Mri-induced neurostimulation as a means of communication with a patient

Abstract

This disclosure provides a system for preparing a patient for examination in a medical magnetic resonance imaging (MRI) environment. The system includes: a magnetic resonance imaging unit (20) applied to the MRI environment and including at least one magnetic coil controlled to provide magnetic stimulation to intentionally stimulate nerves and / or muscles of a peripheral body part of the patient during the examination phase; and a first device (10) applied during a patient preparation phase prior to the examination phase; wherein the MRI unit (20) and the first device (10) are configured to provide tactile communication with the patient by intentionally stimulating nerves and / or muscles of a peripheral body part of the patient, wherein the first device (10) includes: at least one stimulation unit (11) adapted to act as a proxy for the MRI unit (20) by simulating subsequent magnetic stimulation from the MRI unit (20) as proxy electrical stimulation and / or proxy magnetic stimulation, and to operate separately from the magnetic stimulation from the MRI unit, and by applying stimulation by a means different from the magnetic stimulation from the MRI unit. The system includes an electrical stimulation and / or magnetic stimulation to intentionally stimulate nerves and / or muscles in the peripheral body parts of the patient; and at least one data processing unit (12) adapted to control the at least one stimulation unit (11) to apply the electrical stimulation and / or the magnetic stimulation, wherein at least one patient stimulation threshold is assigned to the proxy electrical stimulation and / or the proxy magnetic stimulation, and the at least one data processing unit (12) is also adapted to correlate the at least one patient stimulation threshold associated with the proxy electrical stimulation and / or the proxy magnetic stimulation with a corresponding threshold assigned to the magnetic stimulation used in the medical magnetic resonance imaging environment, and to provide control parameters for applying the subsequent magnetic stimulation by the magnetic resonance imaging unit (20) based on the correlation; wherein the at least one data processing unit (12) is also adapted to provide tactile interaction information data and / or tactile interaction instruction data associated with the proxy intentional stimulation via a user interface to train the patient for tactile communication during a subsequent examination phase.

Description

Technical Field

[0001] This invention relates to medical imaging, and more particularly to a system for preparing a patient for examination in a medical magnetic resonance imaging setting, a method for preparing a patient for examination in a medical magnetic resonance imaging setting, and a computer program unit. Background Technology

[0002] In noisy environments, patient interaction (such as communication interaction) in medical MRI settings is challenging and may require the integration of communication modules into the MRI environment. The latter can be difficult because, for example, in an MRI environment, additional technical measures are needed to avoid electromagnetic interaction between the device and the MRI system. Furthermore, patient interaction may also be desired in computed tomography (CT), positron emission tomography (PET), or digital radiometry (DXR) imaging.

[0003] Interactions with patients during medical imaging can be used for, for example, to identify the patient's sedation state, reposition the patient, calm an anxious patient, give instructions for a certain breathing pattern, or any other kind of instruction.

[0004] US2001 / 0020120A1 describes a method and apparatus for increasing the efficiency of a gradient coil system in a magnetic resonance imaging apparatus to optimally utilize the efficiency of the gradient system. This involves determining each patient's individual sensitivity to peripheral nerve stimulation (PNS) by applying a variable magnetic field prior to the MR examination, determining the corresponding maximum magnetic field by scaling, and adjusting the MR apparatus accordingly. Summary of the Invention

[0005] Therefore, improved means of interacting with patients undergoing medical imaging procedures may be needed. The object of the invention is addressed by the subject matter of the independent claims, wherein further embodiments are incorporated in the dependent claims.

[0006] According to a first aspect, a system is provided for preparing a patient for examination in a medical magnetic resonance imaging setting. The system includes:

[0007] Magnetic resonance imaging unit, also referred to as a second device; and

[0008] The first device includes:

[0009] - At least one stimulation unit adapted to operate separately from the magnetic stimulation used in the medical magnetic resonance imaging setting, and adapted to intentionally stimulate nerves and / or muscles of the patient's peripheral body parts by applying electrical and / or magnetic stimulation that is different from and a proxy of the magnetic stimulation used in the medical magnetic resonance imaging setting.

[0010] - At least one data processing unit adapted to control the at least one stimulation unit to apply the electrical stimulation and / or the magnetic stimulation, wherein at least one patient stimulation threshold is assigned to the electrical stimulation and / or the magnetic stimulation.

[0011] In this way, patient preparation and / or training can be performed before, during, and / or after the actual examination in a medical MRI environment, particularly for tactile interaction and / or communication with the magnetic stimulation used in the medical MRI environment. By using at least one stimulation unit as a proxy, the additional arrangement of a complete device, such as that for magnetic stimulation used in the medical MRI environment, can be omitted, resulting in considerable technical and cost savings. Furthermore, patient preparation can be performed separately from the actual medical imaging examination, so that the medical MRI environment (e.g., the medical imaging system) need not be used for patient preparation, but only for the actual medical imaging examination. This increases the efficiency of the medical MRI environment, as it can be dedicated solely to the actual examination. From a functional perspective, the aforementioned device allows for the reproduction of subsequent stimulation in the medical MRI environment as similarly or identically as possible by providing proxy stimulation, thus enabling patient recognition.

[0012] As used herein, patient preparation can also be understood as training the patient, for example, to understand tactile interaction and / or communication, and / or to familiarize the patient with this type of tactile interaction that is not normally known. This preparation or training phase can be performed separately, for example, in a separate room, at a separate time, or during an actual examination in a medical magnetic resonance imaging setting, where the actual examination may also be referred to as the imaging phase. It can also be performed in a separate room, facility, etc.

[0013] As used herein, “surrogate stimulation” can be understood as generating a comparable, similar, or at least nearly identical stimulus using other, but possibly equally applicable, techniques, without necessarily using the actual magnetic stimulation used in a medical MRI setting. For better distinction, the terms “surrogate stimulation” and “actual stimulation” may also be used herein, referring to the stimulus used in a medical MRI setting. Thus, in other words, surrogate stimulation can simulate the actual stimulation during imaging. What surrogate stimulation and actual stimulation have in common is that the patient perceives this as a localized tactile sensation, such as an itchy feeling or a spontaneous, slight muscle contraction, for example, located in the arm, chest, or back. A range of interactions, commands, etc., can be achieved by inducing single or multiple tactile signals through stimulation at one or more locations.

[0014] At least one surrogate stimulation unit may, for example, include an electrical pulse generator adapted to generate electrical pulses to be provided to a patient, for example, through a patient interface (such as a set of electrodes) and / or an electrical pulse generator connected to a magnetic coil adapted to generate a varying current within the magnetic coil that induces a magnetic field. Optionally, at least one stimulation unit may be a portable device. Optionally, it may also be battery-operated, allowing patient preparation to be performed independently of location.

[0015] As used herein, “actual stimulation” can utilize the effects of peripheral nerve stimulation (PNS). This can be beneficially used in a medical magnetic resonance imaging (MRI) setting because the strong current applied to the magnetic resonance gradient coils during the MRI imaging procedure is known to have this undesirable side effect of PNS, which stimulates the patient’s sensory and motor nerves. The patient typically perceives this as an itchy sensation or spontaneous, slight muscle contractions in, for example, the arm or back. This effect is generally considered undesirable and is avoided if entirely possible during an MRI scan. A standard MRI system has three independent gradient coils, X, Y, and Z, and each coil consists of several coil sections connected in series, such that all sections carrying the same current are driven by one of the gradient coil amplifiers X, Y, and Z. The effects of PNS can be intentionally utilized to stimulate the patient during an MRI scan, where portions of the MRI image acquisition unit can be used, and modifications can provide further beneficial effects. Alternatively or additionally, dedicated magnetic stimulation devices for stimulating patients can be used as additional equipment for normal scans utilizing, for example, CT, PET, and DXR.

[0016] The following discussion focuses on the MRI imaging environment; however, the devices, systems, and methods described herein have broader applicability in other medical MRI environments such as CT, PET, and DXR. Therefore, it provides tactile interaction with the patient that would otherwise be impractical without additional equipment, where the patient's sense of touch is generated. This is especially true in closed-cavity systems (such as MRI systems) because there is no direct access to the cavity during the scanning procedure. This is also generally the case in autonomous imaging environments, where minimal or no staff are present for direct human interaction with the patient.

[0017] In an MRI setting, the undesirable PNS side effects of MR imaging may be used as a basis for introducing tactile communication pathways to the patient within the scanner. Therefore, instead of attempting to reduce the amount of PNS felt by the patient, new MR scan sequences are involved that intentionally induce the patient's PNS in a controlled manner. Thus, in an MRI system, at least a portion of the gradient coil used for MRI can be used for intentional magnetic stimulation. For this purpose, strong currents can be applied to the MR gradient coils to induce PNS such that the waveforms of these currents interleave with the waveforms of the scan sequence used for MRI. Details of the conditions for interleaving are known to those skilled in the art of MR sequence design and are described in part in the embodiments below. Strong currents are used to excite the patient's sensory and motor nerves in a predefined spatial and temporal manner. The temporal behavior can be controlled by the waveform of the injected current. The spatial behavior can be controlled by the selection of specific coils, for example, using three coils, where three associated amplifiers are used to generate three gradients (x, y, and z). Note that even specific portions of the gradient coils can be used, where a single coil and amplifier can generate a single gradient, such as x, y, or z. Therefore, two coils with two amplifiers can be used to generate dual gradients, such as (x, y) or (x, z) or (y, z). Thus, as described above, the patient perceives this as a localized tactile sensation, such as an itchy feeling or, for example, a spontaneous, slight muscle contraction located in the arm or back. A range of interactions can be achieved by inducing single or multiple tactile signals at one or more locations.

[0018] According to embodiments, at least one stimulation unit used as a proxy can have a structurally simpler design and / or, optionally, can be more cost-effective than gradient coil systems in MRI systems or magnetic stimulation units used in other medical MRI settings. In other words, the at least one stimulation unit used as a proxy does not necessarily have to provide the same type or technique of stimulation as in the medical MRI setting, provided the patient can at least perceive the similarity between the stimuli. Therefore, the patient can be well prepared and / or trained for the interactions used during the medical imaging examination prior to the actual medical imaging examination, without having to provide the same complex technical equipment for the preparation phase separately.

[0019] In an embodiment, the at least one stimulation unit is adapted to apply the electrical and / or magnetic stimulation by one or more of the following: transcutaneous electrical nerve stimulation (TENS), electrical muscle stimulation or electromyography (EMS), and transcranial magnetic stimulation (TMS).

[0020] TENS can be broadly understood as the stimulation of nerves using an electrical current generated by a device (i.e., at least one stimulation unit). For this purpose, two or more skin electrodes can be used, which are positioned on the patient's skin. Typically, there are three different categories of nerves that can be stimulated: those that activate muscles, pain nerves, and heat-sensitive nerves. These categories of nerves typically differ from each other in, for example, their fiber type, diameter (in μm), conduction velocity (in m / s), and / or the duration of peak impulse (in ms), wherein at least one stimulation unit is controllable to provide different stimuli depending on the type and / or the desired sensation the patient wishes to perceive. For example, at least one stimulation unit may be adapted to provide one or more of the following TENS techniques with selectable parameters (such as pulse rate and pulse width): conventional TENS, wherein low-intensity pulses of, for example, 60 to 200 Hz are applied continuously; burst or Al-TENS, wherein high-intensity pulses of about 1000 Hz are applied intermittently; strong TENS, wherein high-intensity pulses of about 200 Hz are applied continuously; microcurrent TENS, wherein extremely low-intensity pulses of about 200 Hz are applied continuously; and interference TENS, wherein two or more different frequencies are interleaved.

[0021] From a functional perspective, surrogate stimuli can be selected to apply a desired tactile sensation that simulates the actual stimulation applied later in the medical magnetic resonance imaging setting, particularly during the imaging phase. Furthermore, the type and / or number of electrodes can be selected based on the desired simulation or tactile sensation and / or the stimulation to be applied. Stimuli can be selected to reproduce subsequent stimulation as similarly or identically as possible in the medical magnetic resonance imaging setting, thus providing a recognizable effect on the patient.

[0022] EMS can be broadly understood as the use of electrical pulses to induce muscle contraction. At least one stimulation unit can be adapted to generate these electrical pulses for delivery, for example, by electrodes applied to the skin of a patient near the muscle being stimulated. Essentially, the pulses mimic action potentials typically generated by the central nervous system, thereby causing muscle contraction.

[0023] TMS can be broadly understood as non-invasive brain stimulation, in which a changing magnetic field is used to induce an electric current at a specific region of the brain via electromagnetic induction. For this purpose, at least one stimulation unit may include an electrical pulse generator connected to a magnetic coil to be applied to the patient's scalp during operation. At least one stimulation unit is adapted to generate a changing current within the coil that induces the magnetic field, wherein the field then induces a second inductance with a reverse charge within the brain itself.

[0024] This allows for the effective preparation or training of patients using technically simple methods, without the need for the actual stimuli used in a medical magnetic resonance imaging setting.

[0025] According to an embodiment, the surrogate stimulation provided by at least one stimulation unit can be used for tactile communication with a patient, and the magnetic stimulation (i.e., the actual stimulation) used in a medical magnetic resonance imaging setting is adapted to provide at least similar tactile communication with at least one stimulation unit.

[0026] In other words, the intentional stimulus provided by at least one stimulus unit is a proxy for the actual intentional magnetic stimulus, wherein the proxy stimulus simulates the actual stimulus.

[0027] This allows for the effective preparation or training of patients using technically simple methods.

[0028] In an embodiment, the at least one data processing unit is adapted to control the at least one stimulation unit to apply electrical and / or magnetic stimulation at a level higher than at least one assigned patient stimulation threshold.

[0029] This ensures that the patient perceives the stimulation correctly. Preferably, the electrical and / or magnetic stimulation is applied at just above at least one assigned patient stimulation threshold. The term "just above" means preferably above the threshold by less than 10%, more preferably above the threshold by less than 5%, even more preferably above the threshold by less than 2%, and most preferably above the threshold by less than 1%. The closer the stimulation intensity is to above the threshold, the less likely the patient is to experience negative effects from the electrical and / or magnetic stimulation, which may be perceived as unpleasant at high levels.

[0030] In an embodiment, the at least one data processing unit may also be adapted to provide tactile interaction information data and / or tactile interaction instruction data associated with agent intentional stimuli via a user interface to train the patient for tactile communication based on intentional stimuli during the examination phase in the medical magnetic resonance imaging environment.

[0031] For example, the device may also include a user interface suitable for providing the aforementioned data to the patient, such as an audio interface and / or a visual interface, including, for example, speakers, headphones, displays, etc. Tactile interaction information data and / or tactile interaction instruction data may include, for example, the introduction of the concept of tactile interaction through the use of PNS, instructions to apply and / or reposition electrodes to the skin, interpretation of currently applied stimuli, etc.

[0032] By way of example, the associated intentional stimulation of the agent can be applied once or multiple times to the same or different parts of the patient's body to indicate certain types of information. This information can also be the content of tactile interaction information data and / or tactile interaction instruction data, enabling the patient to recognize or train tactile interactions in this context.

[0033] This allows for more efficient and patient-friendly training by providing appropriate instructions. Furthermore, it enables a high degree of automation in medical imaging.

[0034] According to an embodiment, the at least one data processing unit may also be adapted to correlate the at least one patient stimulation threshold associated with the proxy electrical stimulation and / or magnetic stimulation with a corresponding threshold assigned to the magnetic stimulation used in the medical magnetic resonance imaging environment, and to provide control parameters for applying the magnetic stimulation based on the correlation.

[0035] For example, lookup tables, databases, etc., may be provided, which include thresholds for actual and surrogate stimulation considering at least a given gradient coil and scanning sequence, and optionally, for example, a given set of skin electrode locations. This data may be collected, for example, in a test group of volunteers or patients. At least one data processing unit may be adapted to access the threshold data and determine correlations. This determination may be based on the thresholds for surrogate stimulation, which may be determined during the preparation phase.

[0036] This allows for the direct setting of actual stimuli based solely on the previous preparation phase.

[0037] In an embodiment, the at least one data processing unit may also be adapted to control the at least one stimulation unit to gradually increase control parameters toward the at least one patient stimulation threshold, and to receive patient feedback on whether the stimulation is perceived by the patient, and to determine the patient stimulation threshold based on the patient's perception.

[0038] For example, control parameters could be voltage, current, etc., controlling at least one stimulation unit. These control parameters can be gradually increased until the patient can perceive or feel the stimulation, and thus a threshold can be determined as the minimum value at which the patient perceives the stimulation. Patient feedback can be captured manually or electronically. Optionally, the device may also include a means of electronically receiving patient feedback, such as a data interface. The patient can use, for example, a manually operated signal generator to provide feedback to be received from the device. Optionally, feedback can be automatically captured by a detection unit (such as a camera), and its image can be evaluated by the device, for example, using image recognition technology, to determine the patient's feedback. Alternatively or additionally, the patient's perception can be determined and / or measured by sensors (such as a skin conductance (GSR) sensor, an EMG sensor, a motion sensor, etc.).

[0039] Therefore, the patient stimulation threshold can be accurately determined and can be used to correlate with the threshold of stimulation used in a medical magnetic resonance imaging setting.

[0040] According to an embodiment, the at least one data processing unit may also be adapted to apply the surrogate electrical stimulation and / or the surrogate magnetic stimulation at a rate corresponding to the respiratory rate desired for the patient during the examination in the medical magnetic resonance imaging environment.

[0041] For example, a surrogate stimulus can be applied to a body part, such as the chest, in a periodic manner that matches the desired respiratory rate used for medical imaging. The patient can be instructed to adapt their respiratory rate to the surrogate stimulus.

[0042] In an embodiment, at least one data processing unit may also be adapted to change the intensity of surrogate electrical stimulation and / or magnetic stimulation when it is determined that the patient’s respiratory rate is no longer within the desired range.

[0043] For example, at least one data processing unit can change control parameters, such as control voltage or control current.

[0044] This allows the patient to be instructed to maintain the desired breathing rate again.

[0045] According to an embodiment, at least one patient interface is disposed between the at least one proxy stimulation unit and the patient and is adapted to apply the electrical stimulation and / or magnetic stimulation to the patient, the patient interface being formed as one or more of a skin contact interface, a transmitter, and a transmitter.

[0046] For example, the patient interface may include a set of electrodes adapted to be applied to the patient's skin and to apply surrogate stimulation to the patient via skin contact. Furthermore, the transmitter and / or emitter may include at least one magnetic coil adapted to generate a varying current within the magnetic coil that induces a magnetic field.

[0047] In an embodiment, the at least one data processing unit may also be adapted to determine an indicator for locating the at least one patient interface relative to or at the patient based on measurements of one or more electrical values.

[0048] For example, the measurement could include measuring the resistance between the electrode pairs. This allows the determination of the path of lowest resistance between two specific electrodes. Such a low-resistance path ensures that these two electrodes are ultimately positioned to activate the nerve—because nerves are known to have lower resistance than surrounding tissue.

[0049] This allows for increased reliability in determining the stimulation threshold.

[0050] According to an embodiment, the patient interface may include at least one set of electrodes that can be connected to or be connected to at least one stimulation device and are adapted to provide electrical stimulation to the patient through contact.

[0051] In one embodiment, the patient interface includes at least one magnetic coil that can be connected to or attached to the at least one stimulation device and is adapted to provide the magnetic stimulation to the patient by applying it tangentially to the patient's skull.

[0052] According to a second aspect not covered by the claims, a medical imaging system is provided. The system includes:

[0053] -The first device, comprising:

[0054] - At least one surrogate stimulation unit, said at least one surrogate stimulation unit being adapted to operate separately from the magnetic stimulation used in the medical magnetic resonance imaging environment, and being adapted to intentionally stimulate the nerves and / or muscles of the patient's peripheral body parts by applying electrical and / or magnetic stimulation different from the magnetic stimulation used in the medical magnetic resonance imaging environment and which is its surrogate.

[0055] - At least one first data processing unit, said at least one first data processing unit being adapted to control said at least one surrogate stimulation unit to apply the electrical stimulation and / or magnetic stimulation, and at least one patient stimulation threshold being assigned to said electrical stimulation and / or magnetic stimulation; and

[0056] - A second device, which is used in the medical magnetic resonance imaging environment, the second device comprising:

[0057] -Magnetic stimulation unit; and

[0058] - At least one second data processing unit, said at least one second data processing unit being adapted to control the magnetic stimulation unit to intentionally stimulate the nerves and / or muscles of the patient's peripheral body parts by applying magnetic stimulation different from the proxy stimulation to the patient's peripheral body parts.

[0059] In this way, patients can be trained to recognize or become familiar with the actual stimulation, i.e., magnetic stimulation, applied by a second device, using surrogate stimulation. By using at least one stimulation unit as a surrogate, the additional setup of a complete device for magnetic stimulation, as used in a medical MRI environment, can be omitted, resulting in considerable technical and cost savings. Furthermore, patient preparation can be performed separately from the actual medical imaging examination, so that the medical MRI environment (e.g., the medical imaging system) need not be used for patient preparation, but only for their actual medical imaging examination. This increases the efficiency of the medical MRI environment, as it can be dedicated solely to the actual examination. From a functional perspective, the aforementioned device allows for the reproduction of subsequent stimulation in the medical MRI environment as similarly or identically as possible by providing surrogate stimulation, thus enabling patient recognition.

[0060] For example, the first device can be configured as a device according to the first aspect described above.

[0061] The second device may include at least one magnetic coil. The first and / or second data processing unit may be configured to control at least one magnetic coil to provide actual nerve and / or muscle stimulation to the patient in a predefined spatial and / or temporal manner.

[0062] In an embodiment, the first and / or second processing unit is configured to select at least a portion of one of the at least one magnetic stimulation coils to provide intentional nerve and / or muscle stimulation to the patient in a predefined spatial manner.

[0063] In an embodiment, at least one magnetic coil may include multiple magnetic coils. The first and / or second processing unit may be configured to select at least a portion of one or more of the multiple magnetic stimulation coils to provide intentional nerve and / or muscle stimulation to the patient in a predefined spatial manner.

[0064] In an embodiment, the first and / or second data processing unit may be adapted to control the magnetic stimulation unit to provide intentional nerve and / or muscle stimulation to multiple different locations of the patient.

[0065] In an embodiment, the first and / or second data processing unit may be adapted to control the waveform of the current applied to at least one magnetic stimulation coil in order to provide the patient with intentional nerve and / or muscle stimulation in a predefined timing manner.

[0066] In one embodiment, the second device may include a plurality of magnetic stimulation coil drive amplifiers, and at least one magnetic coil includes a plurality of magnetic stimulation coils. Each magnetic coil is configured to be driven by at least one amplifier, wherein each amplifier is configured to drive only one magnetic coil, and wherein the processing unit is configured to control the plurality of amplifiers to provide intentional nerve and / or muscle stimulation to the patient in a predefined spatial and / or temporal manner.

[0067] In one embodiment, the first magnetic stimulation coil is configured to be driven by a first amplifier, and the second magnetic stimulation coil is configured to be driven by a second amplifier. In another example, the third magnetic stimulation coil is configured to be driven by a third amplifier.

[0068] In this way, a coil can be driven by an amplifier to provide a single gradient (e.g., the x-gradient). However, when a coil is driven by an amplifier and a second coil is driven by a second amplifier, two independent gradients (e.g., x, y) can be generated. And when a third coil is driven by a third amplifier, a third independent gradient (x, y, z) can be generated. It should be noted that the amplifier can provide independent magnetic stimulation fields (x, y, z) that do not therefore need to be gradients.

[0069] In an embodiment, the first and / or second data processing unit may be configured to control the magnetic stimulation unit to provide intentional nerve and / or muscle stimulation to the patient in order to provide information to the patient.

[0070] In an embodiment, the second device may be configured to collect at least one patient response to nerve and / or muscle stimulation.

[0071] According to an embodiment, the magnetic stimulation unit can be controlled based on at least one patient stimulation threshold of the at least one stimulation unit.

[0072] As described above with respect to the first aspect, a correlation and / or conversion between the threshold of the surrogate stimulus provided by at least one stimulation unit and the threshold of the magnetic stimulation unit can be performed.

[0073] In another embodiment, the device includes a controller for controlling the magnetic stimulation unit.

[0074] In an embodiment, the magnetic stimulation unit can be controlled to perform a calibration scan based on the at least one patient stimulation threshold, and patient feedback can be received regarding whether the magnetic stimulation of the magnetic stimulation unit is perceived by the patient.

[0075] For example, a calibration scan can be initiated while the patient is already in the medical MRI setting (e.g., in the chamber) but before the actual imaging phase (e.g., the actual scan sequence) to confirm that the thresholds determined during the preparation phase are indeed valid for interactive purposes (i.e., perceived by the patient).

[0076] Optionally, in the case of a particular patient's previous medical imaging procedures, a patient-specific calibration file can be retrieved from the patient profile updated with transformation parameters (from surrogate stimulus to actual stimulus).

[0077] According to an embodiment, the first device and the second device can be operatively connected to each other and the magnetic stimulation unit can be controlled based on monitoring data collected during the preparation phase.

[0078] Monitoring data can include, for example, observations about how well a patient can perform a particular interaction. Based on these observations, it can be determined whether, for example, increasing the intensity level of stimulation, a faster sequence, or an increased number of stimuli can support the imaging sequence to plan an optimized imaging sequence, thus improving patient interaction. Optionally, monitoring data provided to the medical imaging system from the surrogate stimulation device can indicate where the patient may have difficulty detecting or recognizing stimuli, and this indication can be used to increase stimulation during the actual medical imaging (i.e., the medical imaging phase). Therefore, interruptions to the medical imaging phase can be avoided, and thus the medical imaging process can be made more efficient.

[0079] According to a third aspect, a computer-implemented method is provided for preparing a patient for examination in a medical magnetic resonance imaging setting. The method includes the following steps:

[0080] - During the patient preparation phase prior to the examination performed in the medical magnetic resonance imaging environment, nerves and / or muscles in the patient's peripheral body parts are intentionally stimulated by applying electrical and / or magnetic effects, different from the magnetic stimulation used in the medical magnetic resonance imaging environment, as their proxies.

[0081] - During the examination phase performed in the medical magnetic resonance imaging environment, the nerves and / or muscles of the patient's peripheral body parts are intentionally stimulated by applying proxy magnetic stimulation to the patient's peripheral body parts.

[0082] The method can preferably be performed by using the device according to the first aspect and / or by using the system according to the second aspect.

[0083] According to a fourth aspect, a computer program unit is provided, which, when run by a processor, is configured to perform the method of the third aspect and / or control the system according to the second aspect and / or control the device according to the first aspect.

[0084] According to a fifth aspect, a computer-readable storage or transmission medium is provided, which has stored or carried computer program units according to a fourth aspect.

[0085] It should be noted that the above embodiments can be combined with each other, regardless of the aspects involved. Therefore, the method can be combined with the structural features of other devices and / or systems, and similarly, the devices and systems can be combined with each other's features, and also with the features described above regarding the method.

[0086] These and other aspects of the invention will become apparent and will be explained with reference to the embodiments described below. Attached Figure Description

[0087] Exemplary embodiments of the present invention will be described in the following figures.

[0088] Figure 1 A schematic block diagram illustrates an apparatus for preparing a patient for examination in a medical magnetic resonance imaging setting, according to an embodiment.

[0089] Figure 2 A medical imaging system according to an embodiment is illustrated in a schematic block diagram.

[0090] Figure 3 A schematic block diagram illustrates a device for providing magnetic stimulation to a patient according to an embodiment.

[0091] Figure 4 A flowchart of a method for preparing a patient for examination in a medical magnetic resonance imaging setting, according to an embodiment, is shown.

[0092] List of reference numerals in the attached diagram:

[0093] 100 Medical Imaging System

[0094] 10 Equipment

[0095] 11 stimulation units

[0096] 12 Data Processing Units

[0097] 13 User Interface

[0098] 14 Patient Interface

[0099] 20 devices

[0100] 21 magnetic stimulation units

[0101] 22 Data Processing Unit

[0102] 23 Sensor devices

[0103] 24 magnetic stimulation coils

[0104] 25 Magnetic Stimulation Coil Drive Amplifier Detailed Implementation

[0105] Figure 1 A schematic block diagram illustrates an apparatus 10 for preparing a patient for an examination (i.e., a medical imaging procedure) to be performed in a medical magnetic resonance imaging setting, according to an embodiment.

[0106] In this description, the medical magnetic resonance imaging environment can be distinguished from the preparation environment, wherein the two environments are at least functionally separate and may also be physically separate, for example, housed in separate rooms and / or facilities. The preparation environment is used to perform a preparation phase prior to the imaging phase performed in the imaging section.

[0107] The device 10 described herein is specifically designed for the preparation phase or preparation environment. It acts as a proxy for at least one functional and / or structural component of a medical magnetic resonance imaging environment, as will be described in more detail below.

[0108] Device 10 includes at least one stimulation unit 11, hereinafter referred to as surrogate stimulation unit 11. Surrogate stimulation unit 11 is adapted to operate separately from magnetic stimulation (hereinafter referred to as actual stimulation) applied during the imaging phase in a medical magnetic resonance imaging environment. Surrogate stimulation unit 11 is adapted to intentionally stimulate nerves and / or muscles of a patient's peripheral body parts by applying electrical and / or magnetic stimulation (hereinafter referred to as surrogate stimulation) that is different from and surrogate the magnetic stimulation applied in the medical magnetic resonance imaging environment. For this purpose, surrogate stimulation unit 11 includes, for example, an electrical pulse generator adapted to generate electrical pulses to be provided to the patient, for example, through a patient interface (such as a set of electrodes). Alternatively or additionally, surrogate stimulation unit 11 includes, for example, an electrical pulse generator connected to a magnetic coil adapted to generate a changing current within the magnetic coil that induces a magnetic field.

[0109] The surrogate stimulation unit 11 and / or the electrical pulse generator included therein are adapted to apply electrical and / or magnetic stimulation by one or more of the following: transcutaneous electrical nerve stimulation (TENS), electrical muscle stimulation (EMS), and transcranial magnetic stimulation (TMS).

[0110] Furthermore, the device 10 includes at least one data processing unit 12, which is adapted to control at least one stimulation unit to apply electrical and / or magnetic stimulation, and at least one patient stimulation threshold is assigned to the electrical and / or magnetic stimulation. The data processing unit 12 is, for example, a microprocessor, and includes one or more of a processor, memory, data interface, communication interface, etc.

[0111] Alternatively, device 10 may be a portable device and may optionally be battery-operated.

[0112] From a functional perspective, the surrogate stimulation provided by the surrogate stimulation unit 11 can be used for tactile communication and / or interaction with the patient, and the magnetic stimulation applied in the medical magnetic resonance imaging environment is adapted to provide tactile communication and / or interaction that is at least similar to that of the surrogate stimulation unit, so that the patient can identify at least similar stimulation for both the preparation phase and the imaging phase.

[0113] Optionally, the data processing unit 12 may also be adapted to provide tactile interaction information data and / or tactile interaction instruction data associated with surrogate intentional stimuli via the user interface 13 to train the patient for tactile communication of intentional stimuli during the examination phase in a medical magnetic resonance imaging setting. For example, the user interface 13 may include one or more of the following: an audio interface (such as a speaker, headphones, etc.) that provides audio instructions to the patient, and a visual interface (such as a monitor, video screen, etc.) that provides visual instructions to the patient. For example, the tactile interaction information data and / or tactile interaction instruction data may be used to indicate or inform the patient of the meaning of different surrogate stimuli and / or instructions that can be applied to the patient during the preparation phase, so as to train the patient to recognize specific surrogate stimuli assigned to specific instructions.

[0114] Optionally, the data processing unit 12 may also be adapted to correlate at least one patient stimulation threshold (i.e., a first patient stimulation threshold) associated with electrical and / or magnetic surrogate stimulation with a corresponding threshold (i.e., a second patient stimulation threshold) assigned to magnetic stimulation used in a medical magnetic resonance imaging setting, and to provide control parameters for applying magnetic stimulation based on this correlation. For example, the control parameters may include control voltage, control current, etc.

[0115] Optionally, the data processing unit 12 may also be adapted to control at least one stimulation unit 11 to gradually increase a control parameter toward at least one patient stimulation threshold, and to receive patient feedback regarding whether the stimulus is perceived by the patient, and to determine the patient stimulation threshold based on the patient's perception. For example, the control parameter (e.g., control voltage) may be gradually increased until the patient perceives the stimulation effect. The control parameter may then be set to a patient stimulation threshold with optional additional margin.

[0116] Optionally, the data processing unit 12 may also be adapted to apply electrical and / or magnetic surrogate stimulation at a rate corresponding to the patient’s desired respiratory rate during examination in a medical magnetic resonance imaging setting.

[0117] Optionally, the device 10 includes at least one patient interface 14, which is operatively and / or functionally arranged between the surrogate stimulation unit 11 and a patient, and is adapted to apply electrical and / or magnetic stimulation to the patient. The patient interface 14 may be configured as one or more of a skin contact interface, a transmitter, and a emitter. For example, the patient interface 14 may include a set of electrodes adapted to be applied to the patient's skin and to apply surrogate stimulation to the patient via skin contact. Furthermore, the transmitter and / or emitter may include at least one magnetic coil adapted to generate a changing current within the magnetic coil that induces a magnetic field.

[0118] Optionally, the data processing unit 12 may also be adapted to determine an indicator for locating at least one patient interface relative to or at the patient based on measurements of one or more electrical values. For example, the measurements may include measurements of the resistance between the electrode pairs used as patient interface 14. This allows the determination of the lowest resistance path between two specific electrodes. Such a low-resistance path ensures that the two electrodes are ultimately positioned to activate nerves—because nerves are known to have lower resistance than surrounding tissues.

[0119] Figure 2 A medical imaging system 100 is shown. For example, the medical imaging system 100 may be a magnetic resonance imaging (MRI) system; a computed tomography (CT) system; a positron emission tomography (PET) system; a digital X-ray radiometry (DXR) system; or any other medical imaging system. It should be noted that the medical imaging system includes a suitable image acquisition unit adapted to perform the techniques described above.

[0120] As described herein, the medical imaging system 100 includes both a medical magnetic resonance imaging environment and a preparation environment.

[0121] Therefore, the medical imaging system 100 includes a first device that can be configured as the device 10 described above. The device 10 includes at least one surrogate stimulation unit 11, which is adapted to operate separately from the magnetic stimulation used in the medical magnetic resonance imaging environment, and is adapted to intentionally stimulate nerves and / or muscles of a patient's peripheral body parts by applying electrical and / or magnetic surrogate stimulation that is different from and is a surrogate of the magnetic stimulation used in the medical magnetic resonance imaging environment. As described above, the device 10 also includes at least one first data processing unit 12, which is adapted to control the at least one surrogate stimulation unit 11 to apply electrical and / or magnetic stimulation, and at least one patient stimulation threshold is assigned to the electrical and / or magnetic stimulation.

[0122] The medical imaging system 100 also includes a second device 20 for a medical magnetic resonance imaging environment. The second device 20 is specifically designed for the preparation phase or preparation environment 200. The second device 20 includes at least one magnetic stimulation unit 21 and at least one second data processing unit 22, which is adapted to control the magnetic stimulation unit 11 to intentionally stimulate the nerves and / or muscles of the patient's peripheral body parts by applying magnetic stimulation different from the surrogate stimulation to the patient's peripheral body parts.

[0123] Optionally, the magnetic stimulation unit 21 is controlled based on at least one patient stimulation threshold of the surrogate stimulation unit 11.

[0124] Optionally, the magnetic stimulation unit 21 is controlled to perform a calibration scan based on at least one patient stimulation threshold, and patient feedback is received regarding whether the patient perceives the magnetic stimulation of the magnetic stimulation unit 21.

[0125] Optionally, the first device 10 and the second device 20 are operatively connected to each other and control the magnetic stimulation unit 21 based on monitoring data collected during the preparation phase.

[0126] Figure 3 An example of a second device 20, including a magnetic stimulation unit 21 and a second data processing unit 22, is illustrated in a schematic block diagram. The data processing unit 22 is configured to control the magnetic stimulation unit to provide intentional nerve and / or muscle stimulation to the peripheral body parts of the patient.

[0127] Optionally, the second device 20 includes at least one sensor device 23 configured to acquire at least one response to neural and / or muscle stimulation. For example, the at least one sensor device 23 includes: a camera, an EMG sensor, a motion sensor, a tilt sensor, an accelerometer, a microphone, and when operating in image acquisition mode, the at least one sensor device may be the magnetic resonance imaging acquisition unit itself.

[0128] Optionally, the peripheral body parts include a portion of a leg, a portion of a foot, a portion of an arm, and a portion of a hand.

[0129] Alternatively, peripheral body parts refer to any part of the body other than the head, and include, for example, the back / spine.

[0130] Optionally, the second data processing unit 22 is configured to implement a specific set of instructions to provide the patient with intentional nerve and / or muscle stimulation.

[0131] Optionally, the second device 20 includes at least one magnetic stimulation coil 24. The processing unit is configured to control at least one magnetic stimulation coil to provide intentional nerve and / or muscle stimulation to the patient in a predefined spatial and / or temporal manner.

[0132] Optionally, at least one magnetic stimulation coil 24 is part of a magnetic resonance imaging unit.

[0133] Optionally, at least one magnetic stimulation coil 424 includes at least one gradient coil.

[0134] Optionally, the second data processing unit 22 is configured to select at least one portion of a magnetic stimulation coil of at least one magnetic stimulation coil 24 in order to provide intentional nerve and / or muscle stimulation to the patient in a predefined spatial manner.

[0135] Optionally, at least one magnetic stimulation coil 24 includes a plurality of magnetic stimulation coils. The second data processing unit 22 is configured to select at least a portion of one or more of the plurality of magnetic stimulation coils to provide intentional nerve and / or muscle stimulation to the patient in a predefined spatial and / or temporal manner. Also optionally, the second device 20 includes at least one or more magnetic stimulation coil drive amplifiers 25, and at least one magnetic stimulation coil includes a plurality of magnetic stimulation coils. Each magnetic stimulation coil is configured to be driven by at least one amplifier 25, wherein each amplifier 25 is configured to drive only one magnetic stimulation coil, and wherein the processing unit is configured to control the plurality of amplifiers to provide intentional nerve and / or muscle stimulation to the patient in a predefined spatial and / or temporal manner.

[0136] Optionally, at least one magnetic stimulation coil is represented by at least one gradient coil of the MRI unit or system.

[0137] Alternatively, references to magnetic stimulation coils may refer to a portion of the gradient coils of an MRI unit or system.

[0138] The flowchart is shown in the reference. Figure 4 The following describes a computer-implemented method for preparing a patient for examination in a medical magnetic resonance imaging setting.

[0139] In step S1, during the patient preparation phase prior to the examination phase performed in the medical magnetic resonance imaging environment, intentional stimulation is performed on the nerves and / or muscles of the patient's peripheral body parts by applying electrical and / or magnetic effects, different from the magnetic stimulation used in the medical magnetic resonance imaging environment, as their proxies.

[0140] In step S2, during the examination phase performed in a medical magnetic resonance imaging setting, magnetic stimulation is intentionally performed on the nerves and / or muscles of the patient's peripheral body parts by applying magnetic stimulation to the patient's peripheral body parts.

[0141] Note that the nerves and / or muscles involved in steps S1 and S2 may correspond to each other or may be located in the same area of ​​the patient's body.

[0142] As those skilled in the art will recognize, the following detailed embodiments provide further details on how the device 10, the medical imaging system 100, and the methods for preparing a patient can be implemented.

[0143] Example 1: Simulating PNS interaction via electromyography during audiovisual presentation

[0144] Patients typically enter a preparation area or room before the actual examination (i.e., the imaging phase), where the preparation phase can be performed. Especially in self-administered setups, there may be extended patient preparation, which already includes some audiovisual introduction to the next steps of the MR examination.

[0145] In at least some embodiments, the concept of tactile interaction can be introduced to the patient by utilizing the PNS, and it can be simulated during this training using electrical and / or magnetic stimulation provided by the surrogate stimulation unit.

[0146] In at least some embodiments, direct electrical stimulation using skin electrodes, as performed in EMS training devices for muscles, can be used. For this purpose, the electrodes can be temporarily attached during the preparation phase or integrated into a chair or patient support. Preferably, the electrodes are in the form of patches. Such patches are in the form of a matrix of electrodes. In operation, the resistance between each of the electrode pairs can be measured, and the path of lowest resistance between two particular electrodes can be determined. Such a low-resistance path indicates that the two electrodes are ultimately optimally positioned to activate the nerve—because nerves are known to have lower resistance than surrounding tissues. Using this method also increases the reliability of the stimulation threshold determination, as described in Example 4 below.

[0147] Example 2: Use of ECG Electrodes

[0148] When preparing a patient for a cardiac-triggered scan in a medical magnetic resonance imaging setting, electrocardiogram (ECG) electrodes are typically applied to the patient's chest to trigger and connect to an ECG receiver amplifier system during the imaging phase (i.e., the scan). In at least some embodiments, these electrodes have already been applied to the patient during the preparation phase, wherein electronics are connected to a surrogate stimulation unit 11, which may include a transmit amplifier capable of deploying waveforms to provide electrical stimulation (such as EMS).

[0149] Example 3: Simulating PNS Interaction via Transcranial Magnetic Stimulation (TMS)

[0150] Transcranial magnetic stimulation (TMS) can be used to induce activity in the corresponding brain tissue of the cortex by generating muscle activity or sensation similar to pseudoneuropathy (PNS) through the application of magnetic coils to the skull. TMS applied to the skull or another part of the patient's body can be used instead of EMS to mimic PNS, as described in Example 1 above.

[0151] Example 4: Adaptation of Patient Stimulation Threshold

[0152] The actual patient stimulus threshold and the surrogate patient stimulus threshold can vary widely across patients. However, it is expected that the two types of patient stimulus thresholds are correlated for a specific patient because both surrogate and actual stimuli are induced by electric fields acting on motor and sensory nerves. A key difference between actual and surrogate stimuli can be observed, where, in the latter case, the field is induced without any current contact but rather by a rapid change in the magnetic field.

[0153] In at least some embodiments, the data processing unit 12 is adapted to correlate, for example, a given gradient coil and a given imaging scan sequence in a medical magnetic resonance imaging setting, and optionally for a given set of electrode locations, with actual stimulation thresholds and surrogate stimulation thresholds, which may be derived, for example, from a test group of volunteers or patients, by means of a suitable computer program.

[0154] Optionally, for a given patient, one or more individual surrogate stimulation thresholds can be determined during the preparation phase by gradually increasing the applied control parameters (e.g., control voltage or current) until the patient perceives (e.g., can feel) the surrogate stimulation. The determined surrogate stimulation thresholds can then be translated into appropriate gradient currents for use in the PNS sequence applied during the imaging phase in a medical magnetic resonance imaging setting, using the aforementioned correlation between the actual stimulation threshold and the surrogate stimulation threshold.

[0155] Optionally, the surrogate stimulation threshold determined as described above can be used to control a (single) PNS-induced scan in a medical MRI setting. This scan (which may also be referred to as a calibration scan) can be initiated while the patient is in the medical MRI setting (e.g., in the thorax) but before the actual scan sequence (i.e., the actual imaging phase) is initiated to confirm that the assessed threshold is indeed effective for the interactive purpose.

[0156] In the case of a previous imaging procedure assigned to a specific patient, the patient-specific calibration file can be retrieved from the patient profile updated with conversion parameters (from surrogate stimulation threshold to actual stimulation threshold).

[0157] Optionally, a dedicated device for measuring the conversion parameters can be used in the preparation stage, wherein the device can be adapted to generate magnetic fields and PNS sequences, wherein the device need not be a functional MRI scanner, but has a simpler structural design.

[0158] Example 5: Training for a specific purpose as a breathing-guided method

[0159] Patients can be trained to recognize that a single or multiple application of the same or different stimuli to the same or different parts of the body (i.e., PNS) will indicate certain types of information.

[0160] By way of example, a patient can be trained to use a surrogate stimuli (PNS) to guide breathing during an MR scan without physically touching the patient or speaking to him according to audio commands. Preferably, the surrogate stimulation training can be applied to the patient's chest multiple times in a periodic manner at the patient's desired breathing rate. Alternatively, the intensity of the surrogate stimulation can be varied to indicate to the patient that they are no longer properly following breathing guidance.

[0161] Observations of how well a patient performs a specific sequence and how well their response to changes in the strength of the surrogate stimulus can provide information about whether a faster sequence or an increased number of stimuli supports the imaging sequence can be used to plan for an optimized imaging sequence. Communication from the surrogate device to the actual medical imaging system can also indicate where the patient may have problems detecting or recognizing stimuli, enabling the stimulation to be retried during the imaging sequence without stopping, making the entire process more efficient.

[0162] The complete workflow described in this article (including patient profile analysis and setting the correct system parameters for each patient type) can be optimized via artificial intelligence (AI) and learning algorithms to identify and estimate success rates, and also to identify which patient groups are likely to have problems with the applied methods. These patients can then be directly supported by other methods and support staff, leading to a more efficient process overall.

[0163] Example 6: Improving Calibration and Communication via PNS in Medical Magnetic Resonance Imaging Environments

[0164] Following the preparation or training phase, the patient is moved to a medical magnetic resonance imaging (MRI) environment, such as a medical imaging system, and a calibration scan can be performed. In some cases, the surrogate stimulus during the preparation or training phase may not accurately represent the actual stimulus induced in the MRI environment because the individual actual stimulus (i.e., the PNS communication signal) depends on the individual body shape. The calibration scan allows the patient to adapt to the actual stimulus, i.e., the real situation. Optionally, vital signs signals (e.g., RF pilot tones, RADAR, US, or VitalEye infrastructure) can be used to support the calibration scan. Indicators of PNS are motions associated with gradient waveforms, sudden responses of the patient (eyes, face, body). Vital signs signals encompass all patient movements. Those caused by PNS will be precisely correlated with PNS induced by the MR scanner gradient. Therefore, the correlation between vital signs signals and gradient time patterns will give a clear indication of whether PNS is occurring. The signal can also be represented by another optical communication signal given to the patient.

[0165] For calibration, medical imaging systems can be adapted to send several test gradient pulses before scanning until the strongest / fastest programmed gradient rises, in order to estimate whether and when PNS will occur, and if the calibration conforms to the calculated parameters represented by the external stimulus, the patient can tolerate it.

[0166] During the calibration process, the combination of PNS communication signals and visual or acoustic stimuli can further improve and optimize the training process. For example, PNS levels can be visually displayed, allowing patients to learn and adapt to even weak PNS signals and respond to them. This additional information can be used to further refine the calibration of PNS communication signals (through, for example, feedback loops).

[0167] In another exemplary embodiment of the invention, a computer program or a computer program unit is provided, characterized in that it is configured to perform the method steps of the method according to one of the preceding embodiments on a suitable system.

[0168] Therefore, the computer program unit can be stored on the data processing unit, which may also be part of the embodiment. The data processing unit can be configured to perform the steps of the methods described above or induce the execution of the steps of the methods described above. Furthermore, it can be configured to operate components of the device and / or system described above. The computing unit can be configured to automatically operate and / or execute user commands. The computer program can be loaded into the working memory of the data processor. The data processor can thus be equipped to perform the method according to one of the embodiments.

[0169] Furthermore, the computer program unit is capable of providing all the necessary steps of the process for implementing exemplary embodiments of the methods described above.

[0170] According to another exemplary embodiment of the present invention, a computer-readable medium, such as a CD-ROM, a USB stick, etc., is provided, wherein the computer-readable medium has computer program units stored on the computer-readable medium, the computer program units being described in the preceding portion.

[0171] Computer programs can be stored / distributed on suitable media, such as optical storage media or solid-state media provided with or as part of other hardware, but computer programs can also be distributed in other forms, such as via the Internet or other wired or wireless telecommunications systems.

[0172] However, the computer program may also exist on a network such as the World Wide Web and can be downloaded from such a network to the working memory of a data processor. According to another exemplary embodiment of the invention, a medium is provided for making a computer program unit available for download, wherein the computer program unit is arranged to perform the method described in one of the previously described embodiments according to the invention.

[0173] It should be noted that embodiments of the present invention are described with reference to different subjects. Specifically, some embodiments are described with reference to claims of the method type, while others are described with reference to claims of the device type. However, those skilled in the art will understand from the above and below description that, unless otherwise indicated, any combination of features relating to different subjects, in addition to any combination of features belonging to one type of subject, is also considered to be disclosed in this application. However, all features can be combined to provide synergistic effects beyond the simple sum of the features.

[0174] Although the invention has been described and illustrated in detail in the accompanying drawings and the foregoing description, such description and illustration are to be considered illustrative or exemplary rather than restrictive. The invention is not limited to the disclosed embodiments. Other variations of the disclosed embodiments will be understood and implemented by those skilled in the art in practicing the claimed invention by studying the drawings, description, and dependent claims.

[0175] In the claims, the word "comprising" does not exclude other units or steps, and the words "a" or "an" do not exclude multiple. A single processor or other unit may perform the functions of several items recited in the claims. Although specific measures are recited in different dependent claims, this does not indicate that combinations of these measures cannot be advantageously used. Any reference numerals in the claims should not be construed as limiting the scope.

Claims

1. A system for preparing a patient for examination in a medical magnetic resonance imaging setting, comprising: - Magnetic resonance imaging unit (20), which is applied to the medical magnetic resonance imaging environment during the examination phase, and includes at least one magnetic coil, said at least one magnetic coil being controlled to provide magnetic stimulation to intentionally stimulate nerves and / or muscles in the peripheral body parts of the patient; The first device (10) is used in the patient preparation phase prior to the examination phase; The magnetic resonance imaging unit (20) and the first device (10) are configured to provide tactile communication with the patient by intentionally stimulating the nerves and / or muscles of the patient's peripheral body parts; The first device (10) includes: - At least one stimulation unit (11) adapted to act as a proxy for the magnetic resonance imaging unit (20) by simulating subsequent magnetic stimulation of the magnetic resonance imaging unit (20) as proxy electrical stimulation and / or proxy magnetic stimulation, and to operate separately from the magnetic stimulation from the medical magnetic resonance imaging unit, and to intentionally stimulate the nerves and / or muscles of the patient's peripheral body parts by applying electrical stimulation and / or magnetic stimulation in a manner different from the magnetic stimulation of the magnetic resonance imaging unit, and - At least one data processing unit (12) adapted to control the at least one stimulation unit (11) to apply the electrical stimulation and / or the magnetic stimulation, wherein at least one patient stimulation threshold is assigned to the surrogate electrical stimulation and / or the surrogate magnetic stimulation, and the at least one data processing unit (12) is also adapted to correlate the at least one patient stimulation threshold associated with the surrogate electrical stimulation and / or the surrogate magnetic stimulation with a corresponding threshold assigned to the magnetic stimulation used in the medical magnetic resonance imaging environment, and to provide control parameters for applying the subsequent magnetic stimulation of the magnetic resonance imaging unit (20) based on the correlation; The at least one data processing unit (12) is also adapted to provide tactile interaction information data and / or tactile interaction instruction data associated with the agent’s intentional stimulation via a user interface to train the patient for tactile communication during a subsequent examination phase.

2. The system according to claim 1, wherein, The at least one stimulation unit (11) is adapted to apply the electrical stimulation and / or the magnetic stimulation by one or more of the following: -Transcutaneous electrical nerve stimulation (TENS) -Electrical muscle stimulation (EMS), and - Transcranial magnetic stimulation (TMS).

3. The system according to claim 1 or 2, wherein, The at least one data processing unit (12) is adapted to control the at least one stimulation unit (11) to apply the electrical stimulation and / or the magnetic stimulation above the assigned at least one patient stimulation threshold.

4. The system according to claim 1 or 2, wherein, The at least one data processing unit (12) is also adapted to control the at least one stimulation unit (11) to gradually increase the control parameter toward the at least one patient stimulation threshold, and to receive patient feedback on whether the stimulation is perceived by the patient, and to determine the patient stimulation threshold based on the patient's perception.

5. The system according to claim 1 or 2, wherein, The at least one data processing unit (11) is also adapted to apply the surrogate electrical stimulation and / or the surrogate magnetic stimulation at a rate corresponding to the respiratory rate desired for the patient during the examination in the medical magnetic resonance imaging environment.

6. The system according to claim 1 or 2, further comprising: At least one patient interface is disposed between the at least one proxy stimulation unit and the patient and is adapted to apply the electrical stimulation and / or the magnetic stimulation to the patient, the patient interface being formed as one or more of a skin contact interface, a transmitter, and a transmitter.

7. The system according to claim 6, wherein, The at least one data processing unit is also adapted to determine an indicator for locating the at least one patient interface relative to or at the patient based on measurements of one or more electrical values.

8. The system according to claim 1 or 2 further includes a controller adapted to control the at least one magnetic coil based on the at least one patient stimulation threshold of the at least one stimulation unit (11).

9. The system according to claim 8, wherein, The controller is also adapted to control the at least one magnetic coil to perform a calibration scan based on the at least one patient stimulation threshold, and to receive patient feedback regarding whether the magnetic stimulation of the magnetic stimulation unit is perceived by the patient.

10. A method for tactile communication with a patient in a medical magnetic resonance imaging setting, wherein, The method is applied to a system comprising a magnetic resonance imaging unit (20) and at least one stimulation unit (11), the magnetic resonance imaging unit being applied during an examination phase, and the at least one stimulation unit being applied during a preparation phase prior to the examination phase, wherein the magnetic resonance imaging unit (20) and the at least one stimulation unit (11) are configured to provide tactile communication with the patient by intentionally stimulating nerves and / or muscles in the patient's peripheral body parts, and wherein the method comprises the following steps: -The at least one stimulation unit (11) intentionally stimulates (S1) the nerves and / or muscles of the patient's peripheral body by applying electrical and / or magnetic effects different from those of the magnetic stimulation of the magnetic resonance imaging unit (20), the at least one stimulation unit acting as a proxy for the magnetic resonance imaging unit (20) by simulating subsequent magnetic stimulation of the magnetic resonance imaging unit (20) as a proxy electrical stimulation and / or a proxy magnetic stimulation, and operating separately from the magnetic stimulation of the magnetic resonance imaging unit (20), and - Control the magnetic resonance imaging unit (20) to intentionally stimulate (S2) the nerves and / or muscles of the patient's peripheral body parts during the examination phase by applying magnetic stimulation different from the proxy electrical stimulation and / or the proxy magnetic stimulation to the patient's peripheral body parts.

11. A computer program product comprising instructions that, when executed by a processor, control the system according to any one of claims 1 to 9.

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