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WO2016203361A1 - Appareil de support - Google Patents

Appareil de support Download PDF

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Publication number
WO2016203361A1
WO2016203361A1 PCT/IB2016/053488 IB2016053488W WO2016203361A1 WO 2016203361 A1 WO2016203361 A1 WO 2016203361A1 IB 2016053488 W IB2016053488 W IB 2016053488W WO 2016203361 A1 WO2016203361 A1 WO 2016203361A1
Authority
WO
WIPO (PCT)
Prior art keywords
probe head
ultrasound
ultrasound probe
support apparatus
support
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IB2016/053488
Other languages
English (en)
Inventor
Raashid Ahmed LUQMANI
Varun MANHAS
Yiaannis VENTIKOS
Jennifer PIPER
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Oxford University Innovation Ltd
Original Assignee
Oxford University Innovation Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Oxford University Innovation Ltd filed Critical Oxford University Innovation Ltd
Publication of WO2016203361A1 publication Critical patent/WO2016203361A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4209—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Clinical applications
    • A61B8/0891—Clinical applications for diagnosis of blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4209—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
    • A61B8/4218—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames characterised by articulated arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4209—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
    • A61B8/4227—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames characterised by straps, belts, cuffs or braces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00149—Holding or positioning arrangements using articulated arms

Definitions

  • the present application relates to a support apparatus for an ultrasound probe head, an ultrasound apparatus including a support apparatus and an ultrasound system, and a method of scanning the temporal artery of a patient, particularly but not exclusively for providing ultrasound images for use in the diagnosis of giant cell arteritis ("GCA").
  • GCA giant cell arteritis
  • Ultrasound is a widely known and used technique for medical imaging and diagnosis, and it has been proposed to use ultrasound to diagnose patients with active GCA and to monitor their treatment.
  • Giant cell arteritis is a form of vasculitis, or inflammation of arteries, usually in the head and neck. Untreated, the condition can result in loss of vision, and the usual treatment is steroid medication.
  • the standard technique used in diagnosis is a biopsy of the temporal artery, but this has disadvantages. A biopsy is necessarily invasive and, since the inflammation is not uniformly distributed, there may be unaffected areas of the temporal artery, which means that a sufficient length of artery is removed to avoid missing the areas of abnormality.
  • a biopsy requires the involvement of a surgeon, a surgical theatre, and a pathology department to process the samples and typically a delay before the result is known of 5 to 10 days from the sample being taken.
  • steroid treatment is not started and the patient does actually have the disease, there is a 20% risk of permanent blindness. Therefore this is a medical emergency, and treatment with steroids has often already started by the time the biopsy is performed, and usually before the results are received; however, in temporal artery sampling, active inflammation in giant cell arteritis disappears within a few days of steroid treatment.
  • GCA not all patients with GCA respond to treatment in the same way, but there are no valid biomarkers to assess therapy response or to diagnose relapse. Changes in the traditional inflammatory markers (CRP and ESR) do not consistently reflect disease activity, but recent evidences have shown correlation between ultrasound changes and clinical response, potentially making ultrasound a very useful tool for monitoring disease activity.
  • a particular problem with ultrasound is that of consistency and training. It is necessary to have the ultrasound scanning carried out by a highly trained sonographer, who is able to properly control the ultrasound probe and interpret the results correctly. This necessarily introduces a subjective component to the test, and also means that repeated tests could be variable and potentially inconsistent. As such, at present the use of ultrasound is limited to a few centres where high expertise is maintained by high throughput and training.
  • a support apparatus for an ultrasound probe head comprising a support arm, the support arm being adjustable and having an ultrasound probe head mount to receive an ultrasound probe head, the ultrasound probe head mount comprising a resilient holder to receive an ultrasound probe head, and an actuator to controllably move the ultrasound probe head mount.
  • the ultrasound probe head mount may hold a probe in a downwardly directed position.
  • the actuator may be operable to move the ultrasound probe head mount in a substantially horizontal direction
  • the support part may be vertically adjustable.
  • the resilient holder of the ultrasound probe head mount may comprise a deformable material to permit movement of the probe head [10]
  • the deformable material may comprise a foam material.
  • the support apparatus may further comprise an operator control to control movement of the ultrasound probe head mount.
  • an ultrasound apparatus comprising a support apparatus according to the first aspect of the invention and an ultrasound system, the ultrasound system comprising an ultrasound probe head and an ultrasound controller connected to the ultrasound probe head, wherein the ultrasound probe head is supported by the ultrasound probe head mount.
  • the ultrasound controller may be operable to take ultrasound images at physically spaced intervals.
  • the spaced intervals may be approximately 1 mm intervals.
  • a method of scanning the temporal artery of a patient using an ultrasound apparatus comprising adjusting the support arm such that the ultrasound probe head is located over the temporal artery, operating the actuator to move the ultrasound probe head, and operating the ultrasound controller to capture a plurality of spaced images.
  • Figure 1 is a side view of an apparatus embodying the present invention
  • Figure 2 is a front view of the apparatus of figure 1
  • Figure 3 is an image of part of the apparatus of figure 1 in use showing an ultrasound probe support head
  • Figure 4 is a flow chart illustrating a method of use of the apparatus of figure 1
  • Figure 5 is a diagram of an alternative apparatus embodying the present invention. Detailed Description of the Preferred Embodiments
  • a support apparatus is shown at 10 in figure 1 and an ultrasound apparatus is generally shown at 100 in figure 2 including the support apparatus 10.
  • the ultrasound apparatus 100 comprises an ultrasound system which has an ultrasound probe head 11 and a controller 12, and an operator control 13, as will be discussed in more detail below.
  • the ultrasound probe head 11 is connected to the controller 12 by a suitable cable generally shown at 14.
  • the support apparatus 10 comprises an upright 20 mounted on a base 21.
  • base 21 may be provided with wheels or castor to enable easy repositioning of the apparatus.
  • a support arm is shown generally at 22, in this example comprising a profiled beam for easy attachment and connection to various parts of the apparatus, but it will be apparent that the support arm 22 may be constructed as desired.
  • a bracket 23 is slidably mounted on the upright 20 and is vertically movable by means of adjustment element 24.
  • the adjustment element 24 comprises a threaded rod rotatably received in a threaded aperture in the bracket 23 and a manually adjustable handle 25 at a top end thereof to permit the adjustment of the height of bracket 23 and support arm 22.
  • the support arm 22 may be fixedly mounted to bracket 23 or may be slidably movable relative thereto, or may be rotatably mounted, for example about an axis substantially perpendicular to the upright 20, to allow for rotation in the plane of the image of figure 2.
  • the ultrasound probe head support comprises a base part 30 provided with means for connection to the arm 22, provided at each and with walls 31, 32 extending outwardly from the base 30.
  • Actuator rod 33 extends between and is supported by walls 31, 32 and is able to rotate relative thereto.
  • Actuator 34 is connected to the actuator rod 33 and is fixed to the end wall 32.
  • the actuator 34 in this example comprises an electric motor controllable through the operator control 13, to rotate the actuator rod 33.
  • An ultrasound probe head mount is shown provided at 35.
  • ultrasound probe head mount 35 is supported on and movable relative to the base 30, and has a threaded aperture (not shown) to receive the actuator rod 33. Operation of the actuator 34 causes rotation of the rod 33 and linear movement of the ultrasound probe head mount 35 in a direction parallel to the support arm 22.
  • the ultrasound probe head mount 35 comprises a C-shaped block 36 supported on a travelling mount 37 which is slidably movable on rails 38 and which engages the actuator rod 33.
  • the block 36 has a shaped deformable element 39 which holds the ultrasound probe head 11 at a desired general orientation and position whilst allowing a degree of vertical movement.
  • the deformable element 39 may comprise a suitable foam material.
  • the deformable element may be shaped to accommodate ultrasound probe heads from different manufacturers.
  • the ultrasound probe head is held in place by flexible straps 40 extending between suitable loops 41, sufficient to hold the ultrasound probe head 11 in place while still permitting a degree of vertical movement.
  • the ultrasound probe head mount 35 should preferably allow for movement of the ultrasound probe head 11 to accommodate variations in the patient anatomy and bone structure, during lateral movement of the ultrasound probe head as discussed below, while still allowing the ultrasound probe head 11 to be maintained with the appropriate orientation and degree of contact. Any other resilient mount may be used, such as a spring-biased mechanical connection between the block 36 and ultrasound probe head 11.
  • the actuator 34 can cause the ultrasound probe head mount 35 and hence the ultrasound probe head 11 to move in a straight line, at a constant speed, whilst the ultrasound controller 12 takes a series of images at appropriate intervals, which may be equal or otherwise.
  • the images are physically spaced by 1 mm, but other spatial and temporal distribution of the images can be selected as desired.
  • the spacing of the images can be determined by simply capturing images at a given time interval, assuming the speed of the ultrasound probe head mount 35 is known, or there may be a position sensor provided on the ultrasound probe head support which is connected to the controller 12 to indicate when images should be captured, or any other suitable trigger responsive to operation of the actuator 34 or the ultrasound probe head mount 35.
  • the controller 12 may be operable to control movement the actuator 34 to move the probe head mount 35 to a desired position, and then capture an image when the ultrasound probe head is stationary.
  • the controller 12 may be operable to analyse the captured images, or the images may be supplied to a separate analysis system for concurrent or subsequent review, using any suitable approach.
  • GCA giant cell arteritis
  • one potential approach is using machine learning techniques based on known images and documented cases held in a suitable database and to use ultrasound images to characterise the findings in the tissue surrounding the blood vessel walls as well as changes to blood flow through the vessel or changes in vessel characteristics such as stenosis (narrowing), occlusion or widening.
  • Characteristics of a temporal artery with vasculitis include a dark halo around the artery wall with a width of approximately 0.3-0.4 mm, which is a specific indicator.
  • stenosis Other features, such as an increase in the blood flow, presence of turbulence, and aliasing are indirect signs of stenosis, which may be correlated to inflammation of the arteries (vasculitis) but are less specific. When the disease is very severe an occlusion of the artery may occur. In an axillary artery with vasculitis, a dark halo around the artery wall with a width greater than 1.5 mm is a definite halo and greater had 1.0 mm represents a possible halo. Other features, such as the presence of stenosis and occlusions may occur due to the vasculitis.
  • a program can then automatically identify features from the images which, statistically, best describe and demarcate both positive and negative cases of GCA. From this database, a generalised machine learned rule can be applied to future scans, for example in a similar way to known face detection algorithms.
  • step 50 the operator positions the patient and ultrasound device, and starts operation of the apparatus 100.
  • the controller 12 or operator control 13 operates the actuator 34 to move the ultrasound probe head 11.
  • the controller 12 captures an image from the ultrasound probe head 11 and stores it, as shown at step 53.
  • step 54 if the scan is not complete the actuator 34 is further operated and a further image captured as discussed above.
  • step 55 once the scan is complete, the captured images can be analysed, for example using reference images or analysis rules held in a database 56.
  • FIG. 10 An alternative support apparatus is shown at 10' in figure 5.
  • the apparatus 10' comprises a flexing arm 60.
  • the flexing arm 60 has a first arm section 61 and a second arm section 62 connected through an elbow joint 63.
  • a first end section 64 pivotally supports the first arm section 61 and has a mount 65 to enable the apparatus 10' to be secured to a suitable support.
  • Second end section 66 supports a resilient probe head support 67 to hold an ultrasound probe head 11.
  • the elbow joint 63 may include interconnections so that the angles between the elbow joint 63 and first arm section 61, and between the elbow joint 63 and second arm section 64, remain equal, and the orientation of the second end section 66 and hence the ultrasound probe head 11 remains constant throughout movement of the arm 60.
  • the arm 60 may be mounted to pivot about a vertical axis through mount 65, and the probe head support may be rotatable about a generally horizontal axis.
  • one or more suitable actuators may be provided to control the movement and positioning of the arm 60 and probe head support 67.
  • the patient is placed on a patient support surface in a suitable posture, this example recumbent with the head turned to one side.
  • Gel or a gel pad is applied to the patient's skin to ensure that there is a sufficient layer to prevent discomfort, but also to allow good contact with the probe as it moves up or down (distally or proximally) along the length of the artery.
  • the support arm 22 is adjusted using bracket 23 to position the ultrasound probe head support 26 at an appropriate and comfortable height.
  • the ultrasound probe head 11 is located at the start of the patient's left temporal artery.
  • the actuator 34 can cause the ultrasound probe head mount 35 and hence the ultrasound probe head 11 to move in a straight line, at a constant speed, whilst the ultrasound controller 12 takes a series of images at appropriate intervals.
  • the images are physically spaced by 1 mm, but other spatial and temporal distribution of the images can be selected as desired.
  • the spacing of the images can be determined by simply capturing images at a given time interval, assuming the speed of the ultrasound probe head mount 35 is known, or there may be a position sensor provided on the ultrasound probe head support which is connected to the controller 12 to indicate when images should be captured, or any other suitable trigger responsive to operation of the actuator 34 or the ultrasound probe head mount 35.
  • the support apparatus thus allows an operator to position the ultrasound probe 11 in the optimal place to acquire images of the artery, either at the most proximal position, just in front of the ear, or over the temple, above the ear.
  • the operator would need to hold the probe manually and then move it along the course of the artery at a steady pace in order to acquire images and video along the length of the vessel. It is not easy to manually move the probe at a set pace whilst keeping the probe in a linear path, as well as ensuring that the probe is kept in constant contact with the gel with the same amount of pressure, and allowing for variation in facial contours. If the probe is pressed too lightly, the signal is lost or distorted.
  • the actuator 34 can be set to move the ultrasound probe head 11 at a fixed rate in a straight line.
  • the movement of the probe head is thus standardized, and will be consistent each time the support apparatus is used.
  • the examples of the support apparatus shown above move the probe head in a substantially horizontal direction, it will be apparent that the support apparatus may be configured or positioned to provide movement of the probe head in an inclined or substantially vertical direction as most suitable for the particular target area to be scanned.
  • the resilient mount which means that when the probe is placed against the patient's skin, slight pressure is exerted by the support apparatus onto the probe head, so that any contours of the patients head and face are followed closely. This ensures that the probe head remains in contact with the gel or gel pad and that the image obtained is adequate throughout the length of the artery.
  • a further advantage is that the image data can be transformed into a 3-dimensional view. This would allow information about abnormalities that are either symmetrically or asymmetrically distributed along the length of the artery to be recorded.
  • Use of the support apparatus means that scans can be repeated, such that it is possible to reproducibly measure the same area of artery so any changes in response to treatment given can be assessed.
  • the 3-D information may be used for determining further risks to the patient, particularly of developing complications from GCA, either in the short term (e.g. loss of vision or stroke) or the long term (e.g. risk of aortic aneurysms in the future).
  • Example of other uses of the apparatus can include scans of hand and wrist joints. For the assessment of the hand joints, each hand is scanned separately. The palmar surface of the hand will be faced down and a layer of gel applied to the metacarpophalangeal joints (MCPs), and proximal and distal interphalangeal joints (PIPs and DIPs) to allow the contours of the joints to become more harmonized and easier to scan.
  • MCPs metacarpophalangeal joints
  • PIPs and DIPs proximal and distal interphalangeal joints
  • the apparatus is then controlled to make the probe move in a horizontal direction from the lateral to the medial region of the hand. Initially, it will place the probe on the 5th MCP longitudinally across the joint space and it will scan towards the 1st MCP in a linear movement. This will be repeated 4 times, taking approximately 3 minutes per sweep.
  • the probe will then move to the PIPs and the same procedure will be performed. Depending on the condition to be assessed, the probe may also be moved to the DIPs. For each joint the initial 2 longitudinal scans will only be done using B- Mode to assess grey scale synovitis, and the other two longitudinal scans will be performed using power Doppler to assess the presence of active inflammation or synovitis.
  • a transverse scanning of the hand joints can also be performed, as follows. After the longitudinal scanning, the probe will be placed again on the 5th MCP, but now on a transverse plane over the joint, and trough the mechanical arm, the probe will be moved distally towards the 5th PIP (or DIP, depending on the disease assessed). This linear movement will be repeated 2 times only using B-mode and taking approximately 1 minute per sweep. The same procedure will be repeated on the rest of the fingers.
  • the mechanical arm will place the probe transversely at the wrist crease, and will allow some tilting of the probe, back and forth, to optimize depiction of the soft-tissues contained within the carpal tunnel. It will then move proximately, to the musculo-tendinous junctions, and distally to the tendons insertions. This movement will allow the evaluation of the medium nerve, assessing the presence of the common carpal tunnel syndrome, and the ulnar nerve, assessing its integrity. The apparatus will then be rotated to move the probe to a longitudinal view and perform two sweeps to assess the integrity of the tendons and surrounding structures.
  • Other vessels such as the carotid, vertebral, axillary, subclavian, humeral, radial, ulnar, femoral, anterior and posterior tibial and peroneal arteries, as well as the abdominal aorta, could also be scanned to diagnose and monitor large-vessel vasculitis or other disorders of the vessels such as atherosclerosis, fibromuscular dysplasia, heritable disorders of connective tissue (e.g. Marian ' s syndrome), etc.
  • This automated ultrasound system could also be used to screen for and monitor abdominal aortic aneurysms in asymptomatic people at risk of developing aneurysms (such as men aged 65 and over) and in patients with known large- vessel vasculitis.
  • This apparatus may also be used to scan elbows (humeroradial, humeroulnar, proximal radioulnar joints), feet (mid-tarsal, intertarsal, tarsometatarsal, intermetatarsal, metatarsophalangeal and proximal and distal interphalangeal joints), ankles (talocrural, subtalar and inferior tibiofibular joints) and knees (tibiofemoral and patellofemoral joints) to assess the bone surfaces, cartilage, soft tissue and fluid-containing structures, allowing the diagnosis and monitoring of inflammatory arthropathies, such as rheumatoid arthritis or psoriatic arthritis, osteoarthritis, crystal associated arthropathies and others.
  • tendons, ligaments, enthesis and muscles of the lower and upper limbs could be evaluated, looking for an inflammatory process or tear. Injuries and compression of peripheral nerves, could also be assessed through this scanning device.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Vascular Medicine (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

La présente invention concerne un appareil de support pour une tête de sonde à ultrasons, l'appareil de support comprenant un bras de support, le bras de support étant réglable et ayant une monture de tête de sonde à ultrasons destinée à recevoir une tête de sonde à ultrasons, la monture de tête de sonde à ultrasons comprenant un élément de retenue élastique destiné à recevoir une sonde à ultrasons, et un actionneur pour déplacer de façon contrôlable la monture de tête de sonde à ultrasons.
PCT/IB2016/053488 2015-06-17 2016-06-14 Appareil de support Ceased WO2016203361A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB1510663.6A GB201510663D0 (en) 2015-06-17 2015-06-17 Support apparatus
GB1510663.6 2015-06-17

Publications (1)

Publication Number Publication Date
WO2016203361A1 true WO2016203361A1 (fr) 2016-12-22

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Family Applications (1)

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PCT/IB2016/053488 Ceased WO2016203361A1 (fr) 2015-06-17 2016-06-14 Appareil de support

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GB (1) GB201510663D0 (fr)
WO (1) WO2016203361A1 (fr)

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH11239578A (ja) * 1997-12-17 1999-09-07 Nippon Koden Corp 三次元位置校正器および校正方法
JP2005143783A (ja) * 2003-11-14 2005-06-09 Aloka Co Ltd 超音波探触子ホルダおよび超音波探触子保持装置
WO2005104729A2 (fr) * 2004-04-26 2005-11-10 U-Systems, Inc. Balayage a ultrasons polyvalent du sein
US20050261572A1 (en) * 2004-05-20 2005-11-24 Babaliaros Vasilis Constantino Limb stabilizer for ultra sound detector
WO2007047506A2 (fr) * 2005-10-17 2007-04-26 Dartmouth-Hitchcock Clinic Systeme de stabilisation et de positionnement biomedical
US20080249403A1 (en) * 2007-04-04 2008-10-09 Suri Jasjit S Tracker holder assembly
US20140194740A1 (en) * 2013-01-07 2014-07-10 Cerebrosonics, Llc Emboli detection in the brain using a transcranial doppler photoacoustic device capable of vasculature and perfusion measurement
WO2015021304A2 (fr) * 2013-08-07 2015-02-12 Cibiem, Inc. Ablation de corps carotidien par énergie dirigée
US20150201900A1 (en) * 2012-01-25 2015-07-23 Mubin I. Syed Multi-pane imaging transducer associated with a guidewire

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH11239578A (ja) * 1997-12-17 1999-09-07 Nippon Koden Corp 三次元位置校正器および校正方法
JP2005143783A (ja) * 2003-11-14 2005-06-09 Aloka Co Ltd 超音波探触子ホルダおよび超音波探触子保持装置
WO2005104729A2 (fr) * 2004-04-26 2005-11-10 U-Systems, Inc. Balayage a ultrasons polyvalent du sein
US20050261572A1 (en) * 2004-05-20 2005-11-24 Babaliaros Vasilis Constantino Limb stabilizer for ultra sound detector
WO2007047506A2 (fr) * 2005-10-17 2007-04-26 Dartmouth-Hitchcock Clinic Systeme de stabilisation et de positionnement biomedical
US20080249403A1 (en) * 2007-04-04 2008-10-09 Suri Jasjit S Tracker holder assembly
US20150201900A1 (en) * 2012-01-25 2015-07-23 Mubin I. Syed Multi-pane imaging transducer associated with a guidewire
US20140194740A1 (en) * 2013-01-07 2014-07-10 Cerebrosonics, Llc Emboli detection in the brain using a transcranial doppler photoacoustic device capable of vasculature and perfusion measurement
WO2015021304A2 (fr) * 2013-08-07 2015-02-12 Cibiem, Inc. Ablation de corps carotidien par énergie dirigée

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
SCHMIDT W A ET AL: "What the practising rheumatologist needs to know about the technical fundamentals of ultrasonography", BAILLIERE'S BEST PRACTICE AND RESEARCH. CLINICAL REUMATOLOGY, BAILLIERE TINDALL, LONDON, GB, vol. 22, no. 6, 1 December 2008 (2008-12-01), pages 981 - 999, XP025689633, ISSN: 1521-6942, [retrieved on 20081127], DOI: 10.1016/J.BERH.2008.09.013 *

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