JPH10262946A - Antenna device for nmr measurement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To expand a balloon including a magnetic resonance reception circuit into a desired size without damaging it when inserting an endoscope treatment tool channel. SOLUTION: The antenna device 1 for NMR measurement is constituted by providing a slender and soft fluid conduit 2 for supplying air and a rectangular balloon 4 including a coil 3 for NMR measurement and covering the tip end of fluid conduit 2, and the coil 3 for NMR measurement is formed around the end face of balloon 4. On the top end side face of fluid conduit 2 covered with the balloon 4, a slit 5 is formed for supplying air to be supplied to the fluid conduit 2 into the balloon 4. On the base of balloon 4, a non-magnetic base sheet 7 composed of shape memory resin storing a winding form at the intra-celom temperature, for example, is provided by adhesion, etc.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an antenna apparatus for NMR measurement, and more particularly to an antenna apparatus for NMR measurement characterized by a balloon portion including a magnetic resonance receiving circuit.

[0002]

2. Description of the Related Art In recent years, non-invasive methods for diagnosing the human body using the nuclear magnetic resonance (hereinafter abbreviated as NMR) phenomenon have been developed. For example, in nuclear magnetic resonance imaging (hereinafter abbreviated as MRI) utilizing the NMR phenomenon, a human body is placed in a magnetic field, a high frequency (magnetic field) having a predetermined frequency is applied, and a nucleus having spin in the human body is excited. Then, an NMR signal of a predetermined frequency from the excited nucleus is detected and processed by a computer to obtain a tomographic image of a human body. The tomographic image obtained by the MRI is extremely useful for diagnosis of cancer or the like. That is, it is generally known that NMR signals obtained from cancer cells and normal cells have different relaxation times, and it is possible to diagnose whether or not cancer is present by measuring the relaxation times.

[0003] Conventionally, when an abnormal location is visually found during endoscopic observation, there has been a demand to determine to some extent whether or not the abnormal location is, for example, a malignant one. On the other hand, when the above-mentioned MRI is used in combination, there is a problem that it is difficult to associate a visually recognized portion with a tomographic image with a tomographic image.

Therefore, as shown in, for example, Japanese Patent Application Laid-Open No. 64-20832, an NMR measurement coil is provided on a balloon which is inserted endoscopically into a body cavity, and a lesion in the body cavity is endoscopically viewed. When performing NMR measurement in a mirror, an antenna device for NMR measurement corresponding to the above-mentioned request that enables accurate NMR measurement by inflating a balloon and pressing a coil for NMR measurement against a target site in a body cavity has been proposed. I have.

[0005]

SUMMARY OF THE INVENTION However, NMR
The purpose of using the balloon with the embedded measurement coil is NM
Insert the R measurement coil into the body cavity in a small state,
By inflating the balloon after insertion, to perform the NMR measurement with increased accuracy in a state where the NMR measurement coil is stretched as much as possible for the target site in the body cavity,
When the balloon to be greatly expanded is inserted into the treatment instrument channel of the endoscope insertion portion in a folded state, the balloon is in a wrinkled state, and the wrinkle causes the balloon to come into contact with the treatment instrument channel at the time of insertion. In a balloon that is likely to be damaged and broken, and cannot be wrinkled (does not require folding), there is a problem that the balloon, that is, the NMR measurement coil cannot be stretched to a desired size.

The present invention has been made in view of the above circumstances, and expands a balloon enclosing a magnetic resonance receiving circuit to a desired size without damaging a balloon enclosing a magnetic resonance receiving circuit when an endoscopic treatment instrument channel is inserted. It is an object of the present invention to provide an NMR measurement antenna device capable of performing the following.

[0007]

According to the present invention, there is provided an antenna apparatus for NMR measurement, comprising: a thin tube which can be inserted into a body cavity; and a balloon which is provided at the tip of the thin tube and includes a magnetic resonance receiving circuit for receiving a magnetic resonance signal. In the NMR measurement antenna device for inflating the balloon by injecting a fluid from the thin tube, the balloon is formed in a flat plate shape, and when no fluid is injected from the thin tube, the balloon is deformed into a wound state. Is done.

In the antenna device for NMR measurement of the present invention,
The balloon is formed in a flat plate shape, and when the fluid is not injected from the thin tube, the balloon is deformed into a wound shape, thereby damaging the balloon containing the magnetic resonance receiving circuit when the endoscope treatment instrument channel is inserted. It is possible to expand to a desired size without any problem.

[0009]

Embodiments of the present invention will be described below with reference to the drawings.

FIGS. 1 to 5 relate to a first embodiment of the present invention. FIG. 1 is a configuration diagram showing a configuration of an NMR measurement antenna device, and FIG. 2 is a modification of the NMR measurement antenna device of FIG. FIG. 3 is a configuration diagram showing a configuration of a flexible endoscope for introducing the NMR measurement antenna device of FIG. 1 into a body cavity, and FIG. 4 is a configuration diagram showing the NMR measurement antenna device of FIG. FIG. 5 is a configuration diagram showing the configuration of the rigid endoscope to be introduced, and FIG. 5 is an explanatory diagram illustrating the operation of the NMR measurement antenna device of FIG.

(Construction) As shown in FIG. 1A, an antenna apparatus 1 for NMR measurement according to the present embodiment comprises a non-magnetic fluid conduit 2 for feeding elongated, soft air or the like, and a fluid conduit. A rectangular balloon 4 made of silicon rubber or latex enclosing an NMR measurement coil 3 covering the end of the path 2 is provided. The NMR measurement coil 3 is formed around the end face of the balloon 4. 1 is a sectional view taken along the line AA in FIG. 1A.
As shown in FIG. 2B, a slit 5 for sending air supplied to the fluid conduit 2 into the balloon 4 is formed on the tip side surface of the fluid conduit 2 covered by the balloon 4. .

Here, the balloon 4 is in a state in which the inner surface of a belt-shaped annular member made of silicon rubber or latex is pressed against the side surface opposite to the end side surface of the fluid conduit 2 in which the slit 5 is formed. After the coaxial cable 6 is connected to the NMR measurement coil 3, the open side end surface of the member made of silicon rubber or latex is hermetically sealed with an adhesive or welding.

Although not shown, a matching circuit for impedance matching with the NMR measurement coil 3 is provided on the base end side of the coaxial cable 6.

On the bottom surface of the balloon 4, a non-magnetic base sheet 7 made of a shape memory resin which stores a wound shape as shown in FIG. As will be described later, a fluid conduit 2 having a wound balloon 4 at the distal end as shown in FIG. 1C is inserted through the treatment instrument channel of the endoscope, and the distal end of the endoscope is inserted. The balloon 4 is made to protrude further, and the balloon 4
By blowing air into the inside and inflating the balloon 4, the balloon is made into a rectangular shape as shown in FIG. 1A, and by stopping the air supply, the base sheet 7 stores the balloon 4 based on the temperature in the body cavity. 1 (c), and the fluid conduit 2 is recovered from the treatment instrument channel of the endoscope.

As shown in FIG. 2A, a matching circuit 8 for impedance matching with the coil 3 for NMR measurement may be provided in the balloon 4, and the matching circuit 8 shown in FIG.
A base sheet 7 may be provided on the upper surface side of the balloon 4 as shown in FIG. By providing the base sheet 7 also on the upper surface side, the balloon 4
Can be returned to the shape shown in FIG. Here, the base sheet 7 is made of the shape memory resin, but is not limited to this, and may be formed of a resin member having a winding habit.

As shown in FIG. 3, an endoscope for inserting a fluid conduit 2 having a balloon 4 at a distal end thereof, for example, a flexible endoscope 11, has a flexible insertion portion 12 inserted into a body cavity and this insertion portion. A universal cord 1 provided with an operating unit 13 provided at a base end of the operating unit 13 for performing various operations, and a connector 14 extending from a side of the operating unit 13 and connected to a light source device (not shown) at a distal end.
5 and the illumination light supplied from the universal cord 15 is applied to the target site from the distal end surface by a light guide (not shown), and the obtained endoscope image is provided in an image guide (not shown) provided in the insertion portion 12. And an eyepiece section 16 provided on the operation section 13 for transmitting the endoscope image by transmitting the image data through the eyepiece section 16).

The insertion portion 12 of the flexible endoscope 11 is composed of a distal end hard portion 17, a bendable bending portion 18, and a soft flexible thin tube 19 from the distal end, and the operation portion 13 has a bending operation for bending the bending portion 18. A knob 20 is provided and the balloon 4
There is provided a communication mouthpiece 21 which communicates with a treatment instrument channel (not shown) through which the fluid conduit 2 having an end at the end is inserted.

The endoscope through which the fluid conduit 2 having the balloon 4 at its tip is inserted is not limited to the flexible endoscope 11, but may be a rigid endoscope. That is, as shown in FIG. 4, a rigid insertion portion 12a to be inserted into a body cavity, and an operation portion 13 provided at a base end of the insertion portion 12a and performing various operations.
A universal cord 15 having a connector 14 connected to a light source device (not shown) at the end extending from the side of the operation unit 13, and an endoscope image obtained by illumination light supplied from the universal cord 15. The rigid endoscope 11a may be constituted by an eyepiece section 16 provided on an operation section 13 for transmitting an endoscope image through a relay lens (not shown) provided in the inside 12a. Here, the insertion portion 12a includes a distal end hard portion 17, a bendable bending portion 18, and a hard rigid thin tube 19a from the distal end.
Is provided with a bending operation knob 20 for bending the bending portion 18, and a communication base 21 communicating with a treatment instrument channel (not shown) through which the fluid conduit 2 having the balloon 4 at its tip is inserted. ing.

(Operation) The flexible endoscope 11 is inserted into the body cavity, and an image of the inside of the body cavity is provided in the hard distal end portion 17 as shown in FIG. The inside of the body cavity is observed by transmitting the light to the eyepiece unit 16 by the objective optical system 31 and the image guide 32 provided in the insertion unit 12. The fluid channel 2 having the wound balloon 4 shown in FIG. 1C at the distal end is inserted from the communication mouthpiece 21 into the treatment instrument channel 33 disposed in the insertion portion 12 of the endoscope 11, and the distal end hard portion is formed. The balloon 4 is made to protrude from the opening 35 of the treatment instrument channel 33 on the distal end surface of the balloon 17. The outermost diameter of the wound balloon 4 shown in FIG. 1C is smaller than the inner diameter of the treatment instrument channel 33.

After the distal end of the fluid conduit 2 including the balloon 4 is projected from the opening 35, air is supplied to the air supply conduit 2 from an air supply pump (not shown) to inflate the balloon 2. As a result, the balloon 4 overcomes the elasticity of the base sheet 7 and expands in a rectangular shape with inflation, so that the balloon N is enclosed and provided around the end face of the balloon 4.
The MR measurement coil 3 is stretched to a desired size having substantially the same area as the balloon 4 having a rectangular shape.

In the above state, the NMR signal of a predetermined frequency from the excited nucleus of the living body is received by the NMR measurement coil 3, and this NMR signal is transmitted through the coaxial cable 6, though not shown, through a matching circuit (not shown). Is sent to the MRI apparatus for arithmetic processing to obtain a tomographic image. Thus, optical observation with an endoscope and diagnosis of a tomographic image with MRI can be performed.

Here, generation of a tomographic image by MRI can be performed by known means. That is, the subject is MR
I placed in a static magnetic field generated by the
The MR signal is received by the NMR measurement coil 3 and sent to the MRI apparatus via the coaxial cable 6. In the MRI apparatus, information (NMR parameters) such as relaxation time is detected by arithmetically processing the NMR signal, and a tomographic image is generated.
Since the relaxation time of the obtained NMR signal is different between the normal tissue and the abnormal tissue such as cancer, it is possible to detect an abnormal site deep under the mucosa based on the tomographic image.

When the NMR measurement is completed, the air supply to the air supply line 2 is stopped. As a result, the temperature in the body cavity
The balloon 4 is returned to the wound shape shown in FIG. 1C by the base sheet 7 storing the wound shape shown in FIG.
From the treatment instrument channel 33, the antenna device 1 for NMR measurement
Collect.

(Effect) As described above, the NMR of this embodiment
In the measurement antenna device 1, the balloon 4 provided at the distal end of the fluid conduit 2 is wound into the wound shape shown in FIG. 1C and is inserted through the treatment instrument channel 33. At this time, FIG.
Is smaller than the inner diameter of the treatment instrument channel 33, and since the outer surface of the balloon 4 is the base sheet 7 in this state, the balloon 4 is a treatment instrument. The balloon 4 can be smoothly inserted into the channel 33 and the treatment instrument channel 3
3, the balloon body, which is the inflating portion, can be reliably prevented from being damaged by the base sheet 7, and the NMR measurement coil 3 can be stretched to a desired size. NMR measurement becomes possible.

FIGS. 6 to 9 relate to a second embodiment of the present invention. FIG. 6 is a diagram showing the configuration of an antenna device for NMR measurement. FIG. FIG. 8 is a first explanatory view illustrating the operation of the NMR measurement antenna device of FIG. 6, and FIG. 9 is a second explanatory diagram illustrating the operation of the NMR measurement antenna device of FIG. FIG.

Since the second embodiment is almost the same as the first embodiment, only different points will be described, and the same components will be denoted by the same reference numerals and description thereof will be omitted.

(Construction) As shown in FIG. 6, the NMR measurement antenna device 40 of the present embodiment has an elongated hollow shaft portion 41 inserted into the treatment instrument channel of the endoscope insertion portion. The hollow portion of the shaft portion 41 forms an air supply passage 46, and the tip of the shaft portion 41 is closed. Further, a wide groove 43 is formed in an outer peripheral portion on the tip side of the shaft portion 41 in a circular shape. An expandable balloon 44 is attached to the groove 43 by a fixing member 45. The shaft portion 41 is provided with a ventilation hole 47 at a position inside the balloon 44 for communicating an air supply passage 46 of the shaft portion 41 with the inside of the balloon 44.

An NMR measurement coil 48 is embedded in the film forming the balloon 44. This N
The MR measuring coil 48 is disposed all around the balloon 44. Both ends of the NMR measurement coil 48 are connected to, for example, a cable 50 embedded in the shaft 41. The base side of the cable 50 is connected to an NMR transmission / reception circuit (not shown).
Is connected to an air supply device (not shown).

Shaft 41 having balloon 44 at its tip
As shown in FIG. 7, this is inserted and arranged in the hollow of an elongated cylindrical outer tube 52 having a tapered portion 51 at the tip, and this outer tube 52 is provided in the insertion section 12 of the flexible endoscope 11. Then, the distal end of the outer tube 52 is projected through the opening 35 of the treatment instrument channel 33 on the distal end surface of the distal end hard portion 17. The mantle tube 5
The outer diameter of 2 is smaller than the inner diameter of the treatment instrument channel 33.

Then, with the tip of the shaft portion 41 including the balloon 44 protruding from the tapered portion 51 of the mantle tube 52, an air supply device (not shown) supplies an air supply passage 4 of the shaft portion 41.
This air can be moved forward by, for example, sending air into
The air is supplied into the balloon 44 through the ventilation hole 47,
The balloon 44 expands as shown in FIG.

The other structure is the same as that of the first embodiment.

(Operation) The flexible endoscope 11 is inserted into the body cavity, and the image in the body cavity is inserted into the objective optical system 31 and the insertion section 12 provided in the distal end hard portion 17 as shown in FIG. The inside of the body cavity is observed by transmitting the image to the eyepiece unit 16 by the image guide 32 provided, and when the target site, which is a lesion, is observed, it is disposed on the insertion section 12 of the flexible endoscope 11. The sheath tube 52 in which the shaft portion 41 having the balloon 44 at the distal end is inserted into the hollow is inserted through the communication mouthpiece 34 through the treatment instrument channel 33, and the opening of the treatment instrument channel 33 on the distal end surface of the distal end hard portion 17. The distal end of the outer tube 5 is made to protrude from 35, and in this state, the distal end of the shaft portion 41 including the balloon 44 is made to protrude from the tapered portion 51 of the outer tube 52.

Other operations are the same as those of the first embodiment.

(Effect) As described above, in the present embodiment, the shaft 41 provided with the balloon 44 at the distal end is inserted into the hollow of the outer tube 52, and the outer tube 52 is inserted into the treatment instrument channel 33. Since the balloon 44 does not directly contact the treatment instrument channel 33, the balloon 44 can be reliably prevented from being damaged, and the NMR measurement coil 48 can be stretched to a desired size. Highly accurate NMR measurement can be performed.

By the way, as described above, the balloon inserted into the body cavity transendoscopically is provided with a coil for NMR measurement, and the lesion in the body cavity is transendoscopically NMR-measured. It is possible to determine whether the abnormal site is, for example, a malignant one. However, if it is determined that the abnormal site is a malignant one, the tissue of the abnormal part, which is a lesion, is collected and a pathological examination is performed.

In this case, the antenna device for NMR measurement is removed from the treatment instrument channel, and a hollow needle for aspirating the tissue is inserted into the treatment instrument channel so as to protrude from the distal end, and pierces the tissue at the lesion to collect the tissue at the lesion. I do. At this time, the approximate position of the lesion is confirmed under observation with an endoscope,
Since the antenna device for NMR measurement is removed, the exact position of the lesion inside the body wall in the body cavity is held by the external coil of the MRI device.

However, the position of the endoscope cannot be grasped by the measurement using the external coil of the MRI apparatus, and the needle is pierced based on the confirmation of the approximate position under the observation of the endoscope. There is a problem that collection of some organizations is difficult.

Next, an endoscope that can accurately grasp the position of the endoscope and the insertion direction of the needle under measurement by an external coil of the MRI apparatus and reliably collect the tissue of the lesion will be described. I do.

FIGS. 10 to 15 relate to an embodiment of an endoscope for surely recovering the tissue of a diseased part. FIG. 10 is a configuration diagram showing a configuration of the endoscope, and FIG. 11 is an endoscope of FIG. FIG. 12 is a configuration diagram showing the configuration of the distal end surface of the mirror, FIG. 12 is a first explanatory diagram illustrating the operation of the endoscope in FIG. 10, and FIG. 13 is a second explanatory diagram illustrating the operation of the endoscope in FIG. FIG. 14 is a configuration diagram showing a configuration of a first modification of the needle inserted into the endoscope of FIG. 10, and FIG. 15 is a configuration of a second modification of the needle inserted into the endoscope of FIG. FIG.

An endoscope 61 for surely recovering the tissue of a lesion.
As shown in FIG. 10, the image in the body cavity is
The inside of the body cavity can be observed by transmitting to the eyepiece unit 16 by the objective optical system 31 provided therein and the image guide 32 provided in the insertion unit 12, A treatment tool channel 33 which is protruded from the distal end and into which a treatment tool for performing various treatments can be inserted is provided in the insertion portion 12.

Although not shown in the drawing, a light guide for transmitting illumination light from the light source device,
An air supply / water supply line connected to the air supply / water supply device is provided, and the end surface of the endoscope 61 is provided with illumination for illuminating illumination light from a light guide to a target portion, as shown in FIG. Window 6
3 and an observation window 6 for allowing an image in the body cavity to enter the objective optical system 31
4. A nozzle 65 for cleaning the observation window 64 by air / water supply from an air / water supply line and an opening 3 of the treatment instrument channel 33.
5 are provided.

The inner diameter of the treatment instrument channel 33 of the endoscope 61 on the distal end side is filled with three MR contrast agents 66 on the same plane.
A contrast agent 67 is provided. And the above-mentioned NMR
It is determined whether or not the abnormal site is, for example, a malignant one by NMR measurement using the measurement antenna device. That is, the NMR measurement antenna device is extracted from the treatment instrument channel, and first, a thin and conical cylindrical needle 68 having a sharp tip is pierced into the tissue of the lesion,
Thereafter, although not shown, a hollow needle for aspirating the tissue is inserted into the treatment instrument channel and protruded from the distal end, and pierces the tissue at the lesion to collect the tissue at the lesion. An MR contrast agent 69 is also provided around the tip of the needle 68.

In the measurement by the external coil of the MRI apparatus, one section of the treatment instrument channel 33, that is, the needle insertion surface is determined by the three MR contrast agents 66 as shown in FIG. That is, the surgeon performs a bending operation on the lesion so that the three MR contrast agents 66 are displayed on the MRI tomographic image, and the puncture surface of the needle 68 with respect to the lesion is calculated as shown in FIG. And MR contrast agents 67 and 6
9, the tip position of the endoscope 61 and the tip position of the needle 68 are displayed on the tomographic image. Then, after the needle 68 is pierced into the lesion, the needle 68 is withdrawn from the treatment instrument channel 33, and a tissue collection needle having a hollow path and having a sharp tip is pierced, and the tissue is recovered from the lesion by suction. Do.

As described above, in the endoscope 61, the piercing surface of the needle 68 with respect to the lesion can be calculated by the measurement using the external coil of the MRI apparatus, and the tip position of the endoscope 61 and the tip position of the needle 68 are grasped. Therefore, it is possible to reliably collect the tissue of the lesion.

Although the MR contrast agent 68 is provided on the inner diameter of the distal end of the treatment instrument channel 33 of the endoscope 61, the present invention is not limited to this, and the MR contrast agent may be provided on the needle side. That is, as shown in FIG. 14, a needle 71 is formed into an elongated, conical cylindrical inner needle 72 having a sharp tip and an inner needle 72.
And a cylindrical outer needle 74 having a sharp conical shape and having a hollow passage 73 through which the outer needle 74 is inserted.
Is provided with an MR contrast agent injection channel 75 between the hollow portion 73 and the outer surface.

The contrast medium injection passage 75 is provided from the base end side to the hollow passage 7.
3 and a first straight path 7 extending along
6, a U-turn path 77 that rotates 180 degrees around the longitudinal axis of the outer needle 74 in front of the conical tip, and a U-turn path 77.
And a second straight path 78 extending proximally along the hollow path 73.

Then, the MR contrast agent is injected into the contrast agent injection path 75, and the first linear path 76, the U-turn path 77 and the second linear path 78 are filled with the MR contrast agent.
1 is inserted into the treatment instrument channel 33. As a result, the first
The piercing surface of the needle 71 with respect to the lesion is calculated by the MR contrast agent in the straight path 76 and the second straight path 78. When the piercing surface of the needle 71 is calculated, the MR contrast medium is extracted from the contrast medium injection path 75. Then, the inner needle 72 is connected to the outer needle 74.
The needle 71 is pierced into the lesion in a state where the outer needle 74 protrudes from the tip of the outer needle 74.
The tissue of the lesion is collected by suction from the hollow passage 73.

Therefore, the piercing surface of the needle 71 with respect to the lesion can be calculated, and at the time of piercing of the needle 71, the MR contrast agent is extracted from the contrast medium injection path 75, so that only the lesion is displayed in the MRI tomographic image. As a result, it becomes possible to obtain a tomographic image that is easy to observe.

Although the contrast medium injection path for injecting the MR contrast medium is provided in the outer needle, the contrast medium injection path may be provided in the inner needle. That is, as shown in FIG. 15, the inner needle 81 has a sharp conical shape with a sharp tip, and in addition to this conical portion, a cross section perpendicular to the longitudinal axis of the inner needle 81 is provided with a hollow portion 82 on a double circle. May be configured. The proximal end of the inner needle 81 is sealed with a sealing plug 83 having an opening at the distal end of a hollow portion 82 and fitted with an introduction tube 86, and a discharge portion 84 is provided on the side surface of the proximal end with a sealing member 85. It is provided sealed.

Then, from the base end of the introduction tube 86, the hollow portion 82 is formed.
Is injected with an MR contrast agent. Thereby, the piercing surface of the inner needle 81 with respect to the lesion is calculated.

On the other hand, as described above, when the lesion is collected and the pathological examination confirms that the lesion is malignant, the lesion is treated.

Next, an endoscope for performing ultrasonic treatment using concentrated ultrasonic waves under MR measurement will be described.

FIGS. 16 to 23 relate to an embodiment of an endoscope for performing an ultrasonic treatment using concentrated ultrasonic waves under MR measurement, and FIG. 16 is a structural view showing the structure of an MRI apparatus.
7 is a configuration diagram showing a configuration of an endoscope used in the MRI apparatus of FIG. 16, FIG. 18 is a cross-sectional view showing a cross section of a distal end portion of the endoscope of FIG. 17, and FIG. FIG. 20 is a configuration diagram illustrating a configuration of a modification of the endoscope of FIG. 17, FIG. 20 is a configuration diagram illustrating a configuration of a second modification of the endoscope of FIG. 17, and FIG. FIG. 22 is a third view of the endoscope of FIG.
FIG. 23 is a cross-sectional view showing a cross section of the distal end portion of the endoscope in FIG. 22.

As shown in FIG. 16, the subject is placed in a static magnetic field generated by the MRI apparatus 91, and the NM from the subject is
The R signal is received by the NMR measurement antenna 92 and sent to the MRI apparatus 91 via the coaxial cable 93. MRI device 9
In step 1, information (NMR parameters) such as relaxation time is detected by arithmetically processing the NMR signal, and a tomographic image is generated. Since the relaxation time of the obtained NMR signal is different between the normal tissue and the abnormal tissue such as cancer, the lesion 94 deep under the mucosa can be detected based on the tomographic image.

Then, an endoscope 97 having an NMR measurement antenna 95 and an ultrasonic wave generator 96 in the distal end is inserted into a body cavity, and the distal end of the endoscope 97 is pushed against a body wall having a lesion 94. A focused ultrasonic wave is applied to the lesioned part 94 from the applied ultrasonic generator 96 to cauterize the lesioned part 94.

As shown in FIGS. 17 and 18, the distal end 98 of the endoscope 97 has an NMR measurement antenna 95 for receiving an NMR signal from the lesion 94 and a backing member 9.
9 is provided with an ultrasonic generator 96 comprising an ultrasonic transducer 102 for irradiating concentrated ultrasonic waves from an acoustic window 101 via an ultrasonic medium 100 via an ultrasonic medium 100, and an NMR measurement antenna 95 is provided with a matching circuit 103. The high frequency generator 96 is connected to an ultrasonic transducer driving circuit (not shown).

The endoscope 97 is a perspective endoscope for observing the irradiation direction of the focused ultrasonic wave, and an illumination window 104 for irradiating illumination light in a perspective direction is provided on the base end side of the distal end portion 98. An observation window 105 for receiving an endoscope image in a perspective direction is provided.

Further, a balloon 106 is provided on the side of the distal end portion 98 opposite to the irradiation direction of the concentrated ultrasonic wave, so that the balloon can be inflated by air supplied from an air supply line 107 provided in the insertion portion of the endoscope 97. It has become.

First, an NMR signal is obtained by an external NMR measurement antenna 92 in the MRI apparatus 91, and information (NMR parameters) such as relaxation time is detected by arithmetic processing to generate a tomographic image. Then, while inserting the endoscope 97 into the body cavity and performing optical observation, the distal end portion 98 is positioned near the lesion 94. At this time, the NM in the tip 98
The R measurement antenna 95 receives a strong NMR signal from the lesion 94. This NMR measurement antenna 9
5 outputs the strong NMR signal from the lesion 94 received from the lesion 94 to the MRI apparatus 91 via the matching circuit 103, so that the tomographic image by the external NMR measurement antenna 92 and the lesion 94 received by the NMR measurement antenna 95 are received. Strong NM from
The position of the lesion 94 is specified based on the R signal, and the acoustic window 101 is pressed against the body wall surface. Then, air is supplied from the air supply line 107 to inflate the balloon 106, and the acoustic window 101 and the body wall are fixed. Then, the ultrasonic generator 96 is driven to irradiate the ultrasonic transducer 102 with concentrated ultrasonic waves on the lesion 94. Cauterize.

As described above, in the endoscope 97 for performing the ultrasonic treatment using the concentrated ultrasonic wave under the NMR measurement, the endoscope 97 is inserted into the body cavity while performing the optical observation, and the NM provided in the distal end portion 98 is provided.
Strong NM from lesion 94 due to R measurement antenna 95
Since the R signal is obtained and the position of the lesion 94 can be specified, the ultrasonic transducer 102 can irradiate concentrated ultrasonic waves to cauterize the lesion 94 accurately and reliably. In addition, balloon 1
Since the acoustic window 101 and the body wall surface can be fixed by inflating 06, displacement of the pressing position of the acoustic window 101 due to the vibration of a living body in a body cavity or the like is eliminated, and the focused ultrasonic wave is reliably applied to the lesion 94. Can be.

The acoustic window 101 is provided by the balloon 106.
However, in a relatively large body cavity such as the stomach, the acoustic window 10
It may be difficult to fix the body wall to the body. Therefore, in such a relatively large body cavity, as shown in FIG. 19, not only the distal end portion 98 but also the curved portion 11 of the endoscope 97 is provided.
0 and the balloon 11 in a range including the distal end of the flexible conduit 111.
2, the acoustic window 101 and the body wall surface may be fixed by inflating the balloon 112 throughout the relatively large body cavity by insufflation from the insufflation duct 107.

FIG. 20 shows a first modified example of an endoscope that performs an ultrasonic treatment using concentrated ultrasonic waves under NMR measurement.
Alternatively, the tip may be configured as shown in FIG. That is, as shown in FIGS. 20 and 21, as a first modified example, a second NMR measurement antenna 121 orthogonal to the NMR measurement antenna 95 is provided in the distal end portion 98 and the NMR measurement is performed.
Measurement antenna 95 and second NMR measurement antenna 1
21 may be used to obtain a strong NMR signal from the lesion 94.

When the direction of the static magnetic field of the MRI apparatus and the direction of the NMR measurement antenna are parallel, the strength of the received signal deteriorates in principle.

The first NMR measurement antenna and the first
When disposing a second NMR measurement antenna orthogonal to the NMR measurement antenna, when one NMR measurement antenna is parallel to the static magnetic field direction, the other NMR measurement antenna is always orthogonal to the static magnetic field. , The two N
No matter which direction the tip with the built-in MR measurement antenna faces the static magnetic field, strong NM from the lesion 94
Since the R signal can be obtained, the position of the lesion can be specified more easily.

FIG. 22 shows a second modification of the endoscope for performing the ultrasonic treatment using the concentrated ultrasonic wave under the MR measurement.
Alternatively, the tip may be configured as shown in FIG. That is, as shown in FIGS. 22 and 23, as a second modification, an NMR measurement antenna 131 may be provided on the bottom surface side of the ultrasonic wave generator 96. In this case, MRI
NM by an external NMR measurement antenna 92 in the device 91
An R signal is obtained, and information (NMR parameter) such as relaxation time is detected by performing arithmetic processing to generate a tomographic image.
Then, while inserting the endoscope 97 into the body cavity and performing optical observation, the distal end portion 98 is positioned near the lesion 94.

Next, the NMR signal from the subject is received by the NMR measurement antenna 131 and sent to the MRI apparatus 91 via the coaxial cable 93. In the MRI apparatus 91, the N
By processing the MR signal, information (NMR parameters) such as relaxation time is detected, and a tomographic image near the lesion 94 is generated. Also at this time, the NMR measurement antenna 95 in the distal end portion 98 receives a strong NMR signal from the lesion 94.

Therefore, also in the second modification, the position of the lesion can be accurately specified, and a tomographic image near the lesion 94 can be obtained by detecting the NMR signal by the NMR measurement antenna 131. Thus, the cauterized state of the lesion 94 can be confirmed, and more reliable treatment can be performed.

[Supplementary Note] (Supplementary Note 1) A thin tube that can be inserted into a body cavity, and a balloon that is provided at the distal end of the thin tube and includes a magnetic resonance receiving circuit that receives a magnetic resonance signal, and injects fluid from the thin tube In the antenna device for NMR measurement, the balloon is formed in a flat plate shape, and when the fluid is not injected from the thin tube, the balloon is deformed into a wound shape.

(Additional Item 2) The antenna apparatus for NMR measurement according to Additional Item 1, wherein the balloon has a resin sheet that is deformed into a rolled state.

(Additional Item 3) The antenna apparatus for NMR measurement according to Additional Item 2, wherein the resin sheet is a shape memory resin sheet.

(Additional Item 4) The thin tube has a fluid conduit made of a soft, non-magnetic material, and a slit communicating with the hollow portion of the fluid conduit is provided within a range where the balloon is disposed. NM according to Additional Item 1, characterized in that:
R measurement antenna device.

(Supplementary Note 5) A thin tube that can be inserted into a body cavity, and a balloon that is provided at the tip of the thin tube and includes a magnetic resonance receiving circuit that receives a magnetic resonance signal, and the balloon is injected by fluid from the thin tube. NMR to expand
The antenna device for NMR measurement, wherein the balloon is inserted into a mantle tube.

(Additional Item 6) An endoscope apparatus provided with an endoscope having a communication conduit which can be used together with a magnetic resonance apparatus and projects a treatment instrument for performing treatment and treatment in a body cavity into the body cavity. And the vicinity of the distal end of the insertion portion of the endoscope and the longitudinal center axis of the communication conduit opening. An endoscope apparatus comprising a magnetic resonance imaging contrast agent in at least three places.

(Supplementary note 7) The treatment instrument has a magnetic resonance imaging contrast agent near the distal end thereof.
An endoscope apparatus according to claim 1.

(Additional Item 8) An endoscope having an ultrasonic treatment means for performing treatment by irradiating ultrasonic waves, an optical observation system for performing optical observation, and a high-frequency antenna for receiving a magnetic resonance signal at a distal end portion. 3. The endoscope according to claim 1, further comprising a tip position fixing means for fixing a position of the tip portion.

(Additional Item 9) The endoscope according to Additional Item 8, wherein the distal end portion position fixing means is a balloon.

(Appendix 10) An endoscope apparatus provided with an endoscope which can be used in combination with a magnetic resonance apparatus and has a communication conduit for projecting a treatment instrument for performing treatment and treatment in a body cavity into the body cavity. The treatment tool comprises an inner needle and an outer tube for inserting the inner needle, the outer tube has two hollow portions opened at a base end in a longitudinal direction on a radial center axis, and the two An endoscope apparatus comprising: a magnetic resonance imaging contrast agent injection conduit including a communication conduit provided inside a distal end that communicates a hollow portion at the distal end.

(Additional Item 11) The inner needle communicates from the first opening at the base end to the second opening via the U-turn at the tip.

An endoscope according to additional item 10, characterized in that:

[0080]

As described above, according to the antenna apparatus for NMR measurement of the present invention, the balloon is formed in a flat plate shape, and when the fluid is not injected from the thin tube, the balloon is deformed into a wound shape. When the treatment instrument channel is inserted, the balloon containing the magnetic resonance receiving circuit can be expanded to a desired size without damaging the balloon.

[Brief description of the drawings]

FIG. 1 is a configuration diagram showing a configuration of an NMR measurement antenna device according to a first embodiment of the present invention.

FIG. 2 is a configuration diagram showing a configuration of a modification of the antenna device for NMR measurement in FIG. 1;

3 is a configuration diagram showing a configuration of a flexible endoscope for introducing the antenna device for NMR measurement of FIG. 1 into a body cavity.

4 is a configuration diagram showing a configuration of a rigid endoscope for introducing the antenna device for NMR measurement of FIG. 1 into a body cavity.

FIG. 5 is an explanatory diagram illustrating the operation of the antenna device for NMR measurement in FIG. 1;

FIG. 6 is a configuration diagram showing a configuration of an NMR measurement antenna device according to a second embodiment of the present invention.

FIG. 7 is a configuration diagram showing a configuration of a mantle tube into which the NMR measurement antenna device of FIG. 6 is inserted and arranged.

FIG. 8 is a first explanatory view illustrating the operation of the antenna device for NMR measurement in FIG. 6;

FIG. 9 is a second explanatory view for explaining the operation of the antenna device for NMR measurement in FIG. 6;

FIG. 10 is a configuration diagram illustrating a configuration of an endoscope according to an embodiment of the endoscope that reliably collects tissue at a lesion;

11 is a configuration diagram showing a configuration of a distal end surface of the endoscope in FIG. 10;

FIG. 12 is a first explanatory view illustrating the operation of the endoscope in FIG. 10;

FIG. 13 is a second explanatory view illustrating the operation of the endoscope in FIG. 10;

FIG. 14 is a configuration diagram showing a configuration of a first modification of the needle inserted into the endoscope in FIG. 10;

FIG. 15 is a configuration diagram showing a configuration of a second modification of the needle inserted into the endoscope in FIG. 10;

FIG. 16 is a configuration diagram showing a configuration of an MRI apparatus according to an embodiment of an endoscope that performs ultrasonic therapy using concentrated ultrasound under MR measurement.

FIG. 17 is a configuration diagram showing a configuration of an endoscope used in the MRI apparatus of FIG. 16;

18 is a cross-sectional view showing a cross section of a distal end portion of the endoscope of FIG.

FIG. 19 is a configuration diagram showing a configuration of a first modification of the endoscope in FIG. 17;

20 is a configuration diagram showing a configuration of a second modification of the endoscope in FIG. 17;

FIG. 21 is a sectional view showing a section of a distal end portion of the endoscope in FIG. 20;

FIG. 22 is a configuration diagram showing a configuration of a third modification of the endoscope in FIG. 17;

23 is a sectional view showing a section of a distal end portion of the endoscope of FIG. 22;

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Antenna device for NMR measurement 2 ... Fluid pipeline 3 ... Coil for NMR measurement 4 ... Balloon 5 ... Slit 6 ... Coaxial cable 7 ... Base sheet

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[Procedure amendment]

[Submission date] June 12, 1997

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0014

[Correction method] Change

[Correction contents]

On the bottom surface of the balloon 4, a non-magnetic base sheet 7 made of a shape memory resin which stores a wound shape as shown in FIG. As will be described later, a fluid conduit 2 having a wound balloon 4 at the distal end as shown in FIG. 1C is inserted through the treatment instrument channel of the endoscope, and the distal end of the endoscope is inserted. The balloon 4 is made to protrude further, and the balloon 4
By inflating the balloon 4 to air and air to the balloon in a rectangular shape as shown in FIG. 1 (a) within, stop the air supply
Mel or return the balloon 4 by removing the air in the winding shape as shown in FIG. 1 (c) that the body cavity temperature base sheet 7 is stored,, N from the treatment instrument channel of an endoscope
The MR measurement antenna device 1 is collected.

[Procedure amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0049

[Correction method] Change

[Correction contents]

Although the contrast medium injection path for injecting the MR contrast medium is provided in the outer needle, the contrast medium injection path may be provided in the inner needle. That is, as shown in FIG. 15, the inner needle 81 has a sharp conical shape with a sharp tip, and other than this conical portion, a hollow cross section perpendicular to the longitudinal axis of the inner needle 81 has a double circular shape. It may be configured to include the unit 82. The proximal end of the inner needle 81 is sealed with a sealing plug 83 having an opening at the distal end of a hollow portion 82 and fitted with an introduction tube 86, and a discharge portion 84 is provided on the side surface of the proximal end with a sealing member 85. It is provided sealed.

[Procedure amendment 3]

[Document name to be amended] Statement

[Correction target item name] 0052

[Correction method] Change

[Correction contents]

Next, an endoscope for performing ultrasonic treatment using concentrated ultrasonic waves under NMR measurement will be described.

Claims (1)

[Claims] 1. A thin tube which can be inserted into a body cavity, and a balloon which is provided at a distal end of the thin tube and includes a magnetic resonance receiving circuit for receiving a magnetic resonance signal, wherein the balloon is inflated by fluid injection from the thin tube. In the antenna device for NMR measurement, the balloon is formed in a flat plate shape, and is deformed into a rolled state when a fluid is not injected from the capillary tube.