate Software analysis programs are detected automatically or the visual Detection on the MRI images can be significantly simplified.

moreover the catheter should be over one or more working channels feature. In the case of a guidewire are these working channels unnecessary.

Description - Invention

The invention describes a system for use as a catheter or guidewire for use in the human body. In order to overcome the disadvantages described above, a system is proposed which consists of an end piece ( 1 ), which in turn is used for therapy use. This tail could z. As a pair of pliers, scissors, a needle, a screen or other suitable for therapeutic or diagnostic procedures tool. It could also be a tail in the classic sense, ie it simply marks the end of the catheter or guidewire. This part is made of a metal that is safe to use in MRI (ie, no magnetic forces are applied to the metal piece) and that produces little or no image artifacts in the generated MRI image. Image artifacts are image information that can complicate the diagnostic interpretation of the MRI image or lead to false diagnoses.

low Artifacts can but also for identification z. As a catheter or Fhrungsdrahts be used. In the present case, a z. B. generated by the metal of the tail Artifact the end of the catheter or the position of the tool.

It offer themselves as metallic materials with low materials diamagnetic or low paramagnetic properties. Alternatively, the tail Naturally also be made of an insulator material.

Concrete The invention concerns the combination of conductive materials with less well conductive materials or insulators.

In this case, the tail can therefore also consist of an insulator, as long as the subsequent intermediate piece ( 2 ) again consists of a better conductive or highly conductive material. On this intermediate piece z. B. an expansion balloon for an already described balloon dilation be mounted and welded or screwed or glued a portion ( 3 ) with the same or similar material properties as the tail ( 1 ) to be assembled.

The resulting MRI image would now be used for the tail ( 1 ) have a certain size and length and a certain contrast. Are illustrated length and size of the tail ( 1 ) larger than in reality it is called an artifact. Depending on the choice of material and the choice of MRI parameters, the contrast and the signal intensity can be both positive (signal-enhancing) and negative (signal-reducing or signal-extinguishing).

The material of a subsequent intermediate piece ( 2 ) is ideally chosen so that there is a clearly distinguishable contrast or even a complete signal reversal compared to the signal intensity of the tail ( 1 ) having. The section ( 3 ) again has the same or very similar intensity and contrast as the tail ( 1 ).

This allows you to determine the position of the respective segments ( 1 ) 2 ) and ( 3 ) clearly identify and thus z. B. the position of one on an intermediate piece ( 2 ) mounted balloons exactly, or on the tail ( 1 ) mounted therapy tool.

By the different choice of material is also prevented from becoming electrical currents induced by the dynamic magnetic fields and the high frequency Energies on the catheter or the guide wire can spread. In order to be for the patient dangerous warming avoided.

An insulator may be placed in a lumen (inner volume) of the catheter or guidewire (FIG. 4a ) Accommodate MRI-specific contrast agents or other gels or liquids that enhance or reduce the contrast and signal of the material in the MRI image. In addition, in other designs, work channels ( 4 ) are integrated to z. B. to bring light sources to the therapy or inject or release medication.

Due to the alternating contrasts of the different elements (which can also be achieved, for example, by means of corresponding nanocoatings of insulators and conductors), the guide wire / catheter can easily be visually identified on the MRI image (see 6 .).

It is also conceivable that a corresponding developed software program with image analysis capability allows automatic detection of the catheter and thus the position of the catheter can also be displayed in real time or near real time at any time. The program could z. For example, you can always select only the relevant MRI slice recording via appropriate feedback to the MRI system.

Description - drawings

1 .- 3 , show possible embodiments of the catheter / guidewire. Shown are a differently designed tail ( 1 ) (in the patient for therapy or diagnosis), usually made of a metal and in the case of use in the MRI of a metal with low diamagnetic or paramagnetic material properties (μ _r = B / B ₀ , μ _r <1 or μ _r > 1, eg precious metals, nickel-titanium alloys). The metal will usually cause a negative contrast (signal cancellation) in the MRI system. The tail ( 1 ) is with an intermediate piece ( 2 ) screwed / welded or glued. The centerpiece ( 2 ) consists of an insulator material (eg PU, PE, polymers, glass fibers), which is usually not visible in an MRI image. Another section ( 3 ) can in turn with the intermediate piece ( 2 ) screwed / welded or glued. However, there may also be versions that only one end piece ( 1 ) and an intermediate piece ( 2 ), so usually a conductor and an insulator.

In 2 , and 3 Further versions are shown, with more or less long spacers ( 2 ) and sections ( 3 ), ie with more or less long insulators and conductors or conductors and insulators.

In 4 , are the cross-sections of the catheter at the point a-a '( 1 .). In illustration a) as a guidewire with only one cavity ( 4a ), the z. B. filled with contrast agent or gel, which generates a positive (signal amplifying) or negative contrast (signal-reducing or signal-canceling) in the MRI image, compared with the environment of the catheter. In illustration b) is next to the cavity ( 4a ) also a working channel ( 4 ) which is parallel to the overall orientation of the catheter and thus parallel to the cavity (FIG. 4a ) runs. In illustration c) are next to the cavity ( 4a ) three more working channels ( 4 ).

In 5 , is shown a possible site of use of the catheter in the human body, in which the catheter or guide wire consisting of the elements ( 1 ) and ( 2 ) respectively. ( 1 ) and ( 2 ) and ( 3 ) can be advanced via a leg vein from the outside over the vena cava to the heart.

In 6 , Three possible embodiments are shown and how they are visualized in the MRI image (in this case in an MRI image with coronary orientation) 5a) z. B. are the tail ( 1 ) and an intermediate piece ( 2 ) shown by the different contrasts clearly show the sale of the catheter and thus significantly facilitate the guidance and localization of the catheter and thus significantly increase safety for medical use.

• • (1) Endstück
• • (2) Zwischenstück
• • (3) Teilstück
• • (4a) Hohlraum für Kontrastflüssigkeit
• • (4) Arbeitskanäle
• • (5) Katheter

In 5b) and c) further embodiments are shown with corresponding contrast differences.

• • ( 1 ) Tail
• • ( 2 ) Intermediate piece
• • ( 3 ) Section
• • ( 4a ) Cavity for contrast fluid
• • ( 4 ) Working channels
• • ( 5 ) Catheter

Claims (16)

System and method for a catheter for applications in body cavities, especially in blood vessels in the MRI system, characterized in that it according to 2 and 3 , from different elements ( 1 . 2 . 3 ) whose material alternately consists of electrical conductors and insulators (eg PU, PE, polymers, glass fibers). System according to claim 1, characterized in that the conductive materials are metals which have only slightly paramagnetic or slightly diamagnetic properties (μ _r = B / B ₀ , μ _r <1 or μ _r > 1, eg Precious metals, nickel-titanium alloys). System according to claims 1-2, characterized in that the elements ( 1 . 2 , respectively. 1 . 2 . 3 ) are glued together, welded or screwed. System according to claim 1-3, characterized in that the catheter with at least one hollow body ( 4a ) which can be filled with a liquid or a gel ( 4a ), which causes a specific contrast in the MRI system. System according to claim 1-4, characterized in that in addition to the hollow body according to claim 4 further hollow body ( 4 ), which can be used as working channels. System according to claims 1-5, characterized in that one or all of the working channels ( 4 ) with a membrane ( 6 ) can be closed at the end of the system, via which fluids (eg contrast agent, stem cell len, pharmaceuticals) can be released. System according to claims 1-6, characterized in that the element ( 1 ) can perform different functions (eg as a needle, as a pair of scissors, as a shield, as a real tail). System according to claim 1, characterized in that the alternately arranged elements ( 1 . 2 . 3 ) may consist of materials of different conductivity. System according to claim 1, characterized in that the alternately arranged elements ( 1 . 2 . 3 ) can consist of different insulators. System according to claim 1, characterized in that the alternately arranged elements ( 1 . 2 . 3 ) are provided with surface coatings that cause correspondingly alternating contrast differences in the MRI system. System according to claims 1-10, characterized in that the hollow bodies ( 4a ) of the alternately arranged elements ( 1 . 2 . 3 ), can be alternately filled with a liquid or a gel ( 4a ), which causes a specific contrast in the MRI system (eg element ( 1 ) with liquid, element ( 2 ) without, element ( 3 ) with liquid) and in each case via a membrane ( 6 ) or another conclusion are sealed. System according to claims 1-4, 7, 10, characterized in that the only element ( 1 ) with element ( 2 ) and the hollow body in element ( 2 ) is carried out according to claim 4. The system of claim 12 combined with the formulated claims 5-6. System and method according to claims 1-13, characterized in that the alternately used elements ( 1 ) and ( 2 ) respectively. ( 1 ) and ( 2 ) and ( 3 ) in the MRI image enable elemental differentiation through different contrasts. These can be signal-amplifying from element to element as well as signal-reducing or signal-canceling. The system and method of claim 1-14 characterized in that the element distances in the MRI image are proportional to certain lengths and sizes are. For example, a real element spacing of 10mm in the MRI image may be due Addition of the elements and direct comparison with the body structures give important therapy conclusions. System and method according to claim 1-15 characterized in that by the different contrasts a automatic detection of the catheter by appropriate software analysis programs possible is.