Angiography injection synchronized with electrocardiogram

Abstract

An injection system is described that receives a first set of one or more signals from one or more sensors, the signals indicating the current volume of injection fluid dispensed from a fluid reservoir at a first moment. Based on the first set of one or more signals, the injection system determines that a first difference between a dispensing volume limit and the current volume of injection fluid dispensed from the fluid reservoir at the first moment is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases. The injection system also controls itself to avoid performing each of the systolic and diastolic injection phases in response to determining that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases.

Description

[0001] Related applications

[0002] This application claims priority to U.S. Patent Application No. 16 / 996,083, filed August 18, 2020, the contents of which are incorporated herein by reference. Technical Field

[0003] This disclosure relates to fluid injection systems. Background Technology

[0004] Many medical imaging procedures, such as angiography, involve the injection of contrast fluid into a patient. Angiography is a procedure used to diagnose and treat cardiovascular diseases, including abnormalities or restrictions in blood vessels. During angiography, radiographic images of the heart or vascular structures are obtained by injecting contrast fluid into the patient's vascular system (e.g., the coronary arteries) via a catheter. The injected contrast fluid can be delivered to the vascular structures that are in communication with the fluid. X-rays pass through the area of ​​the body where the contrast fluid was injected. The X-rays are absorbed by the contrast fluid, thus forming a radiographic profile or image of the vascular system containing the contrast fluid. Contrast fluid injection can also be used in conjunction with other medical procedures, such as optical coherence tomography (OCT), intravascular ultrasound (IVUS), computed tomography (CT), magnetic resonance imaging (MRI), and interventional device procedures / placement. Summary of the Invention

[0005] Generally, this disclosure describes techniques for synchronizing angiographic injections with an electrocardiogram (ECG) to optimize the use of injection fluid. For example, the injection system can read data indicating the ECG to determine when diastole begins. When diastole begins, the injection system begins injecting fluid into the patient according to the diastolic injection phase (e.g., at a first rate corresponding to the diastolic injection phase and continuing for the entire duration of diastole). From then on, in the angiographic task, after the previous diastolic injection phase is completed, the injection system determines whether the difference between the allocated volume limit (e.g., the maximum amount of fluid that can be injected into the patient in a single injection) and the current injection fluid volume already allocated from the fluid reservoir is large enough to complete both the systolic and diastolic injection phases, while adhering to the allocated volume limit. If the injection system determines that there is a sufficient difference below the allocated volume limit to complete both the systolic and diastolic injection phases, then the injection system continues with both the systolic and diastolic injection phases after completing the previous diastolic injection phase. Conversely, if the injection system determines that too much injection fluid has been dispensed, making it impossible for the system to complete both the next contraction and diastolic injection phases while remaining below the dispensed volume limit (e.g., there is only enough fluid to complete the contraction phase but not the diastolic phase, or not enough fluid to complete either phase), then the injection system will avoid performing either the contraction or diastolic injection phase.

[0006] The technique described herein offers numerous advantages. For example, the low pressure during diastole makes it easier for the infusion fluid to reach its intended destination in the patient. Therefore, more efficient use of the infusion fluid involves injecting it at a higher rate during diastole and at a lower rate during systole. For the same reason, initiating the injection at the onset of diastole is the most efficient use of the infusion fluid to maximize the benefits of low-pressure diastole. Furthermore, by verifying that the subsequent diastolic injection phase can be completed within the allocated volume limits before performing the previous systolic injection phase, the infusion system will not waste fluid by performing the systolic injection phase if the benefits of the diastolic injection phase cannot be achieved. In these ways, waste generated by injecting fluid into the patient when a higher-value injection cannot be completed is eliminated, and the amount is saved for future injections. Thus, the technique described herein maximizes the amount of infusion fluid available for use during diastole while eliminating waste during other phases when the infusion fluid is less useful or during phases when the infusion system cannot complete the entire injection. The technique described herein involves injecting fluid throughout diastole and interventional systole, but not during other times of the cardiac cycle.

[0007] In one example, this disclosure relates to an injection system including a fluid reservoir configured to store injection fluid. The injection system also includes one or more sensors configured to measure the volume of injection fluid dispensed from the fluid reservoir. The injection system further includes one or more processors configured to receive a first set of one or more signals from the one or more sensors, the signals indicating the current volume of injection fluid dispensed from the fluid reservoir at a first moment. The one or more processors are further configured to determine, based on the first set of one or more signals, that a first difference between a dispensing volume limit and the current volume of injection fluid dispensed from the fluid reservoir at the first moment is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases. The one or more processors are further configured to, in response to determining that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases, control the injection system to avoid performing each of the systolic and diastolic injection phases.

[0008] In another example, this disclosure relates to a method comprising receiving, by one or more processors of an injection system and from one or more sensors, a first set of one or more signals indicating the current volume of injection fluid dispensed from a fluid reservoir at a first moment. The method further comprises, by one or more processors and based on the first set of one or more signals, determining that a first difference between a dispensed volume limit and the current volume of injection fluid dispensed from the fluid reservoir at the first moment is less than the necessary fluid volume required to complete both a systolic injection phase and a diastolic injection phase. The method further comprises, in response to determining that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases, avoiding the execution of each of the systolic and diastolic injection phases.

[0009] In another example, this disclosure relates to a non-transitory computer-readable storage medium containing instructions. When executed, the instructions cause one or more processors of an injection system to receive a first set of one or more signals from one or more sensors, the signals indicating the current volume of injection fluid dispensed from a fluid reservoir at a first moment. The instructions also cause the one or more processors to determine, based on the first set of one or more signals, a first difference between a dispensed volume limit and the current volume of injection fluid dispensed from the fluid reservoir at the first moment is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases. The instructions further cause the one or more processors to control the injection system to avoid performing each of the systolic and diastolic injection phases in response to determining that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases.

[0010] In another example, this disclosure relates to a non-transitory computer-readable storage medium containing instructions that, when executed, cause one or more processors of an injection system to receive two or more injection feature inputs, wherein the two or more injection feature inputs include at least the number of images to be captured and image quality inputs. The instructions also cause the one or more processors to determine an injection schedule based on the two or more injection feature inputs, the injection schedule including a first flow rate for the injection fluid during a diastolic injection phase and a second flow rate for the injection fluid during a systolic injection phase, wherein the injection schedule includes an initial diastolic injection phase and one or more systolic / diastolic injection phase pairs, wherein each of the one or more systolic / diastolic injection phase pairs includes a complete systolic injection phase and a complete diastolic injection phase, wherein the injection schedule ends with a portion of a complete diastolic injection phase of one or more systolic / diastolic injection phase pairs, and wherein the first flow rate during each diastolic injection phase is at least partially based on the image quality input. The instructions also cause the one or more processors to control the injection system to inject injection fluid from the injection system's fluid reservoir into the patient according to the injection schedule.

[0011] Details of one or more examples of this disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of this disclosure will be apparent from the description, the drawings, and the claims. Attached Figure Description

[0012] Figure 1 A perspective view of an example of a power fluid injector according to one or more aspects of the technology described in this disclosure is illustrated.

[0013] Figure 2 This is a block diagram illustrating a more detailed example of an injection system configured to perform the techniques described herein.

[0014] Figures 3A-3E This is an example electrocardiogram with an injection schedule superimposed based on existing angiography techniques.

[0015] Figure 4 This is an example electrocardiogram that overlays angiography injection schedules according to one or more techniques described herein.

[0016] Figure 5 This is a flowchart illustrating an example angiography injection process for an injection system configured to synchronize injection with an electrocardiogram, according to one or more aspects of the technology described in this disclosure.

[0017] Figure 6 This is a flowchart illustrating an example angiography injection procedure for an injection system configured to synchronize an injection schedule with an electrocardiogram, according to one or more aspects of the technology described in this disclosure. Detailed Implementation

[0018] Figure 1 This is a perspective view of an example of a powered fluid injector 100. In operation, the powered fluid injector 100 can inject a quantity of fluid into a patient, for example, via a catheter into a blood vessel. The fluid injected by the powered fluid injector 100 can be, for example, a contrast agent fluid, a non-contrast agent fluid (e.g., saline), or a combination thereof. By injecting a quantity of fluid into a patient, the powered fluid injector 100 can facilitate a variety of medical diagnostic and / or interventional procedures, including the collection of image data representing anatomical regions of interest. These procedures may include, for example, optical coherence tomography (OCT) imaging, intravascular ultrasound (IVUS) imaging, computational tomography (CT) imaging, magnetic resonance imaging (MRI), angiography procedures, and interventional device procedures / placement.

[0019] The illustrated power fluid injector 100 includes a drive assembly housing 102 (also referred to herein as a "injector housing") and a sleeve 104. The sleeve 104 may be secured to the drive assembly housing 102. For example, the drive assembly housing 102 may include an opening, and the sleeve 104 may be secured to the drive assembly housing 102 at or near such an opening. The sleeve 104 may extend from the drive assembly housing 102 and may be configured to receive and retain a reservoir 106 (also referred to herein as a "fluid reservoir"). The reservoir 106 may have an internal reservoir volume containing fluid and may include a plunger 108 located within the internal reservoir volume. The plunger 108 can be made of various components, including a wiper configured to move proximally and distally within the fluid reservoir 106, and a push rod extending from the drive assembly housing 102 into the sleeve 104 and configured to engage the wiper when the fluid reservoir 106 is received and secured in the sleeve 104, and to drive the wiper proximally and distally according to instructions received from a controller 110 coupled to the drive assembly housing 102. At least a portion of the drive assembly can be housed within the drive assembly housing 102.

[0020] The drive assembly can be configured to pressurize fluid within the internal reservoir volume. For example, the drive assembly can be coupled to plunger 108, such as at an opening in the drive assembly housing 102, and drive plunger 108 within the internal reservoir volume. As plunger 108 is progressively driven within the fluid reservoir 106, fluid within the internal reservoir volume can be output from the fluid reservoir 106 along a conduit 109 leading to catheter 126, which is inserted into a patient's blood vessel to inject fluid into the vascular system. In some applications of the powered fluid injector 100, the output fluid (such as a contrast agent medium) can be pressurized anywhere between 1000-1500 psi (e.g., 1200 psi).

[0021] The illustrated example of the powered fluid injector 100 includes several features that can be useful for pressurizing and delivering fluid during operation. The powered fluid injector 100 may include a controller 110. The controller 110 may include a user interface for various operational aspects. For example, a user can utilize the controller 110 to set various parameters and / or protocols for a given fluid injection procedure. In one example, a user can interact with the controller 110 to input fluid injection parameters such as flow rate, injection volume (e.g., maximum), injection pressure limit (e.g., maximum), fluid injection duration, rise time, and / or other injection parameters. In one example, the controller 110 includes a touchscreen panel display, allowing the user to view and modify injection parameters. The controller 110 can also be used to initialize the powered fluid injector 100 (e.g., prepare for fluid injection for a patient) or to activate the sequence of certain features or operations. The controller 110 may also provide status information, including information related to past or currently ongoing injection procedures and any appropriate alarms. The controller 110 may include an imaging engine with one or more processors for controlling the operation of the powered fluid injector 100. Such processors can also control other components, such as drive components, peristaltic pump 112 (when present), and / or any sensors and detectors included at the power fluid injector 100.

[0022] In addition to the controller 110, the illustrated power fluid injector 100 also includes a handheld device 113 for user input. The handheld device 113 can be coupled to the power fluid injector 100 and the controller 110 either wirelessly or via a wired connection. As shown, the handheld device 113 is connected to the drive assembly housing 102. In other examples, the handheld device 113 can be directly connected to the controller 110. The handheld device 113 can generate various signals related to the injection procedure and send them to the controller 110 or other connected components. The user can actuate one or more interface components at the handheld device 113 to control the injection procedure. For example, the user can use the handheld device 113 as a variable rate control device to change the fluid flow rate output from the power fluid injector 100 and / or as a mechanism to start or stop fluid injection. The handheld device 113 may include the external body of the controller, its size designed to fit in the user's single hand. In other cases, the size of the handheld device 113 may vary, such as being held by both hands during operation or sitting on a surface.

[0023] The powered fluid injector 100 may also include one or more components useful for supplying fluid to be used in the injection procedure. A container 114 may include a supply of fluid such as a contrast agent medium and a retainer 116 attached to the powered fluid injector 100. Fluid from container 114 may be supplied to fluid reservoir 106 for use during the injection procedure. For example, when plunger 108 retracts, fluid from container 114 may be drawn into fluid reservoir 106, thereby refilling the internal reservoir volume. Similarly, when the powered fluid injector 100 includes a peristaltic pump 112, a second container 118 may include a supply of fluid such as a flushing medium (e.g., saline) and a retainer 120 attached to the powered fluid injector 100. When present, the peristaltic pump 112 can receive fluid from the second container 118 and deliver such fluid to the patient. The peristaltic pump 112 can often be used to deliver non-contrast agent fluids (such as saline) at lower pressures than when the drive assembly delivers contrast agent fluid from fluid reservoir 106. It may include a valve system 124 to selectively place a fluid reservoir 106 or a peristaltic pump 112 in communication with the patient.

[0024] As described elsewhere herein, the controller 110 of the powered fluid injector 100 can control various functions of the powered fluid injector 100, which may include dispensing contrast agent fluid through a conduit. In some examples, the controller 110 may be housed within the housing of a display device. In some examples, the controller may be housed within the injector housing.

[0025] The powered fluid injector 100 can be fluidly and electrically connected to a catheter 126 inserted into a patient's blood vessel (e.g., a coronary artery). When connected in this way, the powered fluid injector 100 can inject contrast agent fluid (of various concentrations) or dispense non-contrast agent fluid into the patient's vascular system via the injection tubing and catheter 126. In many examples, the catheter 126 may include an invasive blood pressure sensor. When the powered fluid injector 100 is connected to the catheter 126, the blood pressure sensor can communicate electrically with a controller 110. When the catheter 126 is fluidly connected to the powered fluid injector 100, the blood pressure sensor can provide a blood pressure signal to the controller 110, and when the catheter 126 is not fluidly connected to the powered fluid injector 100, the blood pressure sensor may not provide a blood pressure signal.

[0026] According to the techniques described herein, the injection system 100 can be modified to perform one or more of the techniques described herein. For example, the injection system 100 may receive a first set of one or more signals from one or more sensors configured to read the fluid level within the fluid reservoir 106, the signals indicating the current volume of injection fluid dispensed from the fluid reservoir 106 at a first moment. The injection system 100 may determine, based on the first set of one or more signals, that a first difference between the dispensed volume limit and the current volume of injection fluid dispensed from the fluid reservoir 106 at the first moment is less than the necessary fluid volume required to complete both the contraction injection phase (e.g., injecting injection fluid into the patient at a reduced rate during the duration of the patient's contraction) and the diastolic injection phase (e.g., injecting injection fluid into the patient at a higher rate during the duration of the patient's diastole). If the injection system 100 determines that the first difference indicates a sufficiently large difference between the dispensed volume limit and the current volume of injection fluid dispensed from the fluid reservoir 106, such that the injection system 100 can complete both the next contraction injection phase and the next diastolic injection phase, then the injection system 100 may continue to perform the next contraction injection phase and the next diastolic injection phase. Conversely, in response to determining that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases, the injection system 100 avoids performing either the systolic or diastolic injection phase. In other words, if there is insufficient fluid for the injection system 100 to complete both the next systolic and diastolic injection phases while still adhering to the allocated volume limits, the injection system 100 will not perform either the next systolic or diastolic injection phase, but will stop the injection process upon completion of the previous diastolic injection phase.

[0027] The injection system 100 can also receive inputs that it can use to define an injection schedule that similarly avoids performing partial systolic or diastolic injection phases if those phases cannot be completed under necessary criteria. For example, the injection system 100 can receive two or more injection characteristic inputs, such as the number of images to be captured and image quality inputs. The injection system 100 can also determine an injection schedule based on two or more injection characteristic inputs, which includes a first flow rate for the injected fluid during the diastolic injection phase and a second flow rate for the injected fluid during the systolic injection phase. The injection schedule can also include an initial diastolic injection phase and one or more pairs of systolic / diastolic injection phases, each of the one or more pairs of systolic / diastolic injection phases including a complete systolic injection phase and a complete diastolic injection phase. The injection schedule ends with a partial diastolic injection phase from one or more pairs of systolic / diastolic injection phases. The first flow rate during the diastolic injection phase is based at least in part on the image quality input. The injection system 100 can inject the injected fluid from the injection system's fluid reservoir into the patient according to the injection schedule.

[0028] Implementing the techniques described herein into the powered fluid injector 100 offers several advantages, as described herein. For example, when injected via the powered fluid injector 100, the low pressure during the diastolic phase makes it easier for the injected fluid to reach its intended destination in the patient. Therefore, more efficient use of the injected fluid involves injecting it at a higher rate during diastole and at a lower rate during systole. For the same reason, initiating injection at the onset of diastole is the most efficient use of the injected fluid to obtain the greatest benefit of low-pressure diastole. Furthermore, by verifying that the subsequent diastolic injection phase can be completed within the allocated volume limit before performing the previous systolic injection phase, the powered fluid injector 100 will not waste fluid by performing the systolic injection phase if the benefits of the diastolic injection phase cannot be achieved while also improving patient safety by ensuring that the allocated volume limit is not exceeded. In these ways, waste generated from injecting fluid into the patient when a higher-value injection cannot be completed is eliminated, and the amount is saved for future injections. Therefore, the technique described herein maximizes the amount of injectable fluid available during cardiac diastole, while eliminating waste during other phases when the injectable fluid is less useful or during phases when the kinetic fluid injector 100 cannot complete the entire injection.

[0029] Figure 2 This is a block diagram illustrating an example computing device configured to synchronize angiography injection schedules with electrocardiograms according to one or more aspects of the technology described in this disclosure. The following will... Figure 2 The injection system 100 is described as follows: Figure 1 Example of an injection system 100. Figure 2Only one specific example of injection system 100 is illustrated, and many other examples of injection system 100 may be used in other situations and may include a subset of the components included in the example injection system 100 or may include... Figure 2 Additional components not shown.

[0030] like Figure 2 As shown in the example, the injection system 100 includes a user interface device (UID) 212, one or more processors 240, one or more communication units 242, one or more input components 244, one or more output components 246, and one or more storage components 248. The UID 212 includes a display component 202. The storage component 248 of the injection system 100 includes a stage detection module 220, an injection module 222, and an electrocardiogram data storage repository 226.

[0031] One or more processors 240 may implement the functionality associated with the injection system 100 and / or execute associated instructions to dynamically extend the interface elements associated with the application displayed on the UID 212 of the injection system 100. That is, processor 240 may implement the functionality associated with the injection system 100 and / or execute associated instructions according to the techniques described herein to synchronize angiographic injection with the patient's electrocardiogram in a manner that suppresses partial injection.

[0032] Examples of processor 240 include application processors, display controllers, auxiliary processors, one or more sensor hubs, and any other hardware configured to function as a processor, processing unit, or processing device. Modules 220 and 222 can be operated by processor 240 to perform various actions, operations, or functions of the injection system 100. For example, processor 240 of injection system 100 can retrieve and execute instructions stored in storage unit 248 that cause processor 240 to perform the operations described with respect to modules 220 and 222. According to the techniques described herein, instructions executed by processor 240 can enable injection system 100 to synchronize angiographic injection with the patient's electrocardiogram in a manner that avoids partial injection.

[0033] The phase detection module 220 can perform operations for managing the electrocardiogram data 226, such as synchronizing angiographic injections to follow the various diastolic and contraction patterns present in the electrocardiogram data 226 within a time frame defined by the electrocardiogram data 226. For example, for a specific patient, the phase detection module 220 of the injection system 100 can receive the electrocardiogram data 226, analyze the electrocardiogram data 226 to isolate the various diastolic and contraction patterns present in the electrocardiogram data, and analyze the diastolic and contraction patterns to determine one or more representative characteristics of the diastolic and contraction patterns.

[0034] The injection module 222 of the injection system 100 can perform operations for controlling the injection and various characteristics of the injection provided by the injection system 100. For example, the injection module 222 can control when the injection starts, when the injection ends, and various injection flow rates, and also make other determinations regarding the fluid injection, as described throughout this disclosure.

[0035] In some examples, the stage detection module 220 and the injection module 222 may execute locally (e.g., at processor 240) to provide functionality associated with the injection system 100. In some examples, the stage detection module 220 and the injection module 222 may act as interfaces to remote services accessible to the injection system 100.

[0036] One or more storage units 248 within the injection system 100 may store information for processing during operation of the injection system 100 (e.g., the injection system 100 may store data accessed by modules 220 and 222 during execution of the injection system 100). In some examples, the storage unit 248 is temporary memory, meaning that the primary purpose of the storage unit 248 is not long-term storage. The storage unit 248 on the injection system 100 may be configured to temporarily store information as volatile memory and therefore not retain the stored contents if power is lost. Examples of volatile memory include random access memory (RAM), dynamic random access memory (DRAM), static random access memory (SRAM), and other forms of volatile memory known in the art.

[0037] In some examples, storage component 248 also includes one or more computer-readable storage media. Storage component 248 in some examples includes one or more non-transitory computer-readable storage media. Storage component 248 can be configured to store a larger amount of information than is typically stored in volatile memory. Storage component 248 can also be configured for long-term storage of information as non-volatile memory space and to retain information after power-on / power-off cycles. Examples of non-volatile memory include magnetic hard disks, optical disks, floppy disks, flash memory, or electrically programmable memory (EPROM) or electrically erasable programmable memory (EEPROM). Storage component 248 can store program instructions and / or information (e.g., data) associated with modules 220 and 222 and data repository 226. Storage component 248 may include memory configured to store data or other information associated with modules 220 and 222 and data repository 226.

[0038] Electrocardiogram (ECG) data 226 can be any data indicating a patient's ECG. In some cases, ECG data 226 can be numerical data indicating electrical impulses measured or recorded by multiple ECG leads (such as ECG lead 254). In other cases, ECG data 226 can be an image of an ECG analyzed by a graphical analysis performed by the phase detection module 220. In still other cases, ECG lead 254 is not a mechanical part of the injection system 100, but rather ECG lead 254 can be communicatively coupled to the injection system 100 via a hemodynamic system that facilitates communication between the two.

[0039] Communication channel 250 can interconnect each of components 212, 240, 242, 244, 246, 248, and 254 for inter-component communication (physical, communicative, and / or operational). In some examples, communication channel 250 may include a system bus, a network connection, an inter-process communication data structure, or any other method for transmitting data.

[0040] One or more communication units 242 of the injection system 100 can communicate with external devices via one or more wired and / or wireless networks by transmitting and / or receiving network signals on one or more networks. Examples of communication units 242 include network interface cards (e.g., such as Ethernet cards), optical transceivers, radio frequency transceivers, GPS receivers, or any other type of device capable of sending and / or receiving information. Other examples of communication units 242 may include shortwave radios, cellular data radios, wireless network radios, and Universal Serial Bus (USB) controllers.

[0041] One or more input components 244 of the injection system 100 can receive input. Examples of input are tactile, audio, and video input. In one example, the input component 244 of the injection system 100 includes a presence-sensitive input device (e.g., a touchscreen, PSD), a mouse, a keyboard, a voice response system, a camera, a microphone, or any other type of device for detecting input from a person or machine. In some examples, the input component 244 may include one or more sensor components 252, one or more position sensors (GPS component, Wi-Fi component, cellular component), one or more temperature sensors, one or more motion sensors (e.g., accelerometer, gyroscope), one or more pressure sensors (e.g., barometer), one or more ambient light sensors, and one or more other sensors (e.g., infrared proximity sensor, hygrometer sensor, etc.). To name just a few other non-limiting examples, other sensors may include a heart rate sensor, a magnetometer, a glucose sensor, an olfactory sensor, a compass sensor, and a pedometer sensor.

[0042] Sensor 252 may also include or communicate with or be incorporated into fluid reservoir 106. In this way, sensor 252 can measure the current volume of the injected fluid within fluid reservoir 106 and transmit one or more signals to injection module 222 indicating the determined current volume.

[0043] One or more output components 246 of the injection system 100 can generate output in a selected modality. Examples of modalities may include tactile notifications, auditory notifications, visual notifications, machine-generated voice notifications, or other modalities. In one example, the output component 246 of the injection system 100 includes a presence-sensitive display, a sound card, a video graphics adapter card, a speaker, a cathode ray tube (CRT) monitor, a liquid crystal display (LCD), or any other type of device for generating output to a person or machine in the selected modality.

[0044] The UID 212 of the injection system 100 may include a display component 202. The display component 202 may be a screen that displays information (e.g., visual indications) using the UID 212. The display component 202 may also detect objects at and / or near the display component 202, such as the presence of a sensitive display.

[0045] Although shown as an internal component of injection system 100, UID 212 can also represent an external component that shares a data path with injection system 100 for transmitting and / or receiving inputs and outputs. For example, in one example, UID 212 represents a built-in component of injection system 100 located within and physically connected to the outer packaging of injection system 100 (e.g., a screen on a mobile phone). In another example, UID 212 represents an external component of injection system 100 located outside the packaging or housing of injection system 100 and physically separate from the packaging or housing of injection system 100 (e.g., a monitor, projector, etc., sharing a wired and / or wireless data path with injection system 100).

[0046] The UID 212 of the injection system 100 can detect two-dimensional and / or three-dimensional gestures as input from the user of the injection system 100. For example, the sensor of UID 212 can detect movement of the user within a threshold distance of the sensor of UID 212 (e.g., movement of a hand, arm, pen, stylus, tactile object, etc.). UID 212 can determine a two-dimensional or three-dimensional vector representation of the movement and associate the vector representation with a gesture input with multiple dimensions (e.g., waving, pinching, patting, drawing, etc.). In other words, UID 212 can detect multidimensional gestures without requiring the user to make gestures at or near the screen or surface on which the information is output by UID 212 for display. Alternatively, UID 212 can detect multidimensional gestures performed at or near a sensor, which may or may not be located near the screen or surface on which the information is output by UID 212 for display.

[0047] While not necessarily included in every example of the injection system 100, in some examples the injection system 100 may also include an electrocardiogram (ECG) lead 254. In such examples, the ECG lead 254 may be an electrode configured to be attached to a patient to develop an ECG for the patient, such as generating ECG data 226. Thus, the ECG lead 254 can provide the ECG data 226 to the injection system 100, enabling the injection system 100 to perform the techniques described herein in real time in a self-contained environment. In other examples, the communication unit 242 may receive the ECG data 226 from a separate server, system, or database outside the injection system 100, such as a hemodynamic system coupled to the injection system 100 and the ECG lead 254.

[0048] According to the technology described herein, in some cases, the injection module 222 can control the injection system 100 to perform an initial diastolic injection phase. The injection module 222 can control the injection system 100 in this manner in response to receiving a user input instruction at the input component 244 to begin the fluid injection process. The phase detection module 220 can then detect the onset of diastole based on the patient's electrocardiogram data 226. In response to the phase detection module 220 detecting the onset of diastole, the injection module 222 controls the injection system 100 to begin injecting the injection fluid from the fluid reservoir according to the initial diastolic injection phase.

[0049] Following the initial diastolic injection phase, and after each subsequent diastolic injection phase, the injection module 222 may receive a first set of one or more signals from the sensor 252 indicating the current volume of injection fluid dispensed from the fluid reservoir 106 at the first moment. This current volume dispensed from the fluid reservoir 106 may represent the amount of fluid that the injection system 100 has injected into the current patient in the current injection. The injection module 222 may determine, based on the first set of one or more signals, that a first difference between the dispensed volume limit and the current volume of injection fluid dispensed from the fluid reservoir 106 at the first moment is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases. The dispensed volume limit may be predefined or user-defined as the maximum amount of injection fluid that can be injected from the injection system 100 into the patient during any single injection. Exceeding this dispensed volume limit may have adverse effects on the patient; therefore, it is recommended that users of the injection system not exceed this dispensed volume limit when imaging the patient's site.

[0050] In some cases, the injection module 222 may determine, based on a first set of one or more signals, that a first difference between the allocated volume limit and the current volume of the injection fluid allocated from the fluid reservoir 106 at a first time is not less than the necessary fluid volume required to complete both the contraction and diastolic injection phases. In this case, in response to determining that the first difference is greater than or equal to the necessary fluid volume required to complete both the contraction and diastolic injection phases, the injection module 222 controls the injection system 100 to perform both the contraction and diastolic injection phases.

[0051] During the systolic and diastolic injection phases, the phase detection module 220 can detect the onset of systole from the patient's electrocardiogram data 226. In response to the phase detection module 220 detecting the onset of systole, the injection module 222 controls the injection system to begin injecting the injection fluid from the fluid reservoir into the patient at a first rate, as defined in the systolic injection phase. The phase detection module 220 can then detect the end of systole and the onset of diastole from the patient's electrocardiogram data 226. In response to the phase detection module 220 detecting the onset of diastole, the injection module 222 controls the injection system 100 to stop injecting the injection fluid at the first rate and begin injecting the injection fluid from the fluid reservoir at a second rate different from the first rate, the second rate corresponding to and defined by the diastolic injection phase.

[0052] The first injection rate during the systolic injection phase can be less than the second injection rate during the diastolic injection phase. Blood pressure is higher during systole than during diastole. Therefore, to take advantage of the relative ease with which the injection fluid is delivered to the correct location at lower blood pressure compared to hypertensive systole, injection module 222 can control injection system 100 to inject fluid at a greater rate during the diastolic injection phase than during the systolic injection phase. For example, the fluid injection rate during systole can be a percentage of the fluid injection rate during diastole. In some cases, the fluid flow rate during systole can be zero. In some cases, the fluid flow rate during cardiac systole can vary between the start and end of systole (e.g., gradually decreasing from a higher diastolic rate at the start of systole to a minimum, and then gradually returning to a higher diastolic rate at the end of systole). Similarly, the fluid flow rate during diastole can vary between the start and end of diastole.

[0053] The injection module 222 can calculate the diastolic injection rate for the diastolic injection phase based on a variety of factors. These factors may include at least the allocated volume limit, the user-defined flow rate, the number of diastolic cycles to be imaged, and the image quality level. For example, if the allocated volume limit is 6 mL of fluid and the user wants to image at least three diastolic cycles, then the injection module 222 can adjust the diastolic injection rate to maintain sufficient fluid at the 6 mL volume limit for at least the three diastolic injection phases to be completed.

[0054] The phase detection module 220 can determine the start and end of systole and diastole by analyzing electrocardiogram (ECG) data 226. For example, when the myocardium contracts, contraction occurs, thus pushing blood out of the heart. Contraction is shown on an ECG as follows: Figures 3A-3E and Figure 4 An example of a brief, sharp rise in blood pressure is shown as a peak on an electrocardiogram (ECG). Simultaneously, diastole occurs when the heart muscle relaxes, allowing blood to fill the various chambers of the heart. Diastole is shown on an ECG as a longer period of relatively constant or shallow slope. The phase detection module 220 can analyze the ECG data 226 to determine when the patient experiences systole and when the patient experiences diastole.

[0055] In cases where ECG data may not be available in real time, the phase detection module 220 can determine the characteristics of the patient's previous diastolic and systolic contractions and utilize this information in relation to the phase detection of this disclosure. For example, the phase detection module 220 can determine the patient's average systolic length and average diastolic length based on numerical or graphical data present in the ECG data 226. In this case, the phase detection module 220 can use the average time length to determine when the transition occurs between the systolic and diastolic injection phases. For example, after the onset of systole is detected, the phase detection module 220 can determine that an amount of time equal to the average cardiac contraction length has elapsed since the detection of cardiac contraction.

[0056] The injection module 222 can also determine a first rate and a second rate based on the electrocardiogram data 226. For example, the injection module 222 can determine that a certain amount of injection fluid should be injected into the patient during diastole and / or systole. Using the corresponding average length of diastole or systole calculated by the phase detection module 220, the injection module 222 can determine the correct rate for the diastolic injection phase and / or systolic injection phase by dividing the determined amount of injection fluid that should be injected into the patient by the average length of the corresponding phase.

[0057] Conversely, injection module 222 can determine, based on a first set of one or more signals, that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases. In response to determining that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases, injection module 222 can control injection system 100 to avoid performing each of the systolic and diastolic injection phases.

[0058] In one or more additional examples, besides or instead of the above regarding Figure 2 The described technique allows the injection module 222 to receive inputs and use those inputs to define an injection schedule that avoids performing partial systolic or diastolic injection phases if those phases cannot be completed under necessary criteria. For example, the injection module 222 may receive two or more injection characteristic inputs, such as the number of images to be captured and image quality. Additional injection characteristic inputs may include maximum injection flow rate, allocated volume limits, injection power ratio, average diastolic length, and average systolic length. In some cases, image quality input may specify the flow rate of the injected fluid during the diastolic injection phase, as the flow rate of the injected fluid affects how bright or dark the corresponding image will be. In some cases, image quality input may be a value about a scale (e.g., 10 is the highest quality, 1 is the lowest quality) or other subjective image quality input. In this case, the injection module 222 may determine the flow rate of the injected fluid during the diastolic injection phase based on the image quality input and one or more anatomical features of the patient.

[0059] Injection module 222 can also determine an injection schedule based on two or more injection characteristic inputs, including a first flow rate of the injection fluid during the diastolic injection phase and a second flow rate of the injection fluid during the systolic injection phase. The second flow rate may be a certain percentage smaller than the first flow rate. The injection schedule may also include an initial diastolic injection phase and one or more systolic / diastolic injection phase pairs, wherein each of the one or more systolic / diastolic injection phase pairs includes a complete systolic injection phase and a complete diastolic injection phase. In some cases, the number of images taken may be related to the number of diastolic injection phases (e.g., one image taken during each diastolic injection phase). The injection schedule ends with a complete diastolic injection phase portion of one or more systolic / diastolic injection phase pairs. The first flow rate during the diastolic injection phase is based at least in part on the image quality input.

[0060] In some cases, the injection module 222 can also adjust the injection schedule based on the maximum injection limit for the injection fluid, such that the total volume of injection fluid allocated according to the injection schedule is less than or equal to the maximum injection limit. In doing so, if the total volume of injection fluid allocated according to the injection schedule exceeds the maximum injection limit, the injection module 222 can remove one or more systolic / diastolic injection phase pairs until the total volume of injection fluid used during the initial diastolic injection phase and the remaining systolic / diastolic injection phase pairs is less than or equal to the maximum injection limit. The maximum injection limit can be a tissue-specific or individually set limit on the amount of injection fluid that can be injected into the patient during an imaging task while remaining safe for the patient.

[0061] Injection module 222 can inject injection fluid from the fluid reservoir of the injection system into the patient according to the injection plan. In some cases, injection module 222 can control injection system 200 to begin pre-injection to increase fluid pressure within injection system 200 before starting injection according to the initial diastolic injection phase.

[0062] In some cases, during the administration of the injection system 200 to the injection fluid, the phase detection module 220 can detect the onset of contraction from the patient's electrocardiogram (ECG) during each systolic / diastolic injection phase pair. In response to the phase detection module 220 detecting the onset of contraction, the injection module 222 can control the injection system to begin injecting the injection fluid from the fluid reservoir into the patient at a second rate. The phase detection module 220 can then detect the end of contraction and the onset of diastole from the patient's ECG. In response to the phase detection module 220 detecting the onset of diastole, the injection module 222 can control the injection system 200 to stop injecting the injection fluid at a first rate and begin injecting the injection fluid from the fluid reservoir at a first rate. In some cases, upon detecting the transition between contraction and diastole, the phase detection module 220 can receive data describing the ECG and determine the patient's average systolic length based on the ECG data. After detecting the onset of contraction, the phase detection module 220 can determine an amount of time equal to the average contraction length that has elapsed since the detection of cardiac contraction.

[0063] Figures 3A-3E The illustration shows example electrocardiograms 300A-300E with an injection schedule overlaid according to existing angiography techniques. Figure 3A The example depicts a conventional injection method that delivers a prescribed volume of fluid at a continuous rate. The total volume of fluid delivered during injection phase 312A will be considered without regard to systole 302A-302E or diastole 304A-304D. Injection phase 312A will begin at time 310A upon receiving a user input instruction to begin (e.g., via a touchscreen or hand button) and will continue until the volume of fluid injected into the patient reaches the allocated volume limit.

[0064] Figure 3B An electrocardiogram (ECG) 300B with basic ECG synchronous injection is shown. Figure 3BIn the example, the injection begins after receiving user input instructions to start at time 310B, and commences with a diastolic injection phase 312B. The process then reduces power during systolic phases 302A-302C to conserve contrast agent injected during systolic injection phases 314B, 318B, and 322B. During diastolic injection phases 316B, 320B, and 324B, power returns to full power. This allows the user to inject the same amount of contrast agent over a longer duration, while still delivering the full requested volume (e.g., reaching the allocated volume limit). These techniques reduce the total requested volume from their standard injection parameters. However, systolic injection phases 314B, 318B, and 322B have less imaging value due to the increased blood pressure, as discussed herein. Similarly, injections for partial diastole have less imaging value, meaning that diastolic injection phases 312B and 324B are less valuable during angiography than diastolic injection phases 316B or 320B.

[0065] Figure 3C An electrocardiogram (ECG) with synchronized injection of clips is shown in Figure 300C. Figure 3C In the example, the injection begins after receiving user input instructions to start at time 310C, and commences with a diastolic injection phase 312C. The process then reduces power during systolic phases 302A-302C to conserve contrast agent injected during systolic injection phases 314C, 318C, and 322C. During diastolic injection phases 316C and 320C, power returns to full power. However, this mode only delivers contrast agent fluid for the equivalent duration of the asynchronous injection. For example, if a 3 mL / s injection at the volume limit of a 6 mL dispensing requires 2 seconds for complete delivery, this mode will deliver contrast agent fluid at reduced power for 2 seconds during systolic phase. This reduces the total amount of contrast agent fluid delivered, but still wastes contrast agent fluid at the leading (312C, 314C) and trailing (322C) ends.

[0066] Figure 3D An electrocardiogram (ECG) with delayed and clipped synchronous injection is shown in the 300D. Figure 3D In the example, the injection does not begin after receiving user input indicating that it should start at time 310D, but is delayed until the first detection of diastole at 304A and the initiation of diastolic injection phase 312D. This process will still reduce power during systole 302B-302C to conserve contrast agent injected during systole injection phases 314D and 318D. During diastolic injection phases 316D and 320D, power will return to full power. Delay and clip synchronization mode with... Figure 3CThe same timing applies to the synchronized injection, except that the start point is delayed until the next diastolic phase begins. This prevents contrast agent waste at the leading edge of the injection. However, this technique still injects an equivalent time of non-synchronization (e.g., 2 seconds), which still allows for contrast agent fluid waste at the injection tails of the systolic injection phase 318D and the partial diastolic injection phase 320D.

[0067] Figure 3E An electrocardiogram of the 300E with delayed and clipped synchronous injection and reduced volume is shown. Figure 3E In the example, instead of initiating the injection after receiving user input instructions to begin at time 310E, the injection is delayed until the first detection of diastole 304A and the initiation of diastolic injection phase 312E. This process still reduces power during contraction phases 302B-302C to conserve contrast agent injected during contraction injection phases 314E and 318E. During diastolic injection phases 316E and 320E, power returns to full power. However, this is a manual process controlled by the user of the fluid injection system. For example, the injection system will determine whether the next contraction 302 or diastole 304 will be completed within the limited time available under the delayed and clipped synchronization method. If there is insufficient time to complete the next contraction 302 or diastole 304, then the injection can be stopped. However, if the last injection is a contraction (e.g., contraction injection phase 318E), then contrast agent fluid may still be wasted at the trailing edge, and injection fluid may be wasted in the final phase (e.g., diastolic injection phase 320E).

[0068] Figure 4 This is an example electrocardiogram that overlays angiography injection schedules according to one or more techniques described herein. Figure 4 An electrocardiogram 400 with optimized synchronous injection according to the technique described herein is shown. Figure 4 In the example, the injection does not begin after receiving user input indicating that it should start at time 410, but is instead delayed until the injection system detects the start of diastole 404A. Once the injection system detects the start of diastole 404A, the injection begins with the initial diastolic injection phase 412.

[0069] Following the diastolic injection phase 412, the injection system determines whether the difference between the dispensing volume limit and the current volume of injection fluid dispensing from the fluid reservoir in the current injection is sufficient to complete the contraction injection phase 414 during contraction 402B (at reduced power) and the diastolic injection phase 416 during diastole 404B (at normal power). In this example, the injection system determines that the difference is large enough for the injection system to complete both the contraction injection phase 414 and the diastolic injection phase 416 while adhering to the dispensing volume limit. Therefore, the injection system performs both the contraction injection phase 414 and the diastolic injection phase 416.

[0070] After the diastolic injection phase 416, the injection system determines whether the difference between the dispensing volume limit and the current volume of injection fluid dispensed from the fluid reservoir in the current injection is sufficient to complete the contraction injection phase 418 during contraction 402C (at reduced power) and the diastolic injection phase 420 during diastole 404C (at normal power). While a difference sufficient to complete the contraction injection phase 418 may exist at the dispensing volume limit, Figure 4 In the example, the injection system determines that there is not a sufficient amount of available injection fluid to complete the diastolic injection phase 420 within the allocated volume limit. Therefore, the injection system avoids performing either the systolic injection phase 418 or the diastolic injection phase 420.

[0071] Generally, optimized simultaneous injection is essentially a delayed start and clipped injection, but the clipping method differs. It's not based on time equivalence to clip the injection; instead, it's based on whether the volume already injected into the patient is sufficiently less than the allocated volume limit, allowing the injection system to complete another diastolic injection phase while adhering to the allocated volume limit. For example, in... Figure 4 In this example, the difference between the substance already injected into the patient and the volume limit allocated at the start of the end-diastolic injection phase 420 can be only 1.2 mL. This is less than the 1.5 mL required to complete the final diastolic injection phase 420 in this example, so the injection will stop. Since the final diastolic injection phase 420 will not occur, the final systolic injection phase 418 will also be canceled, as the injection performed during systole would be of no value if the full diastolic injection phase is not subsequently completed. This type of sequence eliminates lead and tail waste while still capturing the same two full diastolic phases as a conventional injection.

[0072] In some examples, the injection system can operate in either a fixed or variable mode. In fixed mode, the injection system operates according to a schedule programmed into the controller. In variable mode, the user controls the injection via a hand controller. When in variable mode, one or more processors can set a maximum flow rate when the allocated volume limit is approached. In this way, the user is prevented from unintentionally increasing the flow rate to the allocated volume limit during the systolic injection phase or part of the diastolic phase. The maximum flow rate in variable mode during the latter half of the injection sequence helps ensure that the injection sequence ends at the end of the diastolic injection phase, thereby minimizing waste.

[0073] The fluid can be injected according to a schedule involving injection only during the full diastolic phase (i.e., not part of the diastolic phase) and any intervention during the systolic phase. In some examples, the user can input the flow rate and the desired number of images to be taken (e.g., one per diastolic cycle). Alternatively, the user can input the desired image quality level instead of the flow rate and allow the system to select an appropriate flow rate based on one or more anatomical features of the patient. For example, using any of these or other features, the injection system can determine an injection schedule that includes an initial diastolic injection phase 412 and a systolic / diastolic injection phase pair that includes a systolic injection phase 414 and a diastolic injection phase 416. In other words, injection phases 412, 414, and 416 can be predetermined as a schedule, and the injection system can follow that schedule.

[0074] Figure 5 This is a flowchart illustrating an example angiography injection procedure of an injection system configured to synchronize injection with an electrocardiogram according to one or more aspects of the technology described in this disclosure. Figure 5 The technology can be generated by one or more processors of the device (such as...) Figure 1 Injection system 100 and / or Figure 2 The injection system 100 shown is used for execution. This is for illustrative purposes only. Figure 5 The technology is in Figure 2 The device described in the context of the injection system 100, but having a different construction than the injection system 100, can perform the same function. Figure 5 The technology.

[0075] Injection module 222 controls injection system 100 to perform an initial diastolic injection phase during the patient's diastole (502). Injection module 222 then measures the volume of injection fluid dispensed from fluid reservoir 106 by receiving one or more signals from sensor 252 indicating the current volume of injection fluid dispensed from fluid reservoir 106 at a first moment (504). Injection module 222 then determines the difference between the dispensing volume limit and the current volume of injection fluid dispensed from fluid reservoir 106 (506) and compares this difference with the necessary volume of injection fluid required to complete both the systolic injection phase and another diastolic injection phase (508).

[0076] Injection module 222 determines, based on one or more signals from a first set, whether the difference is greater than or equal to the necessary fluid volume required to complete the contraction and diastolic injection phases (510). In response to determining that the difference between the allocated volume limit and the current volume of injection fluid allocated from fluid reservoir 106 is greater than or equal to the necessary fluid volume required to complete the contraction and diastolic injection phases (the "yes" branch of 510), injection module 222 controls injection system 100 to complete the contraction and diastolic injection phases (512). Injection module 222 then receives a follow-up signal (504) with updated information about the fluid volume allocated from fluid reservoir 106, and the process continues.

[0077] Instead, in response to the fact that the difference between the determined volume limit for dispensing and the current volume of the injection fluid dispensed from the fluid reservoir 106 is less than the necessary fluid volume required to complete the contraction and relaxation injection phases (the "no" branch of 510), the injection module 222 controls the injection system to avoid performing each of the contraction and relaxation injection phases (514).

[0078] Figure 6 This is a flowchart illustrating an example angiography injection procedure for an injection system configured to synchronize injection with an electrocardiogram, according to one or more aspects of the technology described in this disclosure. Figure 6 The technology can be generated by one or more processors of the device (such as...) Figure 1 Injection system 100 and / or Figure 2 The injection system 100 shown is used for execution. This is for illustrative purposes only. Figure 6 The technology is in Figure 2 The device described in the context of the injection system 100, but having a different construction than the injection system 100, can perform the same function. Figure 6 The technology.

[0079] For example, injection module 222 may receive two or more injection characteristic inputs, including image quality input and the number of images to be captured (e.g., one image per diastolic injection phase) (602). In some examples, the image quality input specifies the injection flow rate. In some examples, the image quality input may be a value about a scale (e.g., 10 is the highest quality, 1 is the lowest quality) or other subjective image quality input. In this case, injection module 222 may determine the flow rate of the injected fluid during the diastolic injection phase based on the image quality input and one or more anatomical features of the patient. These injection characteristic inputs may also include a maximum injection flow rate, allocated volume limits, injection power ratio, average diastolic length, and average systolic length. Injection module 222 may determine an injection schedule based on two or more injection characteristic inputs, which includes diastolic injection phases equal to the number of images to be captured, a first flow rate for the injected fluid during the diastolic injection phase, and a second flow rate for the injected fluid during each systolic injection phase (604). The second flow rate may be a percentage smaller than the first flow rate. The injection schedule may also include an initial diastolic injection phase and one or more systolic / diastolic injection phase pairs, each of the one or more systolic / diastolic injection phase pairs including a complete systolic injection phase and a complete diastolic injection phase. The injection schedule ends with a complete diastolic injection phase portion of one or more systolic / diastolic injection phase pairs. The first flow rate during each diastolic injection phase is based at least in part on the image quality input. The injection module 222 can then control the injection system 100 to inject the injection fluid into the patient body (606) according to the injection schedule, thereby ending the injection when the last systolic / diastolic injection pair is completed.

[0080] It should be recognized that, depending on the example, certain actions or events of any of the techniques described herein may be performed in a different order, and may be added, combined, or omitted entirely (e.g., not all described actions or events are necessary for practicing these techniques). Moreover, in some examples, actions or events may be performed concurrently, for example, through multithreading, interrupt handling, or multiple processors, rather than sequentially.

[0081] In one or more examples, the described functionality can be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functionality can be stored or transmitted as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing unit. A computer-readable medium can include a computer-readable storage medium, which corresponds to a tangible medium such as a data storage medium, or a communication medium that includes any medium facilitating, for example, the transfer of a computer program from one place to another according to a communication protocol. In this way, a computer-readable medium can generally correspond to (1) a non-transitory tangible computer-readable storage medium or (2) a communication medium such as a signal or carrier wave. A data storage medium can be any available medium that can be accessed by one or more computers or one or more processors to retrieve instructions, code, and / or data structures to implement the techniques described in this disclosure. Computer program products can include computer-readable media.

[0082] By way of example and not limitation, such computer-readable storage media may include RAM, ROM, EEPROM, CD-ROM or other optical disc storage devices, magnetic disk storage devices or other magnetic storage devices, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and is accessible by a computer. Furthermore, any connection is properly referred to as a computer-readable medium. For example, if instructions are transmitted from a website, server, or other remote source using coaxial cable, fiber optic cable, twisted pair, digital subscriber line (DSL), or wireless technologies such as infrared, radio, and microwave, then the definition of medium includes coaxial cable, fiber optic cable, twisted pair, DSL, or wireless technologies such as infrared, radio, and microwave. However, it should be understood that computer-readable storage media and data storage media do not include connections, carrier waves, signals, or other transient media, but rather refer to non-transient, tangible storage media. As used herein, discs and platters include compact discs (CDs), laser discs, optical discs, digital versatile discs (DVDs), floppy disks, and Blu-ray discs, where discs typically reproduce data magnetically, while optical discs reproduce data optically using lasers. The above combinations should also be included within the scope of computer-readable media.

[0083] Instructions can be executed by one or more processors, such as one or more digital signal processors (DSPs), general-purpose microprocessors, application-specific integrated circuits (ASICs), field-programmable arrays (FPGAs), or other equivalent integrated or discrete logic circuit systems. Therefore, the term "processor" as used herein can refer to any of the foregoing structures or any other structures suitable for implementing the techniques described herein. Furthermore, in some aspects, the functionality described herein can be provided within dedicated hardware and / or software modules configured for encoding and decoding, or incorporated into combined codecs. Moreover, these techniques can be fully implemented in one or more circuit or logic elements.

[0084] The techniques disclosed herein can be implemented in a wide variety of devices or apparatuses, including wireless telephones, integrated circuits (ICs), or collections of ICs (e.g., chipsets). Various components, modules, or units are described in this disclosure to emphasize functional aspects of a device configured to perform the disclosed techniques, but are not necessarily required to be implemented by different hardware units. More specifically, as described above, the various units may be combined in a codec hardware unit or provided by a collection of interoperable hardware units, including one or more processors as described above, along with suitable software and / or firmware.

[0085] Various examples of this disclosure have been described. Any combination of the systems, operations, or functions described is contemplated. These and other examples are within the scope of the appended claims.

Claims

1. An injection system (100), comprising: A fluid reservoir (106) is configured to store the injection fluid; One or more sensors (252) are configured to measure the volume of injection fluid dispensed from a fluid reservoir; One or more communication units (242) are configured to receive patient electrocardiogram (ECG) data (226) for synchronizing the injection schedule with the ECG data, and One or more processors (240) are configured to: Receive a first set of one or more signals from the one or more sensors, the signals indicating the current volume of the injection fluid dispensed from the fluid reservoir at a first moment; Based on one or more of the first set of signals, a first difference between the allocated volume limit and the current volume of the injection fluid allocated from the fluid reservoir at the first time is determined to be less than the necessary volume of injection fluid required to complete both the contraction and diastolic injection phases of the injection schedule, wherein the allocated volume limit is the maximum amount of injection fluid that can be injected into the patient in a single injection. as well as In response to determining that the first difference is less than the necessary injection fluid volume required to complete both the contraction and diastolic injection phases, the injection system is controlled to avoid performing either the contraction or diastolic injection phase.

2. The injection system of claim 1, wherein the one or more processors are further configured to: Receive a second set of one or more signals from the one or more sensors, the signals indicating the current volume of the injection fluid dispensed from the fluid reservoir at a second time prior to the first time; Based on one or more of the second set of signals, a second difference is determined between the allocated volume limit and the current volume of the injection fluid allocated from the fluid reservoir at the second time, which is not less than the necessary injection fluid volume required to complete both the systolic and diastolic injection phases; and In response to determining that the second difference is not less than the necessary injection fluid volume required to complete both the contraction and diastolic injection phases, the injection system is controlled to perform the contraction and diastolic injection phases.

3. The injection system of claim 2, wherein the one or more processors are further configured to: The contraction was detected starting from the patient's electrocardiogram data; In response to the detection of the onset of contraction, the injection system is controlled to begin injecting the injection fluid from the fluid reservoir into the patient at a first rate; The end of systole and the beginning of diastole are detected from the patient's electrocardiogram data; as well as In response to the detection of the onset of diastole, the injection system is controlled to stop injecting the injection fluid at a first rate and begin injecting the injection fluid from the fluid reservoir at a second rate different from the first rate.

4. The injection system of claim 3, wherein the first rate is less than the second rate.

5. The injection system of claim 1, wherein the injection system is communicatively connected to a hemodynamic system via the one or more communication units, the hemodynamic system receiving electrocardiogram data from a plurality of electrocardiogram leads configured to record electrocardiograms.

6. The injection system of claim 3, wherein the one or more processors are further configured to: Receive data describing the electrocardiogram; and The patient's average systolic length is determined based on data describing the electrocardiogram. The one or more processors configured to detect the end of contraction and the beginning of relaxation are further configured to determine, after detecting the beginning of contraction, that an amount of time equal to the average contraction length has elapsed since the contraction was detected.

7. The injection system of claim 6, wherein the one or more processors are further configured to determine a first rate and a second rate based on data describing an electrocardiogram.

8. The injection system of claim 1, wherein the one or more processors are further configured to control the injection system to perform an initial diastolic injection phase prior to a first time.

9. The injection system of claim 8, wherein the one or more processors are further configured to: Receive user input to initiate the fluid injection process; The onset of diastole is detected based on the patient's electrocardiogram data; and In response to the detection of the onset of diastole, the control injection system begins to inject injection fluid from the fluid reservoir according to the initial diastolic injection phase.

10. A non-transitory computer-readable storage medium comprising instructions that, when executed, cause one or more processors of an injection system to perform a fluid injection method comprising the following steps: Received from one or more sensors (252) of the injection system: A first set of one or more signals, indicating the current volume of injection fluid dispensed from the fluid reservoir (106) of the injection system at a first moment, and The patient's electrocardiogram data (226) is used to synchronize the injection schedule with the electrocardiogram data; Based on one or more of the first set of signals, a first difference between the allocated volume limit and the current volume of the injectable fluid allocated from the fluid reservoir at the first time is determined to be less than the necessary fluid volume required to complete both the contraction and relaxation phases of the injection schedule, wherein the allocated volume limit is the maximum amount of injectable fluid that can be injected into the patient in a single injection. as well as In response to determining that the first difference is less than the necessary fluid volume required to complete both the systolic and diastolic injection phases, each of the systolic and diastolic injection phases is avoided.

11. The medium of claim 10, wherein the fluid injection method further comprises: Receive a second set of one or more signals from the one or more sensors, the signals indicating the current volume of the injection fluid dispensed from the fluid reservoir at a second time prior to the first time; Based on one or more of the second set of signals, a second difference is determined between the allocated volume limit and the current volume of the injection fluid allocated from the fluid reservoir at the second time, which is not less than the necessary fluid volume required to complete both the systolic and diastolic injection phases; and In response to determining that the second difference is not less than the necessary fluid volume required to complete both the contraction injection phase and the diastolic injection phase, the injection system is controlled to perform the contraction injection phase and the diastolic injection phase.

12. The medium of claim 11, wherein performing the contraction injection phase and the diastolic injection phase comprises: The contraction was first measured from the patient's electrocardiogram data. In response to the detection of the onset of contraction, the injection system is controlled to begin injecting the injection fluid from the fluid reservoir into the patient at a first rate; The end of systole and the beginning of diastole are detected from the patient's electrocardiogram data; as well as In response to the detection of the onset of diastole, the injection system is controlled to stop injecting the injection fluid at a first rate and begin injecting the injection fluid from the fluid reservoir at a second rate different from the first rate.

13. The medium of claim 12, wherein the first rate is less than the second rate.

14. The medium of claim 12, wherein the fluid injection method further comprises: The patient's average systolic length is determined based on data describing the electrocardiogram. The detection of the end of contraction and the beginning of relaxation includes determining, after the beginning of contraction is detected, the amount of time equal to the average contraction length since the contraction was detected has elapsed.

15. The medium of claim 10, wherein the fluid injection method further comprises determining a first rate and a second rate based on data describing an electrocardiogram.

16. The medium of claim 10, wherein the fluid injection method further comprises, prior to a first time, controlling the injection system to perform an initial diastolic injection phase.

17. The medium of claim 16, wherein controlling the injection system to perform the initial diastolic injection phase comprises: Receive user input to initiate the fluid injection process; The onset of diastole was detected based on the patient's electrocardiogram data; as well as In response to the detection of the onset of diastole, the control injection system begins to inject injection fluid from the fluid reservoir according to the initial diastolic injection phase.

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