JP2001170068A - Ultrasonic treatment instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic treatment instrument performing the lithotrity or the treatment by warming/heating by an integrated instrument. SOLUTION: This ultrasonic treatment instrument is provided with a drive circuit for the lithotrity for generating a drive voltage for irradiation of a shock wave for the lithotrity and a drive circuit for warming/heating generating the drive voltage for irradiation of the ultrasonic wave for warming/heating. The treatment is performed by selecting the device circuit according to respective treatment modes. A lithotrity device and a warming/heating treatment device are integrated so as to save a space for the device and the cost.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus for irradiating an ultrasonic wave from outside the body using a piezo element to locally heat and heat a malignant tumor in the body to perform treatment.

[0002]

2. Description of the Related Art In recent years, in order to treat stones such as kidney stones and gallstones, a calculus crushing device that irradiates a shock wave by an ultrasonic wave from outside the body and crushes the calculus noninvasively has been put to practical use. As a shock wave source of such a calculus breaking device, a method using underwater discharge, electromagnetic induction, a small explosion, a method using a piezo element, and the like have been proposed. In particular, the method using a piezo element has excellent features such as no consumables, arbitrarily control of the shock wave intensity, and control of the focal position by controlling the phase of a drive waveform applied to a plurality of piezo elements. (JP-A-60-145131, US
P-4526168). Also, Japanese Patent Application Laid-Open No. 62-42773
As described in Japanese Patent Application Laid-Open Publication No. H10-209, it is also possible to change the focal point shape by controlling the phase of the driving waveform.

[0003] On the other hand, as a method of treating malignant neoplasms, so-called cancer, instead of radiotherapy or drug therapy, heating the tumor tissue to a temperature of 42 to 45 ° C higher than the body temperature to necrosis the tumor tissue. Treatments (also known as hyperthermia) have come to the fore.

[0004] The warming treatment is based on the fact that tumor tissue has a higher heat sensitivity than normal tissue and has the effect of killing at 42.5 ° C or higher, and the tumor site is heated to 42.5 ° C or higher.・ Maintenance is performed by maintenance. At this time, as a method for heating a tumor site in the body, there are a method of irradiating electromagnetic waves in an RF band or a microwave band and a method of using mechanical energy by ultrasonic waves. Of these, it is difficult to selectively heat deep locals due to the electrical characteristics of living organisms by heating with electromagnetic waves, but heating with ultrasonic waves is said to have a high convergence and deep depth of ultrasound beams. It has the advantage of being able to heat deep locals due to its features, and has attracted much attention.

[0005] In recent years, the document “G.
ien, et al. , Progress in Ur
1991, 1, 84-88 ", a completely new treatment for taking the above-mentioned heating treatment one step further, heating the tumor part to 80 ° C. or more, and burning and treating the malignant tumor tissue. Have also been reported.

[0006]

As described above, in each of the above-mentioned conventional treatment methods, the crushing region or the heating region (or the heating region) is uniquely set, and therefore, the treatment efficiency is reduced. It was not preferred.

The present invention has been made to solve such a conventional problem, and an object of the present invention is to provide an ultrasonic treatment apparatus capable of improving treatment efficiency.

[0008]

According to the first aspect of the present invention, there is provided an ultrasonic source for locally irradiating an ultrasonic wave to a diseased part in a patient, and the vicinity of the diseased part. Ultrasound diagnostic imaging device that has an image, recognizes the affected part position by observing the ultrasonic image captured by the ultrasonic diagnostic equipment, irradiates the affected part position with ultrasonic waves from the ultrasonic source In an ultrasonic therapy device that heats and heats the affected area,
An ultrasonic treatment apparatus is provided, which is provided with an irradiation site control means capable of operating an irradiation area by the ultrasonic source, and which can heat and treat the affected part after heating the vicinity including the affected part. Means.

Further, according to the present invention described in claim 2,
An ultrasonic source that locally irradiates ultrasonic waves to an affected part in a patient body, and an ultrasonic image diagnostic apparatus that captures an image of the vicinity of the affected part, and observes an ultrasonic image captured by the ultrasonic image diagnostic apparatus An irradiation area that can operate an irradiation area by the ultrasonic source in an ultrasonic treatment apparatus that heats and treats an affected part by irradiating the ultrasonic wave from the ultrasonic source to the affected part position by recognizing the affected part position. Control means, and sound field display means for displaying a sound field of the ultrasonic wave on the screen according to the control content of the irradiation area control means, and switching of the sound field displayed on the screen in accordance with the operation of the irradiation area An ultrasonic therapy apparatus characterized in that it can be used as a solution.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a block diagram showing a configuration of a first embodiment of an ultrasonic therapy apparatus to which the present invention is applied.

In FIG. 1, a piezo element 1, which is an ultrasonic wave generating source, has a plurality of piezo element groups arranged in a spherical shell such that an ultrasonic transmitting surface is concave, and a flexible water bag. It is coupled to the patient 3 via 2. Also,
An ultrasonic probe 7 for taking an ultrasonic image of the patient 3 is attached to a central portion of the piezo element, and the probe 7 is connected to an ultrasonic diagnostic apparatus 8.

The drive circuit 4 drives the piezo element to irradiate the affected part 21 existing in the body of the patient 3 with ultrasonic waves, and operates under the control of the control circuit 5.

The treatment mode changeover switch 6 selects a calculus breaking mode, a heating mode, and a heating mode.

The control circuit 5 controls the output of the drive circuit 4 according to the selected treatment mode. That is, when the treatment mode is the calculus breaking mode, a trigger for generating a shock wave is output, and when the treatment mode is the heating / heating mode, a burst signal of a constant voltage is continuously output.
Further, a geometrical focus, a sound field area, and a heating / heating area in the set treatment mode are obtained, and these information are converted into a digital scan converter 9 (hereinafter, DSC).
Output to

The DSC 9 superimposes current treatment mode information, a geometrical focus position, a sound field area, a heating / heating area, etc. on an ultrasonic image generated by the ultrasonic image diagnostic apparatus 8. And the superimposed image is displayed on the CRT 10.

According to such a configuration, the desired treatment mode among the calculus breaking mode, the heating mode, and the heating mode is selected by the treatment mode changeover switch 6, so that the output from the piezo element 1 is increased. The sound waves are controlled.
That is, in the calculus crushing mode, an ultrasonic wave for giving a shock wave to the affected part 21 is output, and in the heating / heating mode, an ultrasonic wave for heating / heating the affected part 21 to kill it is output. .

Therefore, the operator can easily switch the treatment mode only by switching the treatment mode switch 6.

FIG. 2 is an explanatory diagram showing an example of a screen displayed on the CRT 10, showing a state where the calculus breaking mode is set. In the figure, a geometrical focus 28 and a shock wave sound field 29 are displayed on the ultrasonic image 27 so that the position where the shock wave is irradiated can be immediately recognized. The display color of the background screen 26 is, for example,
If you distinguish between `` blue '' in calculus breaking mode, `` red '' in heating mode, and `` yellow '' in heating mode, you will not mistake the currently set treatment mode . In other words, for example, if the lithotripsy mode and the heating mode are mistaken and illuminated with a shock wave for lithotripsy when treating a malignant tumor, the human body will be seriously damaged. The color of the background image 26 is distinguished so as not to occur.

Also, as shown in FIG.
A character or symbol 30 indicating the current mode may be displayed at an arbitrary position above.

In addition, the shock wave at the time of calculus breaking almost coincides with the geometrical focus of the applicator and the actual shock focus.
Ultrasonic waves applied to the heating / heating mode are actually heated and heated at a position (region) closer to the geometric focus because of scattering and absorption by the living tissue. Furthermore, in the heating mode, not only heat absorption of the living tissue but also a cooling effect due to the blood flow around the focal point may occur, so that the focal point shape may be different from that obtained by the geometric calculation, and the treatment area may be different. Since it is necessary to maintain a temperature of 42 to 45 ° C. for a certain period of time, it is considered that the heated region is larger than the shock wave focal region and the heated region due to heat conduction of the surrounding tissue.
In addition, in the heating mode, it is considered necessary to consider the effect of thermal denaturation of the tissue due to high heat. Therefore, in the heating / heating mode, as shown in FIG. (Area) is positioned before the geometrical focal point 28. As a result, the operator can know an accurate heating region (or heating region).

The above-mentioned heating area and heating area can be obtained by approximately calculating the focal position, shape, and the like based on calculations such as a fluid equation and a heat absorption coefficient of a living body and parameters. Is performed by the control circuit 5 shown in FIG.

As described above, according to the present embodiment,
The calculus crushing device and the heating / heating device can be integrated and configured.
The treatment mode can be easily switched. Further, the currently set treatment mode is displayed in a manner that is easy for the operator to understand, so that the treatment mode is not mistaken.

FIG. 4 is a block diagram showing the configuration of the second embodiment of the present invention. In this example, separate drive circuits 11, 12, and 13 are provided for each treatment mode, and the output of each drive circuit is selected by a drive circuit changeover switch 14 that operates under the control of the control circuit 5, and is supplied to the piezo element 1. Is done.

In such a configuration, the first
In the same manner as in the embodiment, the calculus crushing device and the heating / heating treatment device can be integrated.

FIG. 5 is a block diagram showing the configuration of the third embodiment of the present invention. As shown in the drawing, in this example, a power supply circuit 15 for supplying power to the drive circuit, a calculus crushing trigger pulse generating circuit 17 for outputting a calculus crushing trigger pulse, and a heating / heating trigger pulse are provided. A heating / heating trigger pulse generating circuit 18 to be output, a gating circuit 19 for controlling the output time of the heating / heating trigger pulse generating circuit, and a driving circuit by switching the output of each of the generating circuits 17 and 18 4 is provided with a trigger pulse changeover switch 16 for supplying the trigger pulse.

The operation of the third embodiment will be described below with reference to the pulse sequences shown in FIGS.

When the calculus breaking mode is selected by the treatment mode changeover switch 6, the control circuit 5 gives an output command to the calculus breaking trigger pulse generating circuit 17 and sets the trigger pulse changeover switch 16 to the calculus breaking trigger pulse. Switch to the generation circuit 17 side. Thereby, the trigger pulse generating circuit 17 for calculus breaking, as shown in FIG.
0 (manual) to several tens [Hz] of trigger pulse
Output to Then, the drive circuit 4 generates a drive voltage synchronized with the supplied trigger pulse and supplies the drive voltage to the piezo element 1 as shown in FIG. As a result, the affected area 21
Is irradiated with a shock wave.

When the heating / heating mode is selected by the treatment mode changeover switch 6 shown in FIG. 5, the control circuit 5 generates a calculus breaking trigger pulse generating circuit 17 and a heating / heating trigger pulse generating circuit 18. And the trigger pulse changeover switch 16 is switched to the heating / heating trigger pulse generation circuit 18 side. When the calculus breaking trigger pulse generation circuit 17 outputs a trigger pulse as shown in FIG. 7C, the gating circuit 19
Gating is performed for a predetermined time in synchronization with the trigger pulse as shown in FIG. Further, the heating / heating trigger pulse generation circuit 18 generates a high-frequency pulse only during the gating period as shown in FIG.

Thereafter, in the drive circuit 4, the piezo element 1 is burst / continuously driven at a constant voltage every time a high-frequency pulse is applied as shown in FIG. 4F, and the tumor is heated to a hyperthermia temperature or a high temperature of 80 ° C. or more. To kill them. Thus, stones and malignant tumors can be treated.

Thus, also in the third embodiment, the calculus crushing device and the heating / heating treatment device can be integrated, and the treatment mode can be easily switched. The versatility is improved, and cost reduction and space saving can be achieved.

In FIG. 5, for example, if the power supply voltage becomes extremely high during driving in the heating / heating mode, the pressure and temperature at the focal point become high and high, and the patient to be treated is extremely dangerous. It is also conceivable that the drive element may be broken beyond the standard wattage of the drive element. In order to prevent such a situation, the limiter signal S1 is applied to the power supply circuit 15 by a signal from the control circuit 5 so that a voltage exceeding a certain level is not output when the heating / heating mode is used.

FIG. 8 is a block diagram showing the configuration of the fourth embodiment of the present invention. In this example, a desired portion is irradiated with ultrasonic waves using the annular type piezo element 1. Therefore, by controlling the drive timing of the plurality of drive circuits 4 to 4 by the plurality of delay circuits 32 to 32,
The focus position, the sound field, and the heating / heating area can be operated without moving the applicator. This operation can be performed by the mode switch 33. In addition,
The operation of moving the focal point position by the delay time control is described in US Pat.
P-4526168 ".

In the fourth embodiment, using this technique, for example, in the calculus breaking mode, the driving delay amount of each of the delay circuits 32 to 32 is calculated based on the data of the wide sound field mode stored in advance. By driving each of the drive circuits 4 to 4, the focal sound field is widened. That is, FIG.
As shown in (a), the calculus 35 projected on the ultrasonic image 27 is focused on the geometrical focus 28, and a wide-range shock wave sound field 29 is set around the calculus 35 to promote the fragmentation. Alternatively, by controlling the delay amount of each of the delay circuits 32 to 32,
As shown in FIG. 11, the focal point 28 is set to 10-20 so that the calculus 35 is completely within the angle of view of the geometrical focal point 28.
[Mm] By placing the calculus in the region 37 where the calculus can be most efficiently crushed by being placed on the back side, energy can be given to the entire calculus 35 to promote split crushing.

After that, the driving delay amount is calculated based on the data of the narrow sound field mode stored in advance, and each of the driving circuits 4 to 4 is driven according to the calculation result, as shown in FIG. A narrow shock wave sound field 29 is generated and crushed.
As a result, large fragments are broken into small fragments, and the treatment efficiency is improved.

Similarly, also in the heating mode, as shown in FIG.
1 is set to heat the periphery of the affected area, and thereafter, FIG.
After heating the heating area 31 as shown in (1), the affected tissue is killed. Thereby, the treatment efficiency can be improved.

At the same time, the focal position and the sound field can be calculated from the delay of each transducer by an arithmetic circuit and displayed on a CRT as a wide sound field mode and a narrow sound field mode via a DSC. Furthermore, realizing an ultrasonic sound field suitable for each of the crushing mode, heating mode, and heating mode,
For example, the focus signal is small on the CRT in the crushing mode, is wide to some extent in the heating mode, and is very small in the heating mode. At the same time, the display can be switched by sending a control signal via the DSC.

In the example shown in FIG. 8, an annular type piezo element 1 is used, but a two-dimensional array type as shown in FIG. 9 may be used.

[0038]

As described above, according to the present invention, it is possible to provide an ultrasonic treatment apparatus capable of improving treatment efficiency.

[Brief description of the drawings]

FIG. 1 is a block diagram showing a configuration of a first embodiment of an ultrasonic therapy apparatus to which the present invention is applied.

FIG. 2 is an explanatory diagram showing an ultrasonic image in a calculus breaking mode.

FIG. 3 is an explanatory diagram showing an ultrasonic image in a heating mode.

FIG. 4 is a block diagram showing a configuration of a second exemplary embodiment of the present invention.

FIG. 5 is a block diagram showing a configuration of a third exemplary embodiment of the present invention.

FIG. 6 is a time chart showing drive pulses during calculus crushing.

FIG. 7 is a time chart showing drive pulses during heating / heating treatment.

FIG. 8 is a block diagram showing a configuration of a fourth exemplary embodiment of the present invention.

FIG. 9 is an explanatory view showing a two-dimensional array type piezo element.

FIG. 10 is a diagram showing a screen display example when the shock wave sound field in the calculus breaking mode is set to a wide sound field and a narrow sound field.

FIG. 11 is a diagram showing an example of a screen display when a geometric focus is set on the back side of a calculus.

FIG. 12 is a diagram showing an example of a screen display when the heating area in the heating / heating mode is widened and narrowed.

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 piezo element 4 drive circuit 5 control circuit 6 treatment mode switch 8 ultrasonic diagnostic imaging device 10 CRT 11 calculus breaking drive circuit 12 heating drive circuit 13 heating drive circuit 14 drive circuit changeover switch 15 power supply circuit 17 calculus breaking Trigger pulse generation circuit for heating 18 trigger pulse generation circuit for heating / heating 19 gating circuit 28 geometric focus 29 shock wave sound field 31 heating area 32 delay circuit 35 calculus

Claims (2)

[Claims] An ultrasonic source for locally irradiating an ultrasonic wave to a diseased part in a patient, and an ultrasonic diagnostic imaging apparatus for photographing the vicinity of the diseased part, wherein the ultrasonic image photographed by the ultrasonic diagnostic imaging apparatus is provided. In an ultrasonic treatment apparatus for observing an ultrasonic image and recognizing the position of an affected part and irradiating the affected part with ultrasonic waves from the ultrasonic source to heat and heat the affected part, an irradiation area by the ultrasonic source is operated. An ultrasonic treatment apparatus, comprising: an irradiation site control unit that can perform treatment by heating the vicinity including the affected part and then heating the affected part. 2. An ultrasonic source for locally irradiating an ultrasonic wave to an affected part in a patient's body, and an ultrasonic image diagnostic apparatus for imaging the vicinity of the affected part, wherein the ultrasonic image captured by the ultrasonic image diagnostic apparatus is provided. Observing the sound wave image to recognize the position of the affected part, and irradiating the affected part with ultrasonic waves from the ultrasonic source to heat and heat the affected part in an ultrasonic treatment apparatus, which operates the irradiation area by the ultrasonic source. Irradiation area control means, and a sound field display means capable of displaying a sound field of the ultrasonic wave on the screen according to the control content of the irradiation area control means, and the screen is displayed in accordance with the operation of the irradiation area. An ultrasonic therapy apparatus, wherein the sound field can be switched.