초록 ▼

An instrument guide is described for mounting an invasive instrument such as a biopsy needle to an imaging probe, controlling its position, monitoring its position, and/or predictively displaying its position on a user display of the medical imaging system. A plurality of substantially rigid segment

An instrument guide is described for mounting an invasive instrument such as a biopsy needle to an imaging probe, controlling its position, monitoring its position, and/or predictively displaying its position on a user display of the medical imaging system. A plurality of substantially rigid segments are hingeably connected to the probe, to an instrument handle, and to each other such that movement of the biopsy needle is restricted to within the imaged plane. However, substantial freedom of movement within the imaged plane is provided such that the instrument may be inserted into the patient over a wide range of angles. In one preferred embodiment, angle detectors are provided at each segment intersection and measurements provided for computing and displaying the instrument position and orientation on the user display. The instrument guide/position monitor is preferably made with low-cost components such that it is disposable after a single use. A predictive user display is provided in which the throw of a spring-loaded instrument is shown on the user display, the throw corresponding to the space that the instrument will occupy after a spring trigger is activated.

대표청구항 ▼

An instrument guide is described for mounting an invasive instrument such as a biopsy needle to an imaging probe, controlling its position, monitoring its position, and/or predictively displaying its position on a user display of the medical imaging system. A plurality of substantially rigid segment

An instrument guide is described for mounting an invasive instrument such as a biopsy needle to an imaging probe, controlling its position, monitoring its position, and/or predictively displaying its position on a user display of the medical imaging system. A plurality of substantially rigid segments are hingeably connected to the probe, to an instrument handle, and to each other such that movement of the biopsy needle is restricted to within the imaged plane. However, substantial freedom of movement within the imaged plane is provided such that the instrument may be inserted into the patient over a wide range of angles. In one preferred embodiment, angle detectors are provided at each segment intersection and measurements provided for computing and displaying the instrument position and orientation on the user display. The instrument guide/position monitor is preferably made with low-cost components such that it is disposable after a single use. A predictive user display is provided in which the throw of a spring-loaded instrument is shown on the user display, the throw corresponding to the space that the instrument will occupy after a spring trigger is activated. g information concerning at least one of fetal abdominal circumference, fetal head circumference, fetal biparietal diameter, fetal femur length, and fetal sex. 10. The method of claim 1 wherein requesting information concerning at least one ultrasonographically measured physical dimension includes determining the presence or absence of information concerning at least one ultrasonographically measured physical dimension and wherein estimating birth weight includes, in response to determining the absence of at least one ultrasonographically measured physical dimension, estimating birth weight based on maternal characteristics only. 11. The method of claim 1 wherein steps (a)-(d) are performed manually. 12. The method of claim 1 comprising requesting information regarding paternal characteristics and wherein estimating birth weight of the fetus includes estimating birth weight based on information obtained regarding paternal characteristics in addition to the information concerning maternal and at least one ultrasonographically measured physical dimension. 13. The method of claim 1 comprising outputting a number on a computer display device, the number being the fetal birth weight estimate. 14. The method of claim 1 comprising outputting a range of birth weights with an associated degree of confidence. 15. The method of claim 1 comprising outputting an array of birth weights corresponding to an array of potential target dates of delivery. 16. The method of claim 1 comprising outputting an array of ranges of birth weights associated with a specified degree of confidence for an array of potential target dates of delivery. 17. The method of claim 1 comprising outputting a confidence interval associated with the selected multivariable birth weight estimation equation, the confidence interval indicating a range of birth weights into which the calculated birth weight is expected to fall and a probability associated with that range. 18. The method of claim 1 wherein the equations are adapted to estimate birth weight at a gestational age that is remote from a predicted delivery date. 19. A method for predicting risk of fetal macrosomia, the method comprising: (a) requesting information concerning maternal physical characteristics for a fetus for which risk of macrosomia is to be estimated; (b) requesting information concerning maternal medical conditions for a fetus for which risk of macrosomia is to be estimated; (c) requesting information concerning maternal laboratory results using maternal blood for a fetus for which risk of macrosomia is to be estimated; (d) requesting information concerning at least one ultrasonographically measured physical dimension of the fetus for which risk of macrosomia is to be estimated; and (e) estimating the risk of macrosomia for the fetus based on information obtained in response to steps (a)-(d), wherein estimating the risk of macrosomia includes selecting, from a plurality of multivariable birth weight estimation equations for calculating birth weight as a function of gestational age for a particular individual, the most accurate equation for which birth weight can be calculated using available information obtained in response to (a)-(d), and calculating the risk of macrosomia based on the estimated birth weight using the selected equation. 20. The method of claim 19 wherein requesting information concerning maternal physical characteristics, maternal medical conditions, maternal laboratory results, and the information concerning at least one ultrasonographically measured physical dimension of the fetus includes presenting a user with a questionnaire requesting the information. 21. The method of claim 20 wherein presenting a user with a questionnaire includes serving the questionnaire from a server to a client over a computer network. 22. The method of claim 20, wherein presenting the user with a questionnaire includes presenting the user with a questionnaire on a handheld computer. 23. The m ethod of claim 20 wherein presenting the user with a questionnaire includes presenting the user with a questionnaire on a personal computer. 24. The method of claim 20 wherein presenting the user with a questionnaire includes presenting a user with software for execution on a computer associated with an ultrasound device. 25. The method of claim 20 wherein presenting the user with a questionnaire includes presenting a user with a user interface over the Internet. 26. The method of claim 20 wherein the equations are adapted to estimate birth weight at a gestational age that is remote from a predicted delivery date. 27. The method of claim 19 wherein requesting information concerning maternal characteristics includes requesting information regarding maternal race, expected due date, and maternal illnesses, in addition to at least one of pre-pregnancy maternal weight, maternal weight during pregnancy, prior pregnancies, hemoglobin concentration, glucose screening test result, and altitude. 28. The method of claim 19 wherein requesting information concerning at least one ultrasonographically measured physical dimension includes requesting information concerning at least one of fetal abdominal circumference, fetal head circumference, fetal biparietal diameter, fetal femur length, and fetal sex. 29. The method of claim 19 wherein requesting information concerning at least one ultrasonographically measured physical dimension includes determining the presence or absence of information concerning at least one ultrasonographically measured physical dimension wherein estimating fetal macrosomia includes, in response to determining the absence of at least one ultrasonographically measured physical dimension, estimating fetal macrosomia based on maternal characteristics only. 30. The method of claim 19 comprising performing steps (a)-(d) manually. 31. The method of claim 19 comprising obtaining information regarding paternal characteristics and wherein estimating risk of macrosomia of the fetus includes estimating risk of macrosomia based on the information regarding paternal characteristics in addition to the information concerning maternal and at least one ultrasonographically measured fetal physical dimension. 32. The method of claim 19 comprising outputting on a computer display device, an indicator of the risk of macrosomia. 33. The method of claim 32 wherein the indicator represents the presence or absence of macrosomia. 34. The method of claim 32 wherein the indicator represents a percentage risk of macrosomia. 35. The method of claim 19 comprising outputting a confidence interval associated with the selected multivariable birth weight estimation equation, the confidence interval indicating a range of birth weights into which the calculated birth weight is expected to fall and a probability associated with that range. 36. A computer program product comprising computer-executable instructions embodied in a computer-readable medium for performing steps comprising: (a) requesting information concerning maternal physical characteristics for a fetus; (b) requesting information concerning maternal medical conditions for a fetus; (c) requesting information concerning maternal laboratory results using maternal blood for the fetus; (d) obtaining information concerning at least one ultrasonographically measured physical dimension of the fetus; and (e) estimating at least one of birth weight, a range of birth weights, confidence intervals, and risk of macrosomia for the fetus based on information obtained in response to steps (a)-(d), wherein estimating birth weight, range of birth weights, confidence intervals and risk of macrosomia includes selecting, from a plurality of multivariate birth weight estimation equations for calculating birth weight for a particular individual as a function of gestational age, the most accurate equation for Which birth weight can be calculated using available information obtained in response to steps (a)- (d) and calculating the birth weight using the selected equation. 37. The computer program product of claim 36 wherein requesting information concerning maternal physical characteristics, maternal medical conditions, maternal laboratory results, and the information concerning ultrasonographically measured physical dimensions of the fetus includes presenting a user with a questionnaire requesting the information. 38. The computer program product of claim 37 wherein presenting a user with a questionnaire includes presenting the questionnaire from a server to a client over a computer network. 39. The computer program product of claim 37 wherein presenting the user with a questionnaire includes presenting the user with a questionnaire on a handheld computer. 40. The computer program product of claim 37 wherein presenting the user with a questionnaire includes presenting the user with a questionnaire on a personal computer. 41. The computer program product of claim 37 wherein presenting the user with a questionnaire includes presenting a user with software for execution on a computer associated with an ultrasound device. 42. The computer program product of claim 37 wherein presenting the user with a questionnaire includes presenting the user with a user interface over the Internet. 43. The computer program product of claim 36 wherein requesting information concerning maternal characteristics includes requesting information regarding maternal race, expected due date, and maternal illnesses, in addition to at least one of pre-pregnancy maternal weight, maternal weight during pregnancy, prior pregnancies, hemoglobin concentration, glucose screening test result, and altitude. 44. The computer program product of claim 36 wherein requesting information concerning at least one ultrasonographically measured physical dimension includes requesting information concerning least one of fetal abdominal circumference, fetal head circumference, fetal biparietal diameter, fetal femur length, and fetal sex. 45. The computer program product of claim 36 wherein requesting information concerning at least one ultrasonographically measured physical dimension includes determining the presence or absence of information concerning at least one ultrasonographically measured physical dimension and wherein estimating birth weight includes, in response to determining the absence of at least one ultrasonographically measured physical dimension, estimating birth weight based on maternal characteristics only. 46. The computer program product of claim 36 wherein estimating birth weight of a fetus includes estimating birth weight with an accuracy of at least about 8.5%. 47. The computer program product of claim 35 comprising requesting information regarding paternal characteristics and wherein estimating birth weight of the fetus includes estimating birth weight based on information obtained regarding paternal characteristics in addition to information obtained concerning maternal and at least one ultrasonographically measured physical dimension. 48. The computer program product of claim 35 comprising outputting a number on a computer display device, the number being the fetal birth weight estimate. 49. The computer program product claim 35 comprising outputting on a computer display device, an indicator of the risk of macrosomia. 50. The computer program product of claim 49 wherein the indicator represents the presence or absence of macrosomia. 51. The computer program product claim 49 wherein the indicator represents a percentage risk of macrosomia. 52. The computer program product of claim 36 comprising outputting a confidence interval associated with the selected multivariable birth weight estimation equation, the confidence interval indicating a range of birth weights into which the calculated birth weight is expected to fall and a probability associated with that range. 53. The computer program product of claim 36 wherein the equations are adapted to estimat