Ultrasonic methods for diagnosis and treatment of stroke

• US RE46,614 E1
• Filed: 08/08/2011
• Issued: 11/28/2017
• Est. Priority Date: 11/10/1999
• Status: Active Grant

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Lipson, David, Forrest, Peter
• Primary Examiner(s): Le, Long V
• Assistant Examiner(s): HOFFA, ANGELA MARIE
• Application Number:
  US13/204,836
• Time in Patent Office: 2,304 Days
• Field of Search: 600454, 600437, 600451, 600465, 600468
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/4076 Diagnosing or monitoring particular conditions of the nervous system A61B5/4821, A61B5/4824 take precedence
• CPC Class Codes: A61B 5/6834 using vacuum
• CPC Class Codes: A61B 6/501 for diagnosis of the head, e.g. neuroimaging or craniography
• CPC Class Codes: A61B 6/5247 combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/0808 for diagnosis of the brain
• CPC Class Codes: A61B 8/4281 characterised by sound-transmitting media or devices for coupling the transducer to the tissue
• CPC Class Codes: A61B 8/4416 related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
• CPC Class Codes: A61B 8/481 involving the use of contrast agent, e.g. microbubbles introduced into the bloodstream analysis of echo signal exploiting properties of a contrast enhancer in devices for short-range imaging with acoustic waves G01S7/52039
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: G01S 15/8993 Three dimensional imaging systems
• CPC Class Codes: G01S 7/52036 using analysis of echo signal for target characterisation
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics

Abstract

A medical diagnostic method, system and related equipment particularly adapted to diagnose disorders of the blood circulation serving the head and neck, and especially the brain. A preferred use of the system is early, rapid, accurate, diagnosis of stroke, especially whether the stroke is due to blockage of a blood vessel or leakage from the blood vessel.

Claims

1. Using non-ultrasonic detection of symptoms of stroke to dynamically couple an ultrasonic transducer/receiver to a skull, in which the non-ultrasonic detection comprises at least one of the group consisting of computed tomography scanning, magnetic resonance scanning, differential spectrophotometric methods, near-infrared detection of tissue characteristics, detection of a biological material, measurement of a biological material, detection of a chemical, measurement of a chemical, detection of S100β

, measurement of S100β

, use of biological assay techniques, detection of change in blood pressure, detection of change in pressure within the eye, detection of change in blood flow in arteries serving organs other than the brain, or detection of change in blood flow in the arteries serving the eye.

2. For a patient having a skull containing brain tissue and blood vessels, a process for diagnosing stroke in the patient, comprising:

a) dynamically coupling at least one ultrasonic transmitter/receiver to at least one man-made opening in the skull of the patient;

b) imaging a region within the skull of the patient; and

c) at least one of;

determining presence of hemorrhagic stroke by identifying relatively diffuse blood flow within the skull of the patient;

determining presence of ischemic stroke by identifying at least one location of inadequate blood flow within the skull of the patient; and

diagnosing between hemorrhagic and ischemic stroke by classifying a region within the skull of the patient in terms of adequacy of blood flow.

3. The process of claim 2, in which the imaging comprises generating and receiving ultrasonic signals suitable for processing into information about the region within the skull of the patient.

4. The process of claim 2, in which a region is classified in terms of normal blood flow.

5. The process of claim 2, in which a region is classified in terms of inadequate blood flow.

6. The process of claim 2, in which a region is classified in terms of relatively diffuse blood flow.

7. The process of claim 2, in which locations of hemorrhagic stroke are determined by identifying relatively diffuse blood flow outside the blood vessels of the brain.

8. The process of claim 2 in which locations of ischemic stroke are determined by identifying relatively inadequate blood flow within the blood vessels of the brain.

9. The process of claim 2 in which presence of ischemic stroke is determined by identifying at least one location where there is at least partial blockage of blood flow.

10. The process of claim 2, further comprising applying a vacuum to the skull.

11. The process of claim 2, further comprising applying an acoustic coupling material to the skull.

12. A stroke diagnosis/treatment method comprising:

mounting a unit having two transmitter/receivers on the head of a subject with each transmitter/receiver acoustically coupled to an acoustic window of the skull, wherein each transmitter/receiver includes a plurality of ultrasonic transducing elements;

activating at least some of the transducing elements to direct ultrasonic signals into the brain;

receiving echo signals from brain tissue and microbubbles in a blood vessel of the brain with one of the transmitter receivers;

processing the echo signals to form two-dimensional or three-dimensional dynamic images of the brain tissue and microbubbles in the blood vessel of the brain; and

diagnosing stroke from an image of the brain tissue and the microbubbles.

13. The method of claim 12, wherein diagnosing further comprises diagnosing whether a stroke has occurred and, if so, what type of stroke has occurred.

14. The method of claim 13, wherein diagnosing whether a stroke has occurred further comprises identifying a blood vessel which may be blocked.

15. The method of claim 13, wherein identifying a blood vessel which may be blocked further comprises determining the type of stroke as ischemic.

16. The method of claim 12, wherein diagnosing whether a stroke has occurred further comprises identifying a region of relatively diffuse blood flow.

17. The method of claim 16, wherein identifying a region of relatively diffuse blood flow further comprises determining the type of stroke as hemorrhagic.

18. The method of claim 12, further comprising:

following the diagnosis of a stroke, performing stroke therapy; and

delivering additional ultrasonic energy during the stroke therapy.

19. The method of claim 18, wherein delivering additional ultrasonic energy during the stroke therapy further comprises delivering additional ultrasonic energy to the brain from which the image of microbubbles in a blood vessel was formed to improve the effectiveness of therapy.

20. The method of claim 19, wherein the image of microbubbles in a blood vessel further comprises a Doppler ultrasonic image of microbubbles in a blood vessel.

21. A method for performing non-ultrasonic detection of symptoms of stroke, the method comprising:

dynamically coupling an ultrasonic transducer/receiver to a patient;

performing ultrasound imaging with the ultrasonic transducer/receiver, the ultrasound imaging comprising imaging microbubbles in the patient;

performing non-ultrasonic detection of symptoms of stroke in which the non-ultrasonic detection comprises at least one of the group consisting of computed tomography scanning, magnetic resonance scanning, differential spectrophotometric methods, near-infrared detection of tissue characteristics, detection of a biological material, measurement of a biological material, detection of a chemical, measurement of a chemical, detection of S100β

, measurement of S100β

, use of biological assay techniques, detection of change in blood pressure, detection of change in pressure within the eye, detection of change in blood flow in arteries serving organs other than the brain, and detection of change in blood flow in the arteries serving the eye; and

determining a diagnosis of stroke based at least in-part on the ultrasound imaging and a detection of symptoms of stroke when performing the non-ultrasonic detection of systems of stroke.