CN1617687A - 对结肠进行分光镜检查的设备和方法 - Google Patents
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Abstract
这里披露了用于对结肠进行分光镜检查的设备和方法。包括一照明装置和一图像捕获装置的分光镜检查装置直接结合进可操纵内窥镜或结肠镜中。或者该分光镜检查装置和可操纵结肠镜可以是分开的装置,它们在功能上结合用来进行内窥镜分光镜检查。该可操纵结肠镜采用蛇行运动以便于快速安全地将结肠镜插入到病人的结肠中。该内窥镜分光镜检查方法可以更快速且更安全地进行。分光镜检查可以通过自动荧光、染料加强荧光或任意其它的已知分光镜技术来进行。也可以采用其它使用其波长在可见范围之外的光的成像技术。可以使用发射光信息来产生出病人结肠以及在初始检查期间所识别出的任意器官病损的位置的三维数学模型。
Description
本申请要求了于2002年1月9日提交的美国临时专利申请序列号No.60/347695的优先权,该文献其全文在这里被引用作为参考。
技术领域
本发明大体上涉及用于进行医学诊断的方法和设备。更具体地说,它涉及用于采用分光镜检查对结肠和其它器官进行疾病诊断的方法和设备。
背景技术
内窥镜分光镜检查是用于对病人体内的癌症和其它疾病进行诊断的新兴技术。分光镜检查可以用来识别采用白光内窥镜检查法不容易看到的器官病损和/或用来对采用白光内窥镜检查法或其它技术发现的可疑器官损伤的组织进行诊断或推断。自动荧光(auto fluorescence)是一种分光镜检查技术,其用一种或多种激发频率照射患者的组织并测量该组织的自然荧光和/或使该组织的自然荧光成像。可以使用在自然荧光中的差异来在正常细胞和某些患病细胞之间进行区分。染料增强荧光是一种分光镜技术,其中局部或系统地向组织施加一种或多种专门的荧光标记染料。然后这些组织用一种或多种激发频率照射,并且测量和/或拍摄这些组织的荧光。可以使用在这些荧光标识染料在吸收中的差异来识别出器官病损和/或在正常细胞和/或某些患病细胞之间进行区分。也可以采用其它已知的分光镜技术。下面的美国专利描述了同样可以与本发明结合使用的各种分光镜技术,每篇专利在这里被引用作为参考:
5421337患病组织的光谱诊断
6129667采用光谱分析的腔诊断
6096289手术中血管内和内窥镜肿瘤和病损检测活组织检查法和治疗
6174291用于进行组织诊断的光学活组织检查系统和方法
6129683光学活组织镊子
6066102诊断组织的光学活组织检查镊子系统和方法
5762613光学活组织镊子
5601087用导线来诊断组织的系统
5439000用导线诊断组织的方法
5383467用于诊断成像的导线插管和设备
5413108用于给组织试样绘图并且根据表示癌症的自然荧光团的荧光测量来区分其不同区域的方法和设备
5827190具有集成CCD传感器的内窥镜
5769792用于患病组织的内窥镜成像系统
5647368在胃肠和呼吸道中使用自然荧光来检测患病组织的成像系统
5590660用于采用集成自动荧光给患病组织成像的设备和方法
5507287用于患病组织的内窥镜成像系统
已经开发出将分光镜检查装置和内窥镜例如结肠镜结合在一起的系统。一些系统使得分光镜检查图像能够重叠到由标准白光内窥镜产生的图像上。虽然这些内窥镜分光镜检查系统在癌症和其它疾病的诊断上是一个重要进步,但是当前的系统受到许多与标准白光内窥镜术一样的限制。具体地说,当前可得到的结肠镜在插入结肠镜方面存在困难,并且在确定并且证明在病人结肠内的可疑器官病损的位置方面存在困难。另外,医生使用白光进行观察以引导结肠镜,然后必须停止并且进行分光镜观察,因此比较耗时。
美国专利No.6129667披露了一种用于采用光谱分析以便产生在病人体内的身体内腔例如血管和结肠、小肠、胃或食道的组织图的内腔诊断的系统。该系统使用无线电频率、磁共振或超声波跟踪技术在它穿过内腔时跟踪分光镜检查装置的位置以便根据在内腔壁处的光反射率和/或吸收率来构造出组织的三维图。虽然该系统在一定程度上解决了对于在病人身体内腔内所检测到的可疑器官病损的位置进行确定和证明的需要,但是该信息的有用性在一定程度上在对结肠组织绘图方面受到限制,因为该位置是参照外部参考位置来确定的。没有告知手术人员该装置相对于结肠的位置。另外,结肠在病人的腹腔内是一定程度可动的,并且由于受到蠕动和其它力所以它可以运动;因此根据即使器官本身在病人体内受到运动也相对于结肠固定的内部参考位置和标记对结肠的组织和可疑器官病损的位置进行绘图是更加有利的。另外,该现有技术系统没有解决将结肠镜插入穿过结肠的曲折通道的困难或者精确地将结肠镜引导回到可疑器官病损位置以作进一步诊断研究或外科干预。
共同所有并且共同未决的于2001年2月20日提交的美国专利申请序列号Nos.09/790204(现在为美国专利No.6468203);于2001年10月2日提交的09/969927;以及于2002年8月27日提交的10/229577,每篇文献其全文在这里被引用作为参考,披露了具有多个铰接段的可操纵结肠镜,它们被控制以一种蛇行的运动方式运动,这便于在结肠壁上施加最小的接触和应力的情况下安全迅速地插入和撤回结肠镜。另外,该可操纵结肠镜的控制系统能够在它在操作人员的控制下前进穿过内腔时构造出结肠的三维数学模型或图。可以将结肠的三维数学模型和在初始结肠镜检查的过程中所识别出的任意器官病损的位置和特性存储并且用于精确地将结肠镜引导回到可疑器官病损位置以便进行进一步诊断研究或外科干预。在这里所述的技术也可以与本发明的方法和设备结合使用以便于通过内窥镜分光镜术来对结肠壁进行检查和诊断。这些专利申请以及在这里所引用的所有专利和专利申请由此其全文被引用作为参考。
发明内容
根据上面的说明,本发明采取了用来对病人的结肠进行分光镜观察并且产生出病人结肠以及在初始检查期间所发现的任意器官病损的位置的三维数学模型的方法和设备。
本发明的分光镜检查方面可以通过自动荧光、染料增强荧光或任意其它公知的分光镜技术来进行。也可以采用使用了其波长在可见范围之外的光的其它成像技术。
分光镜检查装置可以直接结合进可操纵内窥镜或结肠镜中。或者该分光镜检查装置和可操纵结肠镜可以是分开的装置,它们在功能上结合用来例如通过将分光镜装置插入穿过可操纵结肠镜的工作通道或者穿过该分光镜检查装置所作用的通道来进行内窥镜分光镜检查。
在优选实施方案中,本发明利用在共同未决美国专利申请序列号Nos.09/790204(美国专利No.6648203);09/969927;以及10/229577中所述的可操纵结肠镜,这些文献被引用作为参考。在这里所披露的可操纵结肠镜对于进行更具本发明的内窥镜分光镜检查而言提供了许多额外优点。可操纵结肠镜采用了蛇行运动以便于快速安全地将结肠镜插入到病人的结肠中,从而使得该内窥镜分光镜检查方法可以更快速且更安全地进行。另外,可操纵结肠镜能够产生出病人结肠以及在初始检查期间所识别出的任意器官病损的位置的三维数学模型。该信息可以用来迅速精确地使结肠镜返回到所识别出的器官病损处以便进行进一步的诊断研究或外科干预。
本发明的内窥镜分光镜检查法和装置也可以用于其它内窥镜过程,包括但不限于:食管窥镜,胃窥镜,十二指肠窥镜和支气管窥镜。
附图说明
图1显示出根据本发明的内窥镜分光镜系统的第一实施方案,该系统将光纤分光镜装置与可操纵的结肠镜整合在一起。
图2显示出其分光镜装置直接结合进可操纵结肠镜中的内窥镜分光镜系统的第二实施方案。
图3显示出用于通过单根光纤产生、传送和接收光的一个实施方案的示意图。
图4显示出用于通过分开的光纤产生、传送和接收光的另一个实施方案的示意图。
具体实施方式
图1显示出根据本发明的内窥镜分光镜系统的第一实施方案,该系统将光纤分光镜装置102与可操纵的结肠镜100结合在一起。优选的是,可操纵结肠镜100如在美国专利申请No.09/790204(美国专利No.6468203);09/969927和10/229577中所述一样构成,具有多个铰接段,它们被控制成以一种蛇行的运动方式运动,这便于在结肠壁上施加最小的接触和应力的情况下插入和撤回结肠镜。可操纵结肠镜100可以是光纤内窥镜,或者更有选的是为使用CCD照相机等来捕获结肠壁内部的图像的视频内窥镜。另外,可操纵结肠镜100的控制系统在它在操作人员的控制下前进穿过内腔时能够构造出结肠的三维数学模型。结肠的三维数学模型和在初始结肠镜检查的过程中识别出的任何器官病损的位置和特性可以存储并用于精确地将结肠镜100引导回到可疑器官病损的位置以便进行进一步诊断研究或外科干预。光纤分光镜检查装置102可以直接整合进可操纵结肠镜100中,或者光纤分光镜检查装置102和可操纵结肠镜100可以是分开的装置,它们在功能上结合用来例如通过将光纤分光镜检查装置102插入穿过可操纵结肠镜100的工作通道来进行内窥镜分光镜检查。
光纤分光镜检查装置102发出具有一个或多个激发频率的光束来照射病人的组织。激发频率可以包括UV、IR、NIR、蓝光和/或其它可见或不可见频率光。光纤分光镜检查装置102转动以在可操纵结肠镜100前进或撤回时扫描这些组织。该光纤分光镜检查装置102利用自然荧光和/或通过染料增强荧光或其它公知的分光镜技术来捕获从组织表面通过反射返回的光。可操纵结肠镜100提供位置信息,光纤分光镜检查装置102提供旋转信息以及分光镜成像数据,从而产生出组织的光谱特性的三维图。由光纤分光镜检查装置102捕获的结肠的分光镜图像可以重叠在由可操纵结肠镜100捕获的结肠的白光内窥镜图像上以便于对组织和任意所识别出的可疑器官病损进行分析。分光镜检查和白光内窥镜检查可以同时进行,只要它们所使用的波长可以兼容和/或只要这两个图像可以通过适当的光学或电子过滤来分开。或者,可以间断地或以交替的方式进行分光镜检查和白光内窥镜检查,从而所使用的波长不会相互干涉。所产生出的三维图将使得操作人员能够返回到已经具有一些病症或者在前面的检查中怀疑有病症的区域,然后对该区域进行分光镜检查分析,并且将它与来自相同区域的先前图像进行比较。
图2显示出具有直接整合进可操纵结肠镜100中的分光镜检查装置110的内窥镜分光镜系统的第二实施方案。优选的是,该可操纵结肠镜100如在美国专利申请序列号Nos.09/790204(美国专利No.6468203);09/969927;以及10/229577中所述一样构成,具有多个铰接段,它们被控制成以蛇行运动的方式运动,这便于在施加在结肠壁上的接触和应力最小的情况下插入和撤回结肠镜。可操纵结肠镜100可以是光纤内窥镜,或者更有选的是为使用CCD照相机等来捕获结肠壁内部的图像的视频内窥镜。另外,可操纵结肠镜100的控制系统在它在操作人员的控制下前进穿过内腔时能够构造出结肠的三维数学模型。结肠的三维数学模型和在初始结肠镜检查的过程中识别出的任何器官病损的位置和特性可以存储并用于精确地将结肠镜100引导回到可疑器官病损的位置以便进行进一步诊断研究或外科干预。
优选的是,光纤分光镜检查装置110例如通过将分光镜检查装置110整合进可操纵结肠镜100的其中一个铰接段中从而直接整合进可操纵结肠镜100中。在一个特别优选的实施方案中,该分光镜检查装置110围绕着可操纵结肠镜100的圆周延伸,并且能够同时从围绕着分光镜检查装置110的组织的360度圆周中捕获分光镜检查数据。或者,光纤分光镜检查装置110可以构成为在可操纵结肠镜100前进或撤回时对分光镜检查装置110周围的组织进行机械或电子扫描。
该分光镜检查装置110包括一照射装置112,它发出具有一个或多个激发频率的光束以照射病人的组织。优选的是,该照射装置112发出成围绕着分光镜检查装置110的360度圆圈的照射光环。优选的是,该照射装置112包括一个或多个LED或二极管激光器或者其它内置在该装置中的已知光源,用来以一个或多个激发频率产生出光。
或者,该照射装置112可以使用外部光源和光纤照明电缆来发出光束。激发频率可以包括UV、IR、NIR、蓝光和/或在可见或不可见范围内的其它频率的光。分光镜检查装置110包括一图像捕获装置114,用来通过自然荧光和/或通过染料增强荧光或其它公知的分光镜技术来捕获从组织表面通过反射返回的光。优选的是,图像捕获装置114围绕着可操纵结肠镜100的圆周延伸,并且能够同时从分光镜检查装置110周围的组织的360圆圈中捕获分光镜成像数据。在优选实施方案中,图像捕获装置114利用了CCD照相机等内置于该装置中的装置来捕获分光镜成像数据。CCD照相机构成为只对所感兴趣的分光镜成像频率敏感和/或可以使用适当的光学或电子过滤技术。或者,该图像捕获装置可以使用光纤成像电缆和外部成像装置例如CCD照相机以捕获分光镜成像数据。CCD照相机可以构成为捕获结肠内部的广角图像。捕获广角图像的可能方式包括但不限于使用基于照相机的鱼眼镜头或球形镜头。
可操纵结肠镜100提供了位置信息,分光镜检查装置110提供了分光镜成像数据以产生出这些组织的光谱性能的三维图。由分光镜检查装置100捕获的结肠的分光镜图像可以重叠在由可操纵结肠镜100捕获的结肠的白光内窥镜图像上以便于对组织和任意所识别出的可疑器官病损进行分析。分光镜检查和白光内窥镜检查可以同时进行,只要它们所使用的波长可以兼容和/或只要这两个图像可以通过适当的光学或电子过滤技术来分开。或者,可以间断地或以交替的方式进行分光镜检查和白光内窥镜检查,从而所使用的波长不会相互干涉。另一个可选方案是使分光镜装置设置在离顶端足够远的位置,因此用于视觉的光不会与分光镜检查干涉。
分光镜检查成像数据和白光内窥镜成像数据可以实时地观看和/或记录并且存储以便随后对所识别的任意可疑器官病损进行分析和诊断。在使用本发明的内窥镜分光镜系统的一个优选方法中,分光镜检查在可操纵结肠镜100在病人的结肠内前进和回撤时自动地进行。因此操作人员集中精力操纵可操纵结肠镜100以通过结肠的曲折通道并且进行白光内窥镜检查。分光镜检查成像数据和白光内窥镜成像数据与其准确位置的信息一起记录和存储,以便随后对所识别出的任意可疑器官病损进行分析和诊断。内窥镜分光镜检查系统还可以利用图案识别软件等来从分光镜检查成像数据和/或白光内窥镜成像数据中识别出潜在的器官病损,并且告知操作人员结肠的特定部分要进行更进一步的检查。该功能优选在结肠镜检查期间实时地进行,从而可以立即观察可疑的器官病损。另外,该功能可以在所记录的图像数据上进行以提高诊断精确度。
在一个优选方案中,在所示的图像为早先从结肠镜顶端当前所处的位置中获取的图像时,在进入途中记录的分光镜检查数据将在出去途中显示给操作人员。这将通过利用可操纵结肠镜100的三维绘图能力来实现。
另一个可选方案在于,分析分光镜数据的软件将识别出可疑区域,并且在结肠镜撤回并且到达那些可疑器官病损的区域(在进入途中发现的)处时,该系统将给针对该可疑区域给操作人员发信号,并且操作人员将进行再次分光镜检查或者从可疑区域或器官病损中获取活组织切片检查。
也可以使用来自内窥镜分光镜检查系统的存储成像数据和由可操纵结肠镜100产生出的结肠的三维数学模型来长时间跟踪疾病的进展和/或将可操纵结肠镜100引导至所识别的器官病损处以便随后进行外科干预。
为了产生、传送和接收分光镜检查信号,可以使用各种组件。图3显示出在组件120中的一个实施方案,如在图1的实施方案中所示一样,该组件可以使用单根光缆。可以包括激光器、LED等的光源122可以构成为根据所要产生出的信号的期望频率和类型产生出不同频率的光例如UV、IR、NIR、蓝光和/或在可见或不可见范围内的其它频率的光等。光源122可以产生出光124,该光传送穿过光纤,然后通过各种滤波器和/或准直透镜组件126。可以使经过滤波和对准的这个光128通过分光器140并且传送给光纤分光镜装置102的近端。光缆136可以通过位于结肠镜的把手130上或附近的进入口132或134随意导入进结肠镜中。
光纤分光镜检查装置102的远端可以相对于结肠镜100自身前进或撤回。如上所述,在光纤装置102旋转时,它可以发出所传送光或信号,并且也接收具有分光镜检查信息的反射光。该反射光可以通过光纤136在近侧传送回并且作为信号138发射出。该信号138通过镜子式分光镜140反射,从而反射光142朝着滤波器和/或准直透镜组件144引导,该组件可以用来过滤和/或对准信号。经过滤波和反射的光146然后朝着检测器148例如CCD检测器引导,该检测器可以将光信号转换成可以发送给处理器52的电信号150。经过处理的信号154然后可以发送给显示单元156,以便将所反射出的信号传达给用户。
在图4中显示出用于对分光镜检查信息进行传输和处理的另一个实施方案,该图显示出与图3类似的组件160,但是利用了多根如图2的实施方案所示一样的光缆。该变型中,可以采用光源122产生出光,并且将该光引导进光纤136中。该光可以与位于结肠镜100的远端处或附近的照明装置光学连接。如上所述,该照明装置112可以在结肠镜100周围径向引导光。反射信号可以在图像捕获装置114上入射,该图像捕获装置自身可以在圆周上设置在结肠镜100周围。该图像捕获装置114可以与接收光缆162的远端光学连接。信号可以在近侧行进穿过该光缆162并且通过与光纤136相同的进入口132或者第二进入口134传送。
虽然在这里已经针对示例性实施方案和用于实施本发明的最佳方式对本发明进行了说明,但是对于本领域普通技术人员显而易见的是,在不脱离本发明的精神和范围的情况下可以作出许多改变、改进以及这些不同实施方案、改进和变化的再组合。
Claims (20)
1.一种用于对中空身体器官进行分光镜检查的内窥镜装置,它包括:
一细长主体,它具有多个可铰接段和一可操纵远端部分,其中每个段可以构成为在细长主体向远端或向近端行进时呈现出所选的形状;以及
一分光镜检查组件,它具有一照明装置和用来接收从中空身体器官的壁反射的入射光的图像捕获装置,其中该分光镜检查组件设置在细长主体的远端部分处或其附近。
2.如权利要求1所述的内窥镜装置,其中所述照明装置包括设置在细长主体内的光源。
3.如权利要求2所述的内窥镜装置,其中所述光源包括LED或激光二极管。
4.如权利要求1所述的内窥镜装置,其中所述照明装置包括至少一根设置在细长主体内的光纤,该光纤的近端与光源光学连通。
5.如权利要求4所述的内窥镜装置,其中光源包括LED或激光二极管。
6.如权利要求4所述的内窥镜装置,其中所述光源用来发出具有在一范围中的频率的光,该范围选自由UV、IR、NIR、蓝光和可见光构成的组。
7.如权利要求4所述的内窥镜装置,其中所述光纤的远端可以延伸超过细长主体的远端。
8.如权利要求7所述的内窥镜装置,其中光纤能够绕着光纤的纵向轴线转动。
9.如权利要求1所述的内窥镜装置,其中图像捕获装置包括至少一根设置在细长主体内的光纤。
10.如权利要求1所述的内窥镜装置,其中所述图像捕获装置包括一CCD照相机。
11.如权利要求1所述的内窥镜装置,其中所述分光镜组件能够在形成在细长主体内的管腔内向远端前进。
12.如权利要求1所述的内窥镜装置,其中入射光包括通过一种方法从壁发射的光,该方法选自由反射、自然荧光和染料增强荧光构成的组。
13.一种对中空身体器官进行分光镜检查的方法,它包括:
在不损伤中空身体器官的情况下将具有多个可铰接段和一可操纵远端部分的细长主体设置在中空身体器官内;
用设置在细长主体的远端部分上的照明装置照亮中空身体器官的内表面;
用设置在远端部分上的图像捕获装置来接收从中空身体器官的内表面反射的光;并且
处理由图像捕获装置传送出的反射光。
14.如权利要求13所述的方法,其中照明内表面包括用至少一个LED或激光二极管照明。
15.如权利要求13所述的方法,其中照明内表面包括照射具有选自由UV、IR、NIR、蓝光和可见光构成的组的范围中的频率的光。
16.如权利要求13所述的方法,其中照明内表面包括使光纤的远端延伸超过细长主体的远端。
17.如权利要求16所述的方法,还包括在照明内表面的同时使光纤绕着光纤的纵向轴线转动。
18.如权利要求13所述的方法,其中接收反射光包括用光纤接收光并且将光传送给纤维的近端。
19.如权利要求13所述的方法,其中接收反射光包括接收通过反射或荧光从内表面发出的光。
20.如权利要求13所述的方法,还包括在照明中空身体器官的内表面之前向中空身体器官施加荧光标识染料。
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- 2002-12-20 CA CA002472197A patent/CA2472197A1/en not_active Abandoned
- 2002-12-20 AU AU2002360767A patent/AU2002360767A1/en not_active Abandoned
- 2002-12-20 EP EP02796049A patent/EP1469777A4/en not_active Withdrawn
- 2002-12-20 CN CNA028269616A patent/CN1617687A/zh active Pending
- 2002-12-20 IL IL16269702A patent/IL162697A0/xx unknown
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
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CN104055514A (zh) * | 2014-07-04 | 2014-09-24 | 重庆邮电大学 | 微创的支撑式直肠电阻抗特性检测装置 |
CN104055515A (zh) * | 2014-07-04 | 2014-09-24 | 重庆邮电大学 | 一种微创测量直肠电阻抗的方法 |
CN104055514B (zh) * | 2014-07-04 | 2016-07-27 | 重庆邮电大学 | 微创的支撑式直肠电阻抗特性检测装置 |
CN112120655A (zh) * | 2020-10-12 | 2020-12-25 | 温州市人民医院 | 一种精确插空肠的辅助装置 |
Also Published As
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WO2003059150A2 (en) | 2003-07-24 |
CA2472197A1 (en) | 2003-07-24 |
IL162697A0 (en) | 2005-11-20 |
EP1469777A2 (en) | 2004-10-27 |
WO2003059150A3 (en) | 2004-02-26 |
AU2002360767A1 (en) | 2003-07-30 |
JP2005514144A (ja) | 2005-05-19 |
EP1469777A4 (en) | 2007-04-04 |
US20030167007A1 (en) | 2003-09-04 |
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