Compression tray with ultrasonic unit

Abstract

Compression trough (KM) with a guide unit (FE) for an ultrasound unit (US), wherein the guide unit (FE) has a rotatable connecting unit (DV) with at least one axis of rotation (DA), wherein the elongated ultrasound unit (US) which can be coupled to the guide unit (FE) can be pivoted at least into a first or second position (PA, AP), characterized in that the first position (PA), parallel to a scanning direction (SR) in which the ultrasound unit (US) is moved for an ultrasound scan, can be assumed by the ultrasound unit (US) in the rear part of the compression trough (KM) and the second position (AP) can be assumed by the ultrasound unit (US) at a right angle to the scanning direction (SR), wherein the connecting unit (DV) can be locked in the first position (PA), a parking position, and in the second position (AP), a working position.

Description

The invention relates to an apparatus and a method for an ultrasonic head integrated in a compression cavity.In order to be able to better assess a tissue change for a diagnosis, ultrasonic images of the affected organs or body regions are additionally recorded in addition to X-ray recordings. With sonography, echo pulses can be received via the ultrasonic pulses emitted by the ultrasonic head and these can be converted into an ultrasonic image. A trend in mammography is, for example, in the direction that, during a breast examination during breast compression, a plurality of X-ray images for a tomosynthesis method are applied in a first section and at least one ultrasound image is applied from the patient's breast in a second section. In order to apply the ultrasonic recording, in the existing systems the ultrasonic head for ultrasonic recording is either manually guided over a compression cavity of a compression unit covered with a gauze or by a drive and guide means arranged within or in the region of the compression cavity. From the utility model specification DE 2020140000927 U1 an ultrasonic unit integrated in a compression cavity is known. In the device described and shown therein, the ultrasound unit remains outside the x-ray beam in the left or right side region of the compression cavity during an x-ray examination. In order that the ultrasound unit can be positioned outside the X-ray cone emanating from the X-ray source with the same size of the X-ray window, the frame of the compression trough is dimensioned to be wider at least by the width of the ultrasound unit. However, this entails the disadvantage that access to a holding device for the patient arranged on the C-arm or on the stand of the mammography installation is made more difficult. Such a widened compression cavity entails the additional disadvantage that the positioning of the breast in the compression device is hindered.DE 10 2014 202 745 A1 relates to an examination device and a method for combined X-ray and ultrasound scanning. In order to increase the area covered overall by X-ray and / or ultrasound imaging, scanning obliquely to the compression surface is also possible. For this purpose, a sound head can be pivotable during the scanning.DE 32 22 053 A1 discloses an apparatus for ultrasonic scanning of the female breast, which apparatus comprises an ultrasonic applicator. Arranged therein are a send / receive system for ultrasound, which is movable and rotatable at least about the axis of symmetry of the applicator, and also a water supply section. Scanning of the breast in all desired spatial directions should thus be possible.DE 10 2011 083 633 A1 discloses a mammography emulsion which has an ultrasound unit and in which fixation can also be maintained during ultrasound recording.The object of the invention is to configure a compression cavity with an ultrasonic unit arranged therein in such a way that the disadvantages listed above are eliminated.The object is achieved by the features mentioned in claim 1 or claim 6.The subject matter of the invention is a guide unit for an ultrasonic unit arranged in a compression cavity, wherein the guide unit has a rotatable connecting unit, whereby the ultrasonic unit couplable to the guide unit can be pivoted or tilted at least into a first or second position.The invention has the advantage that the patient for breast examination reaches the holding device arranged on the mammography installation in an ergonomically optimized manner.The invention has the advantage that the patient can place his arms on both sides of the compression unit and the chest can be easily positioned for an X-ray and / or ultrasound examination.The invention has the advantage that the width of the X-ray cone emanating from the X-ray source corresponds to the width of the compression well.The invention brings with it the advantage that the compression unit can be made compact.The invention brings with it the advantage that during the rotation between the parking position and the working position, a possible height difference between the two positions is additionally overcome and the ultrasonic unit can be placed on the gauze curved within the compression depression.Advantageous embodiments of the device according to the invention and of the associated method are the subject matter of further patent claims.An exemplary embodiment of the invention is explained in more detail below with reference to a drawing, but is not limited thereto.The following are shown: FIG. 1 is an overview illustration, FIG. 2 is a top view of a compression bowl, FIG. 3 is a further plan view of the compression cavity, FIG. 4 shows a detail view of a guide unit, and FIG. 5 shows a further detail view.By means of a rotatable connecting unit DV between a guide unit FE having an upper and lower part OT, UT and a cam mechanism KVG integrated into the rotatable connecting unit DV, an ultrasonic unit US arranged in a compression cavity KV can be selectively aligned into a working AP or rest position PA, wherein during the rest position PA the ultrasonic unit US can be positioned in the rear part of the compression cavity KV. With the cam gear KVG integrated into the rotatable connecting unit DV, the ultrasonic unit US can additionally be raised or lowered in the respective position.For an ultrasonic scan, the ultrasonic unit US pivots parallel to the left side part LS of the compression trough KV, for example, into the working position AP and begins the displacement of the ultrasonic unit US along a scanning direction SR as indicated in FIG. 3 or FIG. 4. This process is controlled by a control unit arranged, for example, in the mammography installation. An ultrasonic recording can be applied before the beginning of the X-ray recording or can be started only after the X-ray recording or recordings. A query can be provided for this purpose in the control unit.FIG. 1 schematically shows an overview of a mammography system M with an X-ray source RQ that is aligned on a detector DT and that can be moved on a circular arc trajectory T. An X-ray cone RK originating from the X-ray source RQ is likewise indicated.A compression unit KE is arranged between X-ray source RQ and detector DT. The compression unit KE is formed of upper and lower compression members. In this illustration, the surface of the detector DT constitutes the lower compression element. Above this, in a sectional illustration, the upper compression element, also characterizable as compression depression KM, is positioned. A gauze G is clamped within a frame R at the bottom of the compression cavity KM. Jigs SP for the gauze G are respectively integrated on the lower side of the left and right side walls LS, RS. The gauze G stretches over the breast of the patient B when the latter is fixed between gauze G and the contact surface of the detector DT for a breast examination. The curvature of the gauze G is marked according to the compression pressure applied to the breast of the patient B. In the rear region of the frame R of the compression depression KM facing the stand ST of the mammography installation M, an ultrasound unit US with a guide unit FE and guide strip FL is arranged. The ultrasonic unit US is in a parking or rest position PA in this orientation. The elongate ultrasound unit US is oriented in this parking or rest position, for example, parallel to the rear side of the frame R or parallel to the front side of the stand ST of the mammography installation M.In FIG. 2, a compression cavity KM is depicted. The viewing direction of the latter corresponds to the propagation direction of the X-rays emitted by the X-ray source RQ, which are bundled in an X-ray cone RK. In this view, the compression cavity KM has a front edge VK oriented toward the patient, a left side wall LS, a right side wall RS and a rear part RT facing the stand ST of the mammography installation M. A coupling element KPE is formed in a depression formed in the center of the rear part RT. With the coupling element KPE, the compression cavity KM is detachably inserted into a corresponding fastening element, which is arranged in the stand or the compression unit and is adjustable at least in its height. A clamping device SP is integrated at the lower edge of the left and / or right side wall LS, RS. A gauze G connecting the left and right side walls LS, RS of the compression cavity KM can be inserted or clamped in a planar manner into this clamping device SP. By means of the clamping device SP, the gauze G inserted therein is prestressed in the standard way. Patient-specific tightening of the gauze G in the base region of the compression depression KM is carried out according to the requirements for fixing the breast of the patient B before a breast examination. At least one guide strip FL is arranged between the left and right side walls LS, RS in the region of the rear part RT of the compression depression KD. On this at least one guide rail FL, the upper part OT of a guide unit FE formed from an upper and lower part OT, UT is arranged. The direction of movement of the upper part OT of the guide unit FE takes place along the at least one guide strip FL. An ultrasonic unit US can be fastened to the lower part UT of the guide unit FE. The movement of the upper part OT of the guide unit FE on the at least one guide strip FL can be effected mechanically, electronically or semi-electronically. The upper part OT is guided or moved along the guide strip FL, for example, by means of drive means. The upper part OT and the lower part UT of the guide unit FE are connected via a connecting unit DV having a rotational axis DA. A cam thread or cam gear KVG is integrated into the rotatable connecting unit DV between the upper part OT and the lower part UT. In this embodiment, depending on the orientation or position of the lower part UT, the curved thread KVG integrated into the connecting unit DV brings about during a rotation or pivoting either a raising or lowering of the lower part UT with the ultrasound unit US fastened thereto. The ultrasonic unit US which can be inserted into and fixed to the lower part UT of the guide unit FE is raised into a first position, a parking position PA, and is lowered into a second position, a working position AP, correspondingly to the respective level of the possibly curved gauze G. As shown in FIG. 2, the parking position PA is parallel to the rear frame part of the compression depression KM or parallel to the at least one guide rail FL. The working position AP is, as shown in FIG. 3, parallel to one side of the frame R of the compression cavity KM. If an X-ray examination is not planned or has already been completed and preparations for the ultrasonic examination are initiated or completed, the ultrasonic unit US can be rotated or pivoted or moved manually or electronically controlled by means of an electric motor drive from the parking or rest position PA into the working position AP. The working position AP of the ultrasound unit US is reached when the ultrasound head is oriented perpendicular or at right angles to its direction of movement in the scanning operation. In this embodiment, as shown in FIG. 2 or 3, the working position AP is reached when the ultrasound unit US is pivoted laterally parallel to the left side wall LS and lowered to the level of the gauze G clamped in the bottom of the compression trough KM. After the ultrasound unit US has been brought into the working position AP, the ultrasound unit US can be pushed or moved in the scanning direction SR guided by the guide unit FE along the guide strip FL. The ultrasonic unit follows approximately the level of the curved gauze G. For this purpose, the lower part UT is resiliently connected to the connecting unit DV.FIG. 4 shows a detailed view of the upper and lower part OT, UT of the guide unit FE connected to a connecting unit DV. The ultrasound unit US can be integrated into the lower part UT of the guide unit FE. In this embodiment, the cam mechanism KVG is designed in such a way that, when the lower part UT is rotated about the axis of rotation DA extending in the connecting unit DV, the ultrasonic unit US moves from the parking position PA into the working position AP and, depending on the form of the curvature of the gauze G, the lower part UT of the guide unit FE with the ultrasonic unit US is lowered onto the gauze G. The upper part OT of the guide unit FE remains aligned on the guide strip FL. To reduce friction during rotation between the working position and the parking position or the parking position and the working position, a pin N or a nub is inserted for the circumferential spacing of the parts of the rotatable connecting unit DV assigned to the upper part OT and the lower part UT, as illustrated in FIG. 5. Once the working position AP or the rest position PA has been reached, the rotatable connecting unit DV is locked in each case. After reaching the working position AP and arresting the position of the lower part UT, the ultrasonic unit US is guided along the level of the curved gauze G in the scanning direction SR by the upper part OT which can be moved on the guide strip FL. The guide unit FE is designed in such a way that it automatically carries out the guidance of the ultrasound unit US. During the controlled movement, for better transmission of the ultrasonic waves, a gel is dispensed flat onto the respective substrate, for example onto the gauze G, at least from a storage container which can be arranged, for example, at least on one side of the ultrasonic unit US.List of reference charactersM mammography system ST stand RQ x-ray source RK x-ray cone T trajectory DT detector KE compression unit KM compression cavity B breast of the patient KPE coupling unit VK front edge of the compression cavity SB side region of the compression cavity RT rear part of the compression cavity R frame LS left side wall RS right side wall SP clamping device G gauze US ultrasound unit FL guide strip FE guide unit DV connecting unit DA axis of rotation N pin / sliding element / nub KVG cam gear UT lower part of the guide unit OT upper part of the guide unit PA park position for ultrasound unit AP working position for ultrasound unit SR scanning direction for ultrasound unit

Claims

Compression cavity (KM) having a guide unit (FE) for an ultrasound unit (US), wherein the guide unit (FE) has a rotatable connecting unit (DV) having at least one axis of rotation (DA), wherein the elongate ultrasound unit (US) couplable to the guide unit (FE) can be pivoted at least into a first or second position (PA, AP), characterized in that the first position is pivotable with respect to a scanning direction (SR) in which the ultrasound unit (US) is moved for an ultrasound scan, Parallel position (PA) can be taken by the ultrasound unit (US) in the rear part of the compression depression (KM) and the second position (AP) can be taken by the ultrasound unit (US) at right angles to the scanning direction (SR), wherein the connection unit (DV) can be locked in the first position (PA), a parking position, and in the second position (AP), a working position.Compression cavity (KM) according to Patent Claim 1, characterized in that the connecting unit (DV) has a cam mechanism (KVG), it being possible for the ultrasonic unit (US) to be raised when the first position (PA) is reached and lowered when the second position (AP) is reached.Compression cavity (KM) according to Patent Claim 2, characterized in that the cam mechanism (KVG) for the working position (AP) is designed in such a way that the ultrasound unit (US) can be lowered to the respective level of the gauze (G) when it is pivoted into the working position (AP).Compression cavity (KM) according to one of the preceding patent claims, characterized in that the connecting unit (DV) of the guide unit (FE) has an upper part (OT) and a lower part (UT), wherein the upper part (OT) can be moved along at least one guide strip (FL) and the ultrasound unit (US) can be fastened to the lower part (UT).Compression cavity (KM) according to one of the preceding patent claims, characterized in that the ultrasound unit (US) can be moved automatically into the working position (AP) and in that an ultrasound scan can be carried out from the breast of the patient (B) in the scanning direction (SR).Method for positioning an ultrasound unit (US) arranged in a compression cavity (KM), wherein the ultrasound unit (US) can be pivoted at least into a first or second position (PA, AP), characterized in that the first position (PA) parallel to a scanning direction (SR) in which the ultrasound unit (US) is moved for an ultrasound scan is assumed by the ultrasound unit (US) in the rear part of the compression cavity (KM) and the second position (AP) is assumed by the ultrasound unit (US) at right angles to the scanning direction (SR), wherein the connection unit (DV) can be locked in the first position (PA), a parking position, and in the second position (AP), a working position.Method according to claim 6, characterised in that the ultrasound unit (US) can be lifted into the first position (PA) and / or lowered into the second position (AP).Method according to claim 6, characterised in that an ultrasonic scan is carried out automatically with the ultrasonic unit.

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