CA2219161A1 - Medical instrument with improved ultrasonic visibility - Google Patents
Medical instrument with improved ultrasonic visibility Download PDFInfo
- Publication number
- CA2219161A1 CA2219161A1 CA002219161A CA2219161A CA2219161A1 CA 2219161 A1 CA2219161 A1 CA 2219161A1 CA 002219161 A CA002219161 A CA 002219161A CA 2219161 A CA2219161 A CA 2219161A CA 2219161 A1 CA2219161 A1 CA 2219161A1
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- Canada
- Prior art keywords
- needle
- medical instrument
- incident beam
- ultrasonic
- planar surface
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 238000003780 insertion Methods 0.000 claims abstract description 10
- 230000037431 insertion Effects 0.000 claims abstract description 10
- 238000003384 imaging method Methods 0.000 claims abstract description 7
- 238000000034 method Methods 0.000 claims description 30
- 238000001574 biopsy Methods 0.000 claims description 15
- 239000012530 fluid Substances 0.000 claims description 11
- 238000012544 monitoring process Methods 0.000 claims description 3
- 238000002604 ultrasonography Methods 0.000 description 18
- 239000007787 solid Substances 0.000 description 14
- 238000013459 approach Methods 0.000 description 7
- 238000004519 manufacturing process Methods 0.000 description 5
- 238000012806 monitoring device Methods 0.000 description 5
- 239000000463 material Substances 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 3
- 241001465754 Metazoa Species 0.000 description 2
- 238000002669 amniocentesis Methods 0.000 description 2
- 238000001514 detection method Methods 0.000 description 2
- 230000002962 histologic effect Effects 0.000 description 2
- 238000009991 scouring Methods 0.000 description 2
- 238000012360 testing method Methods 0.000 description 2
- 206010028980 Neoplasm Diseases 0.000 description 1
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 1
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 description 1
- 206010000269 abscess Diseases 0.000 description 1
- 238000004458 analytical method Methods 0.000 description 1
- 238000010241 blood sampling Methods 0.000 description 1
- 238000002591 computed tomography Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000003745 diagnosis Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000002708 enhancing effect Effects 0.000 description 1
- 210000004700 fetal blood Anatomy 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- 210000003734 kidney Anatomy 0.000 description 1
- 210000004185 liver Anatomy 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 239000011236 particulate material Substances 0.000 description 1
- 238000002601 radiography Methods 0.000 description 1
- 238000007788 roughening Methods 0.000 description 1
- 239000004576 sand Substances 0.000 description 1
- HBMJWWWQQXIZIP-UHFFFAOYSA-N silicon carbide Chemical compound [Si+]#[C-] HBMJWWWQQXIZIP-UHFFFAOYSA-N 0.000 description 1
- 229910010271 silicon carbide Inorganic materials 0.000 description 1
- 238000009987 spinning Methods 0.000 description 1
- 229940124597 therapeutic agent Drugs 0.000 description 1
- 238000003325 tomography Methods 0.000 description 1
- 238000012285 ultrasound imaging Methods 0.000 description 1
- 238000012800 visualization Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic
Abstract
A medical instrument, and in particular, a needle (104) having improved reflective properties and enhanced ultrasonic visibility when used in conjunction with an ultrasonic imaging system (108, 110) is disclosed. The medical instrument has a non-circular shaped portion adapted for insertion into the body (100), the non-circular shaped portion comprising at least one exterior planar surface capable of reflecting an incident ultrasonic beam.
Description
MEDICAL ~5TRUMENT WITH Il\~PROVED ULTRASONIC VISIBILIl'Y
This invention relates generally to the medical arts and more particularly to a needle or other me~lic~l instrument having improved reflectiveplop~lLies and enlh~nce~ ultrasonic visibility when used in conjunction with an ultrasonic im~ging system.
BACKGROUND OF l HE INVENTION
Many techniques have been developed to non-invasively image or "see"
the internal strucl:ures of human and animal bodies. Such techniques have in the past included radiography, fluoroscopy, and, more recently, ultrasonography, col-lpu~ed tomography, and m~gnetic resonance im~ging.
Prior to the development of these im~ging techniques, exploratory surgery had to be performed in order to see the internal structures of human and animal bodies. However, fatal complications were sometimes encountered with exploratory surgery.
Despite the adv~mces that have been made in the above im~ging itechniques, many entities are difficult to differentiate using only im~ging ~:echniques. Accordingly, it is often very difficult to conclusively ~ nosP
certain conditions bas_cl solely on their image. Only by obtaining a sample of Ihe involved tiSSUI' or fluid can the condition or entity be conclusively identified, and the correct diagnosis made.
In attempt to avoid the dangers associated with surgery, a number of minim~lly invasive techniques for obtaining tissue or fluid samples from the W 096/336S4 PCT~US96/OS418 body have been developed in recent years. These techniques involve the use of im~ging techniques, such as ultrasound, to guide specially desi~nell needles through the inside of the body to the target tissue or fluid. Once guided to thetarget, the specially ~le~igned needle is used to obtain samples of the target S tissue or fluid for analysis outside of the body. Moreover, in certain cirCumst~ncçs~ a tube or c~th~t~r may be in~t~lled at the target for longer termfluid drainage or for ~-lmini~tçring therapeutic agents. Many lives have been saved and surgical complications avoided by the use of such im~ging gui~l~nce techniques for obtaining tissue or fluid samples from the body.
In tissue biopsy, for example, a needle (or puncturing cannula) is inserted into the body and guided to the site of the tumor or other tissue mass to be evaluated. The physician guides the needle to the desired location in the body using an im~ging system such as ultrasound, which permits the physician to monitor the insertion and advancement of the needle in the body.
Ultrasound guidance systems are well known in the art, and work on the principle of reflecting sound waves off of the needle. The reflected wave is detected by a monitor located outside the body, and an image is generated, which reveals the location of the needle in the body. Two examples of ultrasonically guided puncturing cannula apparatuses are found in U.S. Patent No. 3,556,079 and U.S. Patent No. 4,029,084, the disclosures of which are incorporated herein by reference. Needle guidance with ultrasound im~ging may be used to obtain tissue and fluid samples in a variety of procedures such as, for example, para and thoracocenteses, amniocentesis, abscess aspiration, cytologic and core histologic biopsy, and fetal blood sampling.
Accurate guidance of the needle in the body is not only critical to obLahling the proper tissue sample, but accurate guidance is also necessary to avoid unintçntional puncturing or damage to body tissue. Unfortunately, needles conventionally used in biopsy procedures and the like that rely on ultrasonic imaging for guidance have relatively poor ultrasonic visibility. The needles conventionally used in such procedures have a generally tubular shape with a circular cross-section, and thus present a curved surface to the inci(lçnt ultrasonic beam. When the incident beam strikes the curved surface of these W O 96/33654 PCT~US9610541 conventionally s,haped circular needles, only a small portion of the beam is reflPct~i back to the monitoring device; a majority of the incident beam being t scattered away irom the monitoring device. Rec~lse only a small portion of the rçflect~l incident beam is detocteA at the monitoring device, a relatively poor image of the needle is generated, which makes it difficult to ascertain theprecise position of the: needle in the body. In response to this problem, con~iderable effort has been expended to enhance the ultrasonic visibility of conventionally shaped circular nLo~A1os For exanlple, one prior approach to enhancing the ultrasonic visibility of the needle is roughening or scouring the outer surface of the needle itself or by rollgh~oning the surface of a solid stylet that is disposed axially within the lumen of the nffdle. One such example of this approach is found in U.S.
Patent No. 4,869,259, the disclosure of which is incorporated herein by reference. A portion of the exterior surface of the needle is uniformly and randomly particle-blasted with particulate materials such as sand, silicon carbide, or metal ~iliç:~tes. The resulting particulate band, which extends around the circulrnference of the needle, increases its ultrasonic visibility bycausing diffraction of the reflected incident beam as the angle between the needle and the incident beam is deviated from 90 degrees.
Another example of an attempt to make a needle more ultrasonically visible is found in U.S. Patent No. 4,401,124, the disclosure of which is incol~oldted herein by reference. This patent discloses a surgical instrument having diffraction grating disposed on the surface of the instrument. The grating has a specific distance between the depths of adjacent grooves, the ~ t~nce being a function of various parameters including the wavelength of the inci~l~nt beam and the angle between the incident beam and an axis along the surface of the instrument. It is disclosed that the diffraction grating increases the reflection coeffiçiellt of the surgical instrument, which increases its ultrasonic visibility.
Although these prior art approaches may improve the ultrasonic visibility of a needle, the process of rolrghening or scouring the needle adds ~1clitio~1 steps to the manufacturing process, and increases m~nllf~çturing W O 96/33654 PCTrUS96105418 costs. Also, a scoured or roughened needle surface may complicate percutaneous insertion and subsequent passage of the needle through body tissue. t Another approach to increasing the ultrasonic visibility of a needle is disclosed in U.S. Patent No. 5,048,530, the disclosure of which is inco,~u,dted herein by reference. That patent discloses a needle or other tubular cannula having one or more "sounding apertures" positioned along the needle to improve its ultrasonic visibility. The di~mt~tPr of each sounding aperture is substantially equal to a predetermined wavelength of an incident ultrasonic beam. According to the disclosure of the patent, upon striking the sounding aperture, the incident beam is diffracted and the resulting echo diffuses isotopically thelcfiu-ll, thereby improving the ultrasonic detect~l~ility of the needle. Again, as with other prior art approaches, the sounding apc,lll,eapproach may make the needle more difficult to manufacture and increase manufacturing costs.
Another approach to improving the ultrasonic visibility of a needle is to place a transducer in the needle itself to radiate an ultrasonic beam back to a detector located outside the body. However, a shortcoming to this approach is that the needle must be equipped with expensive and complicated electronic ci,cuil,y, which increase the complexity of and the cost to manufacture the needle.
Clearly, there is a need for a medical instrument, and a needle in particular, with enhanced ultrasonic visibility, and which is inexpensive and simple to manufacture.
SUMMARY OF THE INVENTION
Applicant has developed a medical instrument, which s~tic~lçs the need for such an instrument with enhanced ultrasonic visibility. As described in more detail below, a medical instrument such as a needle is provided comprising a non-circular shaped portion having at least one exterior planar surface. The planar surface of the needle provides a greater surface area than that presented by conventionally shaped circular needles for reflecting an CA 022l9l6l l997-l0-24 W 0~6/33654 PCTrUS96/05418 inr;dent beam. Rer~llse of the greater surface area, a greater amount of the incident beam isi reflected back to a monitoring device, thereby enh~n~-ing the visibility of the lleedle. Thus, the needle of this invention is more readily "seen" by ultrasonic im~ging techniques than conventionally shaped circular nPeAl~, In acco~lance with one aspect of the invention, a medic~l instrument for insertion into the body and adapted to be used in conjunction with an im~ging system is provided. The medical instrument comprises a non-circular shaped portion whicll is to be inserted into the body, the non-circular portion having at least one exterior planar surface capable of reflecting an incident beam of energy.
In another aspect of the invention, a method of monitoring the location of a percutaneous positioned medical instrument is provided. A mP~lic~l instrument having a pel~;u~leous positioned non-circular shaped portion compri~ing at least one exterior plaLnar surface is provided. An incident beam of energy is directed at the exterior planar surface of the medical instrument such that the incident beam is reflected. The reflected incident beam is then received and monitored by a monitoring device.
Further aspects of the present invention will be ~parent to those skilled in the art based on the following detailed description of a p~erelred embodiment of the invention and the accompanying drawings.
W 096/3365~ PCTrUS96/05418 BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 is a perspective view of a prerclled needle of the invention.
Fig. la is a cross-section view of the needle illustrated in Fig. 1 along line a--a.
Fig. 2 is a perspective view of a solid stylet wire adapted for placement within the inner lumen of the needle illustrated in Fig. 1.
Fig. 3 is a perspective view of the needle illustrated in Fig. 1 with the solid stylet wire ill--~tr~tPcl in Fig. 2 sitting within the inner lumen of the needle.
Fig. 4 is a cutaway elevational view of a ~lcfellcd needle of the invention having a solid stylet axially disposed therein.
Fig. 5 is a schematic r~lcselltation of an incident beam of energy being reflected from a conventionally shaped circular needle.
Fig. 6 is a schem~tic l~lese,ltation of an incident beam of energy being reflected from a ~,cfcl,cd needle of the present invention having a square-shaped cross-section.
Fig. 7 is a schem~tic representation of the use of a ~lcrellcd needle of the invention with an ultrasound system.
Fig. 8 is a schematic representation of how a pleft:lled needle of the invention appears on the monitor of an ultrasound system.
DETAILED DESCRIPTION OF THE
PRESENTLY PREFERRED EMBODIMENTS
The acco",l,~lying drawings are provided solely for the purpose of illustrating a presently prefellcd embodiment of the invention and are not inten~etl to limit the scope of the invention in any way.
Figs. 1-4 show the external configuration of a plcrcllcd needle of the present invention while Figs. 5 and 6 illustrate the means by which a p.ert;"cd needle of the invention provides improved ultrasonic visibility. Figs. 7 and 8 schP-m~tic~lly depict a prefe~cd needle of the invention in combination with an ultrasound system and the image generated by a preferred needle of the present invention, respectively.
W 0'96/33654 PCTrUS96/0541 With reference to Figs. 1-4, a pr~fe,r~d needle of the present invention compr ~es a hollow needle body 10 having a beveled distal tip 12 and a proximal comlP~tinlJ hub 14 formed on opposite ends of the needle body 10.
In a p-~er~ d aspect of the invention, the needle body 10 has a square-shaped cross-section wi.th planar exterior surfaces 16a, l~b, 16c, and 16d (see Fig.
la). The planar exterior surface is preferably continuous along a substantial portion of the length of the needle body as shown. It should be understood, however, that the needle of the present invention may be of any non-circular cross-section shape thlat has at least one exterior planar surface for reflecting a n incident beam of energy. Thus, other suitably shaped needles contemplated for use in this invention rnay have a triangular cross-section, a pentagonal cross-section, a hemispherical cross-section, etc. Unlike the needle body 10, however, the shape of the needle tip 12 is not critical. Numerous types of needle tips are contennplated for use in this invention such as, for ex~mplç, beveled tips, double beveled tips, and conical tips.
The needle body 10 is configured with a length and cross-section depending on thle procedure and the desired depth of percutaneous insertion of the needle. For eY~mrle, for histologic biopsies of the liver or kidney where a large biopsy is required, a relatively large needle having a size similar to an about 14 gauge conventionally shaped circular needle is ~-~f~lled. On the other hand, fluid aspiration (such as in amniocentesis) or cytologic aspiration calls for a relatively small biopsy sample, and thus a smaller needle having a size similar to an about 20 gauge conventionally shaped needle is p~ ;d.
The needle body 10 is preferably made from any medical grade material such as those market,ed as Superior "microbore" or Sterling "plug drawn."
The comlecting hub 14 is preferably made from a clear plastic m~t~.ri~l.
The connecting hub plreferably comprises two opposing faces 14a and 14b (not shown). The connecling hub 14 further comprises a channel 15 (not shown) defined by a female connector arm 18. The female connector arm 18 has a first opening l9 which leads to the ch~nnel 15. A flange 21 extends around the opening 19 of cormector arm 18. The female connector arm 18 has a second opening 22 ;adapted to receive the needle body 10. The ch~nnel 15 CA 022l9l6l l997-l0-24 W 096/33654 PCT~US96/05418 extends along a longit~in~l axis of connecting hub 14 and communic~t~s with the inner lumen of needle body 10. Finally, three annular ribs 24 extend laterally across the opposing faces 14a and 14b (not shown) of the connecting hub 14 to form convenient finger gripping surfaces whereby the needle may be firmly grasped by the operator during insertion and manipulation of the needle.
Although not critical in the present invention, a solid stylet wire 26, (shown separately in Fig. 2), may optionally be axially disposed within the inner lumen of the needle body 10. The solid stylet wire comprises a solid tip 28 which preferably coll~sponds in configuration to the distal tip 12 of the needle body 10. In the embodiment illustrated in the drawings, the solid stylet wire has a solid beveled tip 28, which corresponds with the beveled tip 12 of the needle body 10. The stylet wire 26iS axially disposed within the inner lumen of the needle body 10 so that the beveled distal tip 28 of the solid stylet wire 26 resides fully within and flush with the open bevel tip 12 of the surrounding needle body 10. The solid stylet wire 26iS most preferably shaped so that it can sit fully within and flush with the needle body 10. Thus, with respect to the embodiment illustrated in the drawings, the solid stylet 26 preferably has a square-shaped cross-section. As those skilled in the art will appreciate, the stylet may be modified to have a variable length trough or cut-out for use in obtaining core tissue samples.
A color coded obturator cap 30 is fixed to the distal end of the solid stylet wire 26 and is configured to fully cover the opening 19 of the female connt~ctor arm 15 of the connecting hub 14 when the solid stylet wire 26 is fully distally advanced in the inner lumen=of the needle body 10. By covering the opening 19, the obturator cap 30 will prevent cont~min~nts from entering the channel 15 of connecting hub 14 and the inner lumen of the needle body 10.
The surgical instrument of the present invention is especially adapted for use in combination with an ultrasonic im~ging system. A discussion of techniques for using ultrasonic im~ging systems in needle glli~i~nce is providedin the book titled "Advances in Ultrasound Techniques and Instrument~tion,"
edited by Peter N. T. Wells, published by Churchill-Livingstone, 1993 (see W 0~6/33654 PCT~US96/0541 _ 9 _ specifically Chapter 7, Needle Guidance Techniques, by W. Norman McDicken), the: discl~sure of which is incorporated herein by reference.
Generally, ultra~sonic im~ging systems emit a low frequency incident beam of about 2 to 10 ~IHz firom a tr~n~ducer through the body tissue. The inci~lent S beam is reflecte~d by the needle, and the reflect~l beam travels back through the body tissue and is, detected by a monitor positioned outside the body (in the more modern ultrasonic im~ing systems the tr~n~ducer is also the detector).
An image of the neeclle is generated by the im~ging system using the reflected inci(lent beam, ther*ly enabling the operator to ascertain the position of the needle in the body.
General]y, whlere small biopsies are performed at shallow depths (e.g., about 1-5 c.m.) the ultrasound imaging system uses about a 7 - 10 MHz transducer to generate the incident beam. For larger biopsies performed at deeper depths (e.g., about 5-15 c.m.), 5 - 2 1/2 MHz tr~n~d-lcers are ~l~r~ d.
Figs. 5 aLnd 6 illustrate how a plefe-l~d needle of the present invention achieves better ultrasonic visibility than conventionally shaped circular needle~
Fig. S shows an ultrasonic beam being geometrically reflected from the outer wall of a conve;ntionally shaped circular needle 62. A transducer 60 is positioned in relation to the needle 62. The incident ultrasonic beam em~n~ting from the tr~n~mitter 60 is indicated by arrows A, B, and C
respectively. ~s depicted in Fig. 5, the incident beam strikes the surface of the conventionally shaped circular needle and is reflected as indicated by arrows A', B', and C'', respectively. As can be ascertained from Fig. 5, only a small portion of the incident beam (e.g., represented by arrow A') is reflect~l back ~o transducer 60 for detection. The majority of the incident beam (e.g., r~,lesen~ed by arrows B' and C', respectively) is reflected in a direction away frorn the transducer 60 and thus is not detected. Thus, the r arrangement depictedl in Fig. S would result in poor visualization of the conventionally shaped circular shaped needle by the im~ging equipment (not shown) to which the tr~nc~ucer is ~tt~hed.
W 096/33654 PCT~US96/05418 Conversely, the arrangement in Fig. 6 provides for substantially improved vi~u~li7~tion of a ~r~ftlled needle of the present invention. The planar surface provided by a p.~er~;l.ed needle of the invention presents a muchlarger surface area for the incident beam to strike in a manner such that the beam is reflected back to the tr~n~ducer for detection. As can be ascertained from Fig. 6, a majority of the reflected incident beam (A', B', and C') is directed back to the transducer 60 when it strikes the planar surface 64 of a pler~;--ed needle of the invention. This, of course, leads to better vi~u~li7~tion of the needle by the imaging equipment (not shown) to which the tr~n~d~lcer is ~tt~hed. Additionally, by spinning the plefe.red needle of the invention during insertion, it is possible to create a micro-cavitation effect, which improves the ultrasonic visibility of the needle.
Finally, Figs. 7 and 8 are schematic .c;~les~ tations of a needle according to the invention in combination with an ultrasonic im~ging system.
A needle 104 according to the invention is inserted into a human body 100 (illustrated in cross-section) and is guided to a target area 102 by an ultrasonic im~ging system. The ultrasonic im~ging system comprises a transducer 108, a tr~n~ducer cable 110, and ultrasound monitor display 114. An image 112 of the needle 104 and the target area 102 is generated on the ultrasound monitor display 114, which enables the operator to guide the needle 104 to the target area 102.
As those skilled in the art will appreciate based on the fo-egoing description, a variety of needles such as fluid aspiration needles (such as amniocent~sis needles) and biopsy needles may be adapted for use in this invention. Also, the needles of the present invention may be adapted for use in various biopsy techniques, including cytologic aspiration, fluid aspiration, histological biopsies, and coaxial percutaneous biopsy techniques.
Additionally, the needles of the present invention may be used in automated biopsy devices such as, for example, the Bard~ Biopty~D System.
Furthermore, the present invention may be adapted for use with meAic~l instruments other than just needles wherever improved ultrasonic visibility is desired. For example, trocars, insertable scopes, catheters, and the like may CA 022l9l6l l997-l0-24 W O 96/33654 PCTrUS96/0541~' be provided witlh a non-circular cross sectional shape having at least one exterior planar surface for reflecting an incident beam. Finally, although the present invention is e~;pec;~lly adapted for use with ultrasonic im~ging systems, it may also be used with im~ging systems such as x-ray im~ging systems, CAT
scan im~ging systems, and the like.
Example Phantom ultrasounds were conducted using the following materials.
Test Materials: A container of metamusal and a canned ham;
Needles: Conventional circular-shaped needles ranging in size from 22 to 18 gauge, and pl~f~,led needles of the invention having a square-shaped cross-section with a size corresponding to the projected cross-sectional area of the circular shaped n~llf s;
Tr~neducç-rs: 4 MHz variable frequency phased array vector ultrasound transducer and a 7 MHz variable frequency phased array linear ultrasound transducer with an Acuson Corporation (Mountain View, CA) 128 X/P 10 ultrasound platform. The ultrasound images were recorded on an Acuson Corporation Aegis image archival system.
Also, the angle between the needle and incident beam was varied in the phantom ultrasounds. The angles tested were 90 clegrees, 45 degrees, 30 degrees, and 15 degrees.
In the phantom ultrasounds, the images generated by the plefell~d n~Alf-s of the present invention were consistently better than the conventional circular-shaped mf~Alf~s As expected, the images generated by all the needles were best when the angle between the incident beam and the needle was 90 degrees. The innage became increasingly poorer as the angle was varied from 45 degrees to 3() degrees, and was at its poorest at 15 degrees. The difference between the images generated by the preferred needles of the invention and conventional circular-shaped needles were most pronounced with larger needles (e.g., lower gauge), at higher frequencies, and the more superficially located (e.g., closer to l:he surface) the needle was in the test material.
W 096/33654 PCT~US96/05418 The foregoing description, examples, and drawings, which describe a ~-er~ ,ed embodiment of the present invention, are to be considered as illustrative and not restrictive in character. The invention, the full scope of which, is defined by the following claims.
This invention relates generally to the medical arts and more particularly to a needle or other me~lic~l instrument having improved reflectiveplop~lLies and enlh~nce~ ultrasonic visibility when used in conjunction with an ultrasonic im~ging system.
BACKGROUND OF l HE INVENTION
Many techniques have been developed to non-invasively image or "see"
the internal strucl:ures of human and animal bodies. Such techniques have in the past included radiography, fluoroscopy, and, more recently, ultrasonography, col-lpu~ed tomography, and m~gnetic resonance im~ging.
Prior to the development of these im~ging techniques, exploratory surgery had to be performed in order to see the internal structures of human and animal bodies. However, fatal complications were sometimes encountered with exploratory surgery.
Despite the adv~mces that have been made in the above im~ging itechniques, many entities are difficult to differentiate using only im~ging ~:echniques. Accordingly, it is often very difficult to conclusively ~ nosP
certain conditions bas_cl solely on their image. Only by obtaining a sample of Ihe involved tiSSUI' or fluid can the condition or entity be conclusively identified, and the correct diagnosis made.
In attempt to avoid the dangers associated with surgery, a number of minim~lly invasive techniques for obtaining tissue or fluid samples from the W 096/336S4 PCT~US96/OS418 body have been developed in recent years. These techniques involve the use of im~ging techniques, such as ultrasound, to guide specially desi~nell needles through the inside of the body to the target tissue or fluid. Once guided to thetarget, the specially ~le~igned needle is used to obtain samples of the target S tissue or fluid for analysis outside of the body. Moreover, in certain cirCumst~ncçs~ a tube or c~th~t~r may be in~t~lled at the target for longer termfluid drainage or for ~-lmini~tçring therapeutic agents. Many lives have been saved and surgical complications avoided by the use of such im~ging gui~l~nce techniques for obtaining tissue or fluid samples from the body.
In tissue biopsy, for example, a needle (or puncturing cannula) is inserted into the body and guided to the site of the tumor or other tissue mass to be evaluated. The physician guides the needle to the desired location in the body using an im~ging system such as ultrasound, which permits the physician to monitor the insertion and advancement of the needle in the body.
Ultrasound guidance systems are well known in the art, and work on the principle of reflecting sound waves off of the needle. The reflected wave is detected by a monitor located outside the body, and an image is generated, which reveals the location of the needle in the body. Two examples of ultrasonically guided puncturing cannula apparatuses are found in U.S. Patent No. 3,556,079 and U.S. Patent No. 4,029,084, the disclosures of which are incorporated herein by reference. Needle guidance with ultrasound im~ging may be used to obtain tissue and fluid samples in a variety of procedures such as, for example, para and thoracocenteses, amniocentesis, abscess aspiration, cytologic and core histologic biopsy, and fetal blood sampling.
Accurate guidance of the needle in the body is not only critical to obLahling the proper tissue sample, but accurate guidance is also necessary to avoid unintçntional puncturing or damage to body tissue. Unfortunately, needles conventionally used in biopsy procedures and the like that rely on ultrasonic imaging for guidance have relatively poor ultrasonic visibility. The needles conventionally used in such procedures have a generally tubular shape with a circular cross-section, and thus present a curved surface to the inci(lçnt ultrasonic beam. When the incident beam strikes the curved surface of these W O 96/33654 PCT~US9610541 conventionally s,haped circular needles, only a small portion of the beam is reflPct~i back to the monitoring device; a majority of the incident beam being t scattered away irom the monitoring device. Rec~lse only a small portion of the rçflect~l incident beam is detocteA at the monitoring device, a relatively poor image of the needle is generated, which makes it difficult to ascertain theprecise position of the: needle in the body. In response to this problem, con~iderable effort has been expended to enhance the ultrasonic visibility of conventionally shaped circular nLo~A1os For exanlple, one prior approach to enhancing the ultrasonic visibility of the needle is roughening or scouring the outer surface of the needle itself or by rollgh~oning the surface of a solid stylet that is disposed axially within the lumen of the nffdle. One such example of this approach is found in U.S.
Patent No. 4,869,259, the disclosure of which is incorporated herein by reference. A portion of the exterior surface of the needle is uniformly and randomly particle-blasted with particulate materials such as sand, silicon carbide, or metal ~iliç:~tes. The resulting particulate band, which extends around the circulrnference of the needle, increases its ultrasonic visibility bycausing diffraction of the reflected incident beam as the angle between the needle and the incident beam is deviated from 90 degrees.
Another example of an attempt to make a needle more ultrasonically visible is found in U.S. Patent No. 4,401,124, the disclosure of which is incol~oldted herein by reference. This patent discloses a surgical instrument having diffraction grating disposed on the surface of the instrument. The grating has a specific distance between the depths of adjacent grooves, the ~ t~nce being a function of various parameters including the wavelength of the inci~l~nt beam and the angle between the incident beam and an axis along the surface of the instrument. It is disclosed that the diffraction grating increases the reflection coeffiçiellt of the surgical instrument, which increases its ultrasonic visibility.
Although these prior art approaches may improve the ultrasonic visibility of a needle, the process of rolrghening or scouring the needle adds ~1clitio~1 steps to the manufacturing process, and increases m~nllf~çturing W O 96/33654 PCTrUS96105418 costs. Also, a scoured or roughened needle surface may complicate percutaneous insertion and subsequent passage of the needle through body tissue. t Another approach to increasing the ultrasonic visibility of a needle is disclosed in U.S. Patent No. 5,048,530, the disclosure of which is inco,~u,dted herein by reference. That patent discloses a needle or other tubular cannula having one or more "sounding apertures" positioned along the needle to improve its ultrasonic visibility. The di~mt~tPr of each sounding aperture is substantially equal to a predetermined wavelength of an incident ultrasonic beam. According to the disclosure of the patent, upon striking the sounding aperture, the incident beam is diffracted and the resulting echo diffuses isotopically thelcfiu-ll, thereby improving the ultrasonic detect~l~ility of the needle. Again, as with other prior art approaches, the sounding apc,lll,eapproach may make the needle more difficult to manufacture and increase manufacturing costs.
Another approach to improving the ultrasonic visibility of a needle is to place a transducer in the needle itself to radiate an ultrasonic beam back to a detector located outside the body. However, a shortcoming to this approach is that the needle must be equipped with expensive and complicated electronic ci,cuil,y, which increase the complexity of and the cost to manufacture the needle.
Clearly, there is a need for a medical instrument, and a needle in particular, with enhanced ultrasonic visibility, and which is inexpensive and simple to manufacture.
SUMMARY OF THE INVENTION
Applicant has developed a medical instrument, which s~tic~lçs the need for such an instrument with enhanced ultrasonic visibility. As described in more detail below, a medical instrument such as a needle is provided comprising a non-circular shaped portion having at least one exterior planar surface. The planar surface of the needle provides a greater surface area than that presented by conventionally shaped circular needles for reflecting an CA 022l9l6l l997-l0-24 W 0~6/33654 PCTrUS96/05418 inr;dent beam. Rer~llse of the greater surface area, a greater amount of the incident beam isi reflected back to a monitoring device, thereby enh~n~-ing the visibility of the lleedle. Thus, the needle of this invention is more readily "seen" by ultrasonic im~ging techniques than conventionally shaped circular nPeAl~, In acco~lance with one aspect of the invention, a medic~l instrument for insertion into the body and adapted to be used in conjunction with an im~ging system is provided. The medical instrument comprises a non-circular shaped portion whicll is to be inserted into the body, the non-circular portion having at least one exterior planar surface capable of reflecting an incident beam of energy.
In another aspect of the invention, a method of monitoring the location of a percutaneous positioned medical instrument is provided. A mP~lic~l instrument having a pel~;u~leous positioned non-circular shaped portion compri~ing at least one exterior plaLnar surface is provided. An incident beam of energy is directed at the exterior planar surface of the medical instrument such that the incident beam is reflected. The reflected incident beam is then received and monitored by a monitoring device.
Further aspects of the present invention will be ~parent to those skilled in the art based on the following detailed description of a p~erelred embodiment of the invention and the accompanying drawings.
W 096/3365~ PCTrUS96/05418 BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 is a perspective view of a prerclled needle of the invention.
Fig. la is a cross-section view of the needle illustrated in Fig. 1 along line a--a.
Fig. 2 is a perspective view of a solid stylet wire adapted for placement within the inner lumen of the needle illustrated in Fig. 1.
Fig. 3 is a perspective view of the needle illustrated in Fig. 1 with the solid stylet wire ill--~tr~tPcl in Fig. 2 sitting within the inner lumen of the needle.
Fig. 4 is a cutaway elevational view of a ~lcfellcd needle of the invention having a solid stylet axially disposed therein.
Fig. 5 is a schematic r~lcselltation of an incident beam of energy being reflected from a conventionally shaped circular needle.
Fig. 6 is a schem~tic l~lese,ltation of an incident beam of energy being reflected from a ~,cfcl,cd needle of the present invention having a square-shaped cross-section.
Fig. 7 is a schem~tic representation of the use of a ~lcrellcd needle of the invention with an ultrasound system.
Fig. 8 is a schematic representation of how a pleft:lled needle of the invention appears on the monitor of an ultrasound system.
DETAILED DESCRIPTION OF THE
PRESENTLY PREFERRED EMBODIMENTS
The acco",l,~lying drawings are provided solely for the purpose of illustrating a presently prefellcd embodiment of the invention and are not inten~etl to limit the scope of the invention in any way.
Figs. 1-4 show the external configuration of a plcrcllcd needle of the present invention while Figs. 5 and 6 illustrate the means by which a p.ert;"cd needle of the invention provides improved ultrasonic visibility. Figs. 7 and 8 schP-m~tic~lly depict a prefe~cd needle of the invention in combination with an ultrasound system and the image generated by a preferred needle of the present invention, respectively.
W 0'96/33654 PCTrUS96/0541 With reference to Figs. 1-4, a pr~fe,r~d needle of the present invention compr ~es a hollow needle body 10 having a beveled distal tip 12 and a proximal comlP~tinlJ hub 14 formed on opposite ends of the needle body 10.
In a p-~er~ d aspect of the invention, the needle body 10 has a square-shaped cross-section wi.th planar exterior surfaces 16a, l~b, 16c, and 16d (see Fig.
la). The planar exterior surface is preferably continuous along a substantial portion of the length of the needle body as shown. It should be understood, however, that the needle of the present invention may be of any non-circular cross-section shape thlat has at least one exterior planar surface for reflecting a n incident beam of energy. Thus, other suitably shaped needles contemplated for use in this invention rnay have a triangular cross-section, a pentagonal cross-section, a hemispherical cross-section, etc. Unlike the needle body 10, however, the shape of the needle tip 12 is not critical. Numerous types of needle tips are contennplated for use in this invention such as, for ex~mplç, beveled tips, double beveled tips, and conical tips.
The needle body 10 is configured with a length and cross-section depending on thle procedure and the desired depth of percutaneous insertion of the needle. For eY~mrle, for histologic biopsies of the liver or kidney where a large biopsy is required, a relatively large needle having a size similar to an about 14 gauge conventionally shaped circular needle is ~-~f~lled. On the other hand, fluid aspiration (such as in amniocentesis) or cytologic aspiration calls for a relatively small biopsy sample, and thus a smaller needle having a size similar to an about 20 gauge conventionally shaped needle is p~ ;d.
The needle body 10 is preferably made from any medical grade material such as those market,ed as Superior "microbore" or Sterling "plug drawn."
The comlecting hub 14 is preferably made from a clear plastic m~t~.ri~l.
The connecting hub plreferably comprises two opposing faces 14a and 14b (not shown). The connecling hub 14 further comprises a channel 15 (not shown) defined by a female connector arm 18. The female connector arm 18 has a first opening l9 which leads to the ch~nnel 15. A flange 21 extends around the opening 19 of cormector arm 18. The female connector arm 18 has a second opening 22 ;adapted to receive the needle body 10. The ch~nnel 15 CA 022l9l6l l997-l0-24 W 096/33654 PCT~US96/05418 extends along a longit~in~l axis of connecting hub 14 and communic~t~s with the inner lumen of needle body 10. Finally, three annular ribs 24 extend laterally across the opposing faces 14a and 14b (not shown) of the connecting hub 14 to form convenient finger gripping surfaces whereby the needle may be firmly grasped by the operator during insertion and manipulation of the needle.
Although not critical in the present invention, a solid stylet wire 26, (shown separately in Fig. 2), may optionally be axially disposed within the inner lumen of the needle body 10. The solid stylet wire comprises a solid tip 28 which preferably coll~sponds in configuration to the distal tip 12 of the needle body 10. In the embodiment illustrated in the drawings, the solid stylet wire has a solid beveled tip 28, which corresponds with the beveled tip 12 of the needle body 10. The stylet wire 26iS axially disposed within the inner lumen of the needle body 10 so that the beveled distal tip 28 of the solid stylet wire 26 resides fully within and flush with the open bevel tip 12 of the surrounding needle body 10. The solid stylet wire 26iS most preferably shaped so that it can sit fully within and flush with the needle body 10. Thus, with respect to the embodiment illustrated in the drawings, the solid stylet 26 preferably has a square-shaped cross-section. As those skilled in the art will appreciate, the stylet may be modified to have a variable length trough or cut-out for use in obtaining core tissue samples.
A color coded obturator cap 30 is fixed to the distal end of the solid stylet wire 26 and is configured to fully cover the opening 19 of the female connt~ctor arm 15 of the connecting hub 14 when the solid stylet wire 26 is fully distally advanced in the inner lumen=of the needle body 10. By covering the opening 19, the obturator cap 30 will prevent cont~min~nts from entering the channel 15 of connecting hub 14 and the inner lumen of the needle body 10.
The surgical instrument of the present invention is especially adapted for use in combination with an ultrasonic im~ging system. A discussion of techniques for using ultrasonic im~ging systems in needle glli~i~nce is providedin the book titled "Advances in Ultrasound Techniques and Instrument~tion,"
edited by Peter N. T. Wells, published by Churchill-Livingstone, 1993 (see W 0~6/33654 PCT~US96/0541 _ 9 _ specifically Chapter 7, Needle Guidance Techniques, by W. Norman McDicken), the: discl~sure of which is incorporated herein by reference.
Generally, ultra~sonic im~ging systems emit a low frequency incident beam of about 2 to 10 ~IHz firom a tr~n~ducer through the body tissue. The inci~lent S beam is reflecte~d by the needle, and the reflect~l beam travels back through the body tissue and is, detected by a monitor positioned outside the body (in the more modern ultrasonic im~ing systems the tr~n~ducer is also the detector).
An image of the neeclle is generated by the im~ging system using the reflected inci(lent beam, ther*ly enabling the operator to ascertain the position of the needle in the body.
General]y, whlere small biopsies are performed at shallow depths (e.g., about 1-5 c.m.) the ultrasound imaging system uses about a 7 - 10 MHz transducer to generate the incident beam. For larger biopsies performed at deeper depths (e.g., about 5-15 c.m.), 5 - 2 1/2 MHz tr~n~d-lcers are ~l~r~ d.
Figs. 5 aLnd 6 illustrate how a plefe-l~d needle of the present invention achieves better ultrasonic visibility than conventionally shaped circular needle~
Fig. S shows an ultrasonic beam being geometrically reflected from the outer wall of a conve;ntionally shaped circular needle 62. A transducer 60 is positioned in relation to the needle 62. The incident ultrasonic beam em~n~ting from the tr~n~mitter 60 is indicated by arrows A, B, and C
respectively. ~s depicted in Fig. 5, the incident beam strikes the surface of the conventionally shaped circular needle and is reflected as indicated by arrows A', B', and C'', respectively. As can be ascertained from Fig. 5, only a small portion of the incident beam (e.g., represented by arrow A') is reflect~l back ~o transducer 60 for detection. The majority of the incident beam (e.g., r~,lesen~ed by arrows B' and C', respectively) is reflected in a direction away frorn the transducer 60 and thus is not detected. Thus, the r arrangement depictedl in Fig. S would result in poor visualization of the conventionally shaped circular shaped needle by the im~ging equipment (not shown) to which the tr~nc~ucer is ~tt~hed.
W 096/33654 PCT~US96/05418 Conversely, the arrangement in Fig. 6 provides for substantially improved vi~u~li7~tion of a ~r~ftlled needle of the present invention. The planar surface provided by a p.~er~;l.ed needle of the invention presents a muchlarger surface area for the incident beam to strike in a manner such that the beam is reflected back to the tr~n~ducer for detection. As can be ascertained from Fig. 6, a majority of the reflected incident beam (A', B', and C') is directed back to the transducer 60 when it strikes the planar surface 64 of a pler~;--ed needle of the invention. This, of course, leads to better vi~u~li7~tion of the needle by the imaging equipment (not shown) to which the tr~n~d~lcer is ~tt~hed. Additionally, by spinning the plefe.red needle of the invention during insertion, it is possible to create a micro-cavitation effect, which improves the ultrasonic visibility of the needle.
Finally, Figs. 7 and 8 are schematic .c;~les~ tations of a needle according to the invention in combination with an ultrasonic im~ging system.
A needle 104 according to the invention is inserted into a human body 100 (illustrated in cross-section) and is guided to a target area 102 by an ultrasonic im~ging system. The ultrasonic im~ging system comprises a transducer 108, a tr~n~ducer cable 110, and ultrasound monitor display 114. An image 112 of the needle 104 and the target area 102 is generated on the ultrasound monitor display 114, which enables the operator to guide the needle 104 to the target area 102.
As those skilled in the art will appreciate based on the fo-egoing description, a variety of needles such as fluid aspiration needles (such as amniocent~sis needles) and biopsy needles may be adapted for use in this invention. Also, the needles of the present invention may be adapted for use in various biopsy techniques, including cytologic aspiration, fluid aspiration, histological biopsies, and coaxial percutaneous biopsy techniques.
Additionally, the needles of the present invention may be used in automated biopsy devices such as, for example, the Bard~ Biopty~D System.
Furthermore, the present invention may be adapted for use with meAic~l instruments other than just needles wherever improved ultrasonic visibility is desired. For example, trocars, insertable scopes, catheters, and the like may CA 022l9l6l l997-l0-24 W O 96/33654 PCTrUS96/0541~' be provided witlh a non-circular cross sectional shape having at least one exterior planar surface for reflecting an incident beam. Finally, although the present invention is e~;pec;~lly adapted for use with ultrasonic im~ging systems, it may also be used with im~ging systems such as x-ray im~ging systems, CAT
scan im~ging systems, and the like.
Example Phantom ultrasounds were conducted using the following materials.
Test Materials: A container of metamusal and a canned ham;
Needles: Conventional circular-shaped needles ranging in size from 22 to 18 gauge, and pl~f~,led needles of the invention having a square-shaped cross-section with a size corresponding to the projected cross-sectional area of the circular shaped n~llf s;
Tr~neducç-rs: 4 MHz variable frequency phased array vector ultrasound transducer and a 7 MHz variable frequency phased array linear ultrasound transducer with an Acuson Corporation (Mountain View, CA) 128 X/P 10 ultrasound platform. The ultrasound images were recorded on an Acuson Corporation Aegis image archival system.
Also, the angle between the needle and incident beam was varied in the phantom ultrasounds. The angles tested were 90 clegrees, 45 degrees, 30 degrees, and 15 degrees.
In the phantom ultrasounds, the images generated by the plefell~d n~Alf-s of the present invention were consistently better than the conventional circular-shaped mf~Alf~s As expected, the images generated by all the needles were best when the angle between the incident beam and the needle was 90 degrees. The innage became increasingly poorer as the angle was varied from 45 degrees to 3() degrees, and was at its poorest at 15 degrees. The difference between the images generated by the preferred needles of the invention and conventional circular-shaped needles were most pronounced with larger needles (e.g., lower gauge), at higher frequencies, and the more superficially located (e.g., closer to l:he surface) the needle was in the test material.
W 096/33654 PCT~US96/05418 The foregoing description, examples, and drawings, which describe a ~-er~ ,ed embodiment of the present invention, are to be considered as illustrative and not restrictive in character. The invention, the full scope of which, is defined by the following claims.
Claims (25)
1. A medical instrument for insertion into a body and used in conjunction with an imaging system adapted to direct an incident beam into the body, the instrument comprising a non-circular shaped portion which is to be inserted into the body, the non-circular shaped portion comprising at least one exterior planar surface capable of reflecting the incident beam.
2. The medical instrument of claim 1 wherein the imaging system comprises an ultrasonic imaging system.
3. The medical instrument of claim 2 comprising a needle.
4. The medical instrument of claim 3 wherein the needle comprises a biopsy needle.
5. The medical instrument of claim 3 wherein the needle comprises a fluid aspiration needle.
6. The medical instrument of claim 2 comprising a catheter.
7. The medical instrument of claim 2 comprising a trocar.
8. The medical instrument of claim 2 comprising an insertable scope.
9. The medical instrument of claim 3 wherein the non-circular shaped portion of the needle comprises a square cross-section.
10. The medical instrument of claim 9 wherein the needle comprises a needle body and a stylet.
11. The medical instrument of claim 1 wherein the exterior planar surface is continuous along a substantial portion of the length of the medical instrument.
12. A method of monitoring the location of a percutaneous positioned medical instrument comprising:
a) providing a medical instrument comprising a percutaneously positioned, non-circular shaped portion having at least one exterior planar surface;
b) directing an incident beam of energy at an exterior planar surface of the medical instrument such that the incident beam of energy is reflected; and c) receiving and monitoring the reflected beam.
a) providing a medical instrument comprising a percutaneously positioned, non-circular shaped portion having at least one exterior planar surface;
b) directing an incident beam of energy at an exterior planar surface of the medical instrument such that the incident beam of energy is reflected; and c) receiving and monitoring the reflected beam.
13. The method of claim 12 wherein the incident beam comprises an ultrasonic beam.
14. The method of claim 13 wherein the medical instrument comprises a needle.
15. The method of claim 14 wherein the needle comprises a biopsy needle.
16. The method of claim 14 wherein the needle comprises a fluid aspiration needle.
17. The method of claim 13 wherein the medical instrument comprises a catheter.
18. The method of claim 13 wherein the medical instrument comprises a trocar.
19. The method of claim 13 wherein the medical instrument comprises a insertable scope.
20. The method of claim 14 wherein the non-circular shaped portion of the needle comprises a square cross-section.
21. The method of claim 20 wherein the needle comprises a needle body and a stylet.
22. The method of claim 12 wherein the exterior planar surface is continuous along a substantial portion of the length of the medical instrument.
23. A needle for insertion into the body and used in conjunction with an ultrasonic imaging system adapted to direct an incident beam of ultrasonic energy into the body, the needle comprising a non-circular shaped portion for insertion into the body, the non-circular portion having at least one exterior planar surface capable of reflecting the incident beam.
24. The needle of claim 23 further comprising a needle body and a stylet.
25. The needle of claim 23 wherein the exterior planar surface is continuous along a substantial portion of the length of the needle.
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US08/427,741 US5611345A (en) | 1995-04-24 | 1995-04-24 | Medical instrument with improved ultrasonic visibility |
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US2830587A (en) * | 1954-02-01 | 1958-04-15 | Everett Samuel James | Hypodermic needles |
US2803587A (en) * | 1956-05-15 | 1957-08-20 | Jung Frederic William | Method of heat treatment, separation, and coking coal |
US3090384A (en) * | 1960-04-15 | 1963-05-21 | Mfg Process Lab Inc | Needle |
US3556079A (en) | 1967-05-16 | 1971-01-19 | Haruo Omizo | Method of puncturing a medical instrument under guidance of ultrasound |
DE2425724C3 (en) * | 1974-05-28 | 1979-09-27 | Siemens Ag, 1000 Berlin Und 8000 Muenchen | Puncture cannula |
US3955558A (en) * | 1974-11-04 | 1976-05-11 | Medcom, Inc. | Instrument for spinal taps |
DE7442924U (en) | 1974-12-23 | 1976-07-15 | Siemens Ag, 1000 Berlin Und 8000 Muenchen | Ultrasonic applicator |
US4401124A (en) * | 1981-08-13 | 1983-08-30 | Technicare Corporation | Reflection enhancement of a biopsy needle |
US4582061A (en) * | 1981-11-18 | 1986-04-15 | Indianapolis Center For Advanced Research, Inc. | Needle with ultrasonically reflective displacement scale |
DE8616477U1 (en) * | 1986-06-20 | 1986-08-21 | Uromed Kurt Drews, 2000 Oststeinbek | Puncture instrument for percutaneous nephroscopy |
US4869259A (en) * | 1988-05-17 | 1989-09-26 | Vance Products Incorporated | Echogenically enhanced surgical instrument and method for production thereof |
US5048530A (en) * | 1988-08-17 | 1991-09-17 | Robert Hurwitz | Method of using an amniocentesis needle with improved sonographic visibility |
US4977897A (en) * | 1988-08-17 | 1990-12-18 | Robert Hurwitz | Amniocentesis needle with improved sonographic visibility |
US5081997A (en) * | 1989-03-09 | 1992-01-21 | Vance Products Incorporated | Echogenic devices, material and method |
US5201314A (en) * | 1989-03-09 | 1993-04-13 | Vance Products Incorporated | Echogenic devices, material and method |
US5249580A (en) * | 1991-10-08 | 1993-10-05 | Griffith James M | Method for ultrasound imaging |
US5421336A (en) * | 1994-04-04 | 1995-06-06 | Echo Cath, Inc. | Method for attaching an interventional medical device to a vibratory member associated with visualization by an ultrasound imaging system |
-
1995
- 1995-04-24 US US08/427,741 patent/US5611345A/en not_active Expired - Fee Related
-
1996
- 1996-04-19 EP EP96912903A patent/EP0830081A4/en not_active Withdrawn
- 1996-04-19 CA CA002219161A patent/CA2219161A1/en not_active Abandoned
- 1996-04-19 JP JP8532608A patent/JPH11504238A/en active Pending
- 1996-04-19 AU AU55567/96A patent/AU695163B2/en not_active Ceased
- 1996-04-19 WO PCT/US1996/005418 patent/WO1996033654A1/en not_active Application Discontinuation
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
USD669577S1 (en) | 2003-11-05 | 2012-10-23 | Kimberly-Clark Worldwide, Inc. | Cannula with band markings |
Also Published As
Publication number | Publication date |
---|---|
EP0830081A1 (en) | 1998-03-25 |
AU695163B2 (en) | 1998-08-06 |
EP0830081A4 (en) | 1999-03-24 |
WO1996033654A1 (en) | 1996-10-31 |
JPH11504238A (en) | 1999-04-20 |
US5611345A (en) | 1997-03-18 |
AU5556796A (en) | 1996-11-18 |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
EEER | Examination request | ||
FZDE | Discontinued |