FR2545349A1 - Device for detecting the shape of human organs or of pathological anomalies or device for implementation thereof - Google Patents

Abstract

This method consists in making two detections of shapes of the organ or organs in question, simultaneously or with a very short time lag, respectively with X-radiation 1 and with another ultrasonic, infrared or NMR radiation 7 for example, then in processing these two types of information in order to obtain an image 11 resulting from the superposition of the two shape detections. Application to making medical and dental diagnosis and monitoring operations.

Description

PROCESS FOR INPUT OF THE FORM OF HUMAN ORGANS OR
OF PATlllOLOGl @ UES FAULTS AND DEVICE FOR IMPLEMENTING IT
IN WORK
The present invention relates to a method of capturing the shape of human organs or pathological anomalies and a device for its implementation.

 There are different methods for grasping the shape of a human organ.

 The first of these consists in using X-rays which are perfectly suitable for visualizing the contour and the bone density, but which, having the disadvantage of being dangerous beyond a certain irradiation value, can only be used for a very short time.

 In addition, X-rays only give an imperfect image of non-bone tissue, especially soft tissue.

 Other methods using ultrasound, infrared radiation or using NMR (nuclear magnetic resonance) and a radiation have the advantage of not being dangerous, of giving a good image of the tissues, of allowing the localization of 'a heating zone with regard for example to infrared, but does not give an accurate image of the bone masses, or else at very high costs and requiring significant processing.

 The existing techniques therefore have a significant gap in certain applications, such as the monitoring of an intervention in the dental, gastroenterological or pneumological field and often make it impossible to monitor an operating procedure, whether in medicine or otherwise.

 To this end, the method which it relates to consists of making two seizures of the shapes of the organ or organs considered, simultaneously or with a very small time difference, respectively, with X-ray radiation and with other ultra- sounds, infrared or NMR for example, then to process these two types of information in order to obtain an image resulting from the superposition of the two shape captures.

 The superimposition of data obtained from the input of shapes, allows the visualization of a good bone contour thanks to X-rays, and the visualization of soft tissue organs or contours thanks to the other type of radiation.

 According to an advantageous embodiment, this process consists, after the initial double capture of the shapes, to be carried out continuously or at determined time intervals, new captures using the second radiation, ultrasound, infrared , NMR or, and to superimpose the images thus obtained with the Initial image obtained using X-rays.

 The image obtained by ultrasonic radiation will be mainly used to follow in general the general movements of the bones or to follow an intervention in the area under study. The image obtained from infrared radiation will be mainly used to visualize physiological or pathological overheating.

Other characteristics of the invention will emerge clearly from the description which follows of a certain number of embodiments of this method and of a device for carrying out said implementations with reference to the appended schematic drawing in which:
Figure 1 is a view of a block diagram of the realization of two seizures of initial shapes g
Figure 2 is a block diagram corresponding to several seizures of successive forms;
Figures -3 and 4 are two schematic views of the adaptation of two seizures of different shapes;
Figures 5 and 6 are two views, respectively in perspective and in cross section of an apparatus for entering shapes of a portion of the lower jaw
Figure 7 is a top view of a lower jaw and two devices for seizing forms s
Figures 8 and 9 are two views, respectively, in section and from below of an apparatus for entering shapes of a part of the upper jaw of an individual g
Figure 10 is a very schematic view of an X-ray capture device;
Figures 11 to 13 show three devices for carrying out an entry of forms;
Figure 14 is a general view of an apparatus for entering the shapes of the jaw of an individual from outside thereof
Figure 15 is a detail view of a part of this device.

As shown in Figure 1 of the accompanying schematic drawing, the method according to the invention consists in capturing the shapes of the area to be studied by means of X-rays (1), in carrying out an analog-digital conversion of the information collected in an area (2), store this information in (3), skeletonize in (4) the outline of the entered shapes and store them in (5) then, simultaneously, or after a very short time difference to initiate from a clock (6) an input of the forms using infrared, ultrasound, NMR or 5eF radiation in (7), to carry out an analog-digital conversion in (8) of the information collected, to to process, at the level of an interface t9) and of a zone (10), the information coming from the capture (7) and from the storage zone (a) of the contour, in order to achieve a superposition of these two images in ( 11) which can then be stored in a memory in (12) .-
Insofar as subsequent captures are carried out using the second radiation, the shape entered is superimposed with the initial shape of the contour obtained using X-radiation and stored in the memory (5).

 According to another of its characteristics, this method consists in carrying out an adaptation of one or the other of the images to be superimposed, in order to allow a correct superposition of these to be achieved.

 This adaptation of one or the other of the images is necessary to obtain a good superimposition, insofar as there may be a displacement of the transmitter and / or the receiver during seizures of forms subsequent to the initial ones, for relation to the object itself or to the extent that the transmitters and receivers of the two types of radiation have positions that are different from each other and independent.

 FIG. 2 represents a block diagram in which the box (13) represents the entry of the shapes using X-radiation, the outline of which is skeletonized in (14) before storage in (15).

It is carried out simultaneously or almost at time tO with a capture of forms by an ultrasound radiation, - infrared or other in (16), which gives a fuzzy definition of the bone contour, but clear with many indefinable details to the radiation. X of a channel (17) for example. This shape is skeletonized in (18) then, after treatment superimposed in (19) on the outline stored in (15), to obtain the image represented in (20). At a later period tl, a simple entry of shapes using ultrasound, infrared or other radiation in (22), which gives rise to a skeletonization in (23), the skeletonized image being processed with respect to the initial contour using '' an adapter shown in (19) giving in (24) an image obtained by superimposing the stored contour obtained by radiation
X, and forms captured in (22) by ultrasound, infrared or other radiation allowing for example the vision of a probe Q5) inside the channel (17).

 The adaptation of one or the other of the two images to be superimposed can be obtained by identification by a system of at least three points, or a grid, like the one shown diagrammatically in FIG. 3 before skeletonization. The three points or n points (grid - grid) are fixed on the object, therefore will be deformed if the analysis angle of the sensors varies compared to the perpendicular to the plane.

 It suffices that the software distorts the image obtained until giving it an exact superposition on the theoretical model of the grid.

The overall distorted image necessarily corresponds to the same incidence as in the initial view and therefore the second view can be superimposed on the stored X-ray image of the first view. The same principle can be repeated n times in real time or deferred throughout the analysis.

 The advantage of this method is to make the correction and image software analyzed independent and to be able to make this correction before skeletonization.

 The adaptation of two views can be done by taking into account the contours, as shown in FIG. 4, where the contour obtained by X-radiation bears the reference (26), after skeletonization and the capture of the forms obtained by ultrasound at the origin carries the reference (27) ensuring the obtaining of an image (28) by superposition which must be adapted, with a view to its superposition with an image (29) captured subsequently. After adaptation, the contour (23) was modified to form the contour (30).

This second dynamic correction method consists in relying on the recognition of particularly clear and visible structures during the first ultrasonic or infrared reading (contour of a vessel - bone rim), to associate it with the reading of the radiation
X and modify the new readings as a function of the deformations of the projection of this member on the sensor.

 This system has the advantage of making the use of markings on the object unnecessary, but it requires more complex software.

 This adaptation can also be carried out in dynamics by progressive correction during the deformation resulting from such or such phenomenon, by action on the vectors of the image, which makes it possible to obtain a superposition at any time.

The principle of superposition of several images resulting, on the one hand, from X-ray radiation and, on the other hand, from infrared, ultrasound or NMR radiation, makes it possible to follow:
- an act of treatment in the organ studied, such as penetration of a nerve puller into a tooth, while retaining a beautiful image of the tooth, thanks to the contour obtained with X-radiation or,
- a movement of the organ itself such as mandibular kinematics, by associating the dynamic study of the movement of the mandible with its static view, and by incorporating a certain amount of information to detect possible pathologies.

 It is possible to associate with the seizures of forms indicated previously values of electromyographic readings for the study of joint movements or facial expressions (ODF).

 After having made the two initial shape seizures, it is possible to follow the movements of the mandibles, thanks to ultrasound or infrared which provide information on circulatory flows and flows and muscle contractions, which can be confirmed by electromyography.

 On this subject and during the movements, if the analysis relates exclusively to the organ in movement, it will be good to hold as interesting to analyze only the points whose vectorial is to be changed.

We know that mathematically a point which varies in space has its vector which varies, whereas a fixed point does not vary. By applying this principle to the analysis described above, it will be possible to follow only the movements. dynamic on a perfectly clear (RX) and static background.

It will thus be possible to follow the movement of the muscles of a leg without opening, as to follow the progress of a medical instrument (nerve puller - probe) ...) without practically using the rays
X.

 Associated with electromyography or any other method of diagnosis, therapeutic research will be carried forward.

 It is therefore very interesting to use this process for endodontic, prosthetic, paradontological, pedodontic, surgical diagnostics in medicine and dentistry.

 Thus in endodontics, it is possible to follow the progress of the milling instruments in relation to the pulp, the use of infrared radiation indicating a possible heating of the pulp. Likewise, it is possible #to follow the evolution of the endocanal instruments, avoiding trauma to the peri-apex, and guiding the practitioner's gesture.

 The ends of the instruments used can be equipped with an infrared emitter to be better detectable.

In the same way, the use of infrared or ultrasound radiation associated with the contour stored in memory "obtained by X-ray, makes it possible to locate and diagnose inflammations, cysts or other pathologies and to locate, without danger and with maximum precision, lesions
On this subject, it should be noted that until then the association of an artificial coloring always related to the gray levels (better visual discrimination). It is proposed to index the colors not to the gray levels of the image, but to the heating recognized by the ultrasonic, infrared or other techniques. The monitor will therefore present a colored view where each color will be a function of the heat. The heat can be a reflection of a pathological indication, it will be possible for the practitioner to visualize the sensitive areas.

 If we automate the colors by linking them to a pathology table, it will be possible to make a diagnosis proposal depending on the response to the method used (difference between 3cist - granuloma - infection etc ...).

 The application of this process in the field of dental prostheses makes it possible to locate the exact ratio of the tooth to be treated and the neighboring and antagonistic teeth at the bone level, and to know its mobility in all directions and, consequently, its value of support and milling possibilities.

 To do this, the determination of the pulp volume and especially its reaction to milling is visualized at any time in infrared or ultrasound to a maximum of details (stored X-ray radiation).

A rise in temperature can materialize by a visual (different colors) or sound signal. Mobility can be rated by the displacement of the skeletal boundaries of the tooth.

 In terms of paradontology, the method according to the invention makes it possible to know the bone, circulatory and nervous pathologies, in order to know how and where to act, and also to follow the action of the instruments at the time of the act and after, according to the techniques described above.

 In terms of surgery, it is possible to locate tumors, organs, bones, teeth, while following the act performed and studying the reports of the area under analysis with regard to veins and arteries in particular. Monitoring the movement of the instrument makes it possible to avoid accidents.

The device for implementing this method comprises an X-ray transmitter and receiver located on either side of the area to be analyzed, and a transceiver of another radiation, ultrasound, infrared or NMR, located on the same side of the area to be analyzed, which is the side on which the ray emitter is located
X.

 Figures 5 and 6 of the accompanying schematic drawing show an apparatus for entering the shapes of several teeth of a lower jaw. This device comprises a hoop (32) intended to come over the area to be studied, which is held in place relative to the latter, using a plate (33) bearing under the patient's chin.

 Near the two edges of the arch are provided saliva suction cannulas (34).

 On either side of the hoop (32) are also provided two small hoops (35) serving as support for cotton (36) absorbing saliva. One of the poles (35) carries an assembly (37) comprising an x-ray emitter, as well as a transceiver of another ray, ultrasound, infrared or NMR, while the other roll bar (35) carries an X-ray receiver (38).

 This device is shown seen in section in Figure 6.

 FIG. 7 represents a jaw equipped with two types of apparatus, namely in its left part, a rectilinear apparatus (39), such as that represented in FIGS. 5 and 6, and in its central part an apparatus (40) according to the curvature of the jaw.

 Figures 8 and 9 of the drawing show an apparatus for gripping the shapes of the upper part of a jaw. To this end, this device (42) comprises at least one elastic arch (43) capable of coming to exert pressure on the tooth (44) on which it is to be fixed.

 On the side of the cheek, a hoop (45) carrying cotton (46) absorbing saliva is provided; This device 2) carries receiver-transmitter assemblies (37) and (38) arranged on either side of the tooth, similar to those described with reference to FIGS. 5 and 6.

It should be noted that the emitter and receiver of the radiation
X, can possibly be removed after the first entry of the forms since they are no longer used during the continuation of the process.

In such conditions, it is necessary, in order to maintain a strict location, to fix, on the organ studied, any location independent of the emission and collection system.

 Advantageously, and as shown in FIG. 10 of the drawing, the X-ray receiver comprises a scintillator (47), a system for transmitting information by optical fibers 1t483 or by a mirror, to a sensor such as a CCD photosensor (49) matrix or linear.

The scintillator aims to transform the radiation
X in photons which can be analyzed by a CCD or a vidicon tube. If the photon analysis system is not in the patient's mouth, an optical fiber placed behind the scintillator, or other system that transforms X-rays into photons, transmits these photons to a CCD or a vidicon tube.

 The use of a CCD is very interesting because it allows maximum efficiency for a minimum of radiation, both in defining the image and in scanning it.

The infrared image is used with a capture by vidicon tube
or by a CCD sensitive to this frequency.

In the embodiment shown in Figure 11, the transmitter
(50) of the X-ray and the receiver (52) are located on the side and
on the other side of the area (53) studied, the transceiver (54) on the other
radiation being located on the same side as the transmitter (50). The reception
teur (52) and Isémettecar-Péêepteur (54) form an angle of which it is
desirable to be as small as possible, to avoid deformation
of the image obtained by X-ray, compared to that obtained
by the other - radiation. For this, it is possible to play on the
focusing of infrared radiation or ultrasound, which respond
both like the laws of traditional optics.

In the embodiment represented in FIG. 12, the emitter killer (55) and receiver (56) of the X-ray are located on either side and
of the object (57) to be analyzed. The other's transceiver (58)
radiation concentrically surrounds the transmitter (55).

In the embodiment shown in Figure 13, in
which the same elements are designated by the same references
that in FIG. 12, the transceiver of the other radiation is not
not centered with respect to the transmitter (55) but offset with respect to
this one. This implies the need to adapt one of the two
images to each other.

Figures 14 and 15 show an apparatus for the
grasping the shapes of an individual's jaw from the outside, necessary
placing a perfect immobility of the patient. To this end, provision is made
a headrest (59) and a support member (60) on the patient's neck, the
transceivers (62, 63) being arranged on either side of
the jaw and secured to a stirrup (64) in the form of a helmet. This system
can be fixed on the practitioner's chair.

As is apparent from the above, the invention provides a
great improvement to the existing technique by providing a process
allowing, by its implementation, to cumulate the advantages of
several traditional processes, without having the disadvantages of these.

It goes without saying that the invention is not limited to only modes
of implementations of this process, or only to the forms of execution
of the device, described above if it embraces, on the contrary, all
variants. This is how the transmitter-receiver assembly
radiation other than RX could be located on the side of the RX receiver.

Claims (10)

 1. - Process for entering the form of human organs or pathological anomalies, characterized in that it consists in making two entries of forms of the organ or organs considered, simultaneously or with a very small time difference , respectively, with X-ray radiation and with other ultrasound, infrared or NMR radiation for example, then to process these two types of information with a view to obtaining an image resulting from the superposition of the two captured shapes.  2. - Method according to claim t, characterized in that it consists, after the initial double entry of the forms, to be carried out continuously or at determined time intervals, new entries using the second radiation, ultrasound , infrared or NMR, and to superimpose the images thus obtained with the initial image obtained using X-rays.  3. - Method according to claim 1, characterized in that it consists in carrying out an entry of shapes of the area to be studied by means of X-rays (1), in carrying out an analog-digital conversion of the information collected in an area (2) to store this information in (3), to skeletonize in (4) the outline of the entered shapes and to store them in (5) then, simultaneously, or after a very short time lag to initiate from a clock (6) an input of the forms using infrared, ultrasound or NMR radiation in (7), to carry out an analog-digital conversion in (8) of the information collected , to process, at an interface (9) and an area t10) the information coming from the capture (7) and from the storage area (9) of the contour, in order to achieve a superposition of these two images in (11) which can then be stored in a memory in (12).  4. - Method according to any one of claims 1 to 3, characterized in that it consists in carrying out an adaptation of one or the other of the images to be superimposed, in order to allow a correct superposition of these to be achieved. this.  5. - Method according to claim 4, characterized in that the adaptation of one of the images- for its superposition with Other image is obtained by a tracking system comprising at least three points, such as a grid or a frame, fixed on the member whose shape is to be captured, the grid of one of the images being deformed if necessary, before skeletonization, in order to be brought into superposition with the grid of the other image.  6. - Method according to claim 4, characterized in that the adaptation of one of the images with a view to its superposition with the other image is obtained by deformation of the contour of the image considered, after skeletonization of the contour of the two images.  7. - Device for implementing the method according to any one of claims 1 to 6, - characterized in that it comprises an emitter (50, 55) and a receiver (52, 56) of X-rays located on either side of the zone (53, 57) to be analyzed, and a transceiver (54, 58) of another radiation, ultrasound, infrared or NMR, located on the same side of the zone to analyze, which side is the X-ray emitter on.  8. - Device according to claim 7, characterized # ized in that it comprises a scintillator (47), a system for transmitting information by optical fibers (48) or by a mirror, to a sensor such as a CCD (49) matrix or linear photosensor.  9. - Device according to any one of claims 7 and g, characterized in that, in the case of its application to grasping the shape of teeth, it comprises a part (34, 43) in the form of an arch, intended to cover the part of the jaw comprising the area to be studied, and carrying, at its ends, on one side (37) the X-ray emitter and the transceiver of the other radiation and the other side of the X-ray receiver (38).  10. - Device according to claim 97 characterized in that the part (34, 43) in the form of a hoop and the emitters and receivers (37, 38) of radiation are fixed on the practitioner's seat.