CN110575627B - Physical mapping device for rapidly acquiring target nerve treatment energy delivery site - Google Patents
Physical mapping device for rapidly acquiring target nerve treatment energy delivery site Download PDFInfo
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- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
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Abstract
The invention relates to a physical mapping device for rapidly acquiring a target nerve treatment energy delivery site, wherein a physical mapping system comprises a vibration sound physical signal pickup system, a vibration sound physical signal display system and a vibration sound physical signal analysis system; the vibration sound physical signal pickup system is used for picking up sound waves and transmitting the sound waves to the vibration sound physical signal display system for processing. Its advantages are: the target nerve treatment energy delivery site can be rapidly obtained, and rapid and accurate detection-ablation integration is realized.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a physical mapping device for detecting and ablating a target nerve treatment energy delivery site.
Background
In recent years, with the development of non-invasive ultrasound systems, it is a mainstream research direction to use ultrasound systems to generate mechanical stimulation to nerves, and detect the reaction of nerve activity through mechanical stimulation, so as to find a target point for disease treatment.
At present, the closest prior art regarding the treatment of ultrasound is that the applicant has already applied for patentability: the specification of the dual-frequency focusing ultrasound system (CN102793890B) describes "diagnosis and treatment of a lesion by combining mechanical stimulation and tissue ablation by dual-frequency focusing ultrasound". However, although the detection and ablation can be integrated in this solution, the integration of the detection and ablation cannot be realized quickly and accurately, that is, when the delivery site of a certain site is detected, the site can not be ablated and treated quickly. The reason is that the technical scheme is applied to physiological mapping and can only be used for detecting the surface nerves, and the delivery site cannot be accurately found for the target nerves in the body and at depth, namely, only one target region where the target nerves are located is possibly detected, so that the integration of detection and ablation cannot be rapidly and accurately realized. Wherein "target nerve" and "target area" are defined, and the target area: specific body tissues containing the "target nerve" include, for example: in hypertension treatment, the target region refers to the perirenal artery tissue containing the renal sympathetic nerves, which refers to the renal sympathetic nerves as well as: in the process of analgesic treatment of cancer pain, the target region refers to deep tissue including abdominal cavity and visceral ganglion, and the target nerve refers to abdominal ganglion
In view of the above, there is a need for a physical mapping device capable of rapidly acquiring a target nerve treatment energy delivery site and rapidly and precisely detecting and ablating the target nerve treatment energy delivery site, and no report about such a physical mapping device is found at present.
Disclosure of Invention
The invention aims to provide a physical mapping device which can quickly acquire a target nerve treatment energy delivery site and can quickly and accurately detect and ablate.
In order to achieve the purpose, the invention adopts the technical scheme that:
a physical mapping device for rapidly acquiring a target nerve treatment energy delivery site comprises a vibration sound physical signal pickup system, a vibration sound physical signal display system and a vibration sound physical signal analysis system; the vibration sound physical signal pickup system is used for picking up sound waves and transmitting the sound waves to the vibration sound physical signal display system for processing; the vibration sound physical signal display system comprises a preamplifier, a filter and a digital oscilloscope; the vibration sound physical signal pickup system is used for picking up echoes generated by different tissues after difference frequency focusing ultrasonic stimulation; the vibration sound physical signal display system is used for converting sound waves or echoes into digitized echo signals, transmitting the digitized echo signals to a preamplifier in the vibration sound physical signal display system, amplifying the echo signals, further transmitting the echo signals to a filter unit in the vibration sound physical signal display system, filtering clutter signals in the echo signals by the filter in a low-pass/high-pass or other mode, and finally transmitting the echo signals to a digital oscilloscope in the vibration sound physical signal display system for display; the vibration sound physical signal analysis system comprises a treatment planning unit, an ultrasonic image unit and a superposed image unit; the treatment planning unit and the superposed image unit are connected with a digital oscilloscope in the vibration sound physical signal display system and used for receiving echo signals on the digital oscilloscope.
The treatment planning unit is used for receiving echo signals on the digital oscilloscope, comparing the obtained echo signals with echo signals generated after differential frequency ultrasonic stimulation of various tissues preset in the treatment planning unit, performing gray-scale scanning to construct a hardness distribution diagram of a target region, displaying the distribution state of target nerves in the target region through the hardness distribution diagram, and displaying in the forms of a gray-scale image, a three-dimensional histogram and a pseudo-color image to visually display an ablation treatment plan;
the ultrasonic image unit comprises an ultrasonic image probe, and can also be a magnetic resonance coil, an electronic computer tomography scanning device and a nuclear medicine detector; the ultrasonic image probe is arranged in the difference frequency focusing ultrasonic transducer, can flexibly turn, and can perform two-dimensional and Doppler blood flow imaging when the difference frequency ultrasonic works;
the superposition image unit superposes and combines the gray-scale image, the three-dimensional histogram, the pseudo-color image and the Doppler blood flow imaging output by the ultrasonic image unit, which are output by the treatment planning unit, and is used for providing image support during ablation, searching a treatment target point and a scanning plane, and setting a treatment energy delivery site by utilizing the virtual focus of the treatment unit through the three-dimensional motion of the treatment unit.
As a preferable technical scheme, the vibration sound physical signal pickup system is a hydrophone, the hydrophone can adopt two pickup modes of a water tank signal and a body signal, the water tank is used for reducing the influence of surface reflection, and flexible sound absorption rubber is paved on the water surface.
As a preferred technical solution, the physical mapping device is further equipped with an ultrasonic signal generator, a difference frequency focusing ultrasonic transducer; the ultrasonic signal generator generates ultrasonic signals with a certain frequency difference, the ultrasonic signals are sent to the difference frequency focusing ultrasonic transducer, and two or more beams of difference frequency focusing ultrasonic waves with a certain frequency difference are generated by the difference frequency focusing ultrasonic transducer.
As a preferred technical solution, the difference frequency focused ultrasound transducer emits the difference frequency focused ultrasound with a certain frequency difference, and the frequency difference is lower than 1% of the fundamental frequency.
As a preferred technical solution, the physical mapping device is further equipped with a physiological mapping system and a main control computer; the physiological mapping system includes: the biological signal acquisition device is used for assisting the discrimination system; the biological signal acquisition device is used for acquiring and recording body physiological electric signals and sending the acquired body physiological signals to the auxiliary judgment system; the auxiliary judgment system is used for analyzing and judging the acquired body physiological signals, comparing the acquired body physiological signals with preset signals, judging the signals by an operator according to the signal analysis result, and sending the result to the main control computer to adjust the focused ultrasound treatment parameters in real time.
As a preferred technical solution, the biological signal collecting apparatus includes: an electrocardiogram analyzer, a multi-channel physiological recorder, a respiration monitor and/or electroencephalograph, a nerve potential analyzer, and a blood biochemical analyzer.
As a preferred technical solution, after the physical mapping device completes the physical mapping, the physical mapping system superimposes the distribution state image of the target nerve in the target region provided by the image unit, the difference frequency focused ultrasound transducer emits two bundles of difference frequency focused ultrasound with a certain frequency difference again to act on the target nerve portion, and the biological signal acquisition device starts to record the physiological effect formed by the target nerve after the difference frequency stimulation, so as to obtain the definition of the target nerve evaluation result.
As a preferred technical solution, the main control computer sends out an ablation instruction by defining the target nerve evaluation result, the instruction is transmitted to the ultrasonic signal generator, two groups of ultrasonic signals with the same frequency are generated and sent to the difference frequency focused ultrasonic transducer, a focused ultrasonic beam with the same frequency is sent out, and ultrasonic ablation is performed on the target nerve according to a composite image generated by the ultrasonic image unit and the superposition image unit.
The invention has the advantages that:
1. the invention relates to a physical mapping device for rapidly acquiring a target nerve treatment energy delivery site, which forms a focus on a deep part of an organism by high-frequency focused ultrasound, creates a physical/physiological property double mapping positioning method on a deep tissue of the organism by using a difference frequency confocal ultrasound interference principle, forms a 'tapping' force by generating mechanical stress of low-frequency vibration sound at the focus and forms a deep nerve stimulation stress principle, guides focused ultrasound energy treatment and a curative effect verification system method, and provides wide application prospects for mapping, regulating, ablating treatment and the like of excitable tissues of the organism.
2. The characteristic that external focused ultrasound is used for non-invasively delivering energy to the deep part of a tissue is utilized, the low-frequency component force is generated by using the ultrasonic difference frequency principle and is used for nerve mapping, and the detection function is skillfully developed under the condition that the main framework of the system is basically maintained. And because the detection and the therapeutic intervention are in the same focus, the accuracy of the therapeutic target is ensured while the system structure is greatly simplified.
3. The physical mapping system adopts a 'tapping' mode to obtain the intensity of vibration sound, and in addition, the part to be tapped is in a mechanical environment with mechanical force, and tapping is carried out through low-frequency vibration, and the design mode can obtain obvious vibration sound intensity.
4. The physical mapping system firstly carries out fast mapping to find the position or the relative position of the detection surface where the target nerve is located, then carries out accurate mapping on the detection surface through the physical mapping system, the interval time between the physical mapping and the physiological mapping is short, the physical mapping can be used for prescanning, the stimulation response is confirmed, the energy can be released immediately for treatment, and the realization of integrated treatment of detection and ablation is facilitated.
5. The physical mapping system takes stress generated by low-frequency vibration generated by the acoustic signal generator as a mapping source, and then taps the tissue of a focus by the stress generated by a difference frequency signal in the difference frequency vibration. The mapping source is carried out in vitro, good acoustic coupling can be realized without any electrode or catheter entering the body, and noninvasive treatment of deep target tissues can be realized; the mode of beating is favorable to comprehensive accurate physical information who obtains the degree of depth tissue.
6. The three-dimensional motion scanning system is arranged, and when physical detection is carried out, the focused ultrasonic transducer is controlled to carry out three-dimensional arbitrary surface motion relative to a target area, and arbitrary three-dimensional scanning can be carried out on a part to be detected, so that the physical mapping system can obtain a hardness distribution map with more comprehensive physical information, and a detection surface can be accurately obtained. When physiological detection is carried out, the focus is not limited by an anatomical structure, and two-dimensional or three-dimensional scanning can be carried out at any point of the solid tissue, so that the same focus is realized during mapping and ablation treatment. However, in the conventional physiological detection, due to the absence of a three-dimensional motion scanning system, the stimulation of the physiological detection in the blood vessel is limited by space, and the physiological detection cannot be detected if the nerve is far away from the blood vessel.
7. The physical mapping device for rapidly acquiring the target nerve treatment energy delivery site can rapidly acquire the target nerve treatment energy delivery site and can rapidly and accurately realize detection-ablation integration.
Drawings
Fig. 1 is a block diagram of a physical mapping device for rapidly acquiring a targeted neuro-therapeutic energy delivery site in accordance with the present invention.
Fig. 2 is a schematic flow diagram of a physical mapping device for rapidly acquiring a targeted neuro-therapeutic energy delivery site in accordance with the present invention.
Fig. 3 is a schematic diagram of a structure of a physical mapping system.
Fig. 4 is a block diagram of a structure of a physiological mapping system.
Detailed Description
The following detailed description of the present invention will be made with reference to the accompanying drawings.
The reference numerals and components referred to in the drawings are as follows:
1. main control computer 2. ultrasonic signal generator
3. Three-dimensional motion scanning system 4. difference frequency focusing ultrasonic transducer
5. Degassing water circulation system 6. physical mapping system
61. Vibro-acoustic physical signal pickup system 62 vibro-acoustic physical signal display system
621. Preamplifier 622 filter
623. Digital oscilloscope 63 vibration sound physical signal analysis system
631. Treatment planning unit 632 ultrasound imaging unit
633. Superimposed image unit 7. physiological mapping system
71. Multichannel physiological recorder 72 auxiliary discrimination system
Example 1
For more clear description of the technical solution, "target nerve" and "target region" are defined in the following schemes, target region: specific body tissues containing the "target nerve" include, for example: in hypertension treatment, the target region refers to the perirenal artery tissue containing the renal sympathetic nerves, which refers to the renal sympathetic nerves as well as: in the analgesic treatment of cancer pain, the target region refers to the deep tissue containing the celiac, visceral ganglia and the target nerve refers to the celiac ganglia.
Referring to fig. 1 and 2, fig. 1 is a block diagram of a physical mapping device for rapidly acquiring a target nerve treatment energy delivery site according to the present invention. Fig. 2 is a schematic flow diagram of a physical mapping device for rapidly acquiring a targeted neuro-therapeutic energy delivery site according to the present invention. A physical mapping device for rapidly acquiring a target nerve treatment energy delivery site comprises a physical mapping system 6, a physiological mapping system 7, a difference frequency focusing ultrasonic transducer 4, a three-dimensional motion scanning system 3, a main control computer 1, a degassing water circulation system 5 and an ultrasonic signal generator 2; the ultrasonic signal generator 2 sends out two beams of ultrasonic waves with different frequencies, and the difference frequency formed by the two beams of ultrasonic waves generates stress at the focus through the difference frequency focusing ultrasonic transducer 4 to vibrate at low frequency; the physical mapping system 6 obtains a detection surface of the target nerve position through low-frequency vibration; the physiological mapping system 7 detects the treatment target point of the target nerve through physical stimulation, and the physical mapping system 6 firstly quickly maps and finds the position or the relative position of the target nerve, and then carries out accurate mapping through the physiological mapping system 7.
The physical mapping system 6 takes stress generated by low-frequency vibration generated by the acoustic signal generator as a mapping source, taps the tissue of the focus by the stress generated by the difference frequency signal in the difference frequency vibration, and distinguishes the sound intensity of the detection point according to the loudness generated on the tissue of the focus, wherein the sound intensity of the detection point is in one-to-one correspondence with the hardness of the detection point, the hardness characteristic of the detection point is obtained through the sound intensity of the detection point, and a physical signal acted on a target nerve by the low-frequency vibration is further picked up according to the hardness characteristic to obtain a hardness distribution diagram;
the physiological mapping system 7 is used for picking up physiological signals of low-frequency vibration acting on target nerves to obtain mapping points, and the physical mapping system 6 firstly carries out fast mapping to find the position or relative position of the target nerves and then carries out accurate mapping through the physiological mapping system 7;
the difference frequency focusing ultrasonic transducer 4 in the embodiment adopts spherical geometric focusing, and adapts to the geometric size and power requirement required by mapping and treatment of large animals and human beings. Meanwhile, the difference frequency focusing ultrasonic transducer 4 has a stable power emission range, a sufficient focal length and a moderate opening angle. The difference frequency focusing ultrasonic transducer 4 can adopt a symmetrical double-frequency mode, and has higher electrical conversion efficiency and stable service life. Preferably, the difference frequency focusing ultrasonic transducer 4 can also adopt a petal type or a multi-element type.
The ultrasonic signal generator 2 in this embodiment uses a dual-channel ultrasonic signal generating and amplifying circuit with consistent performance, and the circuit can adopt various pulse repetition frequencies and short pulse transmitting modes, has stable power output under a low-power and power working mode, can select a same-frequency and accurate difference frequency working mode, and has accurate difference frequency accuracy to phase control. In addition, in order to generate low frequency vibrations in the target region, first an ultrasound signal with a certain frequency difference is generated by the ultrasound signal generator 2 and transferred to the difference frequency focused ultrasound transducer 4, and two beams of difference frequency focused ultrasound with a certain frequency difference are generated by the difference frequency focused ultrasound transducer 4 (which may include a first … … Nth transducer group), wherein the frequency difference of the difference frequency focused ultrasound is preferably lower than 1% of the base frequency (as described as "the frequency difference thereof is much lower than the base frequency, e.g. < 1% is preferred).
In this embodiment, a three-dimensional motion scanning system 3 is provided, and the three-dimensional motion scanning system 3 includes a motion controller; the motion controller comprises a digital processing chip (DSP), the digital processing chip is matched with the main control computer 1 and receives the instruction of the main control computer 1, the focusing ultrasonic transducer is controlled to carry out three-dimensional arbitrary surface motion relative to the target area, and meanwhile, the arbitrary surface of the target area with the target point is scanned.
In this embodiment, a degassing water circulation system 5 is provided to cool the difference frequency focused ultrasound transducer 4 (which is easy to heat because the difference frequency focused ultrasound transducer 4 works at high power) and to remove bubbles (which may occur when water is at high temperature, and which is an ultrasonic image).
Referring to fig. 3, fig. 3 is a schematic structural diagram of the physical mapping system 6. In this embodiment, a vibration sound physical signal pickup system 61, a vibration sound physical signal display system 62, and a vibration sound physical signal analysis system 63 are provided, and the vibration sound physical signal pickup system 61 is configured to pick up a sound wave and transmit the sound wave signal to the vibration sound physical signal display system 62 for processing; the vibration sound physical signal display system 62 comprises a preamplifier 621, a filter 622 and a digital oscilloscope 623; the vibration sound physical signal pickup system 61 can be arranged around the body, can be a hydrophone, can adopt two pickup modes of a water tank signal and a body signal, and the water tank is paved with flexible sound absorption rubber for picking up echoes generated by different tissues after differential frequency focusing ultrasonic stimulation in order to reduce the influence of surface reflection; the vibration sound physical signal display system 62 is used for converting sound waves or echoes into digitized echo signals and amplifying the echo signals by a preamplifier 621 which is transmitted into the vibration sound physical signal display system 62; the echo signal is further transmitted to a filter 622 unit in the vibration sound physical signal display system 62 of the vibration sound physical signal display system, the filter 622 filters clutter signals in the echo signal by adopting a low-pass/high-pass or other modes, and finally the echo signal is transmitted to a digital oscilloscope 623 in the vibration sound physical signal display system 62 for display.
The vibration sound physical signal analysis system 63 comprises a treatment planning unit 631, an ultrasonic imaging unit 632 and a superposition image unit 633; the treatment planning unit 631 and the superposition image unit 633 are connected with the digital oscilloscope 623 in the vibration sound physical signal display system 62, and are used for receiving the echo signal on the digital oscilloscope 623;
the treatment planning unit 631 is configured to receive the echo signal on the digital oscilloscope 623, compare the obtained echo signal with the echo signal generated after the difference frequency ultrasonic stimulation of a plurality of tissues preset in the treatment planning unit 631, perform gray-scale scanning to construct a hardness distribution diagram of a target region, where the hardness distribution diagram shows the distribution state of target nerves in the target region, and display the hardness distribution diagram in a gray-scale map, a three-dimensional histogram, a pseudo-color map, or other forms as needed to visually display an ablation treatment plan.
The ultrasonic imaging unit 632 includes an ultrasonic imaging probe, or may be a magnetic resonance coil, a nuclear medicine detector, or other imaging devices arranged according to actual needs to form an imaging unit and an ultrasonic imaging host; the ultrasonic image probe is arranged in the difference frequency focusing ultrasonic transducer 4, can flexibly turn, and can perform two-dimensional and three-dimensional Doppler blood flow imaging when the difference frequency ultrasonic works;
the overlay image unit 633 performs overlay combination on the gray-scale image, the three-dimensional histogram, the pseudo-color image and the doppler blood flow imaging output by the ultrasound image unit 632, which are output by the treatment planning unit 631, and is used for providing image support during ablation, searching a treatment target point and a scanning plane, and setting a delivery site of treatment energy through three-dimensional motion of the treatment unit by using a virtual focus of the treatment target point and the scanning plane.
The echo signals (including parameters such as intensity and frequency) fed back by the detection point correspond to the hardness characteristics (including tissue composition and tissue function state) of the detection point one by one. The system can obtain the tissue hardness distribution state of a regenerated target region by picking up echo signals returned after plane or three-dimensional continuous scanning is carried out on the target region by difference frequency focused ultrasound (vibration sound) and comparing the echo signals with preset parameters in the system, and can carry out two-dimensional or three-dimensional display on different tissue compositions and tissue function states in the modes of gray scale, histogram, pseudo color and the like, finally, the target nerve and a treatment target point (kidney sympathy) to be treated are visually presented, the information map is superposed on a two-dimensional or three-dimensional Doppler blood flow image of the target region for providing image support during ablation, and the virtual focus of the information map is utilized to set a delivery site of treatment energy through the three-dimensional motion of a treatment unit.
Referring to fig. 4, fig. 4 is a block diagram of the structure of the physiological mapping system 7. In this embodiment, a vibro-acoustic physiological signal recording and analyzing system is provided, and the vibro-acoustic stimulation signal analyzing system includes a multi-channel physiological recorder 71; the biological signal acquisition device is provided with a plurality of sensors, can acquire a plurality of physiological parameters in real time, and has the functions of invasive blood pressure recording, respiratory movement recording, standard electrocardiogram recording, limb electromyogram recording, a computer physiological signal analysis system, physiological signal change dynamic analysis and the like. The biological signal acquisition device 4 includes: an electrocardiogram analyzer, a multi-channel physiological recorder, a respiration monitor and/or electroencephalograph, a nerve potential analyzer, and a blood biochemical analyzer.
In this embodiment, a vibration acoustic physiological signal auxiliary discrimination system 72 is provided; the vibration acoustic physiological signal auxiliary judging system 72 is used for assisting in judging the positive mapping points and the distribution state of the target nerves.
The main control computer 1 in this embodiment receives the image from the ultrasound image unit 632, and the main control image on which the vibro-acoustic detection information and the virtual focus are superimposed, so as to send a detection signal or a working signal of the difference frequency focusing transducer required for treatment; the main control computer 1 sends a three-dimensional motion or scanning motion signal to the three-dimensional motion scanning system 3, and simultaneously sends a difference frequency detection or treatment same-frequency signal to the difference frequency focusing ultrasonic transducer 4 to control the ultrasonic transducer to work; the main control computer 1 also automatically controls the start, recording and analyzing of the degassing water circulation system 5, the physical mapping system 6 and the physiological mapping system 7.
The embodiment needs to be explained as follows:
the dual-standard detection system also comprises a physical mapping system 6 and a physiological mapping system 7; the physical mapping system 6 obtains a detection surface of the target nerve position through low-frequency vibration; the physiological mapping system 7 detects the treatment target point of the target nerve on the detection surface through physical stimulation. The effect of this design is: firstly, a detection surface where the target nerve is located is determined, and then the target nerve is searched on the detection surface by physiological stimulation, so that deep tissue detection and mapping are realized.
The physical mapping system 6 firstly finds the position or the relative position of the detection surface where the target nerve is located through fast mapping, and then carries out accurate mapping on the detection surface through the physiological mapping system 7. When the scheme is applied to renal nerve double-marking, a two-dimensional surface can be physically marked in seconds (about 50 x 50mm in a region of interest, 1mm in stepping distance and about 2500 points), and the scheme can be used as a pre-scanning scheme. While the renal nerve stimulation responds in pressure for at least 4-10 seconds, typically 10 seconds to achieve a significant response. Therefore, the interval time between the physical mapping and the physiological mapping is short, the time cost of the whole process is low, the physical mapping can be used for pre-scanning, the stimulation response is confirmed, the energy can be released immediately for treatment, and the detection and ablation integrated treatment is favorably realized.
The physical mapping system 6 adopts a 'tapping' mode to obtain the intensity of vibration sound, and in addition, the part to be tapped is in a mechanical environment with mechanical force, and then tapping is carried out through low-frequency vibration. The hardness can be scaled by in vitro measurements to obtain the actual Young's modulus.
The physical mapping system 6 uses the stress generated by the low-frequency vibration generated by the acoustic signal generator as a mapping source, and then "taps" the tissue at the focus with the stress generated by the difference frequency signal in the difference frequency vibration. The mapping source is carried out in vitro, good acoustic coupling can be realized without any electrode or catheter entering the body, and noninvasive treatment of deep target tissues can be realized; the mode of beating is favorable to comprehensive accurate physical information who obtains the degree of depth tissue.
The sound intensity at the probe point is differentiated by the "loudness" produced in the tissue at the focal point, where loudness is a relative quantity that is found to differ in stiffness by comparison with adjacent tissue. Under strictly controlled conditions, it can be used for Young's modulus calibration and measurement. A certain loudness of a particular system after scaling may be defined as (or corresponds to) a certain stiffness.
The sound intensity of the detection point corresponds to the hardness of the detection point one by one, the hardness characteristic of the detection point is obtained through the sound intensity of the detection point, and a physical signal of low-frequency vibration acting on the target nerve is further picked according to a plurality of hardness characteristics to obtain a hardness distribution diagram; the hardness distribution diagram is displayed by continuously scanning the vibration sound in a plane or a three-dimensional manner and displaying the sound intensity signal of each point in a gray scale or pseudo color manner in a two-dimensional or three-dimensional manner. For example, in the treatment of hypertensive disorders, the distribution of nerves in the background of fat (perirenal fat capsule) can be shown by a stiffness profile. The ablation-suggested (reaction positive point distribution) treatment plan is visually displayed in pseudo-color after a large number of renal nerve characteristic signals are acquired.
The physiological mapping system 7 is used for picking up physiological signals of the target nerves of the detection surface acted by low-frequency vibration to obtain the mapping points, wherein the specific principle of the physiological mapping system 7 is as follows: living tissue in vivo can respond to certain stimuli by administering a stimulus to the tissue of a particular nature, and recording and observing whether the biological tissue exhibits a particular response to assess whether the site to which the stimulus is administered is at the correct site. For example, when treating hypertension, the system releases a moderate amount of acoustic energy to act on the renal sympathetic nerves, which causes sympathetic nerve excitation, and causes increased blood pressure, increased heart rate, decreased heart rate variability, respiratory changes, increased muscle tone, cutaneous vasoconstriction, sweating, increased muscle electrical excitation, and the like. Obtaining a blood pressure change response through an invasive pressure sensor; the electrocardio recorder records the heart rate and can analyze the heart rate variability; the motion sensor acquires respiratory motion and muscle motion information; the skin temperature and impedance sensor can obtain information such as vasoconstriction and sweating; the myoelectric sensor can record myoelectric information and the like, and the physiological information has great expandability. When the region of interest is detected point by point in two-dimensional or three-dimensional manner, some points can be found to have response to one or more indexes, which indicates that the stimulation points accurately stimulate nerves, otherwise, the stimulation points are not at the positions where the nerves are distributed.
The sound absorption type water purifier is provided with a hydrophone, a water tank is arranged on the hydrophone, and sound absorption rubber is paved on the water surface of the water tank, so that the influence of surface reflection is reduced conveniently. When the difference frequency ultrasonic transmitting device is made of an acceptable sound wave material, the difference frequency ultrasonic transmitting device can be used as a vibration sound physical signal pickup system.
The vibration acoustic physiological signal auxiliary judgment system 72 is mainly used for further accurately positioning the target nerve and reducing the interference of other factors.
A degassing water circulation system 5 is arranged, and a degassing film is arranged on the degassing water circulation system 5; the degassing membrane is a polypropylene hollow fiber membrane filled with hydrophobicity. The scheme of degassing by adopting a degassing membrane, wherein the degassing membrane is a polypropylene hollow fiber membrane filled with hydrophobicity, and has the characteristics of large filling density, large contact area and uniform water distribution. The liquid phase and the gas phase are in contact with each other on the surface of the membrane, and since the membrane is hydrophobic, water cannot permeate the membrane, but gas can easily permeate the membrane. The degassing is achieved by gas migration through concentration differences. The hydrophobic hollow fiber degassing membrane is adopted, and the degassing speed is more than 20L/h. The deoxidation rate is less than 3 ppm.
The three-dimensional motion scanning system 3 is arranged, and when physical detection is carried out, the focused ultrasonic transducer is controlled to carry out three-dimensional arbitrary surface motion relative to a target area, and arbitrary three-dimensional scanning can be carried out on a part to be detected, so that the physical mapping system 66 obtains a hardness distribution map with more comprehensive physical information, and a detection surface is accurately obtained. When physiological detection is carried out, the focus is not limited by an anatomical structure, and two-dimensional or three-dimensional scanning can be carried out at any point of the solid tissue, so that the same focus is realized during mapping and ablation treatment. However, in the conventional physiological detection, due to the absence of the three-dimensional motion scanning system 3, the stimulation of the physiological detection in the blood vessel is limited by space, and the detection cannot be performed if the nerve is far away from the blood vessel.
The focusing mode of the difference frequency focusing ultrasonic transducer 4 is a melon lobe structure, an annular array structure or an even number element structure. The melon petal structure divides the concave spherical surface ceramic into 8 array elements with the same size, and the odd array elements and the even array elements are respectively connected in parallel. The annular array divides the concave spherical ceramic in the axial direction and cuts the concave spherical ceramic into 2 array elements with the same area. The multi-array element structure is that 100 array elements with the diameter of 8mm are uniformly distributed on a framework of a concave spherical surface so as to achieve the aim of focusing.
Example 2 mapping-ablation treatment of cancer pain on the celiac plexus by a physical mapping device
The incidence rate of pain caused by tumor in late-stage tumor patients is up to 80%, although the pathogenesis of the pain is numerous, the pain-relieving effect of 'damage to abdominal plexus block (NCPB)' is up to more than 90%, the anti-tumor treatment has no definite curative effect, and the late-stage tumor patients with limited survival are expected to have certain value. The ablation of the abdominal ganglia by utilizing the HIFU is gradually applied to clinic, and a certain treatment effect is obtained, however, the abdominal nerve plexus is deeply buried in the body, and the problems of less sperm positioning and peripheral adjacent tissue injury exist depending on the guidance of ultrasonic images; in addition, currently, there is no method for evaluating the nerve function of the abdominal cavity, and the nerve function state after completion of ablation cannot be immediately evaluated.
In the embodiment of the present application, in order to generate low-frequency vibration inside the body (target region), an ultrasonic signal with a certain frequency difference is first generated by the ultrasonic signal generator 2 and sent to the difference frequency focused ultrasonic transducer 4, and the difference frequency focused ultrasonic transducer 4 (which may include the first and second … … nth transducer groups) generates ultrasonic signals with the same frequency and sends the ultrasonic signals to the difference frequency focused ultrasonic transducer, wherein the frequency difference of the difference frequency focused ultrasonic is preferably lower than 1% of the basic frequency.
The difference frequency focusing ultrasonic transducer 4 sends out two focusing sound beams with a certain frequency difference, and after acting on a target area (an area containing the celiac plexus), different reflection echoes are generated according to different tissue compositions of the target area; the reflected echo is picked up by a vibration acoustic physical signal pickup system 61 (a hydrophone can adopt two pickup modes of a water channel signal and a body signal) of the physical mapping system 6, amplified and filtered by a preamplifier 621 and a filter 622 in a vibration acoustic physical signal display system 62, finally converted into an echo signal, and displayed on a digital oscilloscope 623.
The echo signal which is digitally converted in the vibration acoustic physical signal display system 62 is further sent to the treatment planning unit 631 of the vibration acoustic physical signal analysis system 63, compared with various tissue signal parameters preset in the treatment planning unit 631 to construct the tissue hardness state of the point, and under the control of the three-dimensional motion scanning system 3, the difference frequency scanning of the target area is rapidly completed, a hardness distribution state diagram of the whole target area is constructed, and after being compared with various tissue signal parameters preset in the treatment planning unit 631, the distribution condition of the target nerve (abdominal nerve) in the target area is displayed by a gray level diagram, a three-dimensional histogram and a pseudo-color diagram.
The image superposition unit 633 superposes and combines the gray-scale image, the three-dimensional histogram, the color image and the doppler blood flow image output by the ultrasound image unit 632 output by the treatment planning unit 631, and is used for providing image support during further physiological mapping, and finding a mapping target point and a scanning plane.
As shown in fig. 4, the physiological mapping system 7 includes: a biological signal acquisition device 71 and an auxiliary discrimination system 72. The biological signal acquisition device 71 is used for acquiring and recording body physiological electric signals and sending the acquired body physiological electric signals to the auxiliary judgment system 72. The auxiliary discrimination system 72 is used for analyzing and judging the acquired body physiological electric signals, comparing the acquired body physiological electric signals with preset signals, judging the diagnosis or treatment result by an operator through the signal analysis result, and sending the result to the main control computer 1 to adjust the focused ultrasound treatment parameters in real time.
After the physical mapping of the target nerve is completed, in order to further evaluate the functional state of the target nerve, the difference frequency focused ultrasound transducer 4 sends out two beams of difference frequency focused ultrasound with a certain frequency difference again to act on the target nerve part according to the distribution state image of the target nerve in the target region provided by the superposition image unit 633 in the physical mapping system 6. At this time, the biological signal acquisition device 71 of the physiological mapping system 7 starts to record the physiological effect formed by the target nerve after the difference frequency stimulation, in this embodiment of the present application, the target point for diagnosis and treatment is the celiac plexus inside the body, the biological signal acquisition device 71 may use the existing equipment or instrument, such as a nerve potential recorder, an electrocardiograph, an electromyography, and the like, and transmit the recorded physiological electrical signal to the auxiliary discrimination system 72, and in the auxiliary discrimination system 72, the physiological electrical signal may be read manually, or may be determined and identified by using various physiological signal parameters preset in the auxiliary discrimination system 72, so as to further evaluate the functional state of the target nerve, and transmit the definition of the evaluation result to the main control computer 1 for real-time adjustment of the working parameters of the focused ultrasound.
After the physical and physiological double mapping of the target region is completed, the distribution condition and the functional state of the target nerve in the target region are determined, an operator selects a target point suitable for ablation, an ablation instruction is sent out by the main control computer 1 and is transmitted to the ultrasonic signal generator 2, ultrasonic signals with the same frequency are combined and sent to the difference frequency focusing ultrasonic transducer 2 (different from difference frequency focusing ultrasonic in frequency and intensity, and high frequency and high intensity) and ultrasonic ablation is carried out on the target nerve according to a composite image generated by the ultrasonic image unit 632 and the superposition image unit 633. During or/and after the ablation, the operator can repeat the above operation procedures, perform physical and physiological mapping on the target nerve again, and evaluate the functional state of the target nerve by using the tissue hardness condition and the tissue physiological effect after the difference frequency ultrasonic stimulation respectively, thereby achieving the purpose of evaluating the ablation curative effect immediately.
According to the physical mapping device for rapidly acquiring the target nerve treatment energy delivery site, high-frequency focused ultrasound forms a focus at the deep part of an organism, a physical/physiological attribute double mapping positioning method for deep tissues of the organism by utilizing focused ultrasound is created by utilizing a difference frequency confocal ultrasound interference principle, a mechanical stress of low-frequency vibration sound generated at the focus forms a 'tapping' force and a principle of forming deep nerve stimulation stress, a focused ultrasound energy treatment and curative effect verification system method is guided, and a wide application prospect is provided for mapping, regulating, ablating and treating excitable tissues of the organism; the characteristic that external focused ultrasound is used for non-invasively delivering energy to the deep part of a tissue is utilized, the low-frequency component force is generated by using the ultrasonic difference frequency principle and is used for nerve mapping, and the detection function is skillfully developed under the condition that the main framework of the system is basically maintained. Moreover, because the detection and the therapeutic intervention are in the same focus, the accuracy of the therapeutic target is ensured while the system structure is greatly simplified; the physical mapping system 6 adopts a 'tapping' mode to obtain the intensity of the vibration sound, and in addition, the part to be tapped is in a mechanical environment with mechanical force, and tapping is carried out through low-frequency vibration, and the design mode can obtain obvious vibration sound intensity; the physical mapping system 6 firstly carries out fast mapping to find the position or the relative position of a detection surface where a target nerve is located, then carries out accurate mapping on the detection surface through the physiological mapping system 7, the interval time between the physical mapping and the physiological mapping is short, the physical mapping can be used for prescanning, the stimulation response is confirmed, and energy treatment can be released immediately, so that the detection and ablation integrated treatment is favorably realized; the physical mapping system 6 uses the stress generated by the low-frequency vibration generated by the acoustic signal generator as a mapping source, and then "taps" the tissue at the focus with the stress generated by the difference frequency signal in the difference frequency vibration. The mapping source is carried out in vitro, good acoustic coupling can be realized without any electrode or catheter entering the body, and noninvasive treatment of deep target tissues can be realized; the physical information of deep tissue can be comprehensively and accurately acquired by tapping; the three-dimensional motion scanning system 3 is arranged, and when physical detection is carried out, the focused ultrasonic transducer is controlled to carry out three-dimensional arbitrary surface motion relative to a target area, and arbitrary three-dimensional scanning can be carried out on a part to be detected, so that the physical mapping system 66 obtains a hardness distribution map with more comprehensive physical information, and a detection surface is accurately obtained. When physiological detection is carried out, the focus is not limited by an anatomical structure, and two-dimensional or three-dimensional scanning can be carried out at any point of the solid tissue, so that the same focus is realized during mapping and ablation treatment. However, in the conventional physiological detection, due to the absence of the three-dimensional motion scanning system 3, the stimulation of the physiological detection in the blood vessel is limited by space, and the detection cannot be performed if the nerve is far away from the blood vessel.
The above description is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, several modifications and additions can be made without departing from the method of the present invention, and these modifications and additions should also be regarded as the protection scope of the present invention.
Claims (8)
1. A physical mapping device for rapidly acquiring a target nerve treatment energy delivery site is characterized in that the physical mapping device is provided with a physical mapping system; the physical mapping system comprises a vibration sound physical signal pickup system, a vibration sound physical signal display system and a vibration sound physical signal analysis system; the vibration sound physical signal pickup system is used for picking up sound waves and transmitting the sound waves to the vibration sound physical signal display system for processing; the vibration sound physical signal display system comprises a preamplifier, a filter and a digital oscilloscope; the vibration sound physical signal pickup system is used for picking up echoes generated by different tissues after difference frequency focusing ultrasonic stimulation; the vibration sound physical signal display system is used for converting sound waves or echoes into digitized echo signals, transmitting the digitized echo signals to a preamplifier in the vibration sound physical signal display system, amplifying the echo signals, further transmitting the echo signals to a filter unit in the vibration sound physical signal display system, filtering clutter signals in the echo signals by the filter in a low-pass/high-pass or other mode, and finally transmitting the echo signals to a digital oscilloscope in the vibration sound physical signal display system for display; the vibration sound physical signal analysis system comprises a treatment planning unit, an ultrasonic image unit and a superposed image unit; the treatment planning unit and the superposed image unit are connected with a digital oscilloscope in the vibration sound physical signal display system and used for receiving echo signals on the digital oscilloscope;
the treatment planning unit is used for receiving echo signals on the digital oscilloscope, comparing the obtained echo signals with echo signals generated after differential frequency ultrasonic stimulation of various tissues preset in the treatment planning unit, performing gray-scale scanning to construct a hardness distribution diagram of a target region, displaying the distribution state of target nerves in the target region through the hardness distribution diagram, and displaying in the forms of a gray-scale image, a three-dimensional histogram and a pseudo-color image to visually display an ablation treatment plan;
the ultrasonic image unit comprises an ultrasonic image probe; the ultrasonic image probe is arranged in the difference frequency focusing ultrasonic transducer, can flexibly turn, and can perform two-dimensional and Doppler blood flow imaging when the difference frequency ultrasonic works;
the superposition image unit superposes and combines the gray-scale image, the three-dimensional histogram, the pseudo-color image and the Doppler blood flow imaging output by the ultrasonic image unit, which are output by the treatment planning unit, and is used for providing image support during ablation, searching a treatment target point and a scanning plane, and setting a treatment energy delivery site by utilizing the virtual focus of the treatment unit through the three-dimensional motion of the treatment unit.
2. The physical mapping device of claim 1, wherein the vibro-acoustic physical signal pick-up system is a hydrophone, and the hydrophone can adopt both a water tank signal pick-up mode and a body signal pick-up mode, and the water tank is paved with flexible sound-absorbing rubber to reduce the influence of surface reflection.
3. The physical mapping device of claim 2, wherein the physical mapping device is further equipped with an ultrasound signal generator, a difference frequency focused ultrasound transducer; the ultrasonic signal generator generates ultrasonic signals with a certain frequency difference, the ultrasonic signals are sent to the difference frequency focusing ultrasonic transducer, and two or more beams of difference frequency focusing ultrasonic waves with a certain frequency difference are generated by the difference frequency focusing ultrasonic transducer.
4. The physical mapping device of claim 3, wherein the difference frequency focused ultrasound transducer emits the difference frequency focused ultrasound with a frequency difference lower than 1% of a fundamental frequency.
5. The physical mapping device according to claim 3, wherein the physical mapping device is further equipped with a physiological mapping system and a host computer; the physiological mapping system includes: the biological signal acquisition device is used for assisting the discrimination system; the biological signal acquisition device is used for acquiring and recording body physiological electric signals and sending the acquired body physiological signals to the auxiliary judgment system; the auxiliary judgment system is used for analyzing and judging the acquired body physiological signals, comparing the acquired body physiological signals with preset signals, judging the signals by an operator according to the signal analysis result, and sending the result to the main control computer to adjust the focused ultrasound treatment parameters in real time.
6. The physical mapping device of claim 5, wherein the bio-signal acquisition device comprises: an electrocardiogram analyzer, a multi-channel physiological recorder, a respiration monitor and/or electroencephalograph, a nerve potential analyzer, and a blood biochemical analyzer.
7. The physical mapping device according to claim 5, wherein after the physical mapping is completed, the physical mapping system superimposes the distribution state image of the target nerve in the target region provided by the image unit, the difference frequency focused ultrasound transducer re-emits two beams of difference frequency focused ultrasound with a certain frequency difference to act on the target nerve, and the biological signal acquisition device starts to record the physiological effect of the target nerve after the difference frequency stimulation, so as to obtain the evaluation result of the target nerve.
8. The physical mapping device according to claim 7, wherein the main control computer sends an ablation instruction according to the definition of the target nerve evaluation result, the instruction is transmitted to the ultrasonic signal generator, two groups of ultrasonic signals with the same frequency are generated and sent to the difference frequency focused ultrasonic transducer, a focused ultrasonic beam with the same frequency is sent out, and ultrasonic ablation is performed on the target nerve according to the composite image generated by the ultrasonic imaging unit and the superposition image unit.
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| CN111227865A (en) * | 2020-01-16 | 2020-06-05 | 黄晶 | Ultrasonic resonance imaging system |
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