JP2007000218A - Ultrasonic therapy apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic blood vessel irradiation apparatus which can make a blood flow stop by denaturing a blood vessel while reducing a bleeding risk by a vascular breakdown. <P>SOLUTION: To solve the above-mentioned subject, the ultrasonic blood vessel irradiation apparatus of this invention comprises an ultrasound probe for imaging which performs the imaging of the ultrasonic tomogram for the affected part of a subject, an indicating means which displays the ultrasonic tomogram, a blood vessel position sensing means which detects a blood vessel position from information on the affected part obtained by the ultrasound probe for the imaging, one or two or more ultrasonic generators for treatment which irradiate a converged ultrasound for the treatment, and an ultrasonic control means for the treatment which converges the ultrasound for the treatment emitted from the ultrasonic generator for the treatment on the neighborhood of the vascular wall of the blood vessel. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an ultrasonic blood vessel irradiation device intended to obtain medical treatment effects such as tumor growth suppression by irradiating blood vessels with ultrasonic waves to attenuate or disrupt blood flow.

  Ultrasonic waves have characteristics that are not found in electromagnetic waves such as laser light and microwaves, which can propagate to a deep part of a living body at a short wavelength and can be converged to an arbitrary place. Research and development of ultrasonic therapy taking advantage of this feature is underway. The biological action of ultrasound that can be utilized for treatment is roughly divided into a heating action and a sonochemical action. The former heating action is attributed to the fact that the tissue absorbs ultrasonic waves and generates heat. Therapies that apply this heating effect to medical treatment include “hyperthermia” that treats tumors by continuously heating the affected area to about 40 ° C. to 50 ° C., and powerful focused ultrasound (High Intensity Focused Ultrasound, HIFU). ) Can be roughly divided into “heat coagulation therapy” in which a minute region of an affected area is raised to a temperature causing tissue degeneration such as 70 ° C. to 100 ° C. in a short time.

  “Hyperthermia” for tumors is a treatment that uses the property that tumor cells are vulnerable to persistent high temperatures (about 43 ° C.) compared to normal cells, but it is possible to slow the growth of tumors. Has a low ability to directly necrotize tumor cells, and the temperature rise in the affected area is governed by the blood flow and heat conduction of the surrounding tissue, and it is not easy to maintain the temperature necessary for treatment, and the temperature Because the ascending region is not sufficiently localized, the level of treatment and the stress (side effects) on the living body are not balanced, and the level is not satisfactory. In combination with radiotherapy in actual clinical settings Often used as

  On the other hand, in the heat coagulation treatment using HIFU, intense ultrasonic waves are collected in a minute area of a millimeter unit, and the temperature is instantaneously raised to a temperature that causes tissue degeneration. The heat coagulation treatment using HIFU differs from the above-described thermotherapy in the temperature rising at the site to be treated and the tissue change resulting therefrom. The heat generated in the tissue is carried away by heat conduction and blood flow, but in the case of heat coagulation therapy, the time required for these heat transport and ultrasonic fever to reach an equilibrium state (about 1 minute) In a much shorter time, the focal zone temperature is raised to the protein coagulation temperature or higher by high-intensity ultrasonic waves and solidified. Since the ultrasonic density is low at a portion other than the focal point, the temperature of heat denaturation is not reached, and only the vicinity of the focal point is denatured. Currently, treatment with HIFU is applied to the treatment of prostatic hypertrophy, prostate cancer, and uterine fibroids.

  In the prior art heat coagulation treatment, the region that causes irreversible tissue thermal denaturation by irradiation of focused ultrasound is a very small volume near the focal point. Since there are few areas that can be treated at a time, it is necessary to move the focal point and repeat irradiation when treating the entire tumor.

  Furthermore, when performing multiple irradiations, the next irradiation must be performed after the temperature of the tissue other than the treatment target that has been raised by the previous irradiation is sufficiently lowered by the cooling action such as blood flow, and there is a waiting time between irradiations. Necessary.

  Thus, when treating a tumor that is several centimeters in size, the treatment time may take several hours. Thus, the current heat coagulation treatment has a big problem that the treatment time becomes long. At present, for example, there is a problem that the treatment efficiency is particularly low for a tumor having a particularly large volume, such as uterine fibroids.

  Arterial embolization treatment has recently been attempted as a treatment method for uterine fibroids, liver cancer and the like. In this treatment method, a catheter is inserted into a tumor blood vessel and an embolic material is injected into the blood vessel. The introduced embolic material is clogged in the feeding blood vessels that circulate through the tumor, and the blood flow is blocked to stop feeding the tumor and achieve the purpose of tumor treatment. In general, it is known that a tumor with poor blood flow, such as uterine fibroids, shows a stronger tumor regression effect due to blood flow blockage. However, in this treatment method, it is necessary to insert a catheter from a large artery such as the base of the patient's thigh under local or general anesthesia, and to guide the catheter to a target blood vessel under fluoroscopy. There are many pains caused by exposure to and exposure to catheters.

  Here, as one of the treatment methods for such a tumor, a focused ultrasound is applied to a blood vessel that supplies nutrients to the tumor from outside the body, thereby infarcting the blood vessel and making the tumor noninvasive and less invasive. Treatment methods that block nutrition supply to the child are conceivable. Tumors such as uterine fibroids that have a therapeutic effect due to the above-mentioned blood flow blockage can be treated with much shorter exposure time than focused ultrasound to cover the entire tumor. It is considered that the objective can be achieved.

  Conventional proposals have also been made regarding methods of irradiating blood vessels or the like with powerful ultrasonic waves for therapeutic purposes (see, for example, Patent Documents 1 and 2).

JP2000-037393

JP2003-199760

  However, the focal region formed by HIFU has an elongated shape like a needle, and the sound pressure at the center is particularly high. For this reason, when a high-intensity ultrasonic focal point is located at the center of the blood vessel, the blood vessel wall is subjected to the impact, and there is a risk of causing bleeding or rupture. In addition, blood vessels such as elderly people and diseased patients may be more vulnerable than healthy individuals, and nutritional blood vessels formed with tumor growth are more fragile than normal tissue blood vessels. That is, if HIFU irradiation is applied to the center of blood vessels for elderly people or tumor patients, there is a possibility of blood vessel failure.

  An object of the present invention is to provide an ultrasonic blood vessel irradiation apparatus capable of degenerating blood vessels and disrupting blood flow with higher probability than before while reducing the risk of bleeding due to blood vessel failure.

  In order to solve the above-described problem, an ultrasonic blood vessel irradiation apparatus according to the present invention includes an imaging ultrasonic probe for imaging an ultrasonic tomographic image of an affected part of a subject, and display means for displaying the ultrasonic tomographic image. A blood vessel position detecting means for detecting a blood vessel position from information on the affected part obtained by the imaging ultrasonic probe, and one or a plurality of therapeutic ultrasonic generators for irradiating the focused therapeutic ultrasonic waves, And a therapeutic ultrasonic control means for converging the therapeutic ultrasonic wave irradiated from the therapeutic ultrasonic generator near the blood vessel wall of the blood vessel.

  The ultrasonic blood vessel irradiation device of the present invention detects the position of the target blood vessel, avoids the blood vessel center, and forms one or more therapeutic ultrasonic focal points around the blood vessel wall, thereby strengthening the center of the blood vessel. It is possible to suppress bleeding caused by rupture of the blood vessel wall due to the change in sound pressure, denature the tissue of the blood vessel wall or its surrounding tissue, reduce the blood vessel function, and attenuate or disrupt the blood flow.

  Hereinafter, embodiments of the ultrasonic therapy apparatus of the present invention will be described with reference to the drawings.

FIG. 1 is a diagram showing a schematic configuration of an ultrasonic therapy apparatus according to an embodiment of the present invention.
The therapeutic applicator 1 is a therapeutic ultrasonic transducer 2 composed of one or more spherical therapeutic ultrasonic elements 4 that irradiate high-power ultrasonic waves for treatment, and guides high-power ultrasonic waves to the patient's skin. A medium 5, a water bag 6 that holds the medium in close contact with the applicator, and an imaging probe 3 for ultrasonically observing the affected area.

  Here, the medium 5 usually uses water as a substance having an acoustic impedance close to that of the living body in order to improve the consistency between the living body and the ultrasonic transducer. Degassed so as not to interfere with the transmission of sound waves.

  The therapeutic ultrasonic transducer 2 is driven and controlled by the ultrasonic element driving unit 23 so as to be able to irradiate high-power ultrasonic waves, and is composed of a plurality of ultrasonic transducers such as piezoelectric elements. The amplitude and phase of the high-frequency power applied to each element are controlled independently for each element.

  Information on ultrasonic irradiation is input to the therapeutic ultrasonic control unit 22 by the operation of the input unit 21 or from the system control unit 19, and based on the information, the focal position and sound of each irradiation sound field corresponding to the selected frequency are input. An irradiation code signal defining the pressure distribution shape is given to the ultrasonic element driving unit 23. As a result, the ultrasonic element driving unit 23 drives each element of the therapeutic ultrasonic transducer 2 to irradiate high-power ultrasonic waves, heat and coagulate a portion coincident with the focal point, and narrow or infarct the blood vessel.

  The ultrasonic reception signal received from the living body by the imaging probe 3 is adjusted to a signal in which the amplification and phase are adjusted by the transmission / reception unit 14 and the reception signal from any part in the living body is emphasized. Converted. Based on the received signal, an ultrasonic tomogram is generated by the signal processing unit 15, stored in the memory 17, and displayed on the display 20.

  Then, by extracting the blood vessel position by the blood vessel position detection unit 16, the surgeon can observe the blood vessel 10 of the affected part 9 by looking at the displayed image, and can make a treatment plan.

  An example of a blood vessel position detection method is shown below. Usually, unlike the blood vessel lumen filled with blood, the blood vessel wall reflects a high-intensity received signal. Compared with the soft tissue around the blood vessel, the blood vessel wall has high reflection intensity. In other words, in the region of interest 11 including the treatment blood vessel 10, a structure having a received signal with a predetermined intensity or more can be detected as a blood vessel wall by the blood vessel position detection unit 16 and displayed on the display 20. Here, the ultrasonic wave reflection intensity of the blood vessel wall can be set in advance on the apparatus side using the reflection intensity indicating a typical blood vessel wall structure as an index. Alternatively, the surgeon can leave the received signal intensity at an arbitrary point of the tomographic image in the memory and display it on the display 20 according to a command from the input unit 21. Thereby, the ultrasonic reflection intensity of standard tissues (for example, liver parenchyma or muscle tissue) other than the blood vessel wall can be measured. The surgeon can measure the ultrasonic reflection luminance of, for example, liver parenchyma or muscle tissue immediately before treatment, and set a threshold value of detected reflection intensity as a blood vessel wall based on the luminance. That is, even when the ultrasonic reflection intensity of the liver tissue or muscle tissue differs due to individual differences among patients, the threshold value for detecting the blood vessel wall can be set based on the tissue of the patient to be treated. Here, in detecting the blood vessel wall, in particular, the luminance maximum point of the intima inside the outer wall of the blood vessel wall may be recognized.

  In addition, when recognizing a blood vessel wall, instead of using the reflected luminance as a reference, for example, a blood vessel shape (such as a circle) pattern is recognized in advance in a memory, and the imaging result and the degree of approximation, correlation, and the like are determined. The blood vessel wall may be recognized.

  In addition, as a method for detecting a blood vessel position, a method using a contrast agent is also included. The method is shown below. An ultrasound contrast agent is a drug mainly composed of microbubbles having a diameter of several microns, and has recently been used clinically. As the type of gas, air, carbon dioxide and nitrogen have been used before, but recently, gas such as fluorocarbon which is hardly soluble in water has been used. Furthermore, in order to be able to pass through capillaries of humans and animals, the gas is stabilized with phospholipids and proteins in order to control the main bubble diameter from 1 to several microns. This ultrasound contrast agent is usually administered intravenously immediately before observing the affected area with ultrasound. Since the contrast agent mainly composed of microbubbles usually stays in the blood vessels of humans and animals, the blood flow in the affected area, that is, the blood flow itself can be seen.

  For example, a contrast agent is administered from a patient's vein and the affected part 9 is observed with ultrasound. Since the contrast agent remains inside the blood vessel as described above, the contrast agent flows into the blood vessel 10 of the affected part 9 several seconds after the administration of the contrast agent.

Since the contrast agent mainly composed of bubbles becomes a strong reflector with respect to transmission ultrasonic waves, the intensity of ultrasonic reception signals obtained from the imaging probe 3 is increased. That is, a high echo can be received from inside a blood vessel having a low echo intensity by administration of a contrast agent.
Furthermore, since the bubble has a property of nonlinear vibration, the imaging probe 3 can receive a component such as a harmonic twice as high as that of the transmission ultrasonic wave as a part of a reception signal from the bubble. For the received harmonic component, the signal processing unit 15 can store, for example, only a signal having a frequency component twice the transmission frequency in the memory 17 and display it on the display 20. Alternatively, it can be superimposed on the previous ultrasonic tomogram.

  In this way, the part where the frequency signal twice the transmission frequency is detected is from the place where the contrast agent exists, that is, from the inside of the blood vessel, and since the harmonic component is hardly detected from the tissue where the contrast agent does not exist, It is possible to draw the position of the blood vessel with high accuracy.

  As a method of detecting the blood vessel position, for example, the following method can be used to detect the blood vessel position with higher accuracy. Among the ultrasonic reception signals obtained from the imaging probe 3, the frequency-shifted signal reflected from the blood flow in the living body is processed by the signal processing unit 15 and then analyzed for blood flow velocity calculation. The frequency analysis is performed by the unit 18 to calculate the blood flow velocity. The calculated blood flow velocity is stored in the memory 17. Here, information corresponding to the calculated blood flow velocity is displayed in color on the ultrasonic tomographic image of the affected area, for example, and displayed on the display 20 in a superimposed manner on the ultrasonic tomographic image. The blood vessel site where the flow was detected can be clearly shown to the operator. That is, the captured image data and blood flow velocity data stored in the memory 17 can be read, and the tomographic image of the affected area 9 and the blood flow displayed in color according to the velocity can be superimposed and displayed on the display 20.

  The therapeutic ultrasonic control unit 22 is controlled by a command from the system control unit 19. The system control unit 19 is formed by a computer, for example. The surgeon inputs an execution command from the input unit 21 to the system control unit 19 so that the ultrasonic imaging condition and the treatment condition of the affected part can be arbitrarily set.

  A case where a tumor such as a tumor is infarcted by using the ultrasonic therapy apparatus configured as described above to treat the tumor will be described below.

  The ultrasonic therapy apparatus according to the present embodiment, for example, images an affected part in a living body and performs tomography on an affected part of a tomographic image acquired in this imaging mode. It has a treatment mode for performing treatment by irradiating therapeutic ultrasonic waves.

  For example, an operator such as a doctor first observes the affected area 9 of the patient 8 in the imaging mode. For example, when treating a tumor in the abdomen such as a uterine fibroid, the applicator 1 is placed on the patient body surface 7 and the patient body surface 7 and the water bag 6 are brought into close contact with each other using an ultrasonic jelly or the like. Next, the surgeon moves the applicator 1 in close contact with the patient body surface 7 manually or by instrument assistance while maintaining the degree of close contact with the patient body surface 7, and the surgeon integrates with the applicator 1. Then, an ultrasonic tomography inside the patient is observed with the imaging probe 3 incorporated therein.

  When the surgeon inputs an execution instruction to start imaging using the input unit 21, the system control unit 19 outputs a command to the transmission / reception unit 14 in response to this. As a result, the imaging ultrasonic beam is transmitted from the imaging probe 3 to the affected area. The imaging ultrasonic beam is scanned along the arrangement direction of the imaging probe 3, and the imaging ultrasonic beam 13 is irradiated onto a region along the fan-shaped tomographic plane of the affected part.

The reflected echo of the imaging ultrasound reflected from the region irradiated with the imaging ultrasound is received as a reception signal by the imaging probe 3. The received signal is subjected to phasing processing for each imaging ultrasonic beam by the transmission / reception unit 14, and a two-dimensional ultrasonic image of the tomographic plane is generated by a signal processing unit (including a digital scan converter) 15. The tomographic image is stored in the memory 17 and displayed on the display 20. Further, the surgeon can leave the received signal intensity at an arbitrary point of the tomographic image in the memory and display it on the display 20 according to a command from the input unit 21. Thereby, the ultrasonic reflection intensity of standard tissues (for example, liver parenchyma or muscle tissue) other than the blood vessel wall can be measured.
Then, the blood vessel position is detected by the blood vessel position detection unit, and a treatment plan can be made.

  FIG. 2 is a schematic diagram of an image displayed on the display before irradiating therapeutic ultrasonic waves in the embodiment of the present invention. FIG. 2 shows a tomographic image including the affected part 9 obtained using the imaging probe 3 provided in the applicator. The surgeon can operate the input unit 21 while viewing the image displayed on the display 20. That is, as shown in FIG. 2, a plurality of blood vessels such as the blood vessel 10 and the blood vessel 13 existing in the affected area can be observed, and a treatment policy can be established. Here, the surgeon can set the region of interest 11 that includes the blood vessel 10 to be treated for the time being and does not include the blood vessel 13 that is not to be treated for the time being.

  By irradiating the blood vessel wall so that the focal point 25 of the focused ultrasound for treatment overlaps, the blood vessel wall can be heated and coagulated. By modifying the blood vessel wall, the function of the blood vessel is reduced, the blood vessel is narrowed, and a reduction in blood flow can be expected.

Here, the positional relationship of the focused ultrasound focus with respect to the blood vessel wall is important. FIG. 3 explains the importance of the results with reference to the results of animal experiments. The anesthetized rat was subjected to laparotomy, the inferior vena cava located at the bottom of the abdominal cavity was exposed, and the rat was fixed in a water tank filled with degassed physiological saline. A HIFU transducer was installed in the vicinity of the inferior vena cava and finely adjusted so that the focal point of the intensely focused ultrasound was aimed at the vein wall. The blood vessel 10 of FIG. 3 shows a cross section of the rat inferior vena cava. The focal point 25 usually has an elliptical shape like an elongated rugby ball. Here, the rat inferior vena cava and the focal position are finely adjusted so that the angle between the long axis of the focal point and the line from the intersection of the focal point and the vascular wall to the center of the blood vessel becomes 0, 30, 45, 60, 90 °. And experimented. The frequency of the applied HIFU was 3.25 MHz, the peak intensity of the focus was 3.0 kW / cm ² , and continuous irradiation was performed for 5 seconds. HIFU irradiation was performed on the inferior vena cava of the rat in the positional relationship between the blood vessel and the focal point so that the above angle was obtained. Experiments were performed at five angles, and the presence or absence of vascular failure or rupture after irradiation was examined. As a result, when the angle was 0 °, 5 out of 5 cases showed vascular wall failure, whereas at an angle of 30 °, only 1 case was broken. Above 45 °, no vascular failure was observed. Since the vein wall is thinner than the artery wall, it may break down due to strong HIFU, but it is shown that the failure can be avoided by selecting the incident angle of the convergent ultrasonic wave with respect to the blood vessel wall as described above. On the other hand, the arterial wall is a strong structure rich in elastic fibers, etc., compared to that of veins, but the arteries around the tumor or those of patients who have disease in the arteries are compared to the normal arteries. It may be vulnerable. When fragile arteries are irradiated with HIFU to degenerate blood vessels, the risk of failure can be determined by selecting the incident angle of convergent ultrasound on the blood vessel wall, as in the results of the study on the vena cava of rats. HIFU energy can be input to the periphery of the arterial wall, and as a result, the blood vessel wall tissue or the adjacent tissue adjacent thereto can be denatured to reduce the blood vessel function.

  FIG. 4 shows a cross section of the blood vessel to be treated. As described above, the arterial wall is usually depicted with high brightness on echo compared to the internal blood components and the surrounding soft tissue. However, there are cases where all the cross-sections of the blood vessel 10 cannot be drawn with the same echo intensity. In that case, in the normal ultrasound B-mode image, the target blood vessel may not be drawn as a whole blood vessel cross section as shown in FIG. . In such a case, the operator can describe the axis 26 along the high-intensity region on the display 20 as shown in FIG. An angle α28 formed by the axis line 26 taken into the memory 17 and the axis line 27 of the therapeutic ultrasound beam set in advance is measured by the system control unit 19, and the angle is, for example, as shown in FIG. In the case of 45 ° or more, it can be displayed on the display 20 that the surgeon has selected a blood vessel wall portion that can be treated. Accordingly, the surgeon can set the focal point 25 of the focused ultrasound as shown in FIG. 4D on the blood vessel wall portion that can be treated.

  Next, a second embodiment of the present invention will be described with reference to FIG. This configuration has two therapeutic transducers. In the same process as irradiating the blood vessel wall with one focal point described in FIG. 1, based on the signal received by the probe 3, with respect to the drawn blood vessel 10, In this configuration, two focal points 25 of the two therapeutic transducers 2 can be simultaneously aimed at the blood vessel wall. Each of the therapeutic transducers 2 can be mechanically displaced to change the position of the geometric focus.

  FIG. 6 shows the result of simulating the temperature rise on the focal short axis surface when the living tissue is irradiated with convergent ultrasonic waves (displayed with the relative temperature rise as a contour line). When 3 MHz convergent ultrasound was irradiated in a single focus state, a small temperature rise point was 1 second after irradiation (29 in FIG. 6), but 5 seconds after irradiation (30 in FIG. 6). It can be seen that the temperature rise also spreads around the periphery. On the other hand, in the temperature rise result assuming that two focal points are simultaneously aimed at the opposite side of a blood vessel with a diameter of 1 mm and irradiated at the same time, a 1 mm interval is placed 2 seconds later (31 in FIG. 6) 2 It can be seen that the temperature starts to rise from the point. After 5 seconds (32 in FIG. 6), it can be seen that the temperature rise area spreads over a wide area, and the temperature rise is also observed between the two points due to heat conduction. That is, the tissue around the blood vessel wall can be heated over a wide range by two-point simultaneous irradiation. Furthermore, such a heating effect is further enhanced by simultaneously forming three or more focal points around the blood vessel. By forming a plurality of focal points in this way, there is an effect that blood flow blockage can be promoted while reducing the risk of blood vessel failure as compared with a single focal point.

  Since the ultrasonic focus in which strong pressure fluctuation occurs is aimed at the blood vessel wall, strong sound pressure fluctuation does not reach the central part of the blood vessel. Therefore, in the unlikely event of a blood vessel failure, it can be avoided. On the other hand, by simultaneously irradiating the blood vessel wall with a plurality of focal points, the tissue around the blood vessel wall can be heated, the blood vessel wall and the surrounding tissue can be denatured, and the blood vessel function can be reduced.

FIG. 7 is a diagram showing a blood flow velocity measurement result when HIFU is irradiated to a rat femoral artery in an example of the present invention. The horizontal axis in FIG. 7 indicates the number of irradiations 36 of HIFU, and the vertical axis in FIG. 7 indicates the systolic blood flow velocity (cm / sec) 35 immediately after irradiation. The frequency of the used HIFU transducer was 3 MHz, and the irradiation time for one time was 5 seconds. The white blood circle 34 shows the blood flow velocity immediately after irradiating the femoral artery of the rat with one focal point at the center of the blood vessel. On the other hand, the diameter of the blood vessel of the femoral artery was measured, the two blood foci were aimed at the opposite blood vessel walls, and the blood flow velocity immediately after the simultaneous irradiation was shown as a black circle 33. The peak intensity of the focus was approximately 3.0 kW / cm ² for both the 1 focus and 2 focus.

  In the example of the rat of the white circle 34 in FIG. 7, the blood flow velocity before the focused ultrasound irradiation is about 20 cm / second, and the blood flow velocity is increased to about 30 cm / second by the first irradiation, resulting in vascular stenosis. You can see that The blood flow velocity increases to about 40, 50, 60, and 85 cm / second by irradiation of 2, 3, 4, and 5 times, respectively, and it is considered that vascular stenosis is progressing. Further, when the sixth irradiation is performed, the blood flow velocity measurement result is 0 cm / second, which indicates that the blood flow is interrupted. That is, when the rat femoral artery was irradiated with one focal point, blood flow was interrupted by repeating irradiation six times.

  Similarly, an example of a black circle 33 rat will be described. The blood flow velocity increases from 20 cm / second to about 40 cm / second by the first irradiation, increases to about 40 cm / second by the second irradiation, and increases to about 100 cm / second by the third irradiation. did. And it turns out by the 4th irradiation that the blood flow velocity became 0 cm / sec and the blood flow was interrupted.

  When aiming at one focal point in the center of the blood vessel, increasing the strength of adaptation may reduce the number of times necessary for blood flow blockage, but also increases the risk of blood vessel blockage. By aiming at the two focal points and simultaneously irradiating the blood vessel wall on the opposite side of the blood vessel, the blood flow blockage can be promoted while reducing the risk of blood vessel failure.

  Even when aiming at multiple focal points, the incident angle of the convergent ultrasonic wave with respect to the blood vessel wall is selected in the same manner as when aiming at one focal point (for example, the center of the blood vessel from the focal axis and the intersection of the focal point and the blood vessel wall). It is desirable that the angle formed by the line to be 45 ° or more.

The figure which shows the structure of the ultrasonic blood vessel irradiation apparatus of the Example of this invention. In the Example of this invention, before irradiating a therapeutic ultrasonic wave, the schematic diagram of the image displayed on a display. In the Example of this invention, the schematic diagram which shows the focus position of the convergent ultrasonic wave irradiated to the abdominal vena cava of a rat. The schematic diagram which shows the focus aiming procedure to the high-intensity area | region which is a part of drawn blood vessel in the Example of this invention. The figure which shows the structure of the transducer for ultrasonic therapy of the Example of this invention. The tissue temperature rise simulation result of the Example of this invention. The figure which shows the blood flow velocity measurement result of the rat femoral artery before and behind convergent ultrasound irradiation in the Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Treatment applicator, 2 ... Treatment ultrasonic transducer, 3 ... Imaging probe, 4 ... Treatment ultrasonic element, 5 ... Medium, 6 ... Water bag, 7 ... Patient body surface, 8 ... Patient, DESCRIPTION OF SYMBOLS 9 ... Affected part, 10 ... Blood vessel, 11 ... Area of interest, 12 ... Ultrasound beam for treatment, 13 ... Ultrasound beam for imaging, 14 ... Transmission / reception unit, 15 ... Signal processing part, 16 ... Blood vessel position detection part, 17 ... Memory, 18 ... Blood flow velocity calculation analysis unit, 19 ... System control unit, 20 ... Display, 21 ... Input unit, 22 ... Treatment ultrasonic seat control unit, 23 ... Ultrasonic element drive unit, 24 ... High luminance range 25 ... Focus, 26 ... Axis, 27 ... Axis of therapeutic ultrasonic beam, 28 ... Anti-angular angle, 29 ... Temperature increase after 1 second of 1 focus irradiation, 30 ... Temperature increase after 4 seconds of 1 focus irradiation, 31 ... Temperature increase 1 second after bifocal irradiation, 32 ... bifocal irradiation Temperature increase after 2 seconds, 33 ... black circle indicating blood flow velocity of rat irradiated with 2 focal points, 34 ... white circle indicating blood flow velocity of rat irradiated with 1 focal point, 35 ... systolic blood flow velocity immediately after irradiation 36 ... HIFU irradiation frequency.

Claims (14)

An imaging ultrasound probe for imaging an ultrasonic tomogram of the affected area of the subject;
Display means for displaying the ultrasonic tomogram;
A blood vessel position detecting means for detecting a blood vessel position from information on the affected part obtained by the imaging ultrasonic probe;
One or more therapeutic ultrasound generators for irradiating the focused therapeutic ultrasound;
An ultrasonic therapy apparatus comprising therapeutic ultrasonic control means for converging the therapeutic ultrasonic wave irradiated from the therapeutic ultrasonic generator near a blood vessel wall of the blood vessel.   The ultrasonic therapeutic apparatus according to claim 1, wherein the therapeutic ultrasonic control unit controls an incident angle of the therapeutic ultrasonic wave with respect to the blood vessel wall. The focal point on which the therapeutic ultrasound converges is elliptical,
The therapeutic ultrasonic control means performs control so that an angle formed by the long axis of the ellipse and a line drawn from an intersection of the focal point and the blood vessel wall to the center of the blood vessel becomes a predetermined angle. The ultrasonic therapy apparatus according to claim 1, wherein the apparatus is an ultrasonic therapy apparatus.   The ultrasonic therapeutic apparatus according to claim 1, wherein the therapeutic ultrasonic control means performs control so that the predetermined angle is in a range of 45 degrees to 90 degrees.   2. The ultrasonic treatment apparatus according to claim 1, wherein the blood vessel position detecting means detects a position where the signal intensity detected by the imaging ultrasonic probe is a predetermined value or more as a blood vessel position.   The ultrasonic therapy apparatus according to claim 5, further comprising an input unit that inputs the predetermined value.   The ultrasonic therapy apparatus according to claim 1, further comprising blood flow velocity calculating means for calculating a blood flow velocity from a signal detected by the imaging ultrasonic probe. An imaging ultrasound probe for imaging an ultrasonic tomogram of the affected area of the subject;
Display means for displaying the ultrasonic tomogram;
A blood vessel position detecting means for detecting a blood vessel position from information on the affected part obtained by the imaging ultrasonic probe;
A first therapeutic ultrasound generator for irradiating the focused therapeutic ultrasound; a second therapeutic ultrasound generator for irradiating the focused therapeutic ultrasound;
A therapeutic ultrasonic control means for simultaneously converging the therapeutic ultrasonic waves irradiated from the first therapeutic ultrasonic generator and the second therapeutic ultrasonic generator to both sides of a blood vessel wall of the blood vessel; An ultrasonic therapy apparatus comprising:   The ultrasonic therapeutic apparatus according to claim 8, wherein the therapeutic ultrasonic control unit controls an incident angle of the therapeutic ultrasonic wave with respect to the blood vessel wall. The focal point on which the therapeutic ultrasound converges is elliptical,
The therapeutic ultrasonic control means performs control so that an angle formed by the long axis of the ellipse and a line drawn from an intersection of the focal point and the blood vessel wall to the center of the blood vessel becomes a predetermined angle. The ultrasonic therapy apparatus according to claim 8, wherein the apparatus is an ultrasonic therapy apparatus.   9. The ultrasonic therapy apparatus according to claim 8, wherein the therapeutic ultrasonic control means performs control so that the predetermined angle is in a range of 45 degrees to 90 degrees.   9. The ultrasonic therapy apparatus according to claim 8, wherein the blood vessel position detecting means detects a position where the signal intensity detected by the imaging ultrasonic probe is a predetermined value or more as a blood vessel position.   The ultrasonic therapy apparatus according to claim 12, further comprising an input unit that inputs the predetermined value. 9. The ultrasonic therapy apparatus according to claim 8, further comprising blood flow velocity calculating means for calculating a blood flow velocity from a signal detected by the imaging ultrasonic probe.

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