United States Patent
`
`
`Grady
`
`
`[19]
`
`[54] BIPLANAR VARIABLE ANGLE X-RAY
`
`
`
`
`
`EXAMINING APPARATUS
`
`
`
`[76]
`
`
`
`Inventor:
`
`
`
`
`
`
`
`
`John K. Grady, 111 Slough Rd.,
`Harvard, Mass. 01451
`
`
`
`
`
`
`[21] Appl.No.: 376,109
`
`
`
`
`[22] Filed:
`May 7,1932
`
`Related U.S. Application Data
`
`
`
`
`
`
`
`
`
`
`Continuation-in-part of Ser. No. 67,605, Aug. 20, 1979,
`abandoned, and a continuation-in-part of Ser. No.
`
`
`
`
`
`
`148,298, May 9, 1980, abandoned.
`'
`
`
`
`
`
`Int. Cl.3 .............................................. .. A6lB 6/00
`
`
`
`
`
`.............. .. 378/196; 378/62
`
`
`
`Field of Search ............. .. 378/196, 190, 179, 197,
`
`
`
`
`
`
`
`378/174, 181, 41, 42, 62, 9, 6, 87, 89
`
`
`
`
`
`
`
`
`References Cited
`
`
`U.S. PATENT DOCUMENTS
`
`
`
`5/1974 Clarke et al.
`....................... .. 378/89
`
`
`
`
`
`[63]
`
`[56]
`
`
`
`
`
`[1 1]
`
`[45]
`
`
`4,426,725
`
`
`
`Jan. 17, 1984
`
`[57]
`
`
`
`
`
`Primmy Examiner—Alfred E. Smith
`
`
`
`
`
`Assistant Examiner—T. N. Grigsby
`Attorney, Agent, or Fz'rm——James H. Grover
`
`
`
`
`ABSTRACT
`
`
`X-ray apparatus is shown in which there are two radio-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`logical sets, each set including an X—ray tube and radia-
`
`
`
`
`
`
`
`
`tion receptor (e.g., film holder or image intensifier) and
`means supporting them on a common radiation axis.
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`The two radiation axes of the respective radiological
`
`
`
`
`
`
`
`
`
`
`sets intersect at an isocenter at which the subject of
`
`
`
`
`
`
`
`
`examination, e.g., the human heart, may be located; and
`
`
`
`
`
`
`
`
`at least one set is rotatable on a rotation axis through the
`isocenter and perpendicular to the radiation axes inde-
`
`
`
`
`
`
`
`pendently of, and relative to, the radiation axis of the
`
`
`
`
`
`
`
`
`
`
`other set. One or both of the sets may be retracted from
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`alignment with the isocenter without disturbing the
`
`
`
`
`
`
`
`
`patient to allow unobstructed access and both sets may
`
`
`
`be independently rotatable.
`
`3.809.904
`
`
`
`
`
`
`
`
`
`23 Claims, 15 Drawing Figures
`
`
`
`
`
`Page 1 of 16
`
`Elekta Exhibit 1013
`
`Page 1 of 16
`
`Elekta Exhibit 1013
`
`

`
`US. Patent
`
`
`Jan. 17, 1984
`
`
`
`
`
`
`Sheet 1 of 9
`
`
`
`4,426,725 I
`
`
`
`
`
`
` 45"’
`
`
`
`
`
`
`
`
`
`
`
` FlG.|
`
`
`
`
`
`Page 2 of 16
`
`Page 2 of 16
`
`

`
`
`
`US. Patent
`
`
`
`
`Jan. 17, 1984
`
`Sheet 2 of9
`
`
`4,426,725
`
`
`
`
`
`
`
`F|G.2
`
`
`
`Page 3 of 16
`
`Page 3 of 16
`
`

`
`US. Patent
`
`
`
`Jan. 17, 1984
`
`
`
`
`Sheet 3 of9
`
`
`‘
`
`
`4,426,725
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`Page 4 of 16
`
`Page 4 of 16
`
`

`
`U.S. Patent
`
`Jan. 17, 1984
`
`Sheet 4 of9
`
`4,426,725
`
`.,I%II‘.1
`
`Page 5 of 16
`
`Page 5 of 16
`
`

`
`
`US. Patent
`
`
`
`
`
`Jan. 17, 1984
`
`
`
`Sheet 5 of9
`
`
`
`4,426,725
`
`
`
`
`
`
`
`
`
`Page 6 of 16
`
`Page 6 of 16
`
`

`
`US. Patent
`
`
`
`Jan. 17, 1984
`
`
`
`
`Sheet 6 of9
`
`
`
`
`4,426,725
`
`
`
`
`
`mdmow
`
`pom<4o
`
`.\.A_%4.Ifl\!!flI!Ear4><»!fl!ifl4<
`
`mzw
`
`
`
`
`.ma
`
`Ff<¢_m
`
`«ma
`
`".lI||I.| lFy
`
`._._._.._.........._.:..r........:_____m
`3......%....._j
`
`
`
`NNN_NN<®_N
`
`§
`
`NON
`
`sow
`
`Iflll.
`Tr/ll
`I3aw;
`
`am_-S._~..
`
`El:
`
`Page 7 of 16
`
`Page 7 of 16
`
`
`
`
`
`

`
`US. Patent
`
`
`
`
`Jan. 17, 1984'
`
`
`
`
`Sheet 7 of9
`
`
`
`
`4,426,725
`
`
`
`257
`
`
`
`A
`
`4+“?
`
`
`
`.. U
`..
`;
`.
`
`
`
`
`
`X:1
`
`
`
`
`
`
`
`
`
`
`
`
`
`N giiu.
`
`
`
`
`
`
`
`
`
`
`Page 8 of 16
`
`Page 8 of 16
`
`

`
`U.S. Patent
`
`
`
`
`Jan. 17, 1984
`
`
`
`
`
`Sheet 8 of9
`
`
`
`
`4,426,725
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`Page 9 of 16
`
`Page 9 of 16
`
`

`
`US. Patent
`
`
`
`Jan. 17, 1984
`
`
`
`
`Sheet 9 of9
`
`
`
`
`4,426,725
`
`
`
`
`
`(-) “‘—"> H-)
`
`2|7A
`
`.
`
`._ .
`
`‘
`
`228
`
` ""3iiii“iIIII!I.!_-.!u.!i!.!!
`
`nunIIIIIIlI‘IlIlIlIIfl!!!.flm
`
`
`
`
`
`
`2'6A | (+)<6é-V (‘-9
`
`L EFT
`S L
`
`H
`"N
`01% O\ 2' \
`
`(+1
`
`‘
`
`
`
`Page 10 of 16
`
`Page 10 of 16
`
`

`
`1
`
`BIPLANAR VARIABLE ANGLE X-RAY
`
`
`
`EXAMINING APPARATUS
`
`
`
`
`
`4,426,725
`
`
`2
`
`radiation axis; and a second radiological examining set
`
`
`
`
`
`
`
`including second radiation source means, second radia-
`
`
`
`
`
`
`
`tion receptor means and second support means for hold-
`
`
`
`
`
`
`
`
`ing the second source and receptor means on a second
`
`
`
`
`
`
`
`
`radiation axis aligned to intersect the first radiation axis
`
`
`
`
`
`
`
`
`at an isocenter, the first support means being rotational
`
`
`
`
`
`
`
`
`independently of the second support means about an
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`axis intersecting‘ the isocenter; whereby a series of sub-
`stantially simultaneous radiological examinations can be
`
`
`
`
`
`made on both radiation axes through the subject at
`
`
`
`
`
`
`
`
`variable angles between the radiation axes.
`
`
`
`
`
`
`Further, according to the invention,
`the support
`
`
`
`
`
`
`
`means for one radiation source or receptor means in a
`
`
`
`
`
`
`
`set is movable independently of the support means for
`
`
`
`
`
`
`
`the other radiation means in the same set and includes
`
`
`
`
`
`
`
`
`
`means guiding the independent movement of the sup-
`
`
`
`
`
`
`
`port means on a path from a position of the radiation
`
`
`
`
`
`
`
`
`means in alignment with the isocenter to a position
`
`
`
`
`
`
`
`remote from the isocenter and freeing access to a sub-
`
`
`
`
`
`
`
`
`ject at the isocenter.
`
`
`
`DRAWINGS
`
`10
`
`15
`
`
`
`25
`
`
`
`30
`
`35
`
`
`
`
`FIG. 1 is a side elevation of one form of radiological
`
`
`
`
`
`examining apparatus as shown in application Ser. No.
`
`
`
`
`
`67,605 now abandoned;
`
`
`
`FIG. 2 is an end view of the apparatus of FIG. 1;
`
`
`
`
`
`
`
`FIG. 3 is a side elevation of another form of radiolog-
`
`
`
`
`
`
`
`
`
`
`
`
`
`ical examining apparatus, partly broken away, as shown
`in application Ser. No. 148,298 now abandoned;
`
`
`
`
`
`
`
`FIG. 4 is an end View from lines II—II of FIG. 3;
`
`
`
`
`
`
`
`
`FIG. 5 is a plan View of the apparatus of FIG. 3,
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`partly broken away, and including a patient support
`table;
`
`FIG. 6 is an enlarged, sectional view of a portion of
`
`
`
`
`
`
`FIG. 5;
`
`FIG. 7 is an end elevation of a further form of radio-
`
`
`
`
`
`
`
`
`
`
`logical examining apparatus;
`FIG. 8 is a section on line 8-8 of FIG. 7;
`
`
`
`
`
`FIG. 9 is a section, enlarged on line 9-9 of FIG. 7;
`
`
`
`
`
`
`FIG. 10 is a section on line 10—10 of FIG. 9;
`
`
`
`
`
`FIG. 11 is an enlarged section on line 11-11 of FIG.
`
`
`
`
`
`’
`
`
`FIG. 12 is a schematic drawing of a counterweight-
`
`
`
`
`ing cable system on line 12-12 of FIG. 10;
`
`
`
`
`
`
`
`FIG. 13 is a section on line 13-13 of FIG. 10;
`
`
`
`
`
`
`FIGS. 14 and 15 are electrical diagrams of the cir-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`cuits controlling the motors driving the apparatus of
`FIG. 7.
`
`
`
`
`
`
`
`
`
`7:
`
`This application is a continuation in part of pending
`
`
`
`
`
`
`
`
`
`
`
`
`
`applications of John K. Grady, Ser. No. 67,605, filed
`Aug. 20, 1979 and now abandoned, entitled RADIO-
`
`
`
`
`
`
`
`
`LOGICAL X-RAY SYSTEM, and Ser. No. 148,298,
`
`
`
`
`
`
`
`filed May 9, 1980 and now abandoned, entitled RA-
`
`
`
`
`
`
`
`
`DIOLOGICAL SUPPORT APPARATUS.
`
`
`
`BACKGROUND OF THE INVENTION
`
`
`
`Some X-ray examining procedures can involve more
`
`
`
`
`
`
`
`than routine discomfort and hazards to a diagnostic
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`patient.
`In patients with coronary artery disease,
`oblique views of the right and left anterior ventricle are
`
`
`
`
`
`
`
`
`
`considered optimal for assessment of regional wall mo-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`tion. With equipment previously used, the patient was
`strapped to a cradle and a radiological examination on
`
`
`
`
`
`20
`one plane was made and then the patient was tilted on
`
`
`
`
`
`
`
`
`
`
`
`the cradle to provide for examination in the second
`
`
`
`
`
`
`
`
`plane. Such examinations are not desirable because the
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`procedure of tilting the patient to take biplanar views
`can be traumatic. In addition to the patient’s motional
`
`
`
`
`
`
`
`discomfort, the time required for a series of biplanar
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`X-ray exposures through the organ examined and the
`accumulation of X-ray dosage should be minimized.
`
`
`
`
`
`
`
`Also the amount’ of radiopaque or radioisotopic injected
`
`
`
`
`
`
`material must be minimized while maximizing the num-
`
`
`
`
`
`
`
`ber of exposures over a wide range of angles. For exam-
`
`
`
`
`
`
`
`
`ple,
`in radiological examination of the heart a radi-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`opaque liquid, toxic in large concentrations, is injected
`through a suitable arterial system for each X-ray expo-
`
`
`
`
`
`
`
`
`sure which must be made quickly. The injection toxic-
`
`
`
`
`
`
`
`
`ity, discomfort, and elapsed time can be reduced by one
`
`
`
`
`
`
`
`
`half by making two X-ray exposures simultaneously or
`
`
`
`
`
`
`in rapid sequence in two planes through the subject.
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`Apparatus for taking two biplanar X-ray exposures of a
`subject is shown in U.S. Pat. No. 3,459,885 to Ander-
`
`
`
`
`
`
`
`sson and U.S. Pat. No. 3,659,099 to Bertheau. While the
`
`
`
`
`
`
`
`
`
`apparatus of these patents simultaneous biplanar expo-
`
`
`
`
`
`
`sures of a subject at the intersection of the two axes, the
`
`
`
`
`
`
`
`
`two axes are fixed at a right angle to each other. Two
`
`
`
`
`
`
`
`
`
`biplanar exposures at right angles through a subject are
`
`
`
`
`
`
`
`45
`not always at the best or the necessary angle for useful
`
`
`
`
`
`
`
`
`
`examination of the subject. If the optimum angle or
`
`
`
`
`
`
`
`
`
`plane for one exposure is selected, the relatively fixed
`
`
`
`
`
`
`
`
`angle of the second exposure may be useless. Moreover,
`
`
`
`
`
`
`
`it is often desirable to repeat the exposure in one plane
`
`
`
`
`
`
`
`
`
`while changing the second exposure plane. Accord-
`
`
`
`
`
`
`
`ingly, one- object of the present invention is to provide
`
`
`
`
`
`
`
`
`apparatus for biplanar radiological examination on two
`
`
`
`
`
`
`
`
`
`
`
`
`
`axes through a common subject which permits adjust-
`ment of one axis relative to the other.
`
`
`
`
`
`
`Also, although it is possible to make fixed angle bipla-
`
`
`
`
`
`
`
`
`nar exposures with the apparatus of the Andersson and
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`Bertheau patents, both patentees recognize the problem
`of ready access to the patient through the two sets of
`
`
`
`
`
`
`
`
`
`
`X-ray equipment. It is a further object of the present
`
`
`
`
`
`
`
`
`60
`invention to permit freeaccess to the patient in biplane
`
`
`
`
`
`
`
`
`X-ray apparatus.
`SUMMARY OF THE INVENTION
`
`
`
`According to the invention, radiological apparatus
`
`
`
`
`
`for examination of a subject comprises a first radiologi-
`
`
`
`
`
`
`cal examining set including first radiation source means,
`
`
`
`
`
`
`
`first radiation receptor means and first support means
`
`
`
`
`
`
`
`
`for holding the first source and receptor means on a first
`
`
`
`
`
`
`
`
`
`
`40
`
`
`
`
`
`50
`
`
`
`55
`
`
`
`
`
`
`
`65
`
`DESCRIPTION ‘
`
`I—The Embodiment of FIGS. 1 and 2
`
`
`
`
`II—The Embodiment of FIGS. 3 to 6
`
`
`
`III—The Embodiment of FIGS. 7 to 15
`
`
`
`I—The Embodiment of FIGS. 1 and 2
`
`
`
`
`As shown in FIGS. 1 and 2, a patient P is disposed in
`
`
`
`
`
`
`a fixed position on a radiation-transparent table T. The
`
`
`
`
`
`
`patient is shown with his heart located at an isocenter C
`
`
`
`
`
`
`
`which is the intersection of an axis of rotation A1 of the
`
`
`
`
`
`
`radiological examining system and a common radiation
`
`
`
`
`
`
`axis A2 between an X-ray tube 23 and a radiation image
`
`
`
`
`
`
`
`intensifier 22 and a common radiation axis A3 between
`
`
`
`
`
`
`an X-ray tube 54 and a radiation image intensifier 40.
`
`
`
`
`
`
`
`
`When filming the ventricle of the heart located at isoc-
`
`
`
`
`
`
`
`
`enter C, the axis A3 can be perpendicular to axis A2
`
`
`
`
`
`
`
`
`which, in turn, can be perpendicular to axis Al. When
`
`
`
`
`
`
`
`providing cardiac angiography, the heart can be exam-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`ined by tilting the X-ray tube_23 through 360° of angle
`
`Page 11 of 16
`
`Page 11 of 16
`
`

`
`4,426,725
`
`10
`
`15
`
`
`20
`
`25
`
`
`30
`
`45
`
`
`3
`
`around central axis A1 of the system which is aligned
`
`
`
`
`
`
`
`with the long axis of the patient. The common axis A2
`
`
`
`
`
`
`
`
`
`can also be rotated 90° about a secondary axis perpen-
`
`
`
`
`
`
`
`
`dicular to the central axis A2 about the isocenter C, that
`
`
`
`
`
`
`
`
`is a solid angle defined from the head to the foot. Simul-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`taneously, the radiological apparatus 40, 41 is focused
`
`
`
`
`
`
`
`upon the isocenter C thereby allowing oblique biplane
`filming of the same point.
`
`
`
`
`The system for providing these types of X-rays com-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`prises a heavy base 1 anchored to the floor 50 of the
`examining room, the base 1 having arcentral rotor shaft
`
`
`
`
`
`
`
`
`2 joumaled in rotor bearing 51. A first transverse mem-
`
`
`
`
`
`
`
`ber 3 extending at a right angle to the rotor shaft 2 is
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`pivotally attached to the rotor shaft at 4. A second
`transverse member 5 parallel
`to the first transverse
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`member 3 is pivotally supported at the distal end ofthe
`rotor shaft 2 at 7. Upper and-lower support arms 8 and
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`9 are pivotally connected by bearing pins 10, 11, 12 and
`
`
`
`
`
`
`
`13 to form an angularly adjustable parallelogram (3, 5,
`
`
`
`
`
`
`
`
`
`8, 9) whose sides are of a fixed length between the piv-
`otal connections, that is the distance between pin 10 and
`
`
`
`
`
`
`
`
`12 is the same as the distance between pins 11 and 13
`
`
`
`
`
`
`
`
`and the distance between pins 10 and 11 is the same as
`
`
`
`
`
`
`
`
`
`the distance between 12 and 13. Upper and lower sup-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`port arms 8 and 9 have extensions 8A and 9A from ‘the
`
`
`
`
`
`
`
`parallelogram for a distance sufficient to allow the table
`T and the patient P to be located close to the transverse
`
`
`
`
`
`
`
`member 5. At the distal ends of the extensions 8A and
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`9A are two pivots 52 and 17 for the image intensifier 22
`
`
`
`
`
`
`
`
`
`
`
`and the X-ray tube 23. The pivot points 12, 13 and 17
`are in a straight line parallel to the central axis Al and
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`spaced the same distance from the central axis as a line
`
`
`
`
`
`
`
`
`
`
`through pivot points 10, 11 and 52. One end of a first
`link 15 is pivotally attached to-the second transverse ’
`
`
`
`
`
`
`
`35
`member 5 and the other end is pivotally attached to the
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`image intensifier 22 at 53. Similarly one end of a second
`
`
`
`
`
`
`
`link 19 is pivotally attached to a pivot point 18 in a
`second transverse member 5 and pivot point 20 of X-ray
`
`
`
`
`
`
`
`tube 23. The distances between points 17 and 20 and
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`points 52 and 53 are equal, as are the distances between
`
`
`
`
`
`
`
`
`
`
`points 18 and 13 and point 11 and the unshown point
`
`
`
`
`
`
`
`attaching link 15 to second transverse member 5. In this
`way movement of the first transverse member 3 around
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`point 4 will cause X-ray tube 23 and image intensifier 22
`
`
`
`
`
`
`to move simultaneously in equal angles respectively
`
`
`
`
`
`
`
`around points 17 and 52. Simultaneously, equal angular
`movement of X-ray tube 23 and image intensifier 22
`
`
`
`
`
`
`
`
`maintains these two units on a common axis, as the
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`equipment is angulated over the long axis A1 of the
`
`
`
`
`patient around the isocenter C.
`
`
`
`
`
`
`The image intensifier 22 includes a fluorescent imag-
`
`
`
`
`
`
`
`
`ing plate 22A which stimulates image intensifier stages
`
`
`
`
`
`
`
`to produce an optical image of required brightness. The
`
`
`
`
`
`
`
`intensifier image enters a beam splitting image distribu-
`55
`tor 26 of known design and transmits the image to an
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`image recorder 27, such as a television camera. The
`camera 27, the image distributor 26 and the intensifier
`
`
`
`
`
`
`
`
`22A areon a common axis which is coincident with the
`
`
`
`
`
`
`
`
`radiation axis A2.
`.
`
`
`
`
`
`
`
`
`
`
`According to the present invention, we=have found
`that for certain angiographic examinations we can move
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`the X-ray tube 23 and the image intensifier 22 through
`loci which can define a spheroidal shape around the
`
`
`
`
`
`
`
`
`isocenter C while simultaneously focusing upon the
`
`
`
`
`
`
`same isocenter from a different angle. Such examina-
`
`
`
`
`
`
`
`tions are particularly valuable in estimating. the ventric~ »
`
`
`
`
`
`
`
`ular volumes. This oblique biplanar examination is pro-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`vided, without moving the patient, by including a see-
`
`65
`
`
`
`4
`
`
`
`
`
`
`
`0nd radiological examining apparatus in the radiologi-
`cal examining system. The apparatus includes an X-ray
`
`
`
`
`
`
`
`tube 54 and an image intensifier 40. The image intensi-
`
`
`
`
`
`
`
`
`fier and the X-ray tube are constructed in a manner
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`similar to equipment used in the radiological examining
`device described previously.
`»
`
`
`
`
`The radiological intensifier 40 is affixed to a support
`
`
`
`
`
`piston 41 that is slidably held by a cylinder 42. The
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`support piston 41 is positioned perpendicular to the
`central axis-A1 and can be raised or lowered through
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`counter, weights (not shown) so as to place the intensi-
`fier 40'on the common axis A3 with X-ray tube 54.
`
`
`
`
`
`
`
`
`
`
`X-ray intensifier 40 is also slidably retained on support
`
`
`
`
`
`
`piston 41 so that it can be reciprocated along common
`
`
`
`
`
`
`axis A3 to vary the focus (as shown in position 40*) and _
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`provide enlargements of the area of the organ being
`X-rayed.uThe cylinder. 42 is attached to a carrier 43 that
`
`
`
`
`
`has wheels~45 mounted within channels 46, each of
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`which is preferably disposed parallel to central axis 46.
`X-ray tube 54 is disposed upon a table and stand 47, that
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`is supported by wheels 48 which travel in tracks 49,
`each of which is parallel to the central axis Al. In use,
`
`
`
`
`
`
`
`
`the units of the radiological examining apparatus are
`
`
`
`
`
`
`
`
`moved on the two sets of tracks 46 and 49 so that the
`
`
`
`
`
`
`
`
`common axis A3 falls into alignment with the isocenter
`
`
`
`
`
`
`
`
`C. Preferably, stops are disposed on the tracks 46 and 49
`
`
`
`
`
`
`
`
`so that the apparatus can be easily wheeled by the trans-
`
`
`
`
`
`
`
`
`
`verse members 3 and 5 to enable the technicians to work
`
`
`
`
`
`
`
`
`
`
`upon the patient.
`In summary, the apparatus of FIGS. 1 and 2 com-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`prises a first radiological examining set of first radiation
`source means, X-ray tube 23, and a first radiation recep-
`
`
`
`
`
`
`
`
`
`tor means, image intensifier 22, having a first common
`
`
`
`
`
`
`
`
`radiation axis A2; and a second radiation examining set
`
`
`
`
`
`
`
`of a second radiation source means, X-ray tube 54, and
`
`
`
`
`
`
`
`
`
`a second radiation receptor means, image intensifier 40,
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`having a second radiation axis A3. The first support
`means for the first set which includes arms 8 and 9 is
`
`
`
`
`
`
`
`
`
`rotatable independently of the support means for the
`
`
`
`
`
`
`
`
`second examining set of radiation source and receptor
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`means, X-ray tube 54 and image intensifier 40 and their
`common radiation axis A3. Further, the second support
`
`
`
`
`
`
`
`
`means for the second radiation means (carrier 43 and
`
`
`
`
`
`
`
`
`
`wheeled stand 47) are individually movable indepen-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`dently of the first support means (arms 8 and 9), in a
`
`
`
`
`
`
`
`direction guided by means including the tracks 46 and
`49, either direction being normal to its radiation axis on
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`a path from a position of the radiation means with its
`axis A3 in-alignment with the isocenter, as shown in
`
`
`
`
`
`
`
`
`FIG. 1, to a position remote from the isocenter, left-
`
`
`
`
`
`
`
`
`ward on the tracks 46 or 49. In this connection, the
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`isocenter is significant only in that it usually represents
`
`
`
`
`
`
`
`
`
`
`the position of the organ of-ya human patient or other
`
`
`
`
`
`
`
`subject under examination, and retracting the radiation
`means frees access to the subject.
`
`
`
`
`
`
`
`
`
`
`
`
`In operation a patient is positioned on the table which
`is movable in horizontal and vertical planes. Such
`
`
`
`
`
`
`
`
`
`
`
`
`
`movement is provided by adjusting the elevation of the
`table or shifting it from side to side. In this way, the
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`organ to be examined, for example the heart, is located
`at the isocenter of the system. To conduct the radiologi-
`
`
`
`
`
`
`
`
`cal examination of the heart, 50 cc of a radiopaque
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`liquid is injected into a peripheral artery by way of a
`catheter. The X-raysystem is then activited and films or
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`.videotape recordings are made of the dynamics of the
`heart motion. The records are then used for determina-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`tion of the ventricular volume and valve action.
`
`
`
`
`
`
`
`Through the use of the present system, two views of the
`
`50
`
`
`
`60
`
`
`Page 12 of 16
`
`Page 12 of 16
`
`

`
`10
`
`15
`
`20
`
`
`
`25
`
`
`
`30
`
`35
`
`
`
`5
`
`organ varying in included angle can be made with one
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`injection of radiopaque liquid and the patient need not
`be titled on the table to obtain the two views..
`
`
`
`
`
`
`
`
`
`II—The Embodiment of FIGS. 3 to 6
`
`
`
`In FIG. 3 there is shown a radiological examination
`
`
`
`
`
`
`apparatus 110 comprising a first U-shaped support arm
`
`
`
`
`
`
`
`112 and a second U-shaped support arm 114, pivotally
`
`
`
`
`
`
`
`
`mounted with respect to one another on a common
`
`
`
`
`
`
`
`
`shaft 116, which itself may be rotationally movable in a
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`collar 18 which is fixedly supported on a heavy base
`120. The first and second support arms 112 and 114
`
`
`
`
`
`
`
`
`
`
`pivot about a common axis A which is the axis of the
`
`
`
`
`
`
`
`
`
`common shaft 16. The axis A is in alignment with that
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`portion of a patient P or subject being examined, shown
`in FIG. 3 on a radiation-transparent table T. The com-
`
`
`
`
`
`
`
`
`
`
`
`mon axis A may be generally horizontally disposed or it
`
`
`
`
`
`
`
`may be vertically arranged about the table T and the
`
`
`
`subject being examined.
`The first support arm 112 comprises a pair of hollow
`
`
`
`
`
`
`
`
`generally parallel extended members 122 and 124 con-
`
`
`
`
`
`
`
`
`nected by a hollow transverse member 126. Each ex-
`
`
`
`
`
`
`
`tended member 122 and 124 has a frame 128 at its distal
`
`
`
`
`
`
`
`
`
`
`end thereof. On one extended member 122, the frame
`
`
`
`
`
`
`
`
`
`128 thereon movable secures a radiation means such as
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`a radiation image receptor 132, and the frame 128 on the
`other extended member 124 secures a radiation means
`
`
`
`
`
`
`
`such as a radiation source 130. The radiation image
`
`
`
`
`
`
`
`
`receptor 130 and the radiation source 130 may move
`
`
`
`
`
`
`
`
`
`radially with respect to the common axis A, in conjunc-
`
`
`
`
`
`
`
`tion with one another to vary the imagery of the radio-
`
`
`
`
`
`
`
`
`
`logical examination. The second -support arm 114 is
`
`
`
`
`
`
`
`arranged in a manner similar to the first support arm
`
`
`
`
`
`
`
`
`112, except that it has a pair of generally parallel ex-
`
`
`
`
`
`
`
`
`
`tended members 134 and 136, which may not be as long
`
`
`
`
`
`
`
`
`as the extended members 122 and 124 of the first arm
`
`
`
`
`
`
`
`
`
`
`112 because of their overlapping relationship. The ex-
`
`
`
`
`
`
`tended members 134 and 136 (only one being shown in
`
`
`
`
`
`
`
`
`
`FIG. 3 for clarity) are interconnected by a hollow trans-
`
`
`
`
`
`
`
`verse member 138. Each extended member 134 and 136
`
`
`
`
`
`
`
`
`
`of the second support arm 114 has a frame 128 at the
`
`
`
`
`
`
`
`
`
`
`distal end thereof. On one of the extended members 134,
`
`
`
`
`
`
`
`the frame 128 movably secures a radiation means such
`
`
`
`
`
`
`
`
`as a radiation image receptor 130 and the frame 128 on
`
`
`
`
`
`
`
`
`
`the other extended member 136 movably secures a radi-
`
`
`
`
`
`
`
`
`ation means such as a radiation source 132 shown more
`
`
`
`
`
`
`
`
`clearly in FIGS. 4 and 5.
`
`
`
`Each extended member 122, 124, 134 and 136 is hol-
`
`
`
`
`
`
`
`
`
`low, as is each transverse member 126 and 138, in which
`
`
`
`
`
`
`
`
`hollow space is disposed a system 140 of cables, pulleys
`
`
`
`
`
`
`
`and counterweights to facilitate the radially directed
`
`
`
`
`
`
`movement of the radiation sources 130 and the radiation
`
`
`
`
`
`
`
`
`image receptors 132. A portion of the system 140 is
`
`
`
`
`
`
`
`
`shown in FIG. 6, in one of the extended members 122,
`
`
`
`
`
`
`
`
`wherein a double pulley 142 having two sheaves is
`
`
`
`
`
`
`
`disposed in the distal end thereof, near the radiation
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`image receptor 132. Another arrangement of pulleys
`144 and 146 is disposed at the elbow or juncture of the
`
`
`
`
`
`
`
`
`interconnecting member 126 and the extended member
`
`
`
`
`
`
`
`60
`122, and a further double pulley 148 having double
`
`
`
`
`
`
`
`
`sheaves is disposed at an intermediate location in the
`
`
`
`
`
`
`interconnecting member 126. A flexible cable 150 is
`
`
`
`
`
`
`attached at one end to an arm 152 which slides on rod
`
`
`
`
`
`
`
`
`
`156 on the radially outwardly directed side of the frame
`
`
`
`
`
`
`
`
`128 on the extended member 122. Limit stops 157 are
`
`
`
`
`
`
`
`
`
`disposed at each end of rod 156. The cable 150 wraps
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`partially around_the radially inward portion on one of
`
`
`
`
`
`
`
`
`
`the sheaves on the double pulley 142 andis carried
`
`
`6
`
`through the hollow portion of the extended member
`
`
`
`
`
`
`
`
`122 to wrap around the radially outer side of one of the
`
`
`
`
`
`
`
`
`
`pulleys 146 at the elbow of the support arm 112, and
`
`
`
`
`
`
`
`
`
`continues radially inwardly in the transverse member
`
`
`
`
`
`
`126 to wrap around a sheave of the further double pul-
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`ley 148 therein, thence radially outwardly to a weight
`W of proper balancing characteristics, and continues
`
`
`
`
`
`
`from the radially outer end thereof around another
`
`
`
`
`
`
`
`
`pulley 144 at the elbow of the support arm 112, out
`
`
`
`
`
`
`
`
`
`through the extended member 122 and around the other
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`sheave of the double pulley 142 and thence radially
`inwardly to be secured on an arm 154 on the radially
`
`
`
`
`
`
`
`inwardly directed side of the frame 128 on the extended
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`member 122. The frame 128 which comprises a portion
`
`
`
`
`
`
`
`of the radiological apparatus is slidable on an end plate
`156 on each extended member. An endless cable 158
`
`
`
`
`
`
`
`
`
`
`
`
`
`may be disposed in a figure eight configuration between
`the second sheave on the double pulley 148 at the inter-
`
`
`
`
`
`
`
`
`
`mediate position in the connecting member 120, and a
`
`
`
`
`
`
`
`sheave on another double pulley 148’ spaced towards
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`the other extended member 124 and which comprises
`
`
`
`
`
`
`
`
`the remaining portion of the funicular system 140 in the
`first support arm 112. The double pulleys 148 and 148’
`
`
`
`
`
`
`
`
`
`
`have their respective sheaves fixedly attached to one
`
`
`
`
`
`
`
`another to facilitate selective effectuation of simulta-
`
`
`
`
`
`
`
`
`
`
`
`
`
`neous radially inwardly and radially outwardly directed
`movement of the support arms respective radiation
`
`
`
`
`
`
`image receptor 132 and the radiation source 130. If
`
`
`
`
`
`
`
`
`
`desired, a single loop can be substituted for the “8”
`
`
`
`
`
`
`
`
`
`configuration to allow simultaneous movement of the
`
`
`
`
`
`receptor 132 and source 130 in the same direction.
`
`
`
`
`
`
`
`
`The pulley system in the second support arm 114 is
`
`
`
`
`
`
`
`
`similar to that described in the first support arm 112,
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`wherein the image intensity may be varied according to
`the particular radial separation of the radiation means.
`
`
`
`
`
`
`
`
`The radiation means on each support arm 112 and 114
`
`
`
`
`
`
`
`
`
`are preferably actuated seriatim to eliminate chance of
`
`
`
`
`
`
`interference between intersecting radiation which
`
`
`
`
`
`
`
`
`
`
`
`
`might otherwise obfuscate the images of the subject on
`
`
`
`
`
`
`
`
`the film plate. A lock 149 is provided on the bearing
`member 153 which engages bearing member 116 so as
`
`
`
`
`
`
`
`to interlock the support arms 112 and 114 in fixed angu-
`
`
`
`
`
`
`
`
`
`
`lar relationship with each other so as to allow the two
`
`
`
`
`
`
`
`
`support arms 112 and 114 to maintain the fixed angular
`
`
`
`
`
`
`
`
`
`overlapping examination around the common axis A,
`
`
`
`
`
`
`
`that is rotational about an isocenter C.
`
`
`
`
`A radiological examination of a patient P is facilitated
`
`
`
`
`
`further by his disposition on a table T, the table itself
`
`
`
`
`
`
`
`being movable in any of three directions, two of which
`
`
`
`
`
`
`
`are shown by the arrows M in FIG. 5. Of these two
`
`
`
`
`
`
`
`
`directions, one is on a common axis normal to the com-
`
`
`
`
`
`
`
`
`mon axis A and the other allows movement parallel to
`
`
`
`
`
`
`
`
`common axis A. In FIG. 3, the support S for the table T
`
`
`
`
`
`
`
`includes an arcuate leg releasable and lockably sup-
`
`
`
`
`
`
`
`
`ported in a base B which is rotatably disposed on a floor
`
`
`
`
`
`
`stand F. The radiological apparatus comprises radiation
`
`
`
`
`
`
`sources’ and radiation receptors which may be moved
`
`
`
`
`
`
`
`inwardly and/or outwardly with respect to the com-
`
`
`
`
`
`
`
`
`mon axis A, by manual stipulation or by motorization of
`
`
`
`
`
`the counterweight system, while the support arms 112
`
`
`
`
`
`
`
`
`and 114 swing around the common axis A, as shown by
`
`
`
`
`
`
`
`
`the arrows R in FIG. 2. Each set of radiation source and
`
`
`
`
`
`
`
`receptor has a radiation axis intersecting the rotational
`
`
`
`
`
`
`
`axis A at a common isocenter C (FIG. 5) inside the
`
`
`
`
`
`
`subject of examination. Also the table T rotates about
`
`
`
`
`
`
`
`
`the isocenter normal to the radiation axes and rotational
`
`
`
`
`
`
`
`
`axis A. Rotation of the table and the independent rota-
`
`
`
`
`
`
`
`
`tion of two U-shaped supports allows examination from
`
`
`
`
`
`
`
`
`4,426,725
`
`40
`
`45
`
`50
`
`
`
`
`
`55
`
`
`
`
`
`65
`
`
`
`Page 13 of 16
`
`Page 13 of 16
`
`

`
`
`8
`
`
`
`
`
`
`
`
`
`dently thereof, and further can be rotated on the second
`
`
`
`
`
`
`
`
`
`ring 201B independently of the first set so that the plane
`of its examination of a subject at the isocenter, that is the
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`examining angle of the second radiation axis may be
`
`
`
`
`
`
`
`
`selected independently of the examining angle of the
`
`
`
`
`
`
`
`
`
`
`first axis, and the included angle between the two axes
`
`
`
`
`
`
`
`
`may be varied throughout nearly 180° , the range of
`relative rotation of the two support rings, which, how-
`
`
`
`
`
`
`
`
`ever, can rotate coordinately through 360°.
`
`
`
`
`
`
`
`
`
`
`
`
`
`FIG. 14 shows the electrical control circuit by which
`
`
`
`
`
`
`
`
`
`
`the two rings 201A and 201B are rotated by the motor
`
`
`
`
`
`
`
`M. A first push button manual switch SA has a first
`
`
`
`
`
`
`
`contactor SA1 which applies power from a source DC
`to either of two contacts CW or CCW connected to
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`corresponding terminals on the motor M to turn it
`
`
`
`
`
`
`clockwise or counterclockwise. The power source may
`
`
`
`
`
`
`
`
`be direct or single phase alternating current but is pref-
`
`
`
`
`
`
`
`erably three phase for a servo or stepping motor M. A
`second contactor SA2, ganged to the first c