JP2001190587A - Ultrasonic medical treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a ultrasonic medical treatment device capable of displaying the guidance of ultrasonic medical treatment and medical treatment process information by three-dimensionally displaying the energy distribution of medical ultrasonic waves. SOLUTION: The ultrasonic fault image of a treated part obtained by a ultrasonic probe 32 is displayed on a ultrasonic fault image display part 24. The condition of ultrasonic energy distribution is three-dimensionally displayed on a three-dimensional information display part 23 in accordance with a radiation time for medical ultrasonic waves to the ultrasonic fault image, its intensity and parameters for a biological tissue. The temperature distribution of the treated part is computed by an energy distribution arithmetic part 21 and three- dimensionally displayed on the three-dimensional information display part 23.

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 to a treatment target site to perform treatment.

[0002]

2. Description of the Related Art An ultrasonic treatment apparatus has been proposed as a device for irradiating a focused part of an ultrasonic wave (treatment ultrasonic wave) to a diseased part such as cancer existing in a patient's body and heating the diseased part for treatment. ing. In an ultrasonic treatment apparatus, a focused ultrasonic wave is applied to an affected area in a body, whereby the area is heated to 80 ° C. or higher, and the cancer cell is necrotic due to protein denaturation to perform treatment.

[0003] At this time, if the ultrasonic energy of the therapeutic ultrasonic wave applied to the target area is small, sufficient heating is not performed, and a sufficient therapeutic effect may not be obtained.
Further, if the ultrasonic energy is too large as intended, the normal cells around the affected area may be heated or excessively heated, which may have other effects than intended.

[0004] For this reason, conventionally, it is very important to grasp the energy distribution and temperature distribution of the irradiated therapeutic ultrasonic waves in order to improve the accuracy of the ultrasonic treatment. In particular, the affected area to be treated is larger than the size that can be cauterized by one ultrasonic irradiation, and when performing multiple irradiations, the total energy distribution input and the temperature distribution generated by the irradiation of the therapeutic ultrasonic waves are reduced. It is important to understand. For example, when performing multiple irradiations, the temperature distribution caused by the first irradiation affects the next irradiation, so the temperature distribution caused by this irradiation is simply the sum of the temperature distributions caused by one irradiation. Does not.

[0005] In a normal cell tissue existing on the path where the therapeutic ultrasonic wave enters the focused region of the ultrasonic wave, there are regions where the therapeutic ultrasonic wave is irradiated a plurality of times by repeated irradiation. With only one irradiation, the temperature increase in the area of normal cell tissue is extremely small, and thus it is considered that the influence on the cells is small. However, in the irradiation of multiple times, since therapeutic ultrasound is repeatedly applied,
The temperature of these normal tissue regions also gradually increases.

Hitherto, in order to eliminate these problems, a method has been devised in which the temperature distribution is accurately grasped and the irradiation of therapeutic ultrasonic waves is accurately controlled.

[0007] For example, as a method of grasping the temperature distribution in the body when performing such a heating treatment using ultrasonic waves, Japanese Patent Application Laid-Open No. 300910/1994 discloses a temperature distribution in an ultrasonic irradiation area using MRI or X-ray CT. It describes a method of performing treatment while measuring the temperature. In addition, 55334 in 1988
In Japanese Patent Application Laid-Open Publication No. H11-264, there is proposed a method of measuring a temperature distribution in a living body after heating by applying an ultrasonic diagnostic imaging apparatus.

As a method for performing accurate irradiation,
No. 47079, a three-dimensional image (volume image) of an affected area is taken by MRI or X-ray CT before treatment.
A method has been proposed in which irradiation simulation of therapeutic ultrasonic waves is performed on the data, and the ultrasonic therapeutic effect (denatured region) is synthesized and displayed on a three-dimensional image to confirm the effect.

[0009]

The problem to be solved when performing an ultrasonic treatment using the above-described ultrasonic treatment apparatus is as follows.

For example, in X-ray CT, it is possible to measure the temperature distribution of the affected tissue portion of the subject in real time, but on the other hand, measures must be taken against exposure of the patient and the operator. In addition, since a relatively long imaging time is required when MRI is used, when a therapeutic ultrasonic irradiation method is used in which the temperature of the affected tissue portion is instantaneously increased, the temperature change of the affected portion is monitored in real time. Not suitable because it cannot be displayed in.

Further, since these X-ray CT apparatuses and MRI apparatuses are large, a room for performing ultrasonic ablation treatment,
For example, it is difficult to introduce the device into an operating room or the like, and when installed, since the patient is in the gantry of the device, there is a problem that the workability required for the ultrasonic ablation treatment is extremely poor.

Further, regarding the temperature measurement method using an ultrasonic diagnostic apparatus, at present, the spatial resolution is not sufficient, and it is difficult to apply the method to heat treatment using focused ultrasonic waves.

[0013] Further, it is difficult to predict the influence on the region where the therapeutic ultrasonic wave is repeatedly applied, even if the expected protein denatured region is displayed and used as a guide for ultrasonic irradiation.

Further, in the method of starting the treatment after performing the irradiation simulation before the ultrasonic treatment based on the three-dimensional tomographic data of the area around the affected part, the source of the therapeutic ultrasonic wave is a mechanical arm or the like. When fixed, it is considered that a treatment result almost corresponding to the simulation is obtained. However, in the case of an ultrasonic therapy system in which the source of the therapeutic ultrasound is held by the surgeon's hand, in the simulation and the actual treatment, if the irradiation position of the ultrasonic wave changes, the expected therapeutic effect in the simulation is expected. May not be obtained as expected.

[0015]

According to a first aspect of the present invention, there is provided an ultrasonic therapy apparatus having an ultrasonic applicator having an ultrasonic source for generating therapeutic ultrasonic waves. In the apparatus, a storage means for obtaining a distribution in three-dimensional space of ultrasonic energy injected into the subject using the ultrasonic generation source and storing the distribution as an input energy distribution, and storing the input energy distribution stored in the storage means. An ultrasonic therapy apparatus, comprising: display means for displaying, is a solution.

Further, according to the present invention as set forth in claim 2,
The input energy distribution is the ultrasonic frequency, intensity distribution,
2. The ultrasonic therapy apparatus according to claim 1, wherein the value is obtained by calculation based on at least one of parameters of an irradiation time, an ultrasonic attenuation rate of an irradiation target portion, and a depth of the irradiation target portion. And

According to the third aspect of the present invention,
The display device according to claim 1, wherein the display unit serves as an irradiation guide unit that guides an irradiation target by sequentially displaying input energy distribution information of the ultrasonic wave applied to the subject. The ultrasonic therapy device described on one side is a solution.

Further, according to the present invention described in claim 4,
The ultrasonic treatment apparatus according to any one of claims 1 to 3, wherein the ultrasonic applicator includes an ultrasonic probe that obtains an ultrasonic tomographic image for observing the ultrasonic irradiation target. The solution.

Further, according to the present invention described in claim 5,
The said display means can superimpose and display the said input energy distribution information on the ultrasonic tomographic image drawn by the said ultrasonic probe, The Claim 1 characterized by the above-mentioned.
The ultrasonic therapy device described in (1) is a solution.

According to the present invention described in claim 6,
6. The marker display unit according to claim 1, wherein the display unit is a marker display unit that displays an ultrasonic intensity distribution in a focal region where the ultrasonic wave is focused and can be displayed as a marker indicating an ultrasonic irradiation region. The ultrasonic therapy apparatus according to one aspect is a solution.

According to the present invention described in claim 7,
The ultrasonic treatment according to any one of claims 1 to 6, wherein the display unit can display the externally input image data input from the outside and the applied energy distribution of the ultrasonic waves in a superimposed manner. The device is the solution.

Further, according to the present invention described in claim 8,
The storage means calculates a temperature distribution in the subject based on the input energy distribution information by calculation and stores the temperature distribution information as temperature distribution information; and the temperature distribution stored in the temperature distribution information storage means. The ultrasonic therapy apparatus according to any one of claims 1 to 7, further comprising temperature distribution display means for displaying information.

According to the present invention as set forth in claim 9,
The ultrasonic wave according to any one of claims 1 to 8, wherein the temperature distribution display means can superimpose and display an ultrasonic tomographic image obtained by the ultrasonic probe and the temperature distribution information. The treatment device is the solution.

According to the tenth aspect of the present invention, at least two or more of the input energy distribution information, the temperature distribution information, the ultrasonic tomographic image, and the external input image data are transmitted. Coordinate information storage means for storing coordinate information of each piece in association with each other, and combination display means for displaying at least two or more pieces of information stored in the coordinate information storage means in combination with each other. The ultrasonic therapy apparatus according to any one of claims 1 to 9 is a solution.

According to the eleventh aspect of the present invention, when resuming the interrupted ultrasonic irradiation and performing the remaining treatment, the present invention is based on the energy distribution information stored before the interruption. Irradiation resumption comprising remaining energy amount calculating means for calculating the required irradiation energy amount after restarting irradiation, and remaining irradiation control means for controlling irradiation according to the remaining treatment in accordance with the result of the remaining energy amount calculating means. 11. The method according to claim 1, further comprising:
The ultrasonic therapy device described in (1) is a solution.

[0026]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to the drawings. Note that “three-dimensional” used in the following description means “three-dimensional space”.

FIG. 1 is a schematic diagram for explaining the configuration of an ultrasonic therapy apparatus according to the first embodiment of the present invention.
FIG. 2 is a schematic configuration diagram for explaining the ultrasonic applicator according to the first embodiment of the present invention.

First, the configuration of the ultrasonic treatment apparatus 1 shown in FIG. 1 includes an ultrasonic applicator 11 for irradiating therapeutic ultrasonic waves and a water circuit 12 for circulating deaerated water through the ultrasonic applicator 11. A drive waveform supply unit 13 for supplying energy to an ultrasonic source (not shown) provided inside the ultrasonic applicator 11, a data input unit 14 for inputting patient data, irradiation conditions of therapeutic ultrasonic waves, and the like; , An operation unit 15 for operating devices necessary for controlling irradiation of ultrasonic waves for use, an irradiation information storage unit 16 for storing irradiation information of ultrasonic waves, and an ultrasonic image diagnostic unit 18 for obtaining image information of a treatment region. And a system control unit 17 that controls and controls the entire ultrasonic therapy apparatus
A three-dimensional position detecting unit 20 for detecting a three-dimensional spatial position including a tilt of the ultrasonic applicator 11, an energy distribution calculating unit 21 for calculating input energy distribution and temperature distribution data, and a three-dimensional volume image An image synthesizing unit 22 for synthesizing the input energy distribution state of the therapeutic ultrasonic waves and an ultrasonic tomographic image around the affected part and the energy distribution of the therapeutic ultrasonic waves.
Three-dimensional information display unit 23 for displaying three-dimensional spatial position information
And an ultrasonic image display unit 24 that mainly displays a two-dimensional ultrasonic tomographic image, a data storage unit 25 that stores image information, a total input energy distribution, a treatment record, and the like, and reads and stores various data. External storage device 26, and a data transfer unit 27 that transfers data using an external network
Consists of

The configuration of the ultrasonic applicator 11 shown in FIG. 2 includes an ultrasonic transducer 31 as a source of therapeutic ultrasonic waves, an ultrasonic probe 32 for drawing an ultrasonic tomographic image, A coupling unit 33 for transmitting therapeutic ultrasonic waves emitted from the ultrasonic transducer 31 to living tissue,
A three-dimensional position sensor 34 that outputs three-dimensional position information including a tilt of the ultrasonic applicator 11 as a signal, and a three-dimensional position sensor 34 that is filled between the ultrasonic transducer 31 and the coupling unit 33 and propagates therapeutic ultrasonic waves. And water 30.

First, in the ultrasonic treatment using the ultrasonic treatment apparatus according to the first embodiment, the diagnosis of the diseased part is performed by the ultrasonic probe 32 built in the ultrasonic applicator 11 before performing the ultrasonic treatment. . At this time, 3 is used to display the ultrasonic energy distribution due to the irradiation of the therapeutic ultrasonic wave.
Determine the origin in dimensional space. In the ultrasonic tomographic image 36, a focus marker 35 as shown in FIG. 3 is displayed in a focal point region of the focused ultrasonic wave. The focus marker 35 simulates a region cauterized by one irradiation, which is assumed from the intensity distribution of the ultrasonic wave.

The center of the focus marker 35 is used as a reference of a position measurement point for determining the origin of the three-dimensional space. The affected part is diagnosed, and an ultrasonic tomographic image is matched to a section including the center of a tumor to be cauterized, for example. Then, the center point of the focus marker 35 is adjusted to the center of the tumor. In this state, the origin of the three-dimensional space is set.

As shown in FIG. 4, the section of the ultrasonic tomographic image at this time is set to the YZ plane, and the center point of the focus marker is set to the origin. After the origin is set, the ultrasonic tomographic image is expressed as shown in FIG. 4 based on the inclination, direction, and position of the ultrasonic applicator detected by the three-dimensional position sensor 34, and the three-dimensional image display unit 23 Will be displayed. On the ultrasonic image display unit 24, a normal ultrasonic tomographic image is displayed as shown in FIG.

Next, the size of the tumor to be cauterized is measured in a three-dimensional space. First, referring to FIG. 4, an ultrasonic tomographic image is adjusted to a position substantially corresponding to the YZ plane. Then, as shown in FIG.
The marking 38 is input via the operation unit 15 above, and the rough shape of the tumor 36 is input. At this time, by further adding the marking 38 along the contour of the tumor in addition to the horizontal direction and the vertical direction, more accurate measurement of the tumor size is performed.

Next, the size of the tumor is measured by aligning the ultrasonic tomographic image 36 with a position substantially corresponding to the XZ plane orthogonal to the YZ plane in FIG. If the tumor size is measured by two orthogonal cross sections, and an image is displayed based on the measurement data, the tumor can be simulated on a three-dimensional image. At this time, the approximate shape of the tumor can be grasped by representing the tumor shape in a simulated spherical or elliptical tumor model from the measured tumor size, and is displayed, for example, as a tumor outline 39 shown in FIG. .

Further, the measurement of the tumor size is performed on a larger number of cross sections, and the tumor shape is marked on the cross section.
By arranging 8 more finely, the shape of the tumor model represented on the three-dimensional image can be made more accurate. The measurement of the tumor size can be selected and added by the operator according to the treatment target site and necessity.
When the tumor on the ultrasonic image can be extracted by image processing, an ultrasonic tomographic image near the affected part is continuously taken, and the tumor size is automatically extracted from the result to obtain a three-dimensional tumor model. It may be expressed on an image.

When the diagnosis is completed through the above operations, the treatment for actually irradiating the therapeutic ultrasonic wave is started. In the treatment mode, an ultrasonic tomographic image is displayed in a three-dimensional space as in the diagnostic mode. At this time, the tumor model is displayed as a tumor outline 39 on the ultrasonic tomographic image.

As the focus marker, a marker display format may be selected according to the operator's preference and purpose. For example, it is also possible to display only the outline 45 of the region cauterized by one irradiation as shown in FIG. 7A, or to simultaneously display the measurement scale 46 as shown in FIG. 7B. . Alternatively, the intensity distribution 40 of the therapeutic ultrasonic wave may be displayed as shown in FIG. 7C, and the intensity distribution 40 may be displayed stepwise based on a predetermined threshold.
This stepwise display is displayed so as to be identifiable by, for example, color coding or color density, and includes a high intensity portion 40a and a medium intensity portion 40a.
b, an identification display such as the low intensity portion 40c is possible. The operator can select from these display formats as necessary, and of course, may simultaneously display a plurality of types of display formats.

The display as shown in FIG. 7 can be changed according to conditions such as the irradiation intensity of the ultrasonic wave, the irradiation time, the irradiation target depth, and the irradiation tissue.

Next, the irradiation position of the therapeutic ultrasonic wave is determined. In the first embodiment of the present invention, a case where cauterization is started from the center of the target tumor will be described as an example. Irradiation of the therapeutic ultrasonic wave can arbitrarily change the cauterization procedure depending on the purpose of the treatment or the target site.

First, the ultrasonic tomographic image and the focus marker are aligned with the center of the tumor. Next, the irradiation of the therapeutic ultrasonic wave is started by operating the irradiation switch of the therapeutic ultrasonic wave.
When the irradiation of the therapeutic ultrasonic waves is started, the energy distribution of the inputted therapeutic ultrasonic waves is displayed in real time. Here, the energy of the therapeutic ultrasonic wave is represented by the product of the intensity of the therapeutic ultrasonic wave and the irradiation time. Specifically, the three-dimensional information display unit 23 and the ultrasonic image display unit 24 show the energy distribution as shown in FIGS. 8A and 8B, respectively.

Here, since the energy distribution is stored as three-dimensional spatial data, for example, if the sectional position of the ultrasonic tomographic image is moved in an arbitrary direction as shown in FIG. The three-dimensional shape of the energy distribution can be observed. As described above, the three-dimensional information display unit 23 superimposes the contour of the tumor measured in this way and the energy distribution of the applied therapeutic ultrasonic waves on the ultrasonic tomographic image in the three-dimensional space, and stereoscopically displays them. You. Here, the energy distribution is represented by a difference in color or displayed using contour lines, and these data can be arbitrarily switched, selected and displayed.

For example, as shown in FIGS. 8 (a) and 8 (b), only the ultrasonic tomographic image 36 and the energy distribution 41 can be shown. Only the contour 39 can be shown. Alternatively, the ultrasonic tomographic image 36 may be temporarily erased to show only the tumor outline 39 and the input energy distribution 41. Further, the energy distribution 41 may be set to a certain threshold value to indicate only a portion where the energy is applied above the threshold value, and only the contour may be displayed on the ultrasonic tomographic image 36 in a superimposed manner.
Since the displayed data can be switched and any display can be selected, the surgeon can confirm the progress of the ultrasonic treatment based on the necessary information, or examine the next ultrasonic irradiation position, irradiation intensity, and irradiation time. be able to.

The XYZ coordinate space displayed on the three-dimensional information display unit 23 can be rotated in any direction, and the energy distribution and the positional relationship between the affected part can be grasped from any direction. is there.

When the first irradiation is completed in this way,
Enter the second irradiation. Using the stereoscopic display of the energy distribution 39 of the therapeutic ultrasonic wave in the first irradiation as a guide, the irradiation position, irradiation intensity, and irradiation time of the therapeutic ultrasonic wave in the second irradiation are determined, and then the irradiation of the therapeutic ultrasonic wave is performed. Here, again, the energy distribution of the therapeutic ultrasonic waves input simultaneously with the irradiation of the therapeutic ultrasonic waves is stereoscopically displayed on the screen in real time. At this time, the second three-dimensional display of the energy distribution is displayed in addition to the first three-dimensional display of the energy distribution. That is, in both the first irradiation and the second irradiation, the sum of the ultrasonic energies is displayed as an energy distribution in the region where the therapeutic ultrasonic waves are applied.

The irradiation position of the therapeutic ultrasonic wave can be confirmed by a focus marker or an energy distribution display, but the position of the center point of the focus marker may be always displayed as coordinates. The display method may be divided into a part for displaying in real time and a part for displaying the position at the start of irradiation. By displaying the position at the start of irradiation as history information when performing repeated irradiation, the position of the previous irradiation start is indicated as coordinates before performing new irradiation, so it is a guide to determine the next irradiation position. Becomes In addition, since the distance between the irradiation start position before the irradiation and the current position of the center of the focus marker can be displayed, the irradiation position can be determined more easily. Thereafter, irradiation is repeated in the same manner until the tumor area is completely cauterized.

The irradiation of the therapeutic ultrasonic waves is repeated in this manner. If there is a possibility that the affected area may move due to body movement or respiratory movement of the patient during the treatment, FIG.
As shown at 0, in the subject 54, at least one or more three-dimensional position sensors 50 are attached to the body surface 53 near the affected part 52, and the movement of the affected part 52 is detected. By reflecting the detected movement in the three-dimensional position information, it is possible to correct the part set as the origin so that it always becomes the origin in the three-dimensional space. Thereby, even if the affected part 52 moves during the treatment process, the accurate positional relationship between the ultrasonic applicator 51 and the affected part can be grasped, and accurate treatment can be performed.

As a guideline for tumor ablation of the affected area, one guideline is that the measured contour of the tumor is completely included in the display area of the amount of energy that can sufficiently cause protein denaturation. For example, if the state as shown in FIG. 11 is observed in the entire tumor, it can be considered that the treatment is completed. FIG. 11 shows a tumor contour 39, a region 41 to which energy is applied above a certain threshold, a low energy region 41c, a medium energy region 41b, and a high energy region 41a.

Up to this point, the flow of a series of ultrasonic treatments has been described. However, in addition to the above configuration, the following warning function can be provided. In this configuration, since the total input energy distribution is always calculated and displayed, a warning is issued when ultrasonic energy exceeding a permissible value is applied to a certain irradiation target area of a therapeutic ultrasonic wave, or a therapeutic ultrasonic wave is emitted. The intensity of the sound wave can be reduced, or the irradiation can be stopped.

For example, if ultrasonic energy is continuously applied to a part of the region, the temperature of the region rises above 100 ° C., so that water may suddenly boil. Therefore, by providing a warning function, it is possible to prevent the input of energy exceeding such an allowable value beforehand, and to perform more accurate and safe treatment.

In this embodiment, the input energy distribution is stored and displayed as three-dimensional data. However, the temperature distribution can be obtained by calculation based on the energy distribution data. If the ultrasonic absorption rate and thermal conductivity of the tissue irradiated with the therapeutic ultrasonic wave are known, the irradiation depth of the therapeutic ultrasonic wave and the input energy can be known from the energy distribution information in the three-dimensional space. A temperature distribution in a three-dimensional space can be calculated by using a heat transport equation or the like.

In the ultrasonic therapy apparatus according to the present embodiment,
Since the sum of the energy distributions is recorded, the ultrasonic energy input every predetermined unit time in the three-dimensional space is obtained. The temperature change per unit time can be calculated and obtained from the value of the ultrasonic energy, and the temperature distribution can be displayed in real time based on the calculation result. Parameter values required for calculation such as the ultrasonic absorption rate and thermal conductivity of the living tissue can be input and set via the data input unit 14. In addition, parameter values are stored in advance in the data storage unit 25 for each tissue that can be expected to be treated,
It can also be used for calculations. Further, the calculation may be performed from the image data of the ultrasonic tomographic image using, for example, a change in gray value as a parameter value.

The ultrasonic absorptivity and thermal conductivity of the tissue to be treated generally change as the temperature rises and the protein denaturation progresses. Or by reading from parameter values stored in advance in accordance with temperature changes and calculating. By displaying the temperature distribution in the three-dimensional space in this manner, more accurate information on the degenerative state of the affected part can be provided, and the treatment accuracy can be improved. When displaying the temperature distribution, the color may be changed depending on the temperature, or may be displayed using an isothermal line or the like. In addition, a certain threshold value may be set to display the contour of a region at or above the temperature. The display of the energy distribution and the temperature distribution can be arbitrarily switched and selected.

At the end of the treatment, the energy distribution, temperature distribution, tumor contour information, and ultrasonic tomographic image information in the three-dimensional space can be stored in the data storage unit 25 as a treatment record.
At this time, the energy distribution, the temperature distribution, the tumor contour information, and the image data are stored together with the spatial position information, and are associated with each other on the spatial coordinates. Thereby, when examining and diagnosing the diseased part after the operation, the correspondence between the input energy and the state of the diseased part can be clarified, and the diagnosis and the determination of the therapeutic effect can be reliably performed. In addition, since the treatment effect can be accurately recorded as treatment data, it can be used as reference data for subsequent treatment. The recorded treatment data can be transferred to and stored in a medium such as a floppy disk, MO, or CD-R using the external storage device 26. Further, the data can be transferred to an external database using the data transfer unit 27 and stored. Conversely, it is also possible to access the external database from the data transfer unit 27 to read past treatment data, and refer to the data before treatment.

In the first embodiment of the present invention, the treatment is started after the examination of the affected part is completed by measuring the size of the tumor, but a simulation of ultrasonic irradiation may be performed before the treatment. At this time, the outline (tumor model) of the cauterized portion corresponding to the tumor extracted in advance from the ultrasonic tomographic image is used.
Then, although the irradiation of the therapeutic ultrasound is not actually performed, the calculation is performed in the case where the therapeutic ultrasonic irradiation is virtually performed on the three-dimensional image with respect to the tumor model.

The virtual irradiation may be performed by inputting condition settings and parameter values using an external input device such as a mouse (not shown) of the operation unit 15, or by performing an ultrasonic application by simulating an actual operation procedure. This may be performed while pressing the phantom against the ultrasonic phantom. Alternatively, the irradiation may not be actually performed, but may be performed while pressing the applicator against the affected part itself to be treated. Also in this case, the total of the energy distribution is displayed on the three-dimensional image as in the actual irradiation. Then, as in the case of the treatment, the pseudo irradiation is repeatedly performed on the tumor model. By performing this simulation, it is possible to know before the treatment how many times the irradiation should be performed from which position to complete the treatment. The result of this simulation makes it possible to perform highly accurate treatment. Further, the temperature distribution can be calculated and displayed also in the simulation.

Next, a second embodiment of the present invention will be described.

FIG. 12 shows a schematic configuration for explaining an ultrasonic therapy apparatus according to the second embodiment of the present invention.
This configuration is obtained by adding an image identification unit 28 for comparing and identifying three-dimensional image data to the configuration shown in FIG. 1 of the first embodiment.

First, before treatment, X-ray CT or MRI
To obtain three-dimensional image data around the affected part. next,
The acquired three-dimensional image data is read into the data storage unit 25 using the external storage device 26 or the data transfer unit 27. When the external storage device 27 is used, data is read from a medium such as an MO, or when the data transfer unit 27 is used, data is read from an external database or the like that stores image information data.

Next, the affected part is diagnosed using an ultrasonic probe for image diagnosis provided in the ultrasonic applicator 11. The ultrasonic applicator 11 has a three-dimensional position sensor 34
(See FIG. 2), the three-dimensional position detector 20 can detect and store the position of the ultrasonic tomographic image. For this reason, when continuously taking ultrasonic tomographic images around the affected area,
Based on the position information, the data of the ultrasonic tomographic image can be stored in association with the coordinate position in the three-dimensional space.

Next, as in the first embodiment, the origin is determined in the three-dimensional space. For example, when the center of the tumor is set as the origin, the center of the focus marker is set to the center of the tumor, and an origin setting button (not shown) is pressed. by this,
An origin is set in a three-dimensional space. The ultrasonic diagnostic data in the three-dimensional space in which the origin is set and the data storage unit 25
The image identification unit 28 performs positioning with the three-dimensional image data photographed by X-ray CT or MRI stored in the storage unit.

The image discriminating section 28 sets the origin of each of the three-dimensional image data by comparing characteristic portions of the three-dimensional image data, for example, contours of blood vessels and organs, shapes of affected parts, and the like. Are aligned on the same three-dimensional space. Also, at the time of image data imaging such as X-ray CT and MRI and at the time of ultrasonic data imaging, physical markers that can be imaged by both diagnostic devices are arranged at the same site and imaging is performed, and alignment is performed based on the positions. You may go. The operator can also manually perform the alignment between these images.

By doing so, it becomes possible to refer to image data captured by X-ray CT, MRI, or the like on a common three-dimensional space. That is, it is possible to display the focus of the therapeutic ultrasonic wave on image data obtained by X-ray CT, MRI, or the like. Further, a cross section of three-dimensional image data corresponding to an ultrasonic tomographic image by the ultrasonic probe 32 is shown on the three-dimensional information display unit 23. Further, image data such as X-ray CT and MRI and an ultrasonic tomographic image can be displayed side by side on the ultrasonic image display unit 24.

The image displayed on the three-dimensional image display unit 23 can be displayed by arbitrarily switching between an ultrasonic tomographic image and three-dimensional image data obtained by X-ray CT or MRI. Thereby, it is possible to perform treatment even in a case where the position of the affected part cannot be sufficiently confirmed only by the ultrasonic tomographic image.

Next, the size of the region to be treated, such as a tumor, is set, and the treatment is started. The procedure for setting the treatment target site is the first
It is the same as the embodiment. However, also in this case, the marking can be arranged on the contour of the treatment target site by arbitrarily selecting and displaying the ultrasonic tomographic image and the X-ray CT and MRI image data. In addition, the treatment proceeds in the same manner as in the first embodiment. At this time, the ultrasonic tomographic image and the image data of the X-ray CT and MRI can be arbitrarily selected and displayed, and the energy distribution and the temperature distribution of the injected therapeutic ultrasonic wave can also be arbitrarily selected. Can be displayed.
In addition, the procedure of the treatment and the measures against the movement of the affected part are the same as those in the first embodiment.

Also, in the second embodiment, a simulation can be performed before treatment, as in the first embodiment. The storage of the treatment data is performed in the same manner as in the first embodiment. At this time, the ultrasonic diagnostic data, the three-dimensional image data by X-ray CT and MRI, the energy distribution data, the temperature distribution data, and the tumor model data, which is the outline of the ablation target, are also stored along with the positional information, so that post-operative treatment is also possible. To be able to reproduce the state of. In the second embodiment, the image data can be properly used depending on the nature and state of the affected part, and highly accurate treatment can be performed.

In the case where the ultrasonic treatment is performed, the treatment may be divided into several treatments, and the time interval between the treatments may be several minutes, several hours, several days, or several months. Become. When the time interval is widened in this way, in order to perform the previous ultrasonic treatment, the data of the treatment target site obtained by the previous ultrasonic treatment becomes important.
Based on the treatment data obtained from the previous ultrasonic irradiation, the irradiation time, intensity, irradiation site, etc. of new therapeutic ultrasonic waves can be determined, and ultrasonic treatment that requires a time interval Thus, accurate treatment without waste can be completed.

For example, as shown in FIG. 13, in the ultrasonic therapy apparatus according to the second embodiment of the present invention, the database filing system 60 is connected to the data transfer unit 27.
Connect to The database / filing system 60 stores all three-dimensional data related to therapeutic ultrasonic irradiation up to a temporary interruption, a two-dimensional ultrasonic tomographic image, or another three-dimensional image input from outside. Data, patient-specific history data, and the like are stored in association with each other.

Even if the treatment is temporarily interrupted, data unique to the patient and data on the progress of protein denaturation at the treatment target site due to the irradiation of the therapeutic ultrasonic wave are stored, so that when the treatment is resumed the next time, In addition, it is possible to perform lean and accurate ultrasonic treatment based on the previous data.

According to the first and second embodiments of the present invention described above, the distribution state of the total of the ultrasonic energies applied in the plural times of irradiation of the therapeutic ultrasonic waves is grasped while the therapeutic state is being grasped. Since the treatment can be advanced by determining the irradiation position, irradiation intensity, and input energy of the ultrasonic wave, highly accurate ultrasonic ablation treatment can be performed.

Even if the treatment is interrupted for some reason, since the input amount of the ultrasonic energy up to that time is recorded together with the three-dimensional position coordinates, the ultrasonic treatment is restarted by referring to the information. can do.

Since the three-dimensional image data and ultrasonic energy distribution around the affected part can be recorded as three-dimensional information, the input energy and the state of the affected part can be correlated after the operation, and the effect of the ultrasonic wave on the living body can be accurately determined. Can be analyzed.

The embodiments described above are described for facilitating the understanding of the present invention, and are not described for limiting the present invention. Therefore, each element disclosed in the above embodiment is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

[0073]

According to the present invention, the irradiation position, irradiation intensity, and applied energy of the therapeutic ultrasonic wave are grasped while grasping the distribution state of the sum of the ultrasonic energies inputted in the plural times of irradiation of the therapeutic ultrasonic wave. Can be determined and the treatment can be advanced, so that the ultrasonic ablation treatment with high accuracy can be performed, and even if the treatment is interrupted for some reason, the input amount of the ultrasonic energy up to that point is three-dimensional position. Since the information is recorded with the coordinates, the ultrasonic treatment can be restarted by referring to the information, and the three-dimensional image data and the ultrasonic energy distribution around the affected part can be recorded as three-dimensional information. It is possible to provide an ultrasonic treatment apparatus capable of associating the input energy with the state of the affected part after surgery and accurately analyzing the effect of ultrasonic waves on a living body.

[Brief description of the drawings]

FIG. 1 is a schematic diagram illustrating a configuration of an ultrasonic therapy apparatus according to a first embodiment of the present invention.

FIG. 2 is a schematic diagram illustrating a configuration of an ultrasonic applicator according to the first embodiment of the present invention.

FIG. 3 is a schematic diagram for explaining image display according to the first embodiment of the present invention.

FIG. 4 is a schematic diagram for explaining image display according to the first embodiment of the present invention.

FIG. 5 is a schematic diagram for explaining image display according to the first embodiment of the present invention.

FIG. 6 is a schematic diagram for explaining image display according to the first embodiment of the present invention.

FIGS. 7A and 7B are schematic diagrams for explaining three-dimensional image display according to the first embodiment of the present invention, wherein FIG. 7A is an example of contour display of an ablation region, and FIG. It is an example of an intensity distribution display, and (c) shows an example of a measurement scale display.

FIGS. 8A and 8B are schematic diagrams for explaining three-dimensional image display according to the first embodiment of the present invention, wherein FIG. 8A is an example of stereoscopic display, and FIG. Here are two examples.

FIG. 9 is a schematic diagram illustrating a three-dimensional image display according to the first embodiment of the present invention.

FIG. 10 is a schematic diagram illustrating a three-dimensional position sensor according to the first embodiment of the present invention.

FIG. 11 is a schematic diagram illustrating a three-dimensional image display according to the first embodiment of the present invention.

FIG. 12 is a schematic diagram illustrating a configuration of an ultrasonic therapy apparatus according to a second embodiment of the present invention.

FIG. 13 is a schematic diagram illustrating a configuration of an ultrasonic therapy apparatus according to a second embodiment of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic treatment apparatus, 11 ... Ultrasonic applicator, 12
... water circuit, 13 ... drive waveform supply section, 14 ... data input section, 15 ... operation section, 16 ... irradiation information storage section, 17 ... system control section, 18 ... ultrasonic image diagnosis section, 20 ... 3D position detection section , 21: Energy distribution calculation unit, 22: Image synthesis unit, 23: Three-dimensional information display unit, 24: Ultrasonic tomographic image display unit, 25: Data storage unit, 26: External storage device, 27 ...
Data transfer unit, 34: three-dimensional position sensor, 35: focus marker, 36: ultrasonic tomographic image

Claims (11)

[Claims] 1. An ultrasonic treatment apparatus having an ultrasonic applicator provided with an ultrasonic generator for generating therapeutic ultrasonic waves, wherein an ultrasonic wave is injected into a subject using the ultrasonic generator. An ultrasonic treatment apparatus comprising: a storage unit that obtains a distribution of energy in a three-dimensional space and stores the obtained distribution as an input energy distribution; and a display unit that displays the input energy distribution stored in the storage unit. 2. The input energy distribution is calculated based on at least one of parameters of an ultrasonic frequency, an intensity distribution, an irradiation time, an ultrasonic attenuation rate of an irradiation target portion, and a depth of an irradiation target portion. 2. The ultrasonic therapy apparatus according to claim 1, wherein the value is obtained by the following. 3. An irradiation guide means for guiding an irradiation target by sequentially displaying input energy distribution information of the ultrasonic wave applied to the inside of the subject. Or the ultrasonic treatment apparatus according to any one of 2. 4. The ultrasonic applicator according to claim 1, wherein the ultrasonic applicator includes an ultrasonic probe for obtaining an ultrasonic tomographic image for observing an ultrasonic irradiation target. Ultrasound therapy device. 5. The display device according to claim 1, wherein the display means is capable of displaying the input energy distribution information in a manner superimposed on an ultrasonic tomographic image drawn by the ultrasonic probe.
5. The ultrasonic treatment apparatus according to any one of 4. 6. The marker display unit according to claim 1, wherein the display unit is a marker display unit that displays an ultrasonic intensity distribution in a focal region where the ultrasonic wave is focused and can be displayed as a marker indicating an ultrasonic irradiation region. The ultrasonic therapy apparatus according to any one of claims 5 to 5. 7. The apparatus according to claim 1, wherein said display means is capable of superimposing and displaying externally input image data input from outside and input energy distribution of said ultrasonic waves. An ultrasonic therapy apparatus according to claim 1. 8. The temperature distribution information storage means for calculating a temperature distribution in a subject based on the input energy distribution information by calculation and storing the calculated temperature distribution information as temperature distribution information, and storing the temperature distribution information storage means in the temperature distribution information storage means. And temperature distribution display means for displaying the obtained temperature distribution information.
The ultrasonic treatment apparatus according to any one of the above. 9. The temperature distribution display means according to claim 1, wherein said temperature distribution information is superimposed on an ultrasonic tomographic image obtained by said ultrasonic probe and said temperature distribution information. The ultrasonic treatment apparatus according to claim 1. 10. At least two or more of the input energy distribution information, the temperature distribution information, the ultrasonic tomographic image, and the external input image data are associated with coordinate information of each of them, and 10. A coordinate information storage means for storing, and a combination display means capable of displaying a combination of at least two or more pieces of information stored in the coordinate information storage means. An ultrasonic therapy apparatus according to any one of the above. 11. When resuming the temporarily interrupted irradiation of ultrasound and performing the remaining treatment, the amount of irradiation energy required after resuming irradiation is calculated based on the energy distribution information stored before the interruption. An irradiation restarting means comprising remaining energy calculating means and remaining irradiation controlling means for controlling irradiation according to the remaining treatment in accordance with the result of the remaining energy calculating means. 10
The ultrasonic treatment apparatus according to any one of the above.