CN1741768A - 利用低相干干涉测量法识别组织的系统和方法 - Google Patents

利用低相干干涉测量法识别组织的系统和方法 Download PDF

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CN1741768A
CN1741768A CN200480002818.1A CN200480002818A CN1741768A CN 1741768 A CN1741768 A CN 1741768A CN 200480002818 A CN200480002818 A CN 200480002818A CN 1741768 A CN1741768 A CN 1741768A
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axial scan
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吉列尔莫·J·蒂尔尼
麦伦·斯蒂芬诺·希斯科夫
尼库尔逊·依夫缇米亚
布雷特·E·布马
玛莎·皮特曼
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0062—Arrangements for scanning
    • A61B5/0066—Optical coherence imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/41—Detecting, measuring or recording for evaluating the immune or lymphatic systems
    • A61B5/414—Evaluating particular organs or parts of the immune or lymphatic systems
    • A61B5/415—Evaluating particular organs or parts of the immune or lymphatic systems the glands, e.g. tonsils, adenoids or thymus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/41—Detecting, measuring or recording for evaluating the immune or lymphatic systems
    • A61B5/414—Evaluating particular organs or parts of the immune or lymphatic systems
    • A61B5/416—Evaluating particular organs or parts of the immune or lymphatic systems the spleen
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/41—Detecting, measuring or recording for evaluating the immune or lymphatic systems
    • A61B5/414—Evaluating particular organs or parts of the immune or lymphatic systems
    • A61B5/418—Evaluating particular organs or parts of the immune or lymphatic systems lymph vessels, ducts or nodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6848—Needles

Abstract

一种适于使用一维干涉测距图像实时针吸活组织检查组织差异的设备，其包括具有套管和针、插入所述针内的光纤以及与光纤相连的光纤成像系统的活组织检查装置。所述成像系统获取图像并将光学性质和图案与标准化组织样本图像的数据库进行比较以确定不同的组织类型。执行活组织检查的医师通过与活组织检查装置相关联的并与成像系统相连的反馈部件获得反馈。当朝目标组织插入针时，所述反馈部件能够提供关于所接触到组织类型的可视的、声音的或振动的反馈。可根据不同的活组织检查对反馈部件进行编程，使得用户能够启动按钮以便根据所需过程和将接触的预测组织选择显示器或其他反馈机构。

Description

利用低相干干涉测量法识别组织的系统和方法
相关申请
本申请要求享有2003年1月24递交的、系列号为60/442,392，标题为“利用低相干干涉测量法进行组织识别的装置和方法”的美国临时申请的优先权，其全部内容在此包含引作参考。
技术领域
本发明涉及一种在针吸活组织检查过程种利用干涉测距(ranging)确定组织类型的设备和方法。更特别地，本发明涉及一种包括探针和在活组织检查过程中检测各种组织类型的运算法则的成像系统。此外，还提供一种利用所述成像系统区分组织类型的方法。
背景技术
手术和活组织检查过程中低效率的重要原因是医师通过肉眼检查不能确认组织类型。例如，头和颈部外科手术，通过肉眼检查不能区分肌肉、脂肪、淋巴结和甲状旁腺导致非必要的手术之间，进而增加这些过程的费用。此外，当没有通过显象方式进行引导时，在25％至35％的情况中，精确的针吸活组织检查获得非诊断组织。在医学中，迫切需要一种廉价、便携和有效的识别组织类型的方法。
之前已经描述了在探针中使用光学相干层析成象和共焦显微术。这些探针让医师获得组织图像。可是，这些常规的探针具有某些缺陷。这些探针中所使用的方法需要通过以二维方式扫描斑点而在样本上成像单一的聚焦斑点，以便产生目标的二维图像。这些公知的成像探针系统的扫描和成像的必要条件需要复杂且昂贵的一次性元件以及面板控制台元件。现在的成像探针的一些元件需要复杂而昂贵的构造，而这使得探针的常规运用实际上不可能。此外，目前的成像探针使用复杂而昂贵的定制的注射器，其不能被消毒或处理。
在过去，已经进行了研究来估算用于组织诊断的低相干干涉测量法(“LCI”)成像的使用。光学相干层析成象(“OCT”)是通过获得许多轴向扫描的同时扫描跨过样本的样本臂梁进而产生二维图像的LCI成像。为了执行LCI图像，常规系统必须满足几个严格要求，包括使用：
1.高速基准臂延迟扫描(至少1,000scans/second)，
2.高功率的宽带宽光源(至少5mW)，
3.复杂的探针(必须具有至少一个透镜和扫描机构)，
4.昂贵的数据采集设备，以及
5.图像显示器。
常规系统的这些必要条件显著地增加了OCT系统和OCT探针的成本。
期望的是具有低成本且精确的成像系统、方法和具有足够分辨率的针吸活组织检查探针，在短时间额外培训的情况下，医师能够使用所述探针。同样，也期望具有一能够使用常规注射器的针吸活组织检查探针和探针组合以避免改进和制造定制套管或针的高成本。也期望上述示例性系统能够提供关于活体组织探针的进程和位置的实时或近实时的反馈。但已经到达目标区域或如果已经遇到不适当的组织，则上述探针也能够确定各种组织类型和分界面(interfaces)，并能够向用户发出警报。分界面是在具有光学折射率的一个组织与另一个接近时发生的折射率界面。所述折射率对于组织的分子构成是唯一的，因此全部组织都出现分界面。这些折射率界面可以引起散射，所述散射为LCI和OCT检测信号。
结合所附权利要求，基于阅读本发明以下实施例的详细说明，使得本发明的其他特征优势变得清晰。
发明内容
本发明通常提供利用干涉测距辨认组织类型的装置、方法、软件配置和存储介质。所述装置的或可处理部份使用单独的单模光纤，所述单模光纤便宜且符合临床可用探针的内腔(lumen)。所述单独的单模光纤可以具有125μm和250μm之间的直径。
根据本发明，不需要二维图像。因此，成像系统必要条件显著减少。所述必要条件包括但不限于使用：
1.低功率宽带宽光源(0.001-0.5mW)，
2.一种简单的探针(不需要透镜或扫描机构)，
3.廉价的数据采集设备，
4.简单、廉价而小的检波器设备，以及
5.简化的图像显示器或声音通知设备。
相应地，根据本发明使用一维干涉测距识别组织的系统，使得系统控制台的成本和尺寸减少并使一次性数据收集探针的成本显著减少。可以以远低于现有系统的材料成本构造根据本发明的一次性探针，并且所需的光源和检测装置花费也明显少于常规的OCT系统。这些因素能够使这些探针用于非常普通的过程中，如放置静脉内导管或引导腰椎穿刺、此外，由于系统组件的成本减少和尺寸缩小，所以能够以手持部件的形式实现本发明。
结合所附权利要求阅读本发明实施例的以下详细描述，使得本发明的其他特征和优势变得清晰。
附图的简要说明
根据以下结合附图的详细说明，使得本发明的其他目的、特征和优势变得清晰，在所述附图中示出了本发明的说明性实施例，其中：
附图1A为对于肌肉组织的LCI反射率的图表。
附图1B为对于脂肪组织的LCI反射率的图表。
附图2为根据本发明一个示例性实施例的组织识别系统的示意图。
附图3A-C为根据本发明一个示例性实施例的不同光纤和探针设计的区域示意图。
附图4为根据本发明一个示例性实施例的活体组织穿针内腔中干涉测距探针的示意图。
附图5为根据本发明一个示例性实施例的注射器干涉测距探针的示意图，其中所述探针具有插入通过注射器体的单模光纤。
附图6为根据本发明一个示例性实施例的注射器干涉测距探针的示意图，其中所述探针具有插入通过活塞的单模光纤。
附图7为根据本发明示意性实施例的注射器干涉测距探针的示意图，所述探针具有插入通过注射器针头锁和针套(housing)之间的中间接合器。
附图8为根据本发明示意性实施例的注射器干涉测距探针的示意图，所述探针具有插入通过注射器针头锁和针套之间的中间接合器并包括位移传感器。
附图9为根据本发明一个示例性实施例的具有活化枪(activationgun)的针吸活组织检查设备的示意图。
附图10为根据本发明一个示例性实施例的套管的示意图，所述套管在体内具有干涉测距探针。
附图11为根据本发明一个示例性实施例的套管的示意图，所述套管在内腔内具有干涉测距探针。
附图12为根据本发明一个示例性实施例的电灸装置中具有干涉测距探针的套管的示意图。
附图13A为标准探针和针套的示意图。
附图13B为根据本发明一个示例性实施例的标准探针和修改针套的示意图。
附图14为根据本发明一个示例性实施例的干涉测距探针光学连接器的示意图。
附图15为根据本发明一个示例性实施例的具有相关反馈部件的活组织检查探针的示意图。
附图16为根据本发明一个示例性实施例的枪和启动按钮的示意详图。
附图17为根据本发明一个示例性实施例的组织识别方法的流程图。
附图18为根据本发明一个示例性实施例的系统配置的示意图。
附图19为根据本发明一个示例性实施例的信号处理顺序的流程图。
在整个附图中，除非另外说明，否则相同的参考数字和字母用于表示所示实施例中相同的特征、元件、组件或部分。此外，虽然现在参照附图详细描述了主题发明，但也结合说明性实施例描述本发明。其意指在不脱离所附权利要求限定的主题发明的实质范围和精神的情况下，可对所述的实施例进行改变和修改。
具体实施方式
根据本发明的系统，附图2示出了根据本发明一个实施例的、利用干涉测距进行组织10识别的组织识别系统2。所述组织识别系统2使用一维数据组来识别组织。不同于使用二维数据以获得识别组织的足够信息的许多现有系统，能够使用一维数据组识别组织。可从一维数据组中了解两种类型组织之间的差异。例如，附图1示出了表示两个不同组织类型的一维干涉测距轴向扫描的两个图表。从这些图表中可以看出，相比于肌肉组织(上面图表示出的)的轴向反射率曲线，脂肪组织(下面图表示出的)具有显著不同的轴向反射率曲线。组织识别系统5包括成像系统5和探针50。
成像系统5包括设置在干涉仪14内的光源12。干涉仪14可以是光纤干涉仪14。同样，虽然在此披露使用的光束用作一个示意性实施例的光源12，但应当理解，可使用其他适合的电磁辐射，如微波、无线电频率、X射线等。本领域技术人员熟知的干涉仪14或其他分束装置可利用循环器以增加样本臂的功率利用率。干涉仪14包括光束分离器18、基准臂20、样本臂24以及与至少一个检波器26相连的通信设备。光源12与干涉仪14相连以便将光源12发出的光传送至光束分离器18。光束分离器18朝基准臂20引导光源12发出的部分光并同时将其余的光被引至样本臂24。基准臂20包括机构26。机构26产生与光学延迟相关的时间。在某一实施例中，机构26可以是可移动的基准反射体或反射镜。可移动的基准反射体或反射镜可产生适合于特殊应用的可变时间延迟。
与样本臂24相关联的光纤29与光耦合器58相连。如下所述，光耦合器58也与插入到探针50内的光纤25相连。从样本臂24基准臂20返回的光信号被光束分离器18所合并，并通过运用至少一个检波器26测量两臂之间的干涉来确定作为组织样本10内部深度函数的反射率(例如，参看附图1A和1B)。通过使用例如分别对应各自的偏振本征态的两个检波器26，能够实现组织双折射的检测(即，将射线分成两个垂直偏振的两束平行射线)。依赖于所用的干涉测距的类型，可使用1至4个检波器26。
在某一实施例中，能够使用以下三种类型的干涉测距中的一个：(i)光学时间域反射测量法，(ii)光谱域反射测量法或(iii)光频域反射测量法。应当理解，对于组织识别系统2也可以使用其他可选类型的干涉测距。如果使用光时域反射测量法，光源12为宽带宽光源，需要干涉仪14，基准臂20可以是一每秒实行20至50次扫描的延迟扫描的低速基准臂，并且检波器26可包括1个至4个检波器。由C.Youngquist等人在Opt.Lett.2，158-160(1987)的“光学相干域反射测量法：一种新的光学估算技术”中，以及K.Takada等人在Appl.Opt.26，1603-1606(1987)的“基于干涉测量技术用于光学波导装置中损坏定位的新测量系统”中详细描述了光时域反射测量法，两篇文献披露的全部内容在此包含引作参考。如果使用光谱域反射测量法，则光源12为宽带宽的光源，需要干涉仪14，检测臂包括分光计，检波器26包括单一检波器，并通过采用测量光谱的傅里叶变换获得低相干干涉测量数据。由J.Deboer等人在Optics Letters2003，Vol.28，P.2067-69的“相比于时间域光学相干X线断层摄影术光谱域中提高的信噪比”中，以及申请号为No.WO03062802、标题为“借助光谱带的平行检测用于低相干干涉测量方法(LCI)和光相干X线断层摄影术(OCT)中测距和降噪的设备和方法”，Deboer等人的公布专利更详细地描述了光谱域反射测量法，两篇文献披露的全部内容在此包含引作参考。如果使用光频域反射测量法，则光源12为扫频波长的光源，需要干涉仪14，检波器26包括一个至四个检波器，并通过采用测量光频傅里叶变换获得低相干干涉测量数据。由S.Yun等人在Optics Express 2003，vol.11，P.2953-63的“高速光频域成像”，以及C.Youngquist等人在Opt.Lett.12，158-160(1987)的“光相干域反射测量法：一种新的光学估算技术”，以及Takada等在Appl.Opt.26，1603-1606(1987)的“基于干涉测量技术适用于光学波导装置内损坏定位的新测量系统”，中详细描述了光频域反射测量法。
在本发明的一个可选实施例中，干涉仪14为Mach-Zehinder干涉仪、迈克尔逊干涉仪、非互惠性或循环干涉仪、萨尼亚克干涉仪、Twyman-Green干涉仪等。
探针50可包括活组织检查装置51，其包括具有与注射器54相关联的孔腔(bore)(未示出)的探针52，通过所述注射器54引入光纤25。光纤25被插入探针50内并依次插入针52。可以朝将成为样本的组织10经由皮肤地插入(或相反)针52和光纤25。在其他示意性实施例中，针52可以是一般的套管、专用套管、针、管心针等。
参照附图3，所述光纤25包括一包层60和裂开的光纤芯62，如附图3中A部分所示。当通过光纤25引入光信号时，形成光束腰64。所述光束腰的直径可以是9μm。其他透镜或光学元件可安装到光纤25上，以允许在组织内更深的聚焦，其包括一梯度指数透镜66(参见附图3的部分B)，有时称作GRIN透镜、球透镜68(参见附图3的部分C)、鼓形透镜，微透镜，锥形光纤端部，棱镜等。可选地，所述光纤25角裂开或用于产生电磁辐射的任意图案。在某一实施例中，所述包层60具有125μm的外直径并且光纤芯具有9μm的外直径。
对于使用计算机断层X射线照相法(CT)、磁共振成象(MRI)或超声引导而传统上实行针活组织检查，如附图4所示，光纤25可插入到活组织检查装置中并可嵌入针吸活组织检查或通过针52的内腔70予以插入。这些类型的过程不使用精确的针吸。结块或肿块不是人工所能识别的，仅可通过一些其他非侵入的成像技术，如CT或MRI予以识别。这些和其他导针活组织检查过程可使用更大和更长的针，同时仍利用光纤25来辅助引导活组织检查过程。
为了将纤维25插入探针50的所述针52内以进行精确的针吸，通过孔72插入光纤25，其中附图5未示出体内的孔72，在注射器51的体内以及随后(i)插入针52中，如附图5所示，(ii)通过注射器51的活塞74，并随后提供进入针52内，如附图6所示，(iii)通过安装在注射器51和针52之间的中段76，和/或使用其他插入配置。探针50用于允许组织10内细胞抽吸的吸入，同时允许光纤25在针52顶端的自由移动。
在一个示意性实施例中，如附图8所示，能够利用注射器和针之间中间耦合器或支架的施用。这允许使用标准针和注射器。在该示意性实施例中，探针100使用前述的成像系统5以识别组织。探针100包括一端安装在成像系统5上而另一端安装在光连接器上的输入光纤102。光纤102与单模输入光纤104相连。通过中间适配器106插入光纤102，并定位在注射器108和针锁110之间。针112安装在针锁110上。位移传感器114可用作光纤104外表面和针内孔表面之间不够间距的结果。为了抽吸组织，位移传感器114通常允许光纤104重新定位。位移传感器114可以是手工位移传感器、自动位移传感器等。在本发明的另一示意性实施例中，针锁110为Luer锁。
附图9示出了组织识别系统122，其包括与枪120一起固定在已知装置内部的注射器108。这种配置允许组织10的抽吸很容易地进入针112的孔腔内。为了使检修容易和使用便捷，上述的一些组件也可以并入组织识别系统122。
附图10根据本发明另一实施例，示出了放置用于IV度介入(access)、胸膜的、腹膜(perioneal)穿刺等的套管200的示意性操作。套管200包括导引导管202和光纤探针204。光纤探针204置于导引导管202内。可选地，探针204可通过导引导管202的内腔206插入，如附图11所示。
附图12示出了仍根据本发明另一实施例的探针306的内操作示意性实施例300。探针306被并入电灸装置301中。光学窗口302可设置在末端光纤尖端304附近以保护探针306不会受到烧灼电极308所造成的热损伤。仍在另一实施例中，探针306可合并在手术刀、单独的手控装置等内，而非并入电灸装置301内。光学窗口302可由蓝宝石制成。
为了使得光纤探头25容易地插入针52，如附图13中部分A所示，可修改标准针套402的内部管腔400使得修改后的针406的内部管腔404为锥形，如附图13B所示。
附图14示出了根据本发明使用的干涉测距探针光连接器500，其为光耦合器58的一边。使探针50与成像系统5相连的光耦合器58应当是坚固的并使用简单的。在另一个实施例中，光耦合器58包括安装在探针50上的相对便宜的裸光纤连接器，而安装在成像系统5上的干涉测距探针光连接器500相对比较贵。使用安装在探针50上裸光纤连接器没有增加探针50的成本。光耦合器58中更贵的部份安装在成像系统5上。干涉测距探针光连接器500被构造得与裸光纤连接器接合，以便形成坚固的连接。所述干涉测距探针光连接器500可包括通过具有与锥形V型沟槽508相连的套管506的外壳504插入的裂开(角度裂开)光纤502(与成像系统5相连的近端，为清楚起见没有示出)，锥形V型沟槽508由光纤停止件510予以封端。外壳504在一端处具有光纤518插入通过的锥体516。光纤518通过锥体516插入导外壳504中直到其到达光纤停止件510。一旦光纤518停止，夹具512远离光纤-光纤界面适当地固定光纤518，以保持空气或液体缺口514。光纤518与探针50相连。在另一实施例中，可以对平坦裂缝使用耦合凝胶以消除缺口514的背反射。
可以使用用于向用户传送特殊信息的许多任意机构或设备，所述信息为在一个过程期间组织识别系统2遇到的相关组织10的信息。附图15示出了系统600的示意图表，其包括成像系统5的组件以及通过光连接器58与光纤25相连的光纤29。光纤25与注射器51操作相关并通过针52的孔腔。支架612通过注射器套管614与注射器51相关联。反馈部件620可以任意几种方式与支架612相连。
支架612可被安装在注射器51上。在一个示意性实施例中，支架612可移动地安装在注射器51上，例如但不限于弹性膜片装配、可移动的粘合剂、夹具、夹子等。通过使支架612可移动地安装在注射器51上，可再利用支架612和相连的反馈部件620并同时能够处理注射器608，进而能够使用常规的注射器并消除定制发展和昂贵探针的需要。
在另一个实施例中，利用枪或注射器支架将支架612可移动地安装在注射器51上。在另一确定实施例中，所述系统600整体与枪相关(如以上相关附图9所述)。仍在另一实施例中，系统600嵌入枪634内部，这固定了反馈部件620和光纤606并改善了医师将组织吸入针610的能力。
反馈部件620向系统600的用户提供信息，包括系统600已经检测的特殊类型组织的信息。在另一个实施例中，反馈部件620为可视显示器，如LED、VGA或其他可视反馈系统。对于LED显示器，如下文所述，软件算法和组织识别判定能够使用却动一个或多个LED的输出信号，可在探针尖端传输通过或接近时启动所述LED以区分组织界面类型(如，脂肪对照肌肉)。当所述尖端接触所关心的组织时，如masticular块，LED灯能够改变颜色或启动不同颜色的LED以便为医师提供已经接触导结块并且活组织检查抽吸或开始其他采样的反馈信息。
仍在本发明的另一实施例中，反馈部件620是一音调发生器，其能够根据不同组织或系统600检测的其他结构提供声频反馈信息。在另一实施例中，反馈部件620为一振动发生器。可视、音频和颤动反馈部件都能为系统600的用户提供简单的而有用的反馈信息，以便更好地使活组织检查探针实时且有把握地到达目标。仍在另一实施例中，反馈部件620为一种可视显示屏，可用于显示一维或二维滚动曲线图像，其包括在形成图像的时间中作为组织内部深度或z函数的聚集反向散射强度即Iz。可视显示器可以是用于提供更多细节或多峰反馈信息的常规的CRT显示器或LCD显示器。所述可视显示器可以与常规手机显示器同样大或比其小，以便为系统600的用户提供组织10的放大视图。
反馈单元620通过实线电缆连接622或无线连接与成像系统602通信耦合。无线连接可以是无线电频率(“RF”)连接、电磁辐射信号等。无线电信号连接使得活组织检查探针的重量减轻并在外科手术地点的布线减少。可使用简单的反馈系统以使医师能够用一只手操作活组织检查探针并具有接近探测器外壳的反馈，使得医师的注意力和观察中心不离开活组织检查区域。
附图16示出了包括显示器630、人工操作按钮或开关632以及枪634的另一实施例的反馈部件620。开关632可操作地与显示器630相连。开关632的开启引起显示器630显示标准活组织检查过程的选择，例如但不限于胸部活组织检查组织、肝组织、脾组织、肌肉组织、淋巴组织、肾组织、前列腺组织等。这些活组织检查过程都包括探针50穿过相对坚实类型的层，其包括皮、肌肉、筋膜等，所述探针对于给定过程按照类似顺序进行穿透。例如，对于腰椎穿刺，探针50所遇到的层顺序为表皮筋膜、椎骨、肌肉、筋膜、隔膜(disk)、硬膜下腔、硬膜外腔、脊髓液体区域。这些组织中的每个组织都能产生相对坚实且可确定的图像信号峰值，当其通过对比的图像分析在真实病人基础上予以标准化且对照实际病人数据减少标准化数据曲线时，能够在活组织检查过程中提供所遇到物质的准确图片。
当针尖穿过每层时，成像系统600检测实际信号并将其与数据库中存储的参考信号进行比较。借助采用例如为获得I(z)而进行的z(附图1中所示)的干涉测距扫描，并采用基于时间的微商dI/dz，能够获得对应样本峰值的一系列线。通过反馈部件620可显示各种连续峰值，以便为用户提供探针所在位置的精确反馈信息并帮助用户引导探针到达目标区域。在特定的过程中如果探针已经偏移、溢出所述目标区域或遇到不期望检测的组织类型，例如在腰椎穿刺实例中，如果探针已经穿过目标区域并打击神经，则反馈部件也可以合并″反运算法则″以提供即时反馈。上述反馈能够使医师将探针顶端重新定位在适当的区域内。
根据本发明的系统和方法也能够确定已经到达目标区域的时间。为了确定何时已经到达目标区域，所述系统处理反射光的数据并寻找在给定过程中指示目标区域内组织类型的背散射标记。上述处理包括特征提取和将这些特征插入到预示组织类型的模式中。该模式可以是物理模式、化学计量学模式或两种模式的组合。物理模式通常在光散射物理原理基础上预测散射信号。化学测量学模式使用培训装置(training set)并利用一些技术，如偏最小二乘(“PLS”)或主成分分析(“PCA”)统计地摘录特征。在已知样本的基础上研发上述模式，并利用该模式测试新的数据。也应当理解，可以获得并处理条纹(fringes)以确定包含双折射、多普勒效应流动和光谱特性的其他组织特征。
通过目测强度、双折射、多普勒效应、光谱轴向反射率外形和/或等实现组织识别。另外，反射率扫描的频谱(强度数据的傅里叶变换)将提供关于组织中与组织构件相关的散射构件间隔的信息。更精密的分析包括但不限于使用相关技术进行的反射率信息的方差分析、一维纹理判别(包括分数维数、空间灰度级协同出现矩阵参数、Markovian距离、边缘计算)、功率谱分析(包括傅里叶域和时间域)，nth序柱状力矩分析和时域分析法(对于固定时间单独比较一个和另一扫描)，将提供关于所观察到的组织类型的信息。可用于表征组织类型的其他关键的定量度量，包括背散射系数、总衰减系数、从多次散射起始进行的各向异性系数(颗粒大小)判断、利用相干门灯散射光谱学从检测光谱获得的颗粒形状和大小等。
利用本发明的系统和方法，能够发现以下示出的组织特征表：脂肪组织、肌肉组织、胶原、神经组织、淋巴结组织、坏死组织、血、腺组织等。脂肪组织在水峰值处显示低吸光率吸收率、由LCI强度图像获得的高低空间频率分量和高各向异性系数。肌肉组织显示水峰值处的高吸收率、中等双折射率、中等各向异性和减少的差异。胶原显示非常高的双折射率。神经组织显示中等至高的双折射率、高水吸收率和减少的功率谱密度。淋巴结组织显示低各向异性系数和低临时差异。坏死组织显示LCI信号的高临时差异、高衰减系数、高水吸收率和低双折射率。血液显示高多普勒频移、高水吸收率、高的总衰减系数和高临时差异。腺组织显示中等空间频率差异和低双折射率。应当理解，本发明设想使用一个以上的分析方法，即多模式系统。这样可以提供组织类型增强的检测和分析。
附图17示出了根据本发明一个示意性实施例的从纤维组织中区分脂肪组织的方法700。所述系统600测量的信号为轴向扫描数量M的平均值。在程序块702中，所述系统600利用信号阈值T1检测组织样本表面。在程序块704中，检测过的信号被分成N个窗口。在程序块706中，进行信号处理以从干涉测距信号获得参数，如计算每个窗口内信号的均差(ADEV)标准偏差(STDEV)(例如，但不限于Press，W等人在剑桥大学出版社，纽约，NY1992发表的“数值处方C”中所披露的技术，其全部内容在此引作参考)。在程序块708中，测试每个窗口以确定阈值T2相对于获得作为深度z函数的组织类型是否过大。在程序块710，如果系统600决定ADEV(或STDEV)大于阈值T2，则认为所述组织为类脂物，并且所述方法700进到程序块712。否则，所述组织不是类脂物并且所述方法700进入程序块714。
这些技术的应用包括手术中导引、针吸活组织检查导引、精确针吸、图像导引活组织检查、引导周围或中央静脉内或动脉内导管配置等目的的组织识别。对于不同的应用可以使用不同的成像方法。这些不同应用包括：引导活组织检查；细胞方法论；静脉-动脉(veni-arterio)、图案或多普勒效应识别；腰椎图案；治疗导引图案和光学法等。探针50还可用作治疗的目标和传送装置。所述探针50能够成像目标面积以根据检测组织类型和界面改变，即组织反射率的改变，确信治疗剂的针注射到达和/或进入目标组织或地点。
为了确定是否所述组织是纤维性组织或脂肪组织，所述方法700使用标准图像处理技术来处理数据以区分纤维性(脂肪)和脂肪组织。以下的表格1示出了遵循数据图像处理的纤维和脂肪组织的不同测量：
  组织类型   敏感性   特殊性
  纤维   0.95   0.98
  脂肪   0.97   0.94
  纤维/脂肪   0.96   0.84
在上述表格中，灵敏度是真正性，即真正性+假负性，而特殊性是真负性，即真负性+假正性。
附图18示出了根据本发明的用于识别组织的干涉测距诊断系统800。系统800使用用于发射具有1.3微米光波长、300微瓦能量以及48纳米带宽的光束的光源。所述光源允许系统800以15微米的分辨率查询组织。因为构建相干图像不是系统800的目的，所以系统800使用低扫描频率的基准臂。通过几个A扫描的平均聚集信息进而识别组织。借助基准臂的一次扫动，实行对应一个深度扫描的A扫描。系统800处理并存储数字数据，并在反馈装置上实时显示组织类型信息。
系统800的LED光源为300毫瓦SUPERLUM LED，其可以是温控或电控的。利用光纤偏振器P线性偏振所述光束并将其传送至光束分离器。使用两个垂直偏振态的光束查询样本以获得双折射率信息。通过将光束传输通过所述光束分离器到达分别位于光束分离器两臂上的两个偏振控制器PC叶片，获得上述两个垂直偏振态的光束，可选择地将两个垂直偏振态送至光纤循环器CIR，其引导光束到达光纤迈克尔逊干涉仪IF。光开关OSW与光延迟线ODL电流计同步，使得所述偏振可选地从一个扫描变至另一个扫描。配置在由电流计驱动的杆上回射器内所存在的非常简单的延迟线，用于进行深度扫描。安装在干涉仪IF样本臂上的探针包括引入注射器针内的裸光纤。反向散射光相干地添加到来自ODL的光中，并将其发送至检波器D1、D2。偏振分裂PS用于选择两个正交态。利用NI DAQ卡预放大检波器的输出信号并使其数字化。
所述系统实行数字采集、滤波和条纹的平均化，并提供以下信息：(1)15微米深度强度的分辨率和光谱信息，(2)双折射率信息：计算斯托克斯参数-IQUV并提取相位延迟，以及(3)多普勒频移信息。
附图19示出了根据本发明一个示意性实施例的信号处理序列的流程图900。最简单形式的组织识别是辨别两个组织类型。在附图1中可以看出两个组织类型之间的差异，其示出了可行性研究结果以区分尸体的纤维和脂肪组织。例如，脂肪组织具有低干涉测距信号部分分开的多重峰值的形态，因此纤维组织具有更低程度的差异和指数衰退。
尽管以上已经详细说明了本发明的几个示意性实施例，但本领域技术人员应当理解，在本质上不脱离本发明的新颖性教导和优势的情况下，在示意性实施例中可进行许多修改。相应地，所有这些修改都倾向于包含在以下权利要求所限定的本发明的范围内。应进一步注意到，所涉及的任何专利、申请或出版物在此全部包含引作参考。

Claims (39)

1.一种用于识别组织特征的设备，其包括：
一辐射源，其用于运用辐射实行所述组织的轴向扫描；和
一成像系统，其适于接收基于所述轴向扫描的轴向扫描辐射，并处理与轴向扫描辐射相干的数据以识别组织的特征。
2.如权利要求1所述的设备，其中所述辐射源是用于发射光束的光源。
3.如权利要求2所述的设备，其中所述光源是一种宽带宽的光源。
4.如权利要求2所述的设备，其中所述光源是一种扫频波长的光源。
5.如权利要求2所述的设备，其中所述光源经由插入装置中设置的光纤向所述组织传递辐射，所述插入装置具有一至少部分设置在所述插入装置内部的末端和一近端。
6.如权利要求5所述的设备，其中所述插入装置用于提供光纤邻近所述组织的末端。
7.如权利要求5所述的设备，其中所述插入装置是套管、针和管心针中的一个。
8.如权利要求1所述的设备，其中所述成像系统进一步包括一干涉仪，其适用于引导所述辐射源发射的部分辐射进入样本臂以及通过所述样本臂从组织回反射的检测辐射。
9.如权利要求8所述的设备，其中所述干涉仪引导另一部分辐射进入基准臂。
10.如权利要求9所述的设备，其中所述成像系统通过处理所述轴向扫描辐射以提供组织特征来识别组织特征，所述轴向扫描辐射包括来自基准臂的辐射和来自样本臂的辐射，并将所述组织特征与多种组织类型的标准化特征的数据库进行比较。
11.如权利要求10所述的设备，其中所述轴向扫描辐射包括反向散射、光谱特性、双折射率和多普勒频移中的至少一个。
12.如权利要求10所述的设备，其中所述成像系统通过执行标准偏差、均差和轴向反射率曲线梯度中至少一个，处理所述轴向扫描辐射。
13.如权利要求10所述的设备，其中所述成像系统将所述轴向扫描辐射的数据输入到统计模式中以预测组织类型。
14.如权利要求13所述的设备，其中的统计模式从所述轴向扫描辐射的数据中提取特征。
15.如权利要求13所述的设备，其中的统计模式至少是偏最小二乘或主成分分析中的至少一个。
16.如权利要求1所述的设备，其中所述成像系统通过利用干涉测距确定所述轴向扫描辐射的反射率特征，并将所述组织的特征与数据库中所存储的多种类型组织的标准化反射率特征相比较，识别所述组织的特征。
17.如权利要求16所述的设备，其中所述类型的干涉测距至少是光时域反射测量法、谱域反射测量法和光频域反射测量法中的一个。
18.一种用于识别组织特征的方法，其包括步骤：
利用辐射实行组织轴向扫描；和
处理与基于轴向扫描的轴向扫描辐射相关的数据以识别组织的特征。
19.如权利要求18所述的方法，其中所述轴向扫描辐射包括反向散射、光谱特性、双折射率和多普勒频移中的至少一个。
20.如权利要求18所述的方法，其中所述处理步骤通过执行与所述轴向扫描辐射相关数据的标准偏差、与所述轴向扫描辐射相关数据的均差以及与所述轴向扫描辐射相关数据的轴向反射率曲线梯度中的至少一个，识别所述组织的特征。
21.如权利要求18所述的方法，其中所述光源经由插入装置中设置的光纤传递辐射以实行所述组织的轴向扫描，所述插入装置具有至少部分设置在所述插入装置内部的末端和近端。
22.如权利要求18所述的方法，其中所述处理步骤通过将所述轴向扫描辐射得到的数据输入到统计模式中来预测组织类型，进而识别组织的特征。
23.如权利要求18所述的方法，其中所述处理步骤通过利用干涉测距确定所述轴向扫描辐射的反射率特征，并将所述组织的特征与数据库中所存储的多种类型组织的标准化反射率特征相比较，识别所述组织的特征。
24.一种存储用于识别组织特征的软件程序的存储介质，其中所述软件程序在由处理装置执行时，用于使得处理装置执行以下步骤：
利用辐射实行组织的轴向扫描；和
处理与轴向扫描辐射相关的数据以识别组织的特征。
25.如权利要求24所述的存储介质，其中所述轴向扫描辐射包括反向散射、光谱特性、双折射率和多普勒频移中的至少一个。
26.如权利要求24所述的存储介质，其中所述处理步骤通过执行与所述轴向扫描辐射相关数据的标准偏差、与所述轴向扫描辐射相关数据的均差以及与所述轴向扫描辐射相关数据的轴向反射率曲线梯度中的至少一个，识别所述组织的特征。
27.如权利要求24所述的存储介质，其中所述光源经由插入装置中设置的光纤传递辐射以实行所述组织的轴向扫描，所述插入装置具有至少部分设置在所述插入装置内部的末端和近端。
28.如权利要求24所述的存储介质，其中所述处理步骤通过将所述轴向扫描辐射得到的数据输入到统计模式中来预测组织类型，进而识别组织的特征。
29.如权利要求24所述的存储介质，其中所述处理步骤通过利用干涉测距确定所述轴向扫描辐射的反射率特征，并将所述组织的特征与数据库中所存储的多种类型组织的标准化反射率特征相比较，识别所述组织的特征。
30.一种用于识别组织特征的逻辑线路，其在由处理装置执行时，可操作的执行以下步骤：
利用辐射实行组织的轴向扫描；和
处理与轴向扫描辐射相关的数据以识别组织的特征。
31.如权利要求24所述的逻辑线路，其中所述轴向扫描辐射包括反向散射、光谱特性、双折射率和多普勒频移中的至少一个。
32.如权利要求24所述的逻辑线路，其中所述处理步骤通过执行与所述轴向扫描辐射相关数据的标准偏差、与所述轴向扫描辐射相关数据的均差以及与所述轴向扫描辐射相关数据的轴向反射率曲线梯度中的至少一个，识别所述组织的特征。
33.如权利要求24所述的逻辑线路，其中所述光源经由插入装置中设置的光纤传递辐射以实行所述组织的轴向扫描，所述插入装置具有至少部分设置在所述插入装置内部的末端和近端。
34.如权利要求24所述的逻辑线路，其中所述处理步骤通过将所述轴向扫描辐射得到的数据输入到统计模式中来预测组织类型，进而识别组织的特征。
35.如权利要求24所述的逻辑线路，其中所述处理步骤通过利用干涉测距确定所述轴向扫描辐射的反射率特征，并将所述组织的特征与数据库中所存储的多种类型组织的标准化反射率特征相比较，识别所述组织的特征。
36.一种用于识别组织特征的设备，其包括：
一辐射源，其用于向所述组织传递辐射；和
一成像系统，其适于接收所述辐射，并处理与所述辐射相关的一维数据以识别组织的特征。
37.一种用于识别组织特征的设备，其包括：
至少一个光纤，设置在具有至少部分设置在针内部的末端和一近端的针内部的至少一个光纤中一个，至少一个光纤中一个的所述末端被放置得邻近组织；以及
一至少一个光纤中一个光纤的所述近端相连通的成像系统，其用于处理来自至少一个光纤的反射光以识别所述组织。
38.如权利要求37所述的设备，其中所述反射光是一维光。
39.如权利要求37所述的设备，其中产生反射光一执行轴向扫描。
CN200480002818.1A 2003-01-24 2004-01-26 利用低相干干涉测量法识别组织的系统和方法 Pending CN1741768A (zh)

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