JP2022505677A - 脈波伝播速度測定システム - Google Patents
脈波伝播速度測定システム Download PDFInfo
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Abstract
Description
a)(ほぼ)同じ位置で流量及び圧力を測定し、圧力の変化と流速の変化との間の関係からPWVを導出することによるもの(例えば、Khirら、Determination of wave speed and wave separation in the arteries、Journal of Biomechanics 34、2001年、1145~1155、及び、Daviesら、Use of simultaneous pressure and velocity measurements to estimate arterial wave speed at a single site in humans、Am J Physiol Heart Circ Physiol 290: H878~H885、2006年)、
b)既知の距離波又は圧力パルスの立ち上がりの時間調整によるもの(Millasseauら、Evaluation of Carotid-Femoral Pulse Wave Velocity: Influence of Timing Algorithm and Heart Rate、Hypertension、2005年、45:222~226、及び、Harbaouiら、Development of Coronary Pulse Wave Velocity: New Pathophysiological Insight Into Coronary Artery Disease、Journal of the American Heart Association、2017、6:e004981)。いずれの方法にもその利点及び欠点がある。圧力-流量の関係によるPWVの測定には、血管内流量-圧力ワイヤが必要である。圧力又は流波を時間調整することは、技術的な要件はより低いが、遅延時間が長く測定が比較的容易な大動脈などの長い血管に対しては最も良好に機能する。しかしながら、腎デナベーションのための患者層別化のような用途では、腎動脈など僅か数cmの血管のPWVを測定する必要がある。
血管内デバイスから管の長さに沿った複数の測定値を受信するステップであって、血管内デバイスは血管内デバイスの長さに沿った異なる場所に設けられている2つのマーカを備える、2つのマーカは追跡装置によって位置を特定可能である、受信するステップと、
追跡装置から2つのマーカの位置情報を受信するステップと、
第1のマーカは第1の位置にあり、第2のマーカは第2の位置にあって、第1の時間に関して複数の測定値のうちのある測定値をマーカの位置と関連付けるステップと、
血管内デバイスが移動するときに位置情報から第1のマーカが第2の位置に達している時点を検出して、第2の時間を関連付けるステップと、
複数の測定値のうちの第1の時間及び第2の時間に関して関連付けられた測定値に基づいて、及び、血管内デバイスの長さに沿った2つのマーカの場所の間の距離に基づいて、管の脈波伝播速度値を確定するステップと、を含む。
Claims (15)
- 管の脈波伝播速度を測定するためのシステムであって、
前記システムは、前記管の長さに沿った複数の測定値を提供するための血管内デバイスと装置とを備え、
前記血管内デバイスは、前記血管内デバイスの長さに沿った異なる場所に設けられている2つのマーカを備え、前記2つのマーカは追跡装置によって位置を特定可能であり、
前記装置は、
前記血管内デバイスから複数の前記測定値を受信し、
前記追跡装置から前記2つのマーカの位置情報を受信し、
第1のマーカは第1の位置にあり、第2のマーカは第2の位置にあって、第1の時間に関して複数の前記測定値のうちのある測定値を前記マーカの位置と関連付け、
前記血管内デバイスが移動するときに前記位置情報から前記第1のマーカが前記第2の位置に達する時点を検出して、第2の時間を関連付け、
複数の前記測定値のうちの前記第1の時間及び前記第2の時間に関して関連付けられた測定値に基づいて、及び、前記血管内デバイスの長さに沿った前記2つのマーカの前記場所の間の距離に基づいて、前記管の前記脈波伝播速度値を確定する、
システム。 - 前記血管内デバイスは、その遠位部分に、前記2つのマーカの一方に近接して、前記管の長さに沿った複数の前記測定値を提供するためのセンサを備える、請求項1に記載のシステム。
- 前記装置は更に、
前記追跡装置から受信された前記位置情報から、前記第1の時間における前記第1のマーカと前記第2のマーカとの間の見かけの距離を確定し、
前記見かけの距離を前記血管内デバイス上の前記2つのマーカの前記場所の間の物理的距離と比較し、
前記見かけの距離及び前記物理的距離に基づいて局所的な補正係数を確定し、
前記脈波伝播速度値及び前記補正係数に基づいて補正された脈波伝播速度値を確定する、請求項1又は2に記載のシステム。 - 前記血管内デバイスは、前記追跡装置によって位置を特定可能な複数のマーカを備え、前記複数のマーカは、前記血管内デバイスの長さに沿った異なる場所に設けられていて、物差しを形成している、請求項1から3のいずれか一項に記載のシステム。
- 前記脈波伝播速度値を表示するユーザインターフェースを更に備える、請求項1から4のいずれか一項に記載のシステム。
- 前記マーカの位置を特定するための前記追跡装置を更に備える、請求項1から5のいずれか一項に記載のシステム。
- 前記追跡装置は放射線装置であり、前記マーカは放射線不透過性材料を含む、請求項6に記載のシステム。
- 前記管の長さに沿った複数の前記測定値は、圧力測定値、流量測定値、管径測定値、及び管断面測定値の各タイプのうちの少なくとも1つを含む、請求項1から7のいずれか一項に記載のシステム。
- 前記追跡装置は超音波プローブであり、前記マーカは、前記超音波プローブに超音波を放射する又は前記超音波プローブから超音波を受信する、能動的又は受動的超音波トランスデューサである、請求項6に記載のシステム。
- 前記超音波プローブは体外の超音波プローブである、請求項9に記載のシステム。
- 前記マーカのうちの少なくとも1つは、前記管の長さに沿った複数の前記測定値を提供するためのセンサとして使用される、請求項9又は10に記載のシステム。
- 前記センサは流量測定値を含む複数の前記測定値を提供する、請求項11に記載のシステム。
- 前記センサは管径又は断面測定値を含む複数の前記測定値を提供する、請求項11に記載のシステム。
- 前記追跡装置は電磁的追跡装置であり、前記マーカは永久磁性材料又は電磁コイルを含む、請求項6に記載のシステム。
- 管の脈波伝播速度を測定する方法であって、前記方法は、
血管内デバイスから前記管の長さに沿った複数の測定値を受信するステップであって、前記血管内デバイスは追跡装置によって位置を特定可能な2つのマーカを備え、前記2つのマーカは前記血管内デバイスの長さに沿った異なる場所に設けられている、受信するステップと、
前記追跡装置から前記2つのマーカの位置情報を受信するステップと、
第1のマーカは第1の位置にあり、第2のマーカは第2の位置にあって、第1の時間に関して複数の前記測定値のうちのある測定値を前記マーカの位置と関連付けるステップと、
前記血管内デバイスが移動するときに前記位置情報から前記第1のマーカが前記第2の位置に達する時点を検出して、第2の時間を関連付けるステップと、
複数の前記測定値のうちの前記第1の時間及び前記第2の時間に関して関連付けられた測定値に基づいて、及び、前記血管内デバイスの長さに沿った前記2つのマーカの場所の間の距離に基づいて、前記管の前記脈波伝播速度値を確定するステップと、
を含む、方法。
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