JP2001204683A - Fluorescent observation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a fluorescent observation device by which a correct fluorescent strength can be continuously obtained regardless of the distance to an observation target and a fluorescent image suitable for fluorescent diagnosis can be obtained regardless of the distance to a tissue, thereby accurate diagnosis can be realized. SOLUTION: The device is provided with a fluorescent laser device 404, a fluorescent image pick up camera 407 for picking up a fluorescent image of the obtained observation target by an exciting light from the laser device 404, a fluorescent image signal processing device 409 for forming a fluorescent image by processing fluorescent image signals of the image picked up by the camera 407, a CCU 408, and a control means 427 for controlling the gain of optical amplification of an image intensifier 422 in the camera 407 by the output signals from processing device. The fluorescent image obtained in this way is optically amplified by the image intensifier 422 in the camera 407, and then is picked up by the CCD 423.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a fluorescence observation device capable of obtaining a fluorescence image by excitation light.

[0002]

2. Description of the Related Art In recent years, autofluorescence from a living body or a drug is injected into a living body, and the fluorescence of the drug is detected as a two-dimensional image.
There is a technique for diagnosing a disease state such as degeneration of a living tissue or cancer from the fluorescent image.

In autofluorescence, when light is applied to a living tissue, fluorescence having a wavelength longer than that of the excitation light is generated. Examples of a fluorescent substance in a living body include NADH (nicotinamide adenine nucleotide), FMH (flavin mononucleotide), and pyridine nucleotide. Recently, the correlation between such endogenous substances and diseases has become clear.

[0004] In the fluorescence of drugs, HpD (hematoporphyrin), Photofrin, ALA (δ-aminole) are used.
Vulinic acid) has a tendency to accumulate in cancer, and by injecting these drugs into a living body and observing their fluorescence, it becomes possible to diagnose a disease site.

That is, in the autofluorescence and the fluorescence by the drug, the fluorescence intensity and the spectrum of the normal part and the lesion part change. Therefore, by detecting and analyzing the intensity and spectrum of the fluorescence from the image, it is possible to distinguish the normal part from the cancer. As a determination method, Japanese Patent Application No.
As shown in JP-A-304429, excitation light λ0 (for example, 3
The affected part is irradiated with a laser (light of 50 mm to 500 mm) (e.g., an excimer laser, a krypton laser, a He-Cd laser, a dye laser). As shown in FIG. 48, for example, the fluorescence of the tissue obtained with the excitation light λ0 of 442 mm has a high intensity in a normal part, and is weaker in a lesion with a shorter wavelength than in a normal part. That is, in the figure, the ratio of the fluorescence intensity is different between λ1, λ2 and the normal and the lesion, so that the lesion can be distinguished from the normal by calculating the ratio of λ1, λ2. Then, the fluorescence was adjusted to a band of 480 to 520 nm and 630 nm.
An image is taken by a high-sensitivity camera (image intensifier) through the two filters in the above-mentioned band, and image processing such as a difference between the wavelengths in each band is performed by an image processing apparatus. Are indicated by displaying green and abnormal parts are indicated by red.

[0006]

By the way, the fluorescence observation device is designed to irradiate a target site via an endoscope or the like in order to stably and accurately diagnose whether or not a living tissue is a normal tissue. The light is evenly applied to the living tissue,
It is important whether the fluorescence generated from the living tissue can be received uniformly. However, a conventional light source for fluorescence observation always emits a constant amount of excitation light and irradiates the observation target site. For this reason, depending on the situation of the observation target site and the distance to the target site, an appropriate amount of fluorescent light may not be obtained, and there may be a case where good fluorescent observation may not be obtained.

The present invention has been made in view of the above circumstances, and always obtains an accurate fluorescence intensity irrespective of the distance to the observation target site, regardless of the distance to the observation target tissue.
It is an object of the present invention to provide a fluorescence observation device capable of obtaining a fluorescence image suitable for performing a fluorescence diagnosis and performing an accurate diagnosis.

[0008]

According to a first aspect of the present invention, there is provided a fluorescence observation apparatus for irradiating excitation light to an object to be observed of a living tissue to observe a fluorescent image by the excitation light. In the light source for generating the excitation light, and detection means for detecting fluorescence in the observation target site,
And control means for controlling the output of the detection means to be a predetermined amount.

A fluorescence observation device according to a second aspect of the present invention is a fluorescence observation device for observing a normal observation image of a site to be observed of a living tissue with normal illumination light and a fluorescence image with excitation light. A light source that generates the excitation light; an excitation light source that generates the excitation light; and a control unit that detects a fluorescence amount of the fluorescence image and controls a light amount of the excitation light source or a fluorescence image detection unit. .

[0010]

1 and 2 relate to a first embodiment of the present invention. FIG. 1 is a configuration diagram showing a configuration of a first embodiment of a fluorescent endoscope apparatus, and FIG. It is a block diagram which shows the structure of the principal part of the modification of an endoscope.

As shown in FIG. 1, a fluorescence endoscope apparatus 1 according to a first embodiment comprises a light source 2 for generating excitation light,
An endoscope 3 that irradiates the living body with excitation light from the camera to detect fluorescence and transmits it outside the living body, a camera 4 that captures a fluorescent image with high sensitivity and converts it into an electric signal, and processes an image from the camera 4 And
The image processing apparatus 5 includes a computer 7 that obtains a fluorescence intensity distribution and performs an inter-image operation, and a computer 7 that controls a light distribution distribution adjusting unit 6 built in the light source 2 based on the fluorescence intensity distribution.

First, a laser (for example, a He-cd laser having a wavelength of 442 nm,
0 mm excimer laser, krypton laser, dye laser) 8 to generate excitation light λ 0,
Through the light guide 9 of the endoscope 3. The light distribution distribution adjusting means 6 includes a beam expander unit 10 and a movable condenser lens 11, and can change the light distribution of the laser light according to the position of the lens 11.
Note that the position of the lens 11 is controlled by the computer 7. The laser light guided to the light guide 9 is applied to the endoscope 3.
The object 13 is expanded through the diffusion lens 12
Is irradiated. Then, the fluorescence emitted from the subject 13 enters the camera 4 through the objective lens 14, the image guide 15, and the eyepiece 16. The fluorescent image incident on the camera 4 is imaged by a CCD 20 through a coupling lens 17, a rotation filter 18, and an image intensifier (II) 19, and is converted into a video signal. As shown in FIG.
For example, the fluorescence of the tissue obtained with the excitation light λ0 of 442 mm has a high intensity in a normal part, and is weaker in a lesion at a shorter wavelength than in a normal part. That is, λ1, λ2 in FIG.
Since the ratio of the fluorescence intensity differs between normal and lesion,
, Λ2, it is possible to distinguish between lesion and normal. Therefore, the rotation filter 18 has 480
Filters transmitting light in a band of ５520 nm and light in a band of 630 nm or more are alternately arranged.

That is, the rotary filter 1 is driven by the motor 21.
8 rotates, the 480 to 520 nm, 630
Fluorescent images in the nm band can be taken alternately.
The rotation of the motor 21 is controlled by a timing controller 22 controlled by the computer 7, and the rotation of the
Reference numeral 20 is driven by a driver 24 by a timing controller.

The fluorescent image obtained by the CCD 20 is input to an image processing device, where the image is calculated between the images for each wavelength band, and a pseudo color image corresponding to the result is displayed on a monitor 23. On the other hand, the computer 7 analyzes the intensity distribution of the fluorescent image, and controls the position of the lens 11 of the light source 2 so as to be uniform.

The adjustment of the light distribution is performed on the standard subject 13 before the endoscopic examination, and the distribution is maintained during the endoscopic examination.

As described above, according to the fluorescence endoscope apparatus 1 of the present embodiment, the light distribution of the light source is changed based on the fluorescence image.
A good fluorescent image can be obtained even if the optical characteristics of the scope change.

By the way, as a modification of the first embodiment, the type of endoscope is detected in advance by a bar code,
Light distribution can be configured according to the type, and with this configuration, there is no need for adjustment before the endoscope inspection as in the first embodiment.

That is, as shown in FIG. 2, as a modification of the first embodiment, a connector 31 of the endoscope 3 includes a bar code 32 in which the model or light distribution data of the endoscope 3 is written.
Barcode scanner 33 that reads the barcode 32
And a computer 34 for controlling the light distribution distribution adjusting means 6 for changing the light distribution so as to obtain an optimum fluorescent image based on the data of the barcode 32.

The connector 31 of the endoscope 3 is connected to the light source 2.
Insert At this time, a bar code 32 describing the model of the endoscope 3 or the light distribution data is attached to the connector 31. The bar code 32 is read by a bar code scanner 33, and a computer 34 Controls the light distribution distribution adjusting means 6.

As a result, an optimum light distribution can be obtained without performing light distribution adjustment using the subject 13 in advance.

In the first embodiment, by using an image fiber having a length of 8 μm or more, the attenuation of red light of 600 nm or more is small, and more stable fluorescence diagnosis is possible.

Next, a second embodiment will be described. FIG. 3 is a configuration diagram showing a configuration of an endoscope distal end portion of the fluorescence endoscope apparatus according to the second embodiment. Since the second embodiment is almost the same as the first embodiment, only different configurations will be described, and the same configurations will be denoted by the same reference numerals and description thereof will be omitted.

In an endoscope comprising an image guide,
In order to improve the resolution of the observed image, the outer diameter of the fiber constituting the image guide is reduced to 7.5 μ, and the number of fibers is increased. Although the transmission efficiency of red was slightly reduced in the peripheral portion of the image guide due to the reduction in the diameter of the fiber, it did not hinder normal endoscope observation.

However, in the technique of diagnosing a lesion such as cancer using fluorescence, since the calculation between wavelengths is performed, for example, the ratio of green to red is calculated, the transmission efficiency of red light around the image guide is reduced. If it is lowered, an error sometimes occurs in discriminating a normal site from a lesion site such as cancer.

Therefore, as a fluorescence endoscope apparatus according to the second embodiment, the transmission effect of the red region around the image guide is improved, and the resolution is improved by increasing the number of fibers. Is determined with higher accuracy.

That is, in an endoscope apparatus for irradiating excitation light into the body cavity and observing fluorescent light emitted from the tissue in the body cavity through an image guide formed of an optical fiber, a center portion and a periphery of the optical fiber constituting the image guide are provided. The band in the red region of the wavelength characteristic of the optical fiber in the peripheral portion was increased in the portion and the central portion as compared with the central portion.

Therefore, even if light rays in the peripheral portion of the image guide are obliquely incident on the surface of the optical fiber, since the band of the red region of the optical fiber is increased, red omission is reduced and the location of the observation region is reduced. Irrespective of the above, it is possible to distinguish between a lesioned part and a normal part.

As a result, in the fluorescence endoscope apparatus of the second embodiment, while improving the resolution by increasing the number of fibers, the transmission efficiency of the peripheral red region is improved. Can be prevented, and the transmission efficiency of green and red does not decrease in the peripheral portion when determining the diseased part and the normal part based on the ratio of green to red and the like, so that good determination can be made in the entire observation image.

The second embodiment will be described in more detail. 3A and 3B are a cross-sectional view of a distal end portion of an endoscope and a distribution diagram of an image guide, and FIG. 3C is a diagram illustrating a wavelength characteristic of an optical fiber.

As shown in FIG. 3, a distal end portion of the endoscope 3 has a light guide 9 for transmitting excitation light from the light source 2 and a concave lens 12 for diffusing and irradiating the excitation light from the light guide 9 into a body cavity. And an objective lens 14 for projecting the fluorescence distribution due to the excitation light onto an end face 36a of the image guide 36, and an image guide 36 for transmitting the fluorescent image to the camera 4. The image guide 36 has a central portion of 7 mm. .
An optical fiber 37a of 5 μm and an optical fiber 37b of 8 μm in the peripheral portion are provided.

Then, the light emitted by the light guide 9 and the concave lens 12 is emitted into the body cavity, and fluorescence corresponding to a lesioned part and a normal part is generated. The fluorescent image is transferred to the objective lens 14.
Is projected on the end face of the image guide 36. At this time, the light beam of the image to be projected enters the optical fiber incident surface forming the end face 36a of the image guide 36 at an angle. For example, the light is incident almost perpendicularly to the optical fiber incident surface at the central portion, but is incident at an angle of about 5 ° at the peripheral portion.

FIG. 3 (c) shows the wavelength characteristics for the outer diameter of the optical fiber and the incident angle of the light beam of 0 ° and 5 °.
The characteristics are as follows. When the outer diameter of the optical fiber becomes 10 μm or less, the thickness of the grad becomes about 1 μm or less, and there is a cutoff frequency in the red to near infrared region.
In other words, as the outer diameter of the optical fiber becomes smaller, the thickness of the grad becomes thinner, and light from the longer wavelength side, that is, from red light to near-infrared light exits the fiber and cannot be transmitted.
On the other hand, when the angle of incidence of the optical fiber is increased, some light exceeds the limit of the angle of incidence and also escapes.

Therefore, when the incident angle is inclined by about 5 ° in the 7.5 μm fiber, the transmission efficiency in the red region is reduced.

On the other hand, in cancer diagnosis, the determination is made by obtaining the ratio between green light of 480 to 540 nm and red light of 620 to 700 nm.

However, if the image guide is constituted by an optical fiber having an outer diameter of 7.5 μm, attenuation of red light occurs in the peripheral portion as shown in FIG. 3C, making it difficult to determine a lesion. Therefore, by configuring the peripheral portion having an incident angle with an optical fiber having an outer diameter of 8 μm, the red band can be increased, and uniform transmission efficiency can be obtained in any region of the image guide.

It is to be noted that the outer diameter may not be set to 8 μm but may be increased to 7.5 μm to increase the thickness of the grad. Also, in this example, 7.
The image guide was composed of 5μ and 8μ.
The structure may be divided into 8.3 μ, 8 μ, 7.7 μ, and 7.4 μ in any number of stages.

Next, a third embodiment will be described. 4 and 5 relate to the third embodiment, FIG. 4 is a configuration diagram showing a configuration of an endoscope distal end portion of a fluorescent endoscope apparatus, and FIG.
FIG. 10 is a configuration diagram showing a configuration of a distal end portion of an endoscope of a modified example of the fluorescence endoscope device of FIG. The third embodiment is almost the same as the first embodiment except that the light distribution distribution adjusting means is provided in the distal end portion of the endoscope. Therefore, only different configurations will be described. The description is omitted.

In the third embodiment, an optical filter having an absorption distribution is arranged before an image guide.
This is a fluorescence endoscope apparatus in which the distribution of the fluorescence intensity is made uniform.

As shown in FIGS. 4A and 4B, an optical filter 40 having an absorption distribution is disposed in the distal end of the endoscope 3a immediately before the image guide 15. Other configurations are the same as those of the first embodiment.

The optical filter 40 is set so that its absorbance decreases from the center to the periphery as shown in FIG.

For example, the fluorescent image is projected on the end face of the image guide 15 through the objective lens 14. At this time, if the optical filter 40 is arranged immediately before the image guide 15, the periphery of the fluorescent image can be made brighter than the center. On the other hand, the irradiation light tends to be darker at the periphery than at the center, and when the distortion of the objective lens 14 is corrected,
After all, the surroundings tend to be dark. Further Image Guide 1
At the periphery of the end surface of No. 5, the incident light beam is inclined by about 3 to 6 degrees as compared with the center, and becomes dark at the periphery similarly to the above. That is, by disposing an optical filter as shown in FIG. 4C immediately before the image guide 15, the light distribution can be made uniform.

The optical filter 15 may have a wavelength characteristic. For example, a filter having a certain absorption distribution only for light of 600 nm or more,
Correction for each wavelength can be made by combining a filter having a certain absorption distribution only for the light of m or using one of them. This may be attached to the eyepiece side.

Accordingly, since no special light distribution adjusting means is required, the configuration can be made inexpensively and easily.

As shown in FIG. 5, the distal end of the endoscope 3b according to the modification of the third embodiment has an optical axis between the objective lens 14 and the end face 15a of the image guide 15, and the optical axis of the light. An optical axis conversion element 41 for converting the light so as to be substantially perpendicular to the fiber is arranged.

As a result, the fluorescence excited by the excitation light is made incident through the objective lens 14, and the optical axis is made substantially perpendicular to the end face by the optical axis conversion element 41, for example, by a convex lens. As a result, even in the periphery of the image guide having the outer diameter of the fiber of 7.5 μm, the transmission efficiency of red does not decrease.

In this case, since it is not necessary to change the outer diameter of the optical fiber depending on the place as in the second embodiment, it is easy to form an image guide.

Next, a fourth embodiment will be described. 6 to 8 relate to the fourth embodiment, FIG. 6 is a configuration diagram showing a configuration of a fourth embodiment of the fluorescence endoscope apparatus, and FIG. 7 is a configuration of a modification of the fluorescence endoscope of FIG. FIG. 8 is an explanatory diagram illustrating an example of a method of correcting the LUT in FIG. Since the fourth embodiment is almost the same as the first embodiment, only different configurations will be described, and the same configurations will be denoted by the same reference numerals and description thereof will be omitted.

In the fourth embodiment, a correction table for each detection wavelength is arranged, and a fluorescence intensity distribution for each detection wavelength is corrected, whereby a highly accurate diagnosis can be performed. It is.

As shown in FIG. 6, the present fluorescence endoscope 50
The laser 8 is guided directly to the light guide 9 and the image processing device 51 for processing the obtained fluorescent image is a CC.
A that converts the video signal from D20 into digital data
A / D converter 52, a correction table 53 for correcting a fluorescence image for each wavelength, an image memory 54 for storing images, a calculator 55 for calculating between images, and the like, and a lesion can be easily identified from the calculation result. A video processor 56 for forming an image (for example, pseudo color), and a motor 21, a correction table 53, an image memory 54,
It comprises a timing control 57 for adjusting the timing of the arithmetic unit 55. Other configurations are the same as in the first embodiment.

The laser light generated by the laser 8 is directly incident on the light guide 9. After correcting the fluorescence intensity distribution by the image processing device 41 with the fluorescence by the excitation light, the monitor 2
3 is displayed.

First, the A / D converter 52 converts a video signal into digital data. The digital data of this image is corrected by the correction table 53 for each wavelength. The correction coefficient is determined in advance by the standard subject 13 to obtain a fluorescence distribution for each wavelength, and is feedback-adjusted so that the distribution becomes uniform.

The corrected data is stored in the image memory 54 for each wavelength, and a difference or a ratio is calculated between the wavelengths by the calculator 55, and a video processor 56 is calculated based on the result.
Is converted into a pseudo color image signal and displayed on the monitor 23.

Therefore, since the correction can be performed for each detection wavelength, the diagnostic accuracy is improved.

As a modification of the fourth embodiment, a configuration as shown in FIG. 7 may be adopted. That is, the image processing device 51
In a, the digital data from the A / D converter 52 is stored in the frame memory 61, and the fluorescent image data is separately stored in the lockup tables (LUT) (R) 63, (G) for each of red and green via the multiplexer 62. 64 (R '= f1 (R), G' = f2 (G): f1, 2
f is a correction function). The multiplexer 62 is synchronized with the rotation filter 18 by the filter switching unit 65 based on the timing controller 57, and the LUT (R) 63, (G)
Switch 64.

In the correction method using the LUTs (R) 63 and (G) 64, for example, as shown in FIG. That is, from the innermost circumference to the outermost circumference, (R ′ =
R, G ′ = G), (R ′ = R × 1.1, G ′ = G × 1.
01), (R ′ = R × 1.15, G ′ = G × 1.0
3), (R ′ = R × 1.2, G ′ = G × 1.05).

By the way, in the fluorescence observation, since the weak fluorescence is amplified at a high magnification, there is considerable noise. In addition, pseudo color display is used to discriminate a cancer from a normal part, and the stereoscopic effect is small. For this reason, when performing a biopsy under fluorescence observation, since the forceps do not emit fluorescence, it was not known where the tip of the forceps was located relative to the lesion.

Therefore, a fluorescent paint is applied to the tip of the forceps,
Further, an embodiment of a fluorescence endoscope apparatus capable of accurately performing a biopsy and treatment of a lesion by forming a forceps with a substance that emits fluorescence will be described.

As shown in FIG. 9, the forceps 72 is inserted through the channel 71 of the endoscope 70. Tip 7 of forceps 72
3 is coated with a fluorescent paint 74, so that the tip of the forceps can be seen even under fluorescent observation, and the position with respect to the lesion 75 can be made accurate. It should be noted that, by using a fluorescent paint having a characteristic different from that of the tissue as shown in FIG. 10 as shown in FIG.
By making the forceps blue for the normal part → green and for the abnormal part → red as shown in FIG. In FIG. 10, .lambda.0 (442 nm) represents an excitation wavelength, and .lambda.1 and .lambda.2 represent detection wavelengths. That is, when the ratio between λ1 and λ2 is obtained, the values are greatly different depending on the lesion, normal, and forceps.

As a fluorescent paint, Lumogen,
There are Shannon Glow, Tiglo Color, Cold Fire Color, etc.

In addition, since the fluorescence from the living body is weak,
I. I. Although the image is taken with high sensitivity at 19 or the like, if the electric lamp in the examination room or the surgical operation light is turned on, it passes through the living body though a little, and enters the body cavity. Even with such a small amount of light, high-sensitivity imaging may cause noise, making accurate diagnosis impossible.

Accordingly, an embodiment of a fluorescent endoscope which can remove the influence of external illumination will be described. As shown in FIG. 12, the light of an electric lamp 80 in a room such as an inspection room is
1 is received by the control device 82 and I.I. I. High-voltage power supply H.19 for controlling the sensitivity of H.19. V. 83 is controlled. That is, if the room is bright, I.I. I. 19, to reduce the effects of noise caused by electric lights, and to further increase the brightness of the room. I. When the sensitivity of No. 19 is saturated or when there is a risk of burn-in, the power supply is turned off. Note that a display means for notifying the operator that the room is bright and noise may be provided.

The fluorescent observation camera 4 is large and does not have a sterilized structure. Therefore, an embodiment of a fluorescence endoscope apparatus which solves such a problem is shown in FIG. As shown in FIG. 13, the sterilization area is secured by connecting the rigid endoscope 90 and the camera 4 with the image guide 91.
Further, since the camera 4 is connected to the image guide 91, the operation of the rigid endoscope 80 becomes easy even without a scope holder or the like.

[Supplementary Note] (1-1) In the fluorescence endoscope apparatus according to claim 1, the light distribution changing means is a plurality of movable lenses.

(1-2) The fluorescence endoscope apparatus according to claim 1, wherein the image correcting means is a correction table including an image memory.

(1-3) The fluorescent endoscope apparatus according to claim 1, wherein the control by the light distribution changing means or the image correcting means is performed using a standard subject which emits uniform fluorescent light.

(1-4) The fluorescence endoscope apparatus according to claim 1, wherein the image detecting means detects fluorescent images of at least two or more different wavelength regions, and the image correcting means detects each of the wavelengths. It has a correction table composed of image memories of two or more screens for correcting each area.

In this configuration, since the correction means corrects for each detection wavelength region using the correction table, even if the wavelength characteristics of the optical system are different, the normal portion and the abnormal portion can be accurately determined in any region of the screen. it can.

(1-5) The fluorescence endoscope apparatus according to supplementary note (1-4), wherein the wavelength region is 480 to 520 nm,
Two of 30 nm or more.

(1-6) In a fluorescence endoscope apparatus for irradiating an excitation light into a body cavity and observing fluorescence emitted from a tissue in the body cavity, an image based on the fluorescence is optically transmitted built in the endoscope. And a distribution changing unit that changes an incident distribution of the fluorescent image incident on the incident end face of the image guide between the image guide to be performed and an objective lens that projects a fluorescent image on the incident end face of the image guide. A fluorescence endoscope apparatus characterized by the above-mentioned.

In this configuration, since the distribution changing means is built in the endoscope in advance, the apparatus is simple, and similarly to the above, the determination of the normal portion and the abnormal portion can be accurately performed in any area of the screen. it can.

(1-7) In the fluorescence endoscope apparatus according to supplementary note (1-6), the distribution changing means is at least one or more optical filters having an absorption distribution.

(1-8) In the fluorescence endoscope apparatus according to supplementary note (1-7), the optical filter has a wavelength characteristic.

In this configuration, since the optical filter has a wavelength characteristic, it is possible to determine the normal part and the abnormal part with any simple structure in any area of the screen even if the wavelength characteristics of the optical system are different. Accurate correction

(1-9) The fluorescence endoscope apparatus according to attachment (1-8), wherein the wavelength characteristic has an absorption distribution at 480 to 520 nm or at 630 nm or more.

(1-10) Irradiating the body cavity with excitation light,
In the endoscope apparatus for observing the fluorescence emitted from the tissue in the body cavity through an image guide made of an optical fiber, the central portion and the peripheral portion of the optical fiber constituting the image guide have a red region having a wavelength characteristic of a peripheral portion as compared with the central portion. A fluorescence endoscope apparatus characterized by having an increased band.

(1-11) In the fluorescence endoscope apparatus according to supplementary note (1-10), the outer diameter of the optical fiber is changed between a central portion and a peripheral portion, and the central portion is made thinner.

(1-12) In the fluorescence endoscope apparatus according to supplementary note (1-10), the outer diameter of the optical fiber is less than 8 μm at the center and 8 μm or more at the periphery.

By the way, excitation light is applied to a site to be examined in a living body, and fluorescence emitted from the site is detected as a two-dimensional image. From this fluorescence image, a disease state such as degeneration of a living tissue or cancer (for example, the type of disease) And the infiltration range), the endoscope or the like is used to irradiate the excitation light from the laser device to the inspection target site through the light guide as described above, and the imaging optical system. To obtain a fluorescent image. In this case, the excitation light from the laser device is transmitted by a light guide using a fiber bundle, so that the intensity of the excitation light is weakened mainly in the peripheral portion in the light distribution of the excitation light, or distortion correction in the imaging optical system, that is, in the peripheral portion, Distortion of the fluorescent image occurs mainly in the peripheral portion of the image, such as a decrease in the fluorescent intensity of the peripheral portion in the fluorescent image obtained by the effect of expanding the image of the fluorescent image, and the peripheral portion of the fluorescent image is likely to be darkened. It can happen. That is, even when a target having completely uniform spatial fluorescence characteristics is imaged, the fluorescence image distortion such that a fluorescence intensity difference occurs in the fluorescence image causes a low light intensity level in the fluorescence image and a signal-to-noise ratio (S / N) may be deteriorated, which may cause a problem such as an error in fluorescence diagnosis in a portion having a poor S / N when judging a normal portion and a lesion portion.

In order to solve the above-mentioned problems, an example of the configuration of an embodiment of a fluorescence observation apparatus capable of improving the S / N in a fluorescence image is shown in FIGS.
Shown in FIG. 14 is a configuration explanatory view showing the overall configuration of the fluorescence observation apparatus, FIG. 15 is a block diagram showing the configuration of the fluorescence image processing apparatus in the configuration of FIG. 14, and FIG. 16 shows the operation of the fluorescence image processing apparatus when creating an image conversion table. FIG.

The fluorescence observation apparatus of this embodiment is provided with an endoscope 101 for guiding excitation light to an observation target site and forming an image of fluorescence from the observation target site. Further, a laser device 102 having a He-Cd (helium-cadmium) laser light generating means for generating, for example, 442 nm violet light is provided as a light source means for fluorescence observation for generating excitation light. The apparatus is provided with a lamp light source device 103 having a lamp 103a such as a xenon lamp that generates white light as light source means for normal observation for observation.

The endoscope 101 includes a light guide 104 for transmitting light emitted from the laser device 102 or the lamp light source device 103 to the front end, and an eyepiece 1 on the rear end side for observation images.
The light guide 104 extends through a universal cord 107 extending from the side of the grip on the hand side and extends to the light guide connector 107a at the end. I have.

Laser device 102 and lamp light source device 10
3 is connected to a light distribution adapter 108 for switching light guided to the endoscope 101, and the light distribution adapter 108 is connected to the light guide connector 107a of the endoscope 101, Excitation light or illumination light for normal observation from the lamp light source device 103 through the light distribution adapter 108.
4 and is emitted from the distal end of the endoscope 101.

The light distribution adapter 108 is composed of a movable mirror 109 provided in the optical path of light emitted from the laser device 102 and the lamp light source device 103, and a driver 110 for driving the movable mirror 109. A switching means 111 is provided to selectively switch the angle of the movable mirror 109 to guide excitation light or illumination light for normal observation to the rear end face of the light guide 104 of the endoscope.

A light receiving adapter 112 is connected to the eyepiece 106 of the endoscope 101.
Is connected to a normal observation camera 113 serving as a normal image receiving unit and serving as a normal observation imaging unit, and a fluorescence observation camera 114 serving as a fluorescence image receiving unit and serving as a fluorescence observation imaging unit. Thereby, a normal observation image and a fluorescence observation image are captured. Normal observation camera 1
Reference numeral 13 denotes an imaging optical system and a CCD 115 serving as an image sensor.
And captures an image (normal observation image) of a test site irradiated with illumination light for normal observation from the lamp light source device 103.

The fluorescence observation camera 114 is composed of an image forming optical system and a rotary filter 1 that allows a fluorescent component of a predetermined band to pass therethrough.
16, a drive motor 117 for rotatingly driving the rotary filter 116, an image intensifier (II) 118 for amplifying an image transmitted through the rotary filter 116, and an image sensor for capturing an output image of the image intensifier 118. And a laser device 102
A fluorescence image (fluorescence observation image) of a test site obtained by irradiating excitation light from the camera is captured.
The rotation filter 116 has, for example, .lambda.1 = 480-520 nm.
And a band-pass filter of .lambda.2 = 630 nm or more are arranged and formed in a disk shape. By rotating, these filters are sequentially inserted in the optical path to pass the fluorescent components of the respective bands. It has become.

The light receiving adapter 112 is an imaging system comprising a movable mirror 120 disposed in the optical path of the subject image transmitted to the eyepiece 106 of the endoscope, and a driver 121 for driving the movable mirror 120. A switching unit 122 is provided to switch the camera between fluorescence observation and normal observation by selectively switching the angle of the movable mirror 120, and the subject image obtained by the endoscope 101 is displayed on the normal observation camera 113 or The camera is guided to the fluorescence observation camera 114.

A camera control unit (CCU) 123 is connected to the normal observation camera 113,
An imaging signal (normal image signal) output from D115 is input, signal processing is performed by CCU 123, and a video signal of a normal observation image is generated.

The fluorescence observation camera 114 is connected to a fluorescence image processing device 124 serving as a fluorescence image processing means.
An image pickup signal (fluorescent image signal) output from the CD 119 is input, signal processing is performed by the fluorescent image processing device 124, and a video signal of a fluorescent observation image is generated.

A timing controller 125 for controlling the operation timing of each section is provided. The driver 110 of the light distribution adapter 108, the driver 121 of the light receiving adapter 112, and the driving motor 11 of the rotary filter 116 are provided.
7, and a timing control signal to the fluorescence image processing device 124.

The CCU 123 and the fluorescence image processing apparatus 1
24 is connected to the video switcher 126 and the CCU 12
3 output normal observation image signal and fluorescence image processing device 124
The output of the fluorescence observation image signal and the video switcher 126
Can be selectively switched by the The video switcher 126 is connected to a foot switch 127 for manually performing image switching control and a video switching controller 128 for automatically performing image switching control based on the calculation result of the fluorescent image processing device 124. I have. A monitor 129 is connected to the output terminal of the video switcher 126 so that the fluorescence observation image signal or the normal observation image signal selected by the video switcher 126 is input to the monitor 129 so that the fluorescence observation image or the normal observation image is displayed. Has become.

Further, the fluorescence observation apparatus includes a fluorescence distortion detection device 130 used when setting the correction amount in the fluorescence image processing device 124.
4 is connected. The fluorescent strain detecting apparatus 130 is provided with a strain detecting fluorescent plate 131 having two-dimensionally and completely uniform fluorescent characteristics with respect to the excitation light irradiation. A control signal is output to the processing device 124.

When performing observation with the fluorescence observation apparatus of this embodiment, the light source and the camera are switched by the light distribution adapter 108 and the light reception adapter 112 in accordance with the instruction of the timing control signal from the timing controller 125, respectively. Select normal observation. At this time,
The timing controller 125 controls the fluorescence image processing apparatus 1
Synchronization of the processing in 24 with the operations of the movable mirror 109 of the light distribution adapter 108, the movable mirror 120 of the light receiving adapter 112, and the rotation filter 116 of the fluorescence observation camera 114 is performed.

In the case of normal observation, the movable mirrors 109 and 120 are moved to positions shown by solid lines in FIG. Thereby, the light guide 104 of the endoscope 101
To the lamp light source device 10 via the light distribution adapter 108.
The illumination light for normal observation from 3 is guided and illuminated on the observation target site. At this time, the subject image (normal observation image) illuminated by the illumination light for normal observation from the lamp 103a passes through the image guide 105, is guided to the camera 113 for normal observation via the light receiving adapter 112, and is captured. The imaging signal of the normal image captured by the CCD 115 is C
The signal is processed by the CU 123 and sent to the video switcher 126 as a normal observation image signal.

On the other hand, in the case of fluorescence observation, the movable mirrors 109 and 120 are moved to the positions indicated by broken lines in FIG. Thereby, the laser device 1 is connected to the light guide 104 of the endoscope 101 via the light distribution adapter 108.
The excitation light from 02 is guided and radiated to the observation target site. At this time, a fluorescence image (fluorescence observation image) of the test site obtained by irradiating the excitation light is provided by the image guide 1.
The image is guided to the fluorescence observation camera 114 through the light receiving adapter 112 through the light-receiving adapter 112 and is imaged. Fluorescence observation camera 11
In step 4, the λ1, λ2
Are transmitted, and the fluorescent image is amplified by the image intensifier 118 and captured by the CCD 119. An image signal of a fluorescent image picked up by the CCD 119 is signal-processed by the fluorescent image processing device 124 and sent to the video switcher 126 as a fluorescent observation image signal.

In this example, the timing controller 125
Switches between the two states of normal observation and fluorescence observation at high speed. As a result, both the normal observation image signal and the fluorescence observation image signal are always sent to the video switcher 126.

The two images of the normal observation image and the fluorescence observation image input to the video switcher 126 are displayed on the monitor 1.
As a method of displaying the image on the display 29, a method of selectively switching an image in accordance with an instruction from the foot switch 127 and displaying only one of the images, a method of controlling the video switching controller 128 based on the operation result of the fluorescent image processing device 124, for example, a cancer or the like Switching image so as to display a fluorescent image when a diseased part is identified, video switcher 1
At 26, a method of combining the fluorescence observation image and the normal observation image to superimpose and display the two images or combining and displaying the two images in a predetermined manner is exemplified.

Next, FIG. 15 shows a detailed configuration of the fluorescence image processing device 124, and the configuration and operation of the fluorescence image processing device 124 will be described.

The fluorescent image processing device 124 has a multiplexer 141 in the signal input section.
At 41, the fluorescence image signal input is
The output destination is switched for each of the fluorescent components in the wavelength band of λ2 and output to the frame memory 142 for λ1 and the frame memory 143 for λ2, respectively. The frame memory (λ1) 142 and the frame memory (λ2) 14
3 stores the fluorescence image signals of λ1 and λ2, respectively. The timing control signal from the timing controller 125 is input to the multiplexer 141, and the timing of the fluorescent image signals of λ1 and λ2 and the switching timing of the multiplexer are synchronized.

At the subsequent stage of the frame memory (λ 1) 142 and the frame memory (λ 2) 143, a switcher (λ 1) 144 and a switcher (λ 2) 14 for switching a signal output destination are provided.
5, each of the switchers 144 and 145 has λ1
And the fluorescence distortion detection circuits 146 and 147 for .lambda.2 and the image conversion tables 148 and 149, respectively.

The fluorescence distortion detection circuits 146 and 147 detect the fluorescence image distortion by comparing the standard signal level of the fluorescence image signal obtained when the fluorescence distortion detection device 130 is irradiated with excitation light with a predetermined value. The correction value setting signal is converted to an image conversion table 14 based on the detection result.
8, 149, and creates respective image conversion tables 148, 149 for correcting the signal level of the fluorescent image signal.

The output terminals of the image conversion tables 148 and 149 are connected to an arithmetic circuit 150. The arithmetic circuit 150 performs a predetermined operation on the fluorescent image signal corrected by the image conversion tables 148 and 149, and outputs a video of the fluorescent observation image. The signal is output as a signal (fluorescence observation image signal).

In the case of performing fluorescence observation, when a living tissue is irradiated with violet light of λ0 = 442 nm by the He—Cd laser of the laser device 102, autofluorescence having a wavelength longer than 442 nm is generated. In the camera 114, the rotating filter 116 separates and transmits two wavelength regions of .lambda.1 = 480 to 520 nm and .lambda.2 = 630 nm or more, and sequentially captures two fluorescent images of .lambda.1 and .lambda.2. The fluorescence sensitivity in the visible region obtained by the excitation light of the violet light is strong at a normal site and weak at a lesion such as cancer.
In the band of 0 to 520 nm, the fluorescence sensitivity at the normal site is strong, and the difference from the lesion is large.

Therefore, the arithmetic circuit 150 performs an arithmetic operation for obtaining a ratio or a difference between the fluorescence intensities at λ1 and λ2, for example, to generate a fluorescence observation image signal capable of determining the properties of the living tissue.

At this time, in order to prevent the fluorescence intensity at the peripheral portion of the fluorescence observation image from weakening and the S / N ratio from deteriorating, the image of the fluorescence image processing device 124 is used by using the fluorescence distortion detecting device 130. The conversion tables 148 and 149 are created, the correction amount is set, and the fluorescence image signal is corrected.

The operation at the time of creating the image conversion tables 148 and 149 will be described below.

When setting the correction amount of the fluorescence image signal, first, the excitation light from the laser device 102 is irradiated on the fluorescent plate 131 for detecting the distortion of the fluorescent distortion detecting device 130, and the fluorescent image of this fluorescent plate is stored inside. A fluorescence image signal obtained by imaging with the fluorescence observation camera 114 via the endoscope 101 is transmitted to the fluorescence image processing device 124. The distortion detecting fluorescent plate 13
Numeral 1 has two-dimensionally and completely uniform fluorescence characteristics with respect to irradiation of excitation light at a fluorescent wavelength to be used, and a fluorescent image having a two-dimensionally constant level of fluorescence intensity can be obtained. . Based on the standard fluorescent image, the fluorescent image processing device 124 performs two-dimensional conversion of the image signal so that the signal level of the fluorescent image signal is two-dimensionally constant, and corrects the fluorescent image signal. Image conversion table 1 for performing
48 and 149 are created.

Upon detecting the irradiation of the excitation light, the fluorescence distortion detecting device 130 supplies a switcher control signal to the switchers 144 and 145 of the fluorescence image processing device 124, and the fluorescent image stored in the frame memories 142 and 143. The switchers 144 and 145 are switched so that signals are sent to the fluorescence distortion detection circuits 146 and 147. And
Image conversion tables 148 and 149 are created and stored based on the detection results of the fluorescence distortion detection circuits 146 and 147. Thereby, the correction amount of the fluorescent image signal is set.

Next, a specific example of an image conversion table creation algorithm in the fluorescence distortion detection circuits 146 and 147 will be described with reference to FIG. In FIG. 16, for simplicity,
Only 8 × 8 pixels are shown.

First, as a first step, a fluorescent image obtained by imaging the fluorescent plate 131 for distortion detection irradiated with excitation light is
Each pixel from the original image shown in FIG. 16A is divided into a first sub-block having 2 × 2 pixels as one unit as shown in FIG. 16B.

Then, as a second step, a luminance integrated value (signal intensity integrated value) of the fluorescent image signal in each first sub-block is obtained, and this value is compared with a predetermined threshold value T 1 to obtain the luminance. When the integrated value is smaller than the threshold value T1, as shown in FIG. 16C, 2 × 2 pixels of the first sub-block are regarded as one pixel, and the signal intensity of the four pixels in the sub-block is reduced. The integrated luminance value is defined as the luminance of this pixel. An operation in which a plurality of pixels in the divided sub-block are regarded as one pixel and the luminance integrated value of the sub-block is set as the luminance of the pixel is referred to as pixel integration. By this pixel integration, the luminance signal level of a pixel regarded as one pixel is about four times that of the original pixel.

That is, in a fluorescent image signal obtained by imaging a standard fluorescent image, if the signal level (fluorescent intensity), which is the luminance at each pixel, is smaller than a predetermined value, the fluorescent intensity at that pixel is reduced. Pixel integration is performed in which a plurality of pixels are regarded as one pixel assuming that the generation of distortion that weakly causes S / N degradation is detected. Here, in each of FIGS. 16A and 16B, the upper right corresponds to the peripheral portion, and the lower left corresponds to the central portion. Pixels corresponding to the peripheral portion have low luminance, and thus pixel integration is performed. In FIG. 16C, 1
This indicates that pixel integration has been performed in one first sub-block.

Next, as a third step, a second sub-block in which 4 × 4 pixels as one unit as shown in FIG. 16D are used as a unit from the pixel-integrated image shown in FIG. Divided into

As a fourth step, only when all of the four first sub-blocks in each of the second sub-blocks are regarded as one pixel by the pixel integration operation described above, the four A luminance integrated value of the fluorescent image signal at the pixel is obtained, and this value is compared with a predetermined threshold value T2. When the luminance integrated value is smaller than the threshold value T2, as shown in FIG.
Four pixels of the sub-block (the first sub-block is 2 ×
(2, that is, 4 × 4 pixels) is regarded as one pixel, and pixel integration is performed using the luminance integrated value obtained by integrating the signal intensities in the sub-block as the luminance of this pixel. In (e) of FIG.
This indicates that pixel integration has been performed in one second sub-block.

In the subsequent steps, the same pixel consolidation operation as described above is performed on the 8 × 8 third sub-block.
Repeat for the fourth sub-block of × 16, and so on. When the sub-block of a predetermined size is reached,
Or, if there is no longer any pixel integration target,
This pixel integration operation ends.

With the above operation, the number of pixels to be integrated is determined while monitoring the light intensity at each pixel when a standard fluorescent image is actually captured, and the integrated state of the obtained pixels is determined by the contents of the image conversion table. Becomes In the example of FIG. 16, the integrated state shown in (e) is an image conversion table. In the fluorescence distortion detection circuits 146 and 147, the pixel integration operation is performed on the fluorescence image signals of λ1 and λ2, and image conversion tables 148 and 149 are created and stored.

At the time of actual fluorescence observation diagnosis, the image data is input to the fluorescence image processing device 124 and is stored in the frame memory 14 in the device.
2 and 143 are stored in the switcher 1
Image conversion tables 148, 14 directly from 44, 145
It is sent to 9. In the image conversion tables 148 and 149,
As soon as the fluorescent image signal is input, pixel integration is performed, the image signal is two-dimensionally converted, and the luminance level at a predetermined position in the fluorescent image signal is corrected. After the fluorescence image signal is corrected by the image conversion tables 148 and 149,
A predetermined operation is performed in the operation circuit 150, and as a result, it is output to the video switcher 126 as a final fluorescence observation image signal.

At this time, a video switching control signal is sent to the video switching controller 128 based on the operation result of the operation circuit 150, and when a diseased part such as a cancer is identified, the video switching controller 126 is controlled by the video switching controller 128.
Automatically switched to display a fluorescent image.

As a method of creating an image conversion table, in addition to the above-described method, a method of performing pixel integration by allowing a block such as a rectangle or a rectangle when dividing into sub-blocks, without limiting to a square block, Alternatively, a method may be considered in which region division is performed in pixel units, not in block units, and a pixel integration range of an arbitrary shape is determined according to the state of the fluorescent image.

[0119] In a standard fluorescent image obtained by imaging the fluorescent plate 131 for distortion detection, a signal level is low even when a fluorescent image of a test site is actually imaged, and the S / N is deteriorated. Therefore, by performing pixel integration, that is, a spatial integration operation of an image signal in a portion having a poor S / N such as a peripheral portion of an image, it is possible to increase luminance of a dark portion having a low signal level, S / N can be improved. That is, it is possible to increase the signal level of the portion where the fluorescence intensity is low so as to obtain an image signal of a constant signal level in the entire image of the standard fluorescent image, and to evenly correct the luminance.

When the spatial integration operation of the image signal is performed, the resolution of the image is reduced by an amount corresponding to the integration. However, in the fluorescent image diagnosis, it is necessary to precisely identify the lesion area in the lesion. It is less important than preventing a part from being overlooked. Therefore, in the configuration in which the spatial integration operation of the image signal is performed as in the present example, errors in the fluorescence diagnosis can be prevented by improving the S / N of the fluorescence image, as compared with the disadvantage that the accuracy of identifying the lesion area is reduced due to the reduced resolution. The effect is larger, and the ability to diagnose fluorescence during fluorescence observation can be greatly improved, and the occurrence of errors in fluorescence diagnosis can be prevented.

Next, FIG. 17 shows an example of the configuration of a fluorescence observation apparatus provided with two laser devices as light sources for fluorescence observation.

In order to perform fluorescence observation, a method of irradiating purple excitation light to observe an image of autofluorescence of a living tissue as shown in the embodiment of FIG. There are two main methods of injecting a fluorescent substance such as hematoporphyrin or photophylline, irradiating a red excitation light of, for example, about 600 nm, and observing a fluorescent image emitting at a longer wavelength. In this example, two laser devices are provided so that the two types of fluorescence observation can be performed.

The endoscope 101 has substantially the same configuration as that of the embodiment shown in FIG. 14. The connector at the end of the universal cord 107 through which the light guide 104 is inserted receives illumination light and fluorescent light for normal observation. A first light distribution adapter 161 for switching to the laser light serving as the excitation light for observation is connected. The first light distribution adapter 161 has a lamp light source 103a that generates white illumination light for normal observation.
And a second light distribution adapter 162 for switching between two types of laser light as excitation light.
And are connected. The second light distribution adapter 162 includes a first laser device 165 having a first laser source 165a for generating a purple excitation light for autofluorescence observation, and a first laser device 165 having a wavelength for exciting the fluorescent substance. A second laser device 166 including a second laser source 166a for generating red excitation light is connected.

A light receiving adapter and a camera (not shown) are connected to the eyepiece 106 of the endoscope 101 so that a normal observation image and a fluorescence observation image can be taken in the same manner as in the embodiment of FIG. .

The first light distribution adapter 161 and the second light distribution adapter 162 have movable mirrors 163 and 163, respectively.
An illumination light switching means having an endoscope 164 is provided.
The illumination light supplied to one light guide 104 can be switched.

In the fluorescence observation apparatus having this configuration, when performing normal endoscope observation, the first light distribution adapter 16 is used.
1 is switched to the position shown by the solid line in the figure, and the white illumination light from the lamp light source device 103 is transmitted to the endoscope 1.
No. 01 light guide 104 to obtain a normal observation image.

On the other hand, when performing the fluorescence observation, the movable mirror 163 of the first light distribution adapter 161 is switched to the position shown by the broken line in FIG.
The excitation light from the laser device 166 is guided to the light guide 104 of the endoscope 101 to obtain a fluorescence observation image. Here, when performing the fluorescence observation using the autofluorescence of the living tissue, the movable mirror 164 of the second light distribution adapter 162 is switched to the position shown by the solid line in the figure, and the autofluorescence observation from the first laser device 165 is performed. The excitation light for use is guided to the endoscope 101 to irradiate the living tissue.

When a fluorescent substance is accumulated in cancer or the like and a fluorescent image is observed, the fluorescent substance is injected into the living tissue 167 to be selectively accumulated in the tumor site 168, and the second light distribution adapter is used. The movable mirror 162 is switched to the position shown by the broken line in the figure, and the excitation light for exciting the fluorescent substance from the second laser device 166 is guided to the endoscope 101 to irradiate the living tissue. Thereby, the tumor site 16 of the living tissue 167 is
8 shows a higher fluorescence intensity than other sites, and by observing this fluorescence image, a tumor site such as cancer can be identified.

As described above, according to the present example, the laser light for fluorescence observation using autofluorescence and the laser light for fluorescence observation using a fluorescent substance are switched as excitation light for fluorescence observation, and the respective excitation lights are irradiated. This enables fluorescence observation using autofluorescence and fluorescence observation using a fluorescent substance, and allows a tumor site to be reliably diagnosed.

Next, FIG. 18 shows an example of the configuration of a fluorescence observation apparatus which enables normal endoscope observation and fluorescence observation with one light source device. The configuration and operation other than the light source device connected to the endoscope 101 are the same as those of the embodiment shown in FIG. 14, and the description thereof will be omitted here.

The light source device 170 of this embodiment is connected to the light guide connector 107a of the endoscope 101 and includes a lamp light source 171 composed of a xenon lamp or the like. The lamp light source 171 is connected to a flash unit 172 for normal observation. Illumination light and excitation light for fluorescence observation can be generated. In the optical path of the light emitted from the lamp light source 171, a rotary filter 173 for time-dividing the normal observation illumination light and the excitation light is provided, and a driving motor 174 is provided.
Is driven to rotate.

The flash unit 172 receives a flash control signal from the fluorescent image processing device 124, and controls the flash emission of the lamp light source 171. The timing of the operation of the flash unit 172 and the driving motor 174 is synchronized by a timing control signal from the timing controller 125.

The light emitted from the lamp light source 171 is time-divided by the rotary filter 173 into illumination light for normal observation and excitation light, alternately guided to the light guide 104 of the endoscope 101, and illuminated to a site to be observed. . At this time, synchronization between the light source device on the light distribution side and the adapter, camera, and signal processing device on the light receiving side is controlled by a timing control signal from the timing controller 125.

The fluorescence image processor 124 monitors the signal level of the fluorescence image signal input from the camera, detects the brightness of the fluorescence image, and monitors the intensity of the excitation light. If it is insufficient, a flash control signal is transmitted from the fluorescent image processing device 124 to the flash unit 172. At this time, while receiving the timing control signal from the timing controller 125, the flash unit 172 flashes the lamp light source 171 at an appropriate timing to increase the excitation light intensity.

By configuring the light source device in this manner, a laser device is not necessary to generate excitation light for fluorescence observation, and one light source device provides illumination light for normal observation and excitation light for fluorescence observation. After that, normal observation and fluorescence observation can be performed. In addition, even when the amount of excitation light is insufficient, a sufficient amount of light can be obtained by flashing the lamp, and good fluorescence observation can be performed.

[Supplementary Notes] (2-1) A fluorescence observation light source means for generating excitation light for obtaining fluorescence of the observation target part, and an observation target part based on excitation by the excitation light from the fluorescence observation light source means A fluorescence observation imaging unit that captures a fluorescence observation image, and a fluorescence observation device that displays a fluorescence observation image, wherein a fluorescence image signal from the fluorescence observation imaging unit is used to obtain a plurality of pixels in the fluorescence observation image. A fluorescence observation apparatus including a fluorescence image processing unit that integrates signal intensities and corrects the fluorescence image signal with these pixels as one pixel.

In this configuration, the fluorescence image processing means integrates the signal intensities of a plurality of pixels in the fluorescence observation image from the fluorescence image signal from the fluorescence observation imaging means, and sets these pixels as one pixel to obtain the fluorescence image. By performing a process of correcting the image signal, the S / N of the fluorescence observation image is improved,
It is possible to prevent the occurrence of errors in fluorescence diagnosis.

(2-2) Normal observation light source means for generating normal observation illumination light, and normal observation imaging for taking a normal observation image of the observation target site by the illumination light from the normal observation light source means Means, a fluorescence observation light source means for generating excitation light for obtaining fluorescence of the observation target part, and fluorescence observation for imaging a fluorescence observation image of the observation target part based on excitation by the excitation light from the fluorescence observation light source means A fluorescence observation apparatus that includes an imaging unit for use and simultaneously displays a fluorescence observation image and a normal observation image, or switches and displays the images in a time-division manner.
A fluorescence observation apparatus comprising: a fluorescence image processing unit that integrates the signal intensities of a plurality of pixels in a fluorescence observation image from a fluorescence image signal from the fluorescence observation imaging unit and uses these pixels as one pixel.

(2-3) The fluorescence image processing means sets the pixels when the plurality of pixels in the fluorescence observation image are one pixel by two-dimensionally capturing a fluorescence image of a fluorescent plate having uniform fluorescence characteristics. The fluorescence observation device according to supplementary note (2-1) performed based on an image signal.

In this configuration, the processing function of the fluorescent image processing means is created based on the result of imaging a fluorescent plate having two-dimensionally uniform fluorescent characteristics, thereby accurately identifying a portion having a poor S / N in the image. It is possible to select appropriate S /
N can be improved.

(2-4) The fluorescence image processing means integrates the signal intensities of the plurality of pixels in the fluorescence observation image such that the integrated value of the signal intensities of the plurality of pixels becomes a predetermined value, and calculates one pixel. The fluorescence observation device according to Supplementary Note (2-1).

(2-5) The fluorescence observation apparatus according to supplementary note (2-1), wherein the plurality of pixels for which the signal intensity is integrated in the fluorescence image processing means are pixel blocks of a predetermined number and shape.

With this configuration, it is possible to simplify the calculation method in the processing of the fluorescence image processing means, to improve the processing speed, and to simplify the hardware configuration.

(2-6) The plurality of pixels for which the signal intensity is integrated in the fluorescence image processing means have an arbitrary number and shape according to the fluorescence observation image. apparatus.

With this configuration, it is possible to select an optimum processing target pixel for improving the S / N in the processing of the fluorescent image processing means, thereby realizing a higher level of the S / N improvement.

By the way, as a transendoscopic procedure for performing a therapeutic procedure using an endoscope, a laser probe connected to a therapeutic laser device is inserted to a target site through a channel of the endoscope, and a laser beam is emitted. There is a laser treatment for performing cauterization, coagulation, transpiration, etc. by irradiating a lesion site or the like. In such a laser treatment apparatus that performs a treatment by irradiating a laser beam, N
d: A high-energy treatment laser beam such as a YAG laser beam is guided to a lesion site by a laser guide means such as a laser probe to irradiate the treatment site, thereby performing treatment such as cauterization, coagulation, and transpiration. .

In the conventional apparatus, a fluorescence observing apparatus for obtaining a fluorescence image of the inspection target site and performing a fluorescence diagnosis as described above and a laser treatment apparatus are provided separately. It is difficult to perform the laser treatment with certainty while recognizing the treatment site while observing the fluorescence while performing the laser treatment with the laser light for use.

In order to solve the above problems, a fluorescence observation device for obtaining, observing, and diagnosing a fluorescence image and a laser treatment device for performing a treatment using a treatment laser beam are provided. An example of the configuration of a fluorescence diagnostic treatment apparatus capable of simultaneously performing fluorescence observation and laser treatment such as described above is shown below.

FIG. 19 is a structural explanatory view showing the overall structure of the apparatus according to the first embodiment of the fluorescence diagnostic treatment apparatus capable of simultaneously performing fluorescence observation and laser treatment.

The fluorescence diagnosis / treatment apparatus of this embodiment is provided with an endoscope 201 for guiding excitation light to an observation target site and for imaging fluorescence from the observation target site. As an excitation light source means for fluorescence observation for generating excitation light, for example, 442 nm
Laser device 202 having He-Cd (helium-cadmium) laser light generating means for generating violet light
And a light source device for normal observation 203 having a lamp 203a such as a xenon lamp for generating white light as a light source for normal observation for observing an endoscope image. Further, a therapeutic laser device as a therapeutic laser generating means having a laser light generating means for generating, for example, an infrared Nd: YAG laser as the therapeutic laser light having an energy capable of treating a lesioned part of a living tissue. 230.

The therapeutic laser device 230 is provided with a laser probe 2 as a laser light guide for transmitting a therapeutic laser beam.
31 is connected, and the generated laser light is
The laser beam is supplied to the laser probe 31 and a therapeutic laser beam can be emitted from the tip of the laser probe 231. The therapeutic laser light generated by the therapeutic laser device 230 has a wavelength range different from the fluorescence wavelength of the fluorescence image obtained by irradiating the excitation light to the living tissue, and has a wavelength outside the visible light range. And an infrared Nd: YAG laser (wavelength 1.0
6 μm), an ultraviolet laser such as an excimer, an infrared H
It is possible to use an o: YAG laser (wavelength: about 2 μm), an Er: YAG laser (wavelength: about 3 μm), or the like.

The endoscope 201 includes an excitation laser device 202.
Alternatively, a light guide 204 for transmitting light emitted from the normal observation light source device 203 to the front end portion and an image guide 205 for transmitting an observation image to the eyepiece portion 206 on the rear end side are inserted. It extends through the inside of the universal cord 207 extending from the side of the grip on the hand side to the light guide connector 207a at the end. The endoscope 201 has a therapeutic laser device 2.
A channel 232 through which the laser probe 231 connected to the end 30 can be inserted is provided to penetrate from the hand side to the distal end, and the laser probe 231 can be inserted into the channel 232 and protruded from the distal end of the endoscope. It is possible.

The excitation laser device 202 and the normal observation light source device 203 are connected to a light distribution adapter 208 for switching light guided to the endoscope 201.
Is a light guide connector 207a of the endoscope 201.
Is connected, and excitation light by laser light from the excitation laser device 202 or illumination light for normal observation from the light source device 203 for normal observation is guided to the light guide 204 of the endoscope via the light distribution adapter 208. , From the distal end of the endoscope 201.

The light distribution adapter 208 includes a movable mirror 209 disposed in the optical path of light emitted from the excitation laser device 202 and the light source device 203 for normal observation, and a movable mirror 2.
An illumination light switching means 211 constituted by a driver 210 for driving the excitation light 09 and the illumination light for normal observation is provided after the light guide 204 of the endoscope by selectively switching the angle of the movable mirror 209. It leads to the end face.

A light receiving adapter 212 is connected to the eyepiece 206 of the endoscope 201.
Is connected to a normal observation camera 213 serving as a normal image receiving unit and a fluorescence observation camera 214 serving as a fluorescent image receiving unit, and a normal observation image and a fluorescence observation image are taken by respective image pickup means. I have. Normal observation camera 21
Numeral 3 is provided with an imaging optical system and a CCD 215 as an image pickup device so as to pick up an image (normal observation image) of a test portion irradiated with illumination light for normal observation from the light source device 203 for normal observation. Has become.

The fluorescent observation camera 214 includes an image forming optical system and a rotary filter 2 that allows a fluorescent component of a predetermined band to pass therethrough.
16, a drive motor 217 for rotatingly driving the rotary filter 216, an image intensifier (II) 218 for amplifying an image transmitted through the rotary filter 216, and an image sensor for capturing an output image of the image intensifier 218. CCD 219 and the rotary filter 21
And a treatment laser cut filter 233 as a filter means for intercepting the treatment laser light disposed between the laser beam 6 and the image intensifier 218. A fluorescence image (fluorescence observation image) of the obtained test site is captured. The rotation filter 216 has, for example, .lambda.1 = 48.
A band-pass filter of 0 to 520 nm and a band-pass filter of .lambda.2 = 630 nm or more are disposed and formed in a disk shape.
By rotating, these filters are sequentially inserted in the optical path, and pass the fluorescent components of each band. In addition, the therapeutic laser cut filter 23
3) When an ultraviolet laser is used for the treatment laser light, an ultraviolet cut filter is used, and when an infrared laser is used, an infrared cut filter is used so that the wavelength component of the treatment laser light is not passed. Is removed (cut).

The light-receiving adapter 212 is an imaging system comprising a movable mirror 220 disposed in the optical path of the subject image transmitted to the eyepiece 206 of the endoscope, and a driver 221 for driving the movable mirror 220. A switching unit 222 is provided, and the camera is switched between fluorescence observation and normal observation by selectively switching the angle of the movable mirror 220, and the subject image obtained by the endoscope 201 is displayed on the normal observation camera 213 or The light is guided to the fluorescence observation camera 214.

The endoscope 201, light receiving adapter 21
2. The fluorescence collecting means includes the fluorescence observation camera 214.

A camera control unit (CCU) 223 is connected to the normal observation camera 213.
An imaging signal (normal image signal) output from D215 is input, signal processing is performed by the CCU 223, and a video signal of a normal observation image is generated.

A fluorescence image processing device 224 as a fluorescence image processing means is connected to the fluorescence observation camera 214.
An image pickup signal (fluorescent image signal) output from the CCD 219 is input, signal processing is performed by the fluorescent image processing device 224, and a video signal of a fluorescent observation image is generated.

A timing controller 225 for controlling the operation timing of each unit is provided. The driver 210 of the light distribution adapter 208, the driver 221 of the light reception adapter 212, and the driving motor 21 of the rotary filter 216 are provided.
7, and a timing control signal to the fluorescence image processing device 224.

The CCU 223 and the fluorescence image processing device 2
24 is a video switcher 226 as an image switching means
And CCU 223 obtained by ordinary observation means
And a fluorescence observation image signal output from the fluorescence image processing device 224 obtained by the fluorescence observation means are selectively switched by the video switcher 226. The video switcher 226 includes a foot switch 2 for manually performing image switching control.
27, a fluorescent light amount having a wavelength longer than the excitation light is detected based on the fluorescent light image signal processed by the fluorescent light image processing device 224 to generate a lesion part identification signal, and the lesion part identification signal is output. A video switching controller 228 for automatically performing image switching control is connected. The output of the video switcher 226 has a monitor 2
The fluorescent observation image signal or the normal observation image signal selected by the video switcher 226 is input to the monitor 229 to display the fluorescence observation image or the normal observation image.

When observation is performed with the fluorescence diagnostic treatment apparatus of this embodiment, the light distribution adapter 208 and the light distribution adapter 208 are operated in accordance with a timing control signal from the timing controller 225.
The light source and the camera are switched by the light receiving adapter 212, and fluorescence observation or normal observation is selected. At this time, the processing in the fluorescence image processing device 224 and the movable mirror 209 of the light distribution adapter 208, the movable mirror 220 of the light reception adapter 212, and the rotation filter 216 of the fluorescence observation camera 214 are performed by the timing controller 225.
Are synchronized with the operations of

The light distribution adapter 208 includes a driver 210
By driving the movable mirror 209, the white illumination light from the lamp 203 a of the normal observation light source device 203 and the excitation light from the excitation laser device 202 are switched and guided to the light guide 204 of the endoscope 201. . The light guided from the light distribution adapter 208 is the light guide 2
The light is transmitted to the distal end portion of the endoscope 201 through the light source 04 and is radiated toward a front observation target portion. The return light from the observation target site is a normal observation image or a fluorescence observation image,
The image is transmitted to an eyepiece 206 on the hand side by an image guide 205 inserted through the endoscope 201.

The light receiving adapter 212 includes a driver 221
By driving the movable mirror 220, the camera that outputs an image from the eyepiece 206 of the endoscope 201 is switched, and the normal observation image is transmitted to the normal observation camera 213, and the fluorescence observation image is transmitted to the fluorescence observation camera 214. Lead.

The subject image (normal observation image) illuminated with the white observation illumination light for normal observation is picked up by the CCD 215 incorporated in the normal observation camera 213. Then, the imaging signal of the normal image is transmitted to the CCU 223 and subjected to signal processing, and is sent to the video switcher 226 as a normal observation image signal.

The fluorescence image (fluorescence observation image) of the test site obtained by irradiating the excitation light is obtained by the fluorescence observation camera 2.
At 14, the λ1, λ
2 is transmitted, and a fluorescent image is optically amplified by an image intensifier 218 and
Is imaged. Then, the image signal of the fluorescent image is subjected to signal processing by the fluorescent image processing device 224 and sent to the video switcher 226 as a fluorescent observation image signal. The fluorescence components of the two wavelength bands λ1 and λ2 separated by the rotation filter 216 have different fluorescence intensities between a normal part and a lesion part. That is, the fluorescence spectrum intensity is different between the normal part and the lesion part, and a fluorescence observation image in which the normal part and the lesion part are distinguished by signal processing in the fluorescence image processing device 224 is generated.

The two images of the normal observation image and the fluorescence observation image input to the video switcher 226 are switched by the identification signal of the lesion site from the video switching controller 228. For example, the lesion site is detected from the fluorescence image of the test site. When it is performed, the fluorescence observation image is output to the monitor 229 in other cases, and the normal observation image or the fluorescence observation image is displayed on the monitor 229. Note that the video switcher 226 selects and outputs a normal observation image or a fluorescence observation image based on the identification signal, and the image can be switched by an instruction from the foot switch 227.

When performing the laser irradiation treatment while performing the fluorescence diagnosis in the fluorescence diagnosis / treatment apparatus of this embodiment, the laser probe 231 connected to the treatment laser apparatus 230 is inserted into the channel 232 of the endoscope 201 to perform the endoscope. The laser beam is projected from the distal end of the mirror, and the treatment laser beam from the treatment laser device 230 is applied to a treatment target site such as a lesion. By this laser irradiation, the laser irradiation part denatures or solidifies, evaporates,
A therapeutic treatment is given.

At this time, in the fluorescence observation camera 214, a treatment laser cut filter 233 for protecting the image intensifier 218 is disposed in front of the image intensifier 218. The component in the wavelength band of the therapeutic laser beam is removed by 233, so that the image intensifier 218 can be prevented from being damaged by the reflected light of the therapeutic laser beam. As described above, the treatment laser light has a wavelength band different from the fluorescence wavelength of the fluorescence observation image generated by the excitation light, and does not affect the fluorescence observation image.

The irradiation position of the therapeutic laser beam from the laser probe 231 is, for example, the channel 23 of the endoscope 201.
A predetermined position in the fluorescence observation image is illuminated on the extension of the opening 2. Note that the distal end of the laser probe 231 may be curved so that a desired position can be irradiated with therapeutic laser light while observing fluorescence.

Since the laser irradiation part by the therapeutic laser light does not emit fluorescence even when the excitation light is irradiated, the fluorescence image of the observation target part includes not only the normal part and the lesion part but also the part to be irradiated by the laser light (treatment). ) Are separated by the state of fluorescence (fluorescence spectrum intensity).

In this example, the fluorescence observation image on the monitor 229 is, for example, green for a normal part and a lesioned part (abnormal part due to disease).
The treatment state by laser irradiation is displayed on the fluorescence observation image by displaying the treatment part with no fluorescence due to red and laser irradiation in a color different from that of the normal part or lesion such as white or black respectively. The treatment state can be easily grasped, and the laser irradiation treatment can be performed while detecting the lesion and judging the lesion and the treatment part.

As described above, in the fluorescence observation camera of the fluorescence diagnosis apparatus, the treatment laser cut filter is provided in front of the optical path of the image intensifier, and the laser probe can be inserted into the channel of the fluorescence diagnosis endoscope. Accordingly, it is possible to easily perform treatment such as coagulation and transpiration with the treatment laser light while performing the fluorescence diagnosis through the endoscope for fluorescence diagnosis in the configuration of the present example. Also, in addition to enabling normal and abnormal parts to be distinguished in the fluorescence observation image, the treatment part by laser irradiation is displayed in a pseudo-color different from the normal part or abnormal part, so that the treatment part is displayed. The laser irradiation treatment can be easily and surely and easily performed while confirming the treatment state.

FIG. 20 is a structural explanatory view showing the whole structure of the apparatus according to the second embodiment of the fluorescence diagnostic treatment apparatus capable of simultaneously performing the fluorescence observation and the laser treatment.

The second embodiment is obtained by adding a functional configuration for controlling the emission of the therapeutic laser beam according to the state of the fluorescence observation image to the apparatus configuration of the first embodiment shown in FIG.
A fluorescence image processing device 224 that processes an image signal of a fluorescence image captured by the fluorescence observation camera 214 is also connected to the treatment laser device 230, and a laser emission control signal from the fluorescence image processing device 224 to the treatment laser device 230. Is sent.

The structure of the other parts is the same as that of the first embodiment shown in FIG. 19, and the description is omitted.

The excitation light from the excitation laser device 202 is irradiated to the observation target site, a fluorescent image of the living tissue is captured by the fluorescent observation camera 212, and the fluorescent image processing device 224 performs signal processing to process the fluorescent observation image. The generated fluorescence observation image is displayed on the monitor 229 to perform fluorescence observation and diagnosis. As described above, while performing the fluorescence diagnosis, the target portion is irradiated with the treatment laser beam from the treatment laser device 230 from the tip of the laser probe 232 through the endoscope 201 to perform the laser irradiation treatment.

The fluorescence observation image includes, for example, the normal part is green, the lesion part is red, and the laser-irradiated treatment part without fluorescence is white or black, as in the first embodiment. Are displayed in pseudo colors in different colors, and the therapeutic laser light is emitted while observing this fluorescence observation image and performing fluorescence diagnosis.

At this time, the fluorescent image processing device 224 determines the range of the lesion or the treatment state from the obtained fluorescence observation image of the treatment site, and outputs a laser emission control signal based on the state of the fluorescence observation image to output the laser emission control signal. The emission of the laser device 230 is controlled.

The area of the lesion is confirmed by the fluorescence diagnosis, and the area is treated by laser irradiation.
The lesion is gradually reduced by the laser irradiation, and the red portion is reduced on the fluorescence observation image of the monitor 229, and the display becomes a black or white display portion indicating a laser irradiated portion (coagulated or evaporated portion). When all of the lesion is irradiated with the laser, the red portion indicating the lesion finally disappears. In this example, when there is a red portion (that is, a lesion) in the fluorescence observation image, a laser emission control signal based on the presence of the signal indicating the lesion is output from the fluorescence image processing device 224 to the treatment laser device 230, and the treatment is performed. The treatment laser light is emitted from the treatment laser device 230. When the red part disappears in the fluorescence observation image, the signal indicating the lesion part disappears, and the laser emission control signal is turned off, the laser beam
Stops emission of the therapeutic laser light.

As described above, by controlling the emission of the therapeutic laser light according to the state of the fluorescence observation image, the laser irradiation can be automatically performed while judging from the fluorescence observation image which part is the lesion. In addition, a laser treatment can be performed on a lesion by performing a minimum required laser irradiation, and safe and efficient laser irradiation can be performed.

Other functions and effects are the same as those of the first embodiment shown in FIG.

FIG. 21 is a structural explanatory view showing the whole structure of a fluorescence diagnostic treatment apparatus according to a third embodiment capable of simultaneously performing fluorescence observation and laser treatment.

In the third embodiment, a functional configuration for controlling the switching between the fluorescence observation image and the normal observation image according to the emission state of the therapeutic laser beam is added to the device configuration of the second embodiment in FIG. Things. The therapeutic laser device 230 that emits the therapeutic laser light is also connected to the video switching controller 228, and the laser emission signal is transmitted from the therapeutic laser device 230 to the video switching controller 228.
To be sent to

The structure of the other parts is the same as that of the first embodiment shown in FIG. 19, and the description is omitted.

When the therapeutic laser beam is emitted from the therapeutic laser device 230 while performing fluorescence observation and diagnosis, and a laser irradiation treatment is performed, in this example, a laser emission signal is output from the therapeutic laser device 230 at the time of laser emission. It is sent to the video switching controller 228 to control switching of the observation image displayed on the monitor 229. Upon receiving the laser emission signal, the video switching controller 228 switches and controls the video switcher 226 to fix the image signal output to the monitor 229 to a normal observation image signal that is a visible image, and displays the normal observation image on the monitor 229. To turn off the fluorescence observation image. That is, during the laser irradiation treatment, the treatment target site is observed using the normal observation image.

At this time, similarly to the second embodiment shown in FIG. 20, the fluorescence image processing device 224 recognizes the treatment state (change in the range of the lesion) from the fluorescence observation image and eliminates the signal of the lesion. Then, the laser emission control signal to the therapeutic laser device 230 is turned off to stop emitting the therapeutic laser light.

As described above, by controlling the switching between the fluorescence observation image and the normal observation image according to the emission state of the therapeutic laser beam, the normal observation image, which is a visible image when the therapeutic laser beam is emitted, is displayed on the monitor. The treatment site can be observed in the same manner as the naked eye observation, and there is no possibility that the treatment laser light enters the observation image, so that the operator can safely and reliably perform the laser irradiation treatment.

Next, FIG. 23 shows a configuration example of a fluorescent observation apparatus using an infrared light source as a light source for generating an infrared image for correcting a fluorescent observation image.

The fluorescent observation apparatus of this example is different from the light source apparatus for normal observation for supplying white illumination light for normal observation, instead of the infrared light source 243a for generating infrared light for obtaining an infrared observation image.
An infrared light source device 243 is provided as infrared light source means, and infrared light is supplied to the endoscope 241 via the light distribution adapter 208.

The endoscope 241 includes an excitation laser device 202.
Alternatively, a light guide 244 for transmitting the light emitted from the infrared light source device 243 to the front end portion and an image guide 245 for transmitting the observation image to the eyepiece portion 246 on the rear end side are inserted, and the light guide 244 is inserted. The light guide connector 247 a at the end of the universal cord 247 is connected to the light distribution adapter 208.

A fluorescence observation camera 214 and an infrared observation camera 248 are connected to a light receiving adapter 212 attached to an eyepiece 246 of an endoscope 241 serving as a fluorescence collection means and an infrared light collection means. An infrared observation image and a fluorescence observation image are picked up by the respective image pickup means. The fluorescence observation camera 214 is connected to the fluorescence image processing device 249, and the image signal of the fluorescence observation image captured by the fluorescence observation camera 214 is sent to the fluorescence image processing device 249 and subjected to signal processing.

Further, the infrared observation camera 248 is a CCU2
The image signal of the infrared observation image picked up by the infrared observation camera 248 is connected to the fluorescence image processing device 249 via the
9, and the fluorescence image signal is corrected based on the infrared image signal to generate a video signal of a fluorescence observation image. The output end of the fluorescent image processing device 249 is connected to the monitor 229, and the fluorescent observation image output from the fluorescent image processing device 249 is displayed on the monitor 229.

In other respects, the same components as those of the first embodiment shown in FIG. 19 are denoted by the same reference numerals and description thereof is omitted.

When performing fluorescence observation in the fluorescence observation apparatus of this embodiment, the timing controller 225 controls the movable mirror 209 of the light distribution adapter 208, the movable mirror 220 of the light reception adapter 212, and the fluorescence observation camera 214.
The operations of the rotary filter 216 are synchronized, and the light source adapter and the light receiving adapter 212 are switched and controlled to switch between the light source and the camera.

The light distribution adapter 208 switches between the excitation light from the excitation laser device 202 and the infrared light from the infrared light source device 243, and guides the light to the light guide 244 of the endoscope 241. The light guided from the light distribution adapter 208 is transmitted to the distal end of the endoscope 241 through the light guide 244, and is irradiated toward the observation target site in front. The return light from the observation target portion is transmitted as a fluorescence observation image or an infrared observation image to an eyepiece 246 on the hand side by an image guide 245 inserted through the endoscope 241.

The light receiving adapter 212 switches the camera that outputs an image from the eyepiece 246 of the endoscope 241, and switches the fluorescence observation image to the fluorescence observation camera 214 and the infrared observation image to the infrared observation camera 248. Lead to.

The subject image (infrared observation image) illuminated with the infrared illumination light is picked up by the built-in CCD 215 in the infrared observation camera 248, and the imaging signal of the infrared image is set to C.
The signal is transmitted to the CU 223, subjected to signal processing, and transmitted to the fluorescent image processing device 249 as an infrared image signal.

The fluorescence image (fluorescence observation image) of the test site obtained by irradiating the excitation light is obtained by a fluorescence observation camera 2.
In 14, the fluorescent components in two wavelength bands having different fluorescence intensity ratios between the normal part and the lesion part are transmitted by the rotating filter 216, the fluorescent image is optically amplified by the image intensifier 218, and is captured by the CCD 219. Then, an image signal of the fluorescent image is transmitted to the fluorescent image processing device 224.

In the fluorescence image processing device 224, the fluorescence image signal from the fluorescence observation camera 214 is signal-processed to generate a fluorescence observation image signal from which a normal part and a lesion part can be separated and determined by the above-described pseudo color display or the like. The fluorescence observation image is displayed on the monitor 229.

The infrared observation image obtained by irradiating the infrared light from the infrared light source device 243 is an image having a luminance level proportional to the blood flow. Is obtained. Since the fluorescence image has a large influence of blood at the test site, an error may occur in the fluorescence diagnosis depending on the blood flow. Therefore, in the present embodiment, the fluorescence image processing device 224 corrects the fluorescence image signal based on the infrared image signal from the CCU 223 and, for example, decreases / increases the signal level according to the blood flow to correct the blood flow. A fluorescence observation image in which the influence of the difference is corrected is generated.

As described above, according to the present example, it is possible to correct the influence of the difference in blood flow at the test site in the fluorescence observation image, and to perform accurate fluorescence diagnosis without being affected by the blood flow. .

Next, FIGS. 24 and 25 show an example of the configuration of a fluorescence observation apparatus in which the light guide means for exciting light is provided on a guide tube for guiding an endoscope for fluorescence observation to a target site. FIG. 24 is a configuration explanatory view showing the entire configuration of the fluorescence observation device, and FIG. 25 is a perspective view showing the configuration of the distal end portion of the guide tube.

[0205] The fluorescence observation apparatus of this example is provided with a guide tube 251 formed of a tracheal tube, a trocar, or the like as guide means for guiding the endoscope 201 to be inserted into a body cavity to a target site. This guide tube 251 has an excitation laser device 2
A laser guide 252 as a light guiding means which is connected to the laser device 02 and guides the excitation light from the laser device is inserted from the near side to the distal end, so that the excitation light from the excitation laser device 202 is guided. . As shown in FIG. 24, the tip of the laser guide 252 is exposed to the tip surface of the guide tube 251, and the excitation light 253 from the excitation laser device 202 is emitted therefrom. In the configuration example shown in FIG.
Are inserted so that the excitation light 253 of the laser light can be uniformly emitted to the front of the guide tube 251.

In this example, no light distribution adapter for switching the light source is provided, and the end of the universal cord 207 of the endoscope 201 is directly connected to the normal observation light source device 203. Illumination light for normal observation from the endoscope 2 is guided to the light guide 204 of the endoscope, and the endoscope 2
01 is emitted from the front end portion.

A normal observation camera 213 and a fluorescence observation camera 214 are connected to the eyepiece 206 of the endoscope 201 via a light receiving adapter 212. The normal observation camera 213 picks up images. The CCU 223 that performs signal processing on the image signal of the observation image and the fluorescence image processing device 224 that performs signal processing on the image signal of the fluorescence observation image captured by the fluorescence observation camera 214 are connected to the video switcher 226. The video switcher 226 selectively switches between a normal observation image signal from the CCU 223 and a fluorescence observation image signal from the fluorescence image processing device 224 according to an instruction from the foot switch 227, and outputs the signal to the monitor 229.

When performing fluorescence observation with the fluorescence observation apparatus of this embodiment, a guide tube 251 such as a tracheal tube or a trocar is inserted into the observation target site in the body cavity, and the guide tube 25 is inserted.
The endoscope 201 is inserted into the body cavity by guiding the insertion portion of the endoscope 201 through the lumen of the subject 1 and guided to the observation target site. When performing normal observation, white illumination light from the normal observation light source device 203 is applied to the observation target site via the light guide 204 of the endoscope 201, and a normal observation image is captured by the normal observation camera 213. To generate a video signal of a normal observation image.

When performing fluorescence observation, the guide tube 251 is used.
An excitation light from the excitation laser device 202 is irradiated to the observation target portion via the laser guide 252 inserted through the laser guide 252, and a fluorescence observation image is captured by the fluorescence observation camera 214 to generate a video signal of the fluorescence observation image.

The normal observation image signal and the fluorescence observation image signal are arbitrarily switched by the video switcher 226 according to an instruction from the foot switch 227 and sent to the monitor 229 for display.

As described above, in this example, the excitation light guiding means is provided separately from the light guide of the endoscope and provided in the guide tube for guiding the endoscope, thereby uniformly illuminating the excitation light over a wide range. As a result, a better fluorescence observation image can be obtained, so that accurate fluorescence diagnosis can be performed.

Next, FIG. 25 shows an example of the configuration of a fluorescence observation apparatus using a parent-child scope type endoscope in which a small-diameter endoscope is used by inserting it into a channel of the endoscope.

In the fluorescence observation apparatus of this embodiment, a large-diameter parent scope 261 is used as an endoscope 260 for performing fluorescence observation.
And a small diameter child scope 262 inserted into the channel of the parent scope 261.

The parent scope 261 is connected to a normal observation light source device 203 for generating white illumination light at an end of a light guide inserted into the universal cord 263, and a normal observation camera is attached to an eyepiece 264 on the hand side. 213 are connected. A video signal processing unit (CCU) 223 is connected to the normal observation camera 213, and an endoscope image monitor 265 is connected to the CCU 223.
At 65, a normal observation image obtained by the parent scope 261 is displayed.

In the child scope 262, an excitation laser device 202 is connected to an end of a light guide inserted into a universal cord 266, and a fluorescence observation camera 214 serving as a fluorescence receiving means is connected to an eyepiece 267 on the hand side. It is connected. The fluorescence observation camera 214 includes the fluorescence image processor 22
4 is connected, a fluorescent image monitor 268 is connected to the fluorescent image processing device 224, and a fluorescent observation image obtained by the child scope 262 is displayed on the fluorescent image monitor 268.

When observation is performed with the fluorescence observation apparatus of this embodiment, the child scope 26
2, the parent scope 261 is inserted into the body cavity, and the distal ends of the parent scope 261 and the child scope 262 are guided to the observation target site. In the example of FIG. 25, the child scope 2 is opened from the channel opening that opens to the side of the insertion section of the parent scope 261.
62 is projected. Then, illumination light for normal observation is radiated by the parent scope 261 to obtain a normal observation image of the observation target portion, which is imaged by the normal observation camera 213, and the image signal is processed by the CCU 223 to process the normal observation image. The image is displayed on the endoscope image monitor 265.

Further, a fluorescence observation image of the observation target site is obtained by irradiating the excitation light with the child scope 262, the fluorescence observation image is captured by the fluorescence observation camera 214, and the captured image signal is processed by the fluorescence image processing device 224. The fluorescence observation image is displayed on the fluorescence image monitor 268.

As described above, by using the parent-child scope endoscope for the fluorescence observation, the fluorescence observation can be performed with the small-diameter child scope 262, and the fluorescence observation and diagnosis can be performed even in a small lumen. Also, in a normal endoscopy, the use of a child scope for fluorescence observation as in the case of other treatment tools enables efficient endoscope diagnosis and treatment.

[Supplementary Notes] (3-1) Excitation light source means for generating excitation light having a wavelength capable of generating fluorescence at the observation target site, and fluorescence at the observation target site based on the excitation light from the excitation light source means Fluorescent collecting means for collecting laser light, therapeutic laser generating means for generating therapeutic laser light having energy capable of treating a diseased part of a living tissue, and laser light guiding means for guiding the therapeutic laser light to a target site A fluorescence image processing means for generating a fluorescence observation image capable of discriminating a normal part, a lesion part, and a treatment part by the treatment laser light in the observation target part based on the fluorescence spectrum intensity of the fluorescence image obtained by the fluorescence collection means; , A fluorescent diagnostic treatment system.

In this configuration, the excitation light from the excitation light source means is irradiated to the observation target part, the fluorescence of the observation target part is collected by the fluorescence collection means to obtain a fluorescence image, and the fluorescence image intensity is obtained based on the fluorescence spectrum intensity of the fluorescence image. In the processing means, a normal part and a lesion part in the observation target part are determined. Further, a treatment laser beam is irradiated to a target portion by a treatment laser generating means and a laser light guiding means, and a normal part, a lesion part, and a normal part in the observation target part are obtained by a fluorescence image processing means based on a fluorescence spectrum intensity of the fluorescence image. A fluorescence observation image from which a treatment site can be determined by the treatment laser light is generated. As a result, the laser treatment site can be determined on the fluorescence image, and a reliable and efficient fluorescence diagnosis and treatment can be performed. In other words, it is possible to realize a diagnosis and treatment system capable of reliably detecting a diseased part by a fluorescent image, promptly treating the detected diseased part, and accurately grasping a treatment state.

(3-2) Excitation light source means for generating excitation light having a wavelength capable of generating fluorescence at the observation target site, and fluorescence for collecting fluorescence at the observation target site based on the excitation light from the excitation light source means Collection means, a therapeutic laser generating means for generating a therapeutic laser light having energy capable of treating a diseased part of a living tissue, and a laser light guiding means for guiding the therapeutic laser light to a target site,
A fluorescence diagnostic treatment system comprising: a fluorescence image processing unit configured to generate a fluorescence observation image from which a part irradiated with the therapeutic laser light can be determined from the fluorescence image obtained by the fluorescence collection unit.

(3-3) The therapeutic laser generating means generates therapeutic laser light having a wavelength outside the visible light range, and the fluorescent light collecting means performs an image intensifier for optically amplifying the fluorescence of the observation target site. (3-1) The fluorescence diagnostic treatment system according to supplementary note (3-1), further comprising a filter means for removing a wavelength of the treatment laser light in front of the image intensifier optical path.

In this configuration, the return light of the therapeutic laser beam from the therapeutic laser generating means is removed by the filter means in front of the image intensifier in the fluorescence collecting means. On the other hand, the fluorescence at the site to be observed due to the excitation light is guided to the image intensifier without being removed by the filter means in the fluorescence collection means, and is amplified.
Thus, the influence of the laser irradiation treatment on the fluorescence observation image can be prevented, the laser irradiation treatment can be performed without affecting the fluorescence diagnosis, and accurate fluorescence diagnosis can be performed.

(3-4) The fluorescence diagnosis / treatment system according to supplementary note (3-1), wherein the fluorescence image processing means controls the emission of laser light from the treatment laser generation means according to the state of the fluorescence image.

In this configuration, when it is recognized by the fluorescent image processing means that the lesion has disappeared in the fluorescent image by the irradiation of the therapeutic laser light, the control is performed so that the emission of the laser light by the therapeutic laser generating means is stopped. Is done. Thereby, the minimum required laser irradiation is performed, and there is no possibility of excessive laser beam irradiation for treatment, and safe laser irradiation treatment can be performed.

(3-5) Further, a normal observation means for generating a normal observation image of the observation target portion obtained by the normal observation illumination light, a normal observation image from the normal observation means, and the fluorescence image processing means The fluorescence diagnostic treatment system according to claim (3-1), further comprising: image switching means for switching between the output and the fluorescence observation image, wherein switching of the image switching means is controlled according to a laser emission state of the therapeutic laser generation means.

In this configuration, when the laser beam is emitted from the treatment laser generation means, the image is switched to the normal observation image from the normal observation means by the image switching means. By displaying the normal observation image at the time of emitting the therapeutic laser in this way, safe laser irradiation treatment can be performed.

(3-6) Excitation light source means for generating excitation light having a wavelength capable of generating fluorescence at the observation target site, and fluorescence of the observation target site based on the excitation light from the excitation light source means are collected. A fluorescence collection unit that obtains a fluorescence observation image, an infrared light source unit that generates infrared light, and an infrared light collection unit that obtains an infrared observation image of an observation target site by infrared light from the infrared light source unit, A fluorescence image processing unit that corrects an image signal of a fluorescence observation image obtained by the fluorescence collection unit based on an image signal of an infrared observation image indicating a blood flow rate of the observation target site obtained by the infrared light collection unit, A fluorescence observation device provided with:

In this configuration, an infrared observation image indicating the blood flow is obtained as an image of the observation target site by the infrared light by the infrared light collecting means, and the image signal of the infrared observation image is obtained by the fluorescence image processing means. An image signal of the fluorescence observation image corrected based on the image signal is generated. This makes it possible to perform accurate fluorescence diagnosis regardless of the influence of the blood flow at the observation target site.

(3-7) Excitation light source means for generating excitation light having a wavelength capable of generating fluorescence at the observation target site, and light guiding means for guiding the excitation light from the excitation light source means to the observation target site A tubular guide means in which the light guide means is provided up to the distal end, and a fluorescent observation image which is inserted into a lumen of the guide means and collects fluorescence of an observation target site based on excitation light from the excitation light source means to form a fluorescence observation image. And an endoscope to obtain.

In this configuration, the excitation light from the excitation light source is radiated to the site to be observed through the guide by the light guide in the guide, and the excitation light is converted into the excitation light by the endoscope inserted through the guide. The fluorescence of the observation target site based on the collected fluorescence observation image is obtained. By providing the guide means for inserting the endoscope with the light guide means for the excitation light as described above, the excitation light can be uniformly illuminated over a wide range in the observation target site, and more accurate fluorescence diagnosis can be performed.

By the way, in order to stably and accurately diagnose whether or not a living tissue is a normal tissue with a fluorescence observation device, excitation light applied to a test site via an endoscope or the like is applied to the living tissue. It is important to uniformly irradiate and to uniformly receive the fluorescence generated from the living tissue. However, when fluorescently observing a test site such as an intestine with severe irregularities on the surface of a living tissue, it is not possible to uniformly irradiate excitation light to the uneven living tissue, and to uniformly receive fluorescence generated from the living tissue. Therefore, it was difficult to perform stable and accurate fluorescence observation. Further, in an organ having no space such as a liver (hereinafter referred to as a “substantial organ”), since there is no space between the living tissue and the endoscope, the living tissue is irradiated with excitation light and the fluorescence generated from the living tissue is irradiated. , It was not possible to observe the fluorescence of the test site.

Therefore, by constructing an endoscope of the fluorescence observation apparatus as follows, the excitation light is uniformly irradiated on the living tissue such as a test part having a large unevenness or a test part in a substantial organ. It is possible to provide a fluorescence observation device that can stably and accurately perform fluorescence observation of a test site by uniformly receiving fluorescence generated from a living tissue.

FIGS. 26 to 28 relate to an embodiment of the space forming means of the fluorescence observation apparatus. FIG. 26 is an explanatory view showing a schematic structure of the fluorescence observation apparatus, and FIG. 27 is an endoscope end portion of the fluorescence observation apparatus. FIG. 28 is an explanatory view showing a transparent cover as a space forming means attached to the endoscope, and FIG. 28 is an explanatory view showing an operation of an endoscope in which a transparent cover as a space forming means is attached to a distal end portion of the endoscope.

As shown in FIG. 26, the fluorescence observation device 300
Are the observation optical system 312 and the illumination optical system 3
13, an optical endoscope (hereinafter referred to as an endoscope) 3102, a light source device 320 for supplying illumination light to the endoscope 310, and an imaging device 330 for imaging a part illuminated by the illumination light It is composed of

As the light source device 320, a normal observation light source device 322 including a xenon lamp 321 for supplying illumination light for normal observation to the illumination optical system 313 of the endoscope 310 is provided.
And a light source device 323 for fluorescence observation for supplying, for example, He-Cd laser light for fluorescence observation.

The illumination light emitted from the normal observation light source device 322 passes through the optical lens 324a of the light source adapter 325 to which the normal observation light source device 322 is connected via the relay lens 321a, and is reflected by the reflection mirror 326. It is reflected, and the grasping part 31 on the hand side of the endoscope is reflected by the optical lens 324c.
The light guide 316 extends from the side of the light guide 316 and is condensed on the rear end face of the light guide 316 passing through the inside of the universal cord 315, guided to the front end side of the light guide 316 and illuminated by the illumination optical system 31
3 is emitted.

On the other hand, the laser light emitted from the fluorescence observation light source device 323 connected to the light source adapter 325 is
The light passes through the optical lens 324b of the light source adapter 325 via the light guide cable 323a,
Light guide 316 extended from endoscope 310 at 4c
The light is condensed on the rear end face, guided to the front end side of the light guide 316, and emitted from the illumination optical system 313.

The universal cord 315 extending from the side of the grip portion of the endoscope 310 is detachably connected to the light source adapter 325 via a connector 315a. The illumination light from the normal observation light source device 322 supplied by the light source adapter 325 and the laser light of the fluorescence observation light source device 323 supplied by the fluorescence observation light source device 323 are driven by a light source driver 327. The angle of the reflection mirror 326 is set to the illumination light switching device 3
By selectively switching to either the solid line position or the broken line position in FIG. 28, each illumination light can be condensed on the rear end face of the light guide via the optical lens 324c.

That is, when the position of the reflection mirror 326 is switched to the solid line position in the figure by the light source driver 327, the normal illumination light emitted from the normal observation light source device 322 is condensed on the rear end face of the light guide and the illumination optical system 313 When the position of the reflection mirror 326 is switched to the position indicated by the broken line in the figure, the fluorescence observation laser light emitted from the fluorescence observation light source device 323 is focused on the rear end face of the light guide and emitted from the illumination optical system 313. It is supposed to be.

Then, the illumination optical system 313 of the endoscope 310
The excitation light radiated through the living tissue is uniformly irradiated on the living tissue, and the fluorescence generated from the living tissue irradiated with the excitation light is uniformly received by the observation optical system 312 of the endoscope 310. As shown in FIG. 27, at the distal end portion of the insertion portion of the endoscope 310, a space portion is formed as a space portion forming means for forming a space portion between the test site and the illumination optical system 313 and the observation optical system 312 of the endoscope 310. A transparent cover 370 having a cylindrical shape and having a transmission of excitation light and fluorescence is provided. The transparent cover 370 is formed of, for example, an optical material such as sapphire glass, quartz glass, BK-7 or the like, or a transparent resin material such as methacrylic resin or polycarbonate resin, which has high transparency to the excitation laser light and the fluorescent light. .

When the endoscope 310 with the transparent cover 370 is inserted into or removed from the body cavity, a hemispherical portion 371 is provided on the insertion side of the transparent cover 370 so as not to damage the living tissue. As will be described later, the distal end of the insertion portion is formed in a substantially hemispherical shape, and a hemispherical portion 371 is formed at the end of the opening 372 on the hand side. In addition, hemispherical part 3
Instead of 71, an inclined surface (not shown) may be formed.

As shown in FIG. 26, an eyepiece 318 provided at the rear end of an image guide 317 extending from the observation optical system 312 of the endoscope 310 has a normal observation camera 332 and a fluorescence observation camera 333. An imaging device 330 configured by connecting the two cameras to the imaging adapter 331 is provided.

The two cameras of the imaging device 330, the normal observation camera 332 and the fluorescence observation camera 333, are connected and fixed to an imaging adapter 331 fixed to the eyepiece 318. The normal observation camera 332 includes an imaging optical system 332a for capturing an image of a test site irradiated with illumination light from the normal observation light source device 322 and a normal observation CCD 332b.
The fluorescence observation camera 333 has a rotation filter 333a for capturing an image of a test site irradiated with laser light from the fluorescence observation light source device 323, and a driving motor 333b for rotating the rotation filter 333a. An imaging optical system 333c for forming an observation image of a test site, an image intensifier (hereinafter abbreviated as II) 333d for enhancing a weak fluorescence endoscopic image, and a fluorescence observation CC.
D333e and the like are provided.

The imaging adapter 331 receives the normal observation subject image and the fluorescence observation subject image transmitted to the eyepiece 318 and the normal observation camera 332 and the fluorescence observation subject connected to the imaging adapter 331. Imaging switching device 33 for switching and guiding to correspond to respective cameras 333
4 are provided.

The imaging switching device 334 includes an imaging driver 334a, a reflection mirror 334b driven by the imaging driver 334a, and the like. When the normal illumination light is emitted from the illumination optical system 313, the imaging driver 334a uses the reflection mirror 334b.
Is switched to the solid line position in the figure to guide the subject image to the normal observation camera 332, and when the fluorescence observation laser beam is emitted from the illumination optical system 313, the position of the reflection mirror 326 is shown by the imaging driver 334a. By switching to the middle broken line position, the subject image is guided to the fluorescence observation camera 333.

The subject image guided to the normal observation camera 332 forms an image on a normal observation CCD 332b, and an electric signal of the subject image is transmitted to a video processor 340 connected to the normal observation camera 332 to generate an image signal. Is converted to The subject image guided to the fluorescence observation camera 333 is formed on the fluorescence observation CCD 333e, and the electric signal of the subject image is converted into an image processing device 351 of the fluorescence image processing device 350 connected to the fluorescence observation camera 333. And converted into an image signal. Then, the image signal converted by the image processing device 351 and the video processor 340 is obtained by converting the image projected on the monitor 365 connected to the synchronization control device 360 into one of a normal endoscope image and a fluorescent endoscope image. The observation image is projected on the monitor screen via the video switcher 361 for switching to the other mode.

The illumination light switching device 328, the imaging switching device 334, and the video switcher 361 are synchronously controlled by a timing controller 362 provided in a synchronous control device 360.

Reference numeral 369 denotes a changeover switch such as a foot switch or a hand switch, which is connected to the timing controller 362 of the synchronization control device 360. The changeover switch 369 is connected to the driver 327 of the light source device 320 and the driver 334a of the imaging device 330.
And the reflection mirror 326 of the illumination light switching device 328
Further, the reflection mirror 334b and the video switcher 361 of the imaging switching device 334 can be switched to either the normal observation state or the fluorescence observation state.

Further, the rotation filter 333a provided in the fluorescence observation camera 333 has, for example, 480-5
A first filter for a 20 nm band and a second filter for a band of 630 nm or more are provided. When irradiating violet light 442 nm with a He-Cd laser from the fluorescence observation light source device 323 to observe a fluorescent image, auto-fluorescence having a wavelength longer than the violet light 442 nm with the He-Cd laser is generated from a living tissue, The fluorescence image is obtained by sequentially capturing the fluorescence with the first filter and the second filter of the rotary filter 333a provided in the fluorescence observation camera 333.

The operation of the fluorescence observation device 300 configured as described above will be described.

Examined part 3 of living tissue 380 having severe irregularities
When observing 81, first, the endoscope 310 is placed in a normal observation state and inserted into the body cavity near a test site. At this time, since the hemispherical portion 371 is formed at the tip of the transparent cover 370, the tissue is not damaged.

Next, as shown in FIG. 28, the distal end surface of the transparent cover 370 attached to the distal end of the insertion section of the endoscope 310 is brought into close contact with the living tissue 380 around the test site. At this time, since the hemispherical portion 371 is formed at the distal end of the transparent cover 370, the transparent cover distal end surface is brought into close contact with the vicinity of the test site without damaging the tissue, so that it is ideal for living tissue 380 with severe irregularities. The endoscope is arranged at a typical position.

In this state, the changeover switch 369 is operated to operate the reflection mirror 326 and the imaging adapter 33 of the illumination light switching device 328 provided in the light source adapter 325.
1, the reflection mirror 3 of the image pickup switching device 334
34b and the video switcher 361 are switched to the fluorescence observation side, and the excitation He-Cd laser light is emitted from the fluorescence observation light source device 323. Then, He-Cd laser light for excitation is applied to the living tissue 380 by the illumination optical system 313 and the space 37.
3 and the transparent cover 370 illuminate the vicinity of the test site, and fluorescence is generated from the living tissue 380. At this time, the fluorescence generated from the living tissue 380 is transmitted to the transparent cover 3.
The light is received by the observation optical system 312 via the space 70 and the space 373, and a fluorescence observation image is displayed on a monitor screen.

[0255] Since fluorescence having different spectra is emitted when the test site is normal and when the test site is abnormal, a disease state of the test site is diagnosed from the difference in the spectrum.

As described above, by attaching the transparent cover having the space as the space forming means to the distal end portion provided with the observation optical system and the illumination optical system of the endoscope, the transparent cover is brought into close contact with the portion to be examined. Excitation light can be uniformly radiated to the vicinity of the test site, and fluorescent light generated from the test site can be uniformly received by maintaining a fixed distance between the end surface of the endoscope and the test site. Therefore, it is possible to stably and accurately perform the fluorescence observation of the test portion having severe unevenness.

It should be noted that the endoscope provided with the transparent cover as the space forming means is not limited to the direct-view type endoscope having the observation optical system and the illumination optical system disposed on the distal end face.
9 and the front perspective endoscope 310b shown in FIG. 30 and the like.
A transparent cover 385 having a distal end surface formed in a hemispherical shape is provided on the endoscope 10a and the front perspective endoscope 310b. In this case, by bringing the side surface of the transparent cover 385 into close contact with the test site 381 as shown in FIG. 31, fluorescence observation of the test site with severe irregularities can be performed stably and accurately.

Also, as shown in FIG.
As the space forming means provided in the endoscope 10a or the front perspective endoscope 310b, a transparent cover 386 formed of a lumen member formed of a transparent member and having both ends opened may be used. In this case, even when the fluorescent observation is performed with the side surface of the transparent cover 386 brought into close contact with the test site, the fluorescent observation of the test site with severe irregularities can be performed stably and accurately.

Further, as shown in FIGS. 33 and 34, the transparent covers 387, 388 having sharpened distal ends are used as space forming means to form the distal end of the side-view type endoscope 310a or the front oblique type endoscope 310b. Section. In this case, FIG.
As shown in FIG. 5, the distal end of the transparent cover is punctured into the real organ 380 to form a space 373 between the test site 381 in the real organ and the endoscope distal end face, thereby exciting the real organ. Since it becomes possible to receive the fluorescence by irradiating the light, it is possible to stably and accurately perform the fluorescence observation of the substantial organ.

FIGS. 36 and 37 relate to another embodiment of the space forming means provided in the endoscope of the fluorescence observation apparatus. FIG. 36 shows a case where the balloon which is the space forming means is provided in the direct-view type endoscope. FIG. 37 is an explanatory diagram showing an operation when a balloon, which is a space forming means, is provided in a front perspective endoscope.

As shown in FIG. 36, the transparent covers 370, 38 serve as space forming means at the distal end of the endoscope 310.
Instead of providing 5,386,387,388, etc., a transparent balloon 390 made of a transparent synthetic rubber having excellent transparency to the excitation laser light and fluorescence is provided at the distal end of the endoscope. Note that reference numeral 391 is a thread-bonded portion.

In a normal state, the transparent balloon 390 is located at the distal end of the endoscope as shown by a broken line in the figure. For this reason, when the endoscope is inserted into the body cavity, the fluorescence observation device should be in the normal observation state and inserted into the target observation site. Then, when the endoscope 310 reaches the vicinity of the subject, a fluid such as water or air is sent into the transparent balloon through a channel (not shown) provided in the endoscope 310, and the transparent balloon 390 is changed to a solid line in the figure. The balloon 390 is inflated as shown to bring a part of the balloon 390 into close contact with the living tissue 380 including the test site 381. Except for the transparent balloon 390 provided at the distal end portion of the endoscope, the configuration and operation of the fluorescence observation device 300 are the same as those of the above embodiment, and the same members are denoted by the same reference numerals and description thereof will be omitted.

In this state, the changeover switch 369 is operated, and the reflection mirror 326 of the illumination light switching device 328 provided in the light source adapter 325 of the fluorescence observation device 300 and the imaging device provided in the imaging adapter 331 are provided. The reflection mirror 334b of the switching device 334 and the video switcher 361
Are switched to the fluorescence observation side, and the excitation He-Cd laser light is emitted from the fluorescence observation light source device 323. Then, He-Cd laser light for excitation is applied to the living tissue by the illumination optical system 31.
3, the light passes through the space 392 and the transparent balloon 390 and is irradiated to the vicinity of the test site, and fluorescence is generated from the living tissue. At this time, the fluorescence generated from the living tissue is transmitted to the observation optical system 31 through the transparent balloon 390 and the space 392.
2 and a fluorescent observation image is displayed on the monitor screen. Since fluorescence having different spectra is emitted when the test site is normal and when the test site is abnormal, a disease state of the test site is diagnosed from the difference between the spectra.

As described above, by disposing the transparent balloon having the inflatable space as the space forming means at the distal end portion of the endoscope, a part of the transparent balloon is brought into close contact with the portion to be inspected, thereby exciting the excitation light. Since it is possible to uniformly irradiate the vicinity of the test site and to uniformly receive the fluorescence generated from the test site by keeping the gap space between the endoscope distal end surface and the test site at a constant distance. In addition, it is possible to stably and accurately perform fluorescence observation of a test site having severe irregularities.

As shown in FIG. 37, the transparent balloon 3
By providing the front oblique endoscope 310b with 90, it is possible to easily penetrate the vicinity of the test site in the lumen, and at the same time, inflate the transparent balloon 390 so that a part of the balloon 390 becomes part of the test site. 381 can be easily observed under fluorescent light by being in close contact with the living tissue 380. Then, by inflating the transparent balloon 390 in the lumen, the living tissue 380 is compressed and the blood flow is reduced, so that fluorescence observation with less influence by the blood flow can be performed.

[Supplementary Notes] (4-1) Excitation light is applied to the site to be inspected from the illumination optical system of the endoscope capable of normal observation, and the fluorescence generated from the site to be inspected is observed by the observation optical system of the endoscope. An optical material that transmits excitation light and fluorescence to the distal end of the endoscope in a fluorescence observation apparatus that performs imaging by a fluorescence observation imaging device connected to a fluorescence observation apparatus for fluorescence observation of a disease state such as degeneration or cancer of a test site. Fluorescence observation in which a space portion is formed between the test portion and the endoscope end by abutting or puncturing the space portion forming means formed by the method described above. apparatus.

According to the configuration of the fluorescence observation apparatus, the excitation light can be uniformly radiated by bringing the space portion forming means into close contact with the portion to be inspected through the space formed by the space portion forming means. Fluorescence generated from the detection site can be received uniformly. In this way, it is possible to uniformly irradiate the excitation light to the living tissue such as the test site with severe irregularities and the test site in the substantial organ, and to uniformly receive the fluorescence generated from the living tissue. Fluorescent observation can be performed stably and accurately.

(4-2) The fluorescence observation apparatus according to (4-1), wherein the space forming means is a transparent balloon provided at the distal end of the endoscope and transmitting the excitation light and the fluorescence.

According to the structure of the fluorescence observation apparatus, the transparent balloon is inflated and brought into close contact with the test site, so that the excitation light can be uniformly irradiated and the fluorescence generated from the test site can be uniformly obtained. Can be In this way, it becomes possible to uniformly irradiate the excitation light to the living tissue such as the test site with severe irregularities and the test site in the parenchymal organ, and to compress the living tissue to reduce the blood flow. Can receive uniformly the fluorescence which is less affected by
Accurate fluorescence observation can be performed.

Next, the first to third embodiments of the fluorescence observation apparatus capable of obtaining a fluorescence image suitable for diagnosis regardless of the distance to the tissue will be described with reference to FIGS. 38 to 45. explain. The background of these embodiments will be described first.

A conventional light source for fluorescence observation always emits a constant amount of excitation light and irradiates an observation target site.
Therefore, depending on the condition of the observation target site and the distance to the target site, an appropriate amount of fluorescent light may not be obtained, and a case may occur in which a good fluorescent observation image cannot be obtained.

FIG. 38 (a) shows a case where the excitation light emitting end and the target part are appropriate, and the fluorescence intensity at that time is as shown in the normal part (solid line) and the lesion part (two-dot chain line) shown in FIG. 38 (c). Characteristics.

An excitation light from an excitation light source (not shown in FIG. 38A) is supplied to a light guide 49 of an endoscope 491.
The light is then guided to the observation target portion 493 side from the distal end surface of the light guide 492 via a lens.

Then, the fluorescence excited by the excitation light in the tissue or the like of the observation target site 493 forms an image on the distal end surface of the image guide 495 by the objective lens 494. However, FIG.
If the excitation light emitting end and the target site are too close as shown in (b), the normal part in FIG. 38 (c) will have the characteristics as indicated by the dotted line, and the lesion will have the characteristics as indicated by the one-dot chain line, and a part of the fluorescence intensity will be saturated. And
In the case of judging normal or lesion based on the characteristics of the fluorescence intensity, the information becomes erroneous and the possibility of erroneous judgment increases.

That is, when it is determined that the state is normal or lesion by the same calculation processing as the characteristic of the fluorescence intensity when it is not saturated, if there is saturation, for example, in the case of a normal part shown by a dotted line, the fluorescence intensity at the wavelength λ1 Becomes relatively small due to saturation, and the difference in the fluorescence intensity at the wavelength λ2 becomes small. Therefore, if the ratio is determined to be normal or lesion based on these ratios, it is erroneously determined to be a lesion, which is problematic.

Also, as in Japanese Patent Application No. 5-304428, it is not known whether or not the fluorescence intensity is an appropriate value even when an appropriate amount of excitation light is constantly irradiated according to the observation target site.

In addition, in the case where a plurality of holes are made in the body surface and an endoscope or various medical instruments are inserted into a body cavity to perform a surgery, stereoscopic vision is used to improve the operability of the operator. However, there is a similar problem in the case of fluorescence observation.

In other words, at the time of surgery, there are various medical instruments and devices, a plurality of operators, and assistants around the operating table.
Providing a monitor for a normal observation image and a monitor for a fluorescent image, respectively, poses a problem because the workability is reduced.

In the case where a plurality of operators perform an operation in cooperation with each other, it is often difficult to see the image for a particular operator but difficult for many other people to use the monitor. It is desired.

The following first to third embodiments (FIG. 39)
45 to FIG. 45) is to provide a fluorescence observation apparatus capable of obtaining a fluorescence observation image suitable for diagnosis regardless of the distance.

It is another object of the present invention to provide a fluorescence observation apparatus which enables an operator and an assistant to always observe a normal image or a fluorescent image in a state that is easy to see without being affected by the position, posture and the like.

An embodiment (and a modification) capable of obtaining a fluorescence observation image suitable for diagnosis regardless of the distance will be described below with reference to the drawings.

As shown in FIG. 39, a fluorescence observation endoscope apparatus 400 according to a first embodiment of the fluorescence observation apparatus for obtaining an appropriate fluorescence observation image regardless of the distance is inserted into a body cavity and used for a disease site or the like. An endoscope 401 for obtaining a normal observation image and a fluorescence observation image of an observation site, and a first adapter 402 attached to the endoscope 401
Illumination light source 4 for supplying white light for normal observation through the
03 and wavelength λ0 (for example, 350 mm to 500 mm)
(For example, excimer laser, krypton laser, He)
A normal observation image obtained by the endoscope 401 is captured via the second adapter 405 by a fluorescent laser device 404 for supplying a Cd laser or a dye laser) and white light from the lamp 403 a of the normal illumination light source 403. Normal TV camera 40
6, a fluorescent image capturing camera 407 that captures a fluorescent image obtained by the endoscope 401 with excitation light λ0 from the fluorescent laser device 404 through the second adapter 405 with high sensitivity, and a normal TV camera 406. A camera control unit (abbreviated as CCU) 408 that performs signal processing on the obtained normal observation imaging signal to generate a normal image, and a fluorescent image imaging camera 4
07, a fluorescence image processing device 409 that performs signal processing on a fluorescence imaging signal captured by the imaging device 07 to generate a fluorescence image, and a CCU 408.
And a signal from the fluorescent image processing device 409, and an image display control device 410 for controlling image display, and a head mounted display (abbreviated as HMD) on which a normal observation image and a fluorescent image are displayed by the image display control device 410 4
11 and the monitor 412, and the image display control device 410
A foot switch 426 for performing an operation of controlling
An image intensifier (I.P.) in the fluorescent image capturing camera 407 is output from an output signal from the fluorescent image processing device 409.
I. I. Controlling the gain of the optical amplification of 422.
I. Control means 427 and this I.I. I. Alarm means 428 for giving an alarm based on the output of the control means 427.

[0284] The endoscope 401 has an elongated insertion portion 401a as a probe that can be inserted into a body cavity or the like, and the insertion portion 40a.
1a, a wide operation unit 401b provided at the rear end, an eyepiece unit 401c provided at the rear end of the operation unit 401b,
It has a light guide cable 401d extended from the operation unit 401b to the outside.

A light guide 415 composed of a flexible fiber bundle for transmitting light is inserted into the insertion portion 401a, and the rear end of the light guide 415 is inserted through a light guide cable 401d. A connector 401e provided at an end of the guide cable 401d is detachably connected to the light output unit 402a of the first adapter 402.

The first and second light input portions of the first adapter 402 are detachably connected to the light output portion 403b of the normal illumination light source 403 and the light output portion 404a of the fluorescent laser device 404, respectively.

In the first adapter 402, the driver 4
By driving the movable mirror 414 at 13, white light from the lamp 403 a of the normal illumination light source 403 and excitation light λ 0 from the fluorescent laser device 404 are switched, and the endoscope 40 is switched.
Light is guided to the light guide 415 inserted through the inside of the light guide 1.

For example, in FIG.
4 is set to the state indicated by the solid line, the lamp 403a
Is reflected by the movable mirror 414, the lens 402 near the light output unit 402a.
The light is guided to the light guide 415 via b. in this case,
The excitation light λ0 from the laser device 404 is
Is shaded.

When the movable mirror 414 is set at the position shown by the broken line, the light of the excitation light λ0 from the laser device 404 is transmitted from the second light input unit via the light guide member 404b such as a fiber. Guided into the first adapter 402,
The excitation light λ 0 is guided to the light guide 415 through the lens 402 b without being blocked by the movable mirror in the retracted state. In this case, the white light of the lamp 403a is shielded by the movable mirror 414.

The light guide 415 is connected to the first adapter 402
Is transmitted to the end face on the distal end side of the insertion section 401a of the endoscope 401, and is further radiated forward through the lens.
The return light from the observation site due to the irradiated light is
An observation image (a normal observation image or a fluorescence observation image) is formed on the distal end surface of the image guide 416 by an objective lens 417 disposed at the distal end of the image guide 1a. The image is transmitted to the end face of the endoscope 1 on the side of the eyepiece 401c by the image guide 416 as an image transmission means inserted through the endoscope 401.

A second adapter 405 is detachably connected to the eyepiece 401c. The second adapter 405 switches between a normal observation image and a fluorescence observation image by driving a movable mirror 419 with a driver 418 (see FIG. 3). The position of the movable mirror 419 in the case of the normal observation image is a solid line, the position of the movable mirror 419 in the case of the fluorescence observation image is a broken line), the normal observation image is in the normal TV camera 406, and the fluorescence image is in the fluorescence image capturing camera 407.
Lead to.

The movable mirrors 414 and 419 are driven in synchronization by drivers 413 and 418, respectively. When one is set at the position indicated by the solid line, the other is also set at the position indicated by the solid line, and the other is set at the position indicated by the broken line. In this case, the other is set at the position indicated by the broken line.

For example, when the movable mirrors 414 and 419 are set at the positions indicated by the solid lines, the reflected light from the observation object side illuminated by the normal illumination light is reflected by the observation optical system of the endoscope 401 (that is, the objective lens). 417, an image guide 416, and an eyepiece), and is guided into the second adapter 405.

The lens 40 facing the eyepiece lens
5a, a movable mirror 419, a lens arranged on the optical path changed by the movable mirror 419, the normal TV camera 40
A normal observation image is formed on the CCD 420 via the lens 406a in 6.

[0295] The C built into the normal TV camera 406
A normal observation image pickup signal corresponding to the normal observation image picked up by the CD 420 is transmitted to the CCU 408.

On the other hand, when the movable mirrors 414 and 419 are set at the positions indicated by the broken lines, the excitation light λ0 of the laser device 404 is transmitted by the light guide 415, and the object to be observed is irradiated with the excitation light λ0. The fluorescence image generated by the fluorescence excited by the excitation light λ0 is guided into the second adapter 405 by the observation optical system of the endoscope 401.

The light-guided fluorescent image is converted into a lens 405a and a lens 405 facing the lens 405a.
b, this lens 405b in the fluorescence image capturing camera 407
The lens 407a disposed on the optical path facing the camera and the rotary filter 421 enable high-sensitivity imaging. I. After being optically amplified at 422, the image is captured by the CCD 423.

[0298] The fluorescent image signal picked up by the CCD 423 is transmitted to the fluorescent image processing device 409.

Here, FIG. 38 (c) shows the fluorescence characteristics when irradiated with the excitation light λ0. For example, an excitation light λ of 442 mm
The fluorescence of the tissue obtained at 0 is strong at a normal site, and weaker at a lesion at a shorter wavelength than normal. That is, since the ratio of the fluorescence intensity is different between the wavelengths λ1 and λ2 in the figure and the normal and the lesion, the lesion can be distinguished from the normal by calculating the ratio of the image portions of the wavelengths λ1 and λ2. Therefore, the fluorescent images of λ 1 and λ 2 are separated by two pass band filters provided in the rotary filter 421 and are picked up by the CCD 422.

In FIG. 39, the movable mirror 41
4 and 419 are driven by drivers 413 and 418 in synchronization with each other by a timing controller 425, and the drive timing of a motor 424 that rotates the rotary filter 421 is also controlled by the timing controller 425.

The image display control device 410 can also switch the normal image or the fluorescent image displayed on the monitor 412 and the HMD 411 which is an operator-mounted display device mounted on the operator's head by the foot switch 426. It has become.

The HMD 411 is constituted by a liquid crystal display device and has a see-through function. In other words, the image is displayed on a display device that transmits light, so that the surgeon can observe a normal image or a fluorescent image by displaying the image in front of the eye. You can also see the parts.

Next, the operation of the fluorescence observation endoscope apparatus 400 will be described. I. I. The control unit 427 receives a signal of the wavelength λ1 having a strong fluorescence intensity from the fluorescence image processing device 409. Then, a limit value slightly smaller than a preset saturation intensity is compared with the fluorescence intensity at the wavelength λ1, and if the difference is large, the I.V. I. The control voltage is output so as to increase the gain of 422.

That is, I. I. According to the output of the control means 427, I. The control voltage for controlling the gain of 422 is controlled so that the output signal waveform of the CCD 554 functions as if AGC was performed, so that the fluorescence intensity characteristic does not saturate and becomes a large waveform level.

As described above, the ratio of the fluorescence intensities λ1 and λ2 can be always accurately obtained by directly detecting the fluorescence intensity and obtaining strong fluorescence without saturation. Fluorescence intensity λ
By displaying a fluorescent image (pseudo color display) of the observation target site and a normal observation image on the monitor 412 in accordance with the ratio of 1 and λ2, it can be determined whether the observation target site is normal or not.

Also, the fluorescent image is used for the right eye of the HMD 411.
The normal observation image may be displayed for the left eye. Further, the fluorescent image and the normal observation image may be superimposed and displayed on the HMD 411.

In the above embodiment, the I.V. Although the gain of I422 was controlled, the peak value of the fluorescence intensity was detected and I.P.I. I. The gain of 422 may be controlled.

Further, an average value of the fluorescence intensity may be used.
When the wavelength λ1 is used, it may have a spectrum or a certain band. In addition, I. I. Instead of controlling the gain of I.422. I. An aperture mechanism may be provided before 422, and the intensity of the fluorescence passing through the aperture may be controlled by the aperture of the aperture mechanism.

In addition, I. I. For example, when the gain of 422 is maximized, when the fluorescence intensity does not reach the predetermined amount, if the determination is made based on the signal level, since the S / N is small, an incorrect determination or a low reliability determination may be made. In such a case, the operator is notified by the alarm means 428 or the notification means. Then, the surgeon obtains a fluorescent image by bringing the emission end closer to the observation target site based on the notification, thereby increasing the S / N and obtaining a fluorescent image from which it is possible to determine whether the lesion is normal or not.

[0310] Even when the fluorescence intensity does not partially reach the predetermined amount, the alarm means 428 may notify the fact. For example, when the distance is set to be smaller than that shown in FIG. 38 (b) and the excitation light irradiation range is only a part of the observation range of the observation system, the detected fluorescence image is partially , The fluorescence intensity becomes large, but in the remaining portion, a portion where the fluorescence intensity is hardly detected appears.

In such a state, for example, the distribution of the fluorescence intensity on the peripheral side in the fluorescence image obtained by the CCD 423 is
For the output signal of the CD 423 (the fluorescent image processing device 40
9) can be discriminated or identified. Also in such a case, the alarm means 428 may notify the user (for example, that a part of the fluorescent image cannot be observed, or that the distance should be set larger).

The alarm means 428 may be any of a sound (a buzzer may be used), lighting of a lamp, feedback by vibration of an operation unit, display on the monitor 412, and the like.

The HMD 411 may be provided with a line-of-sight detecting means, and by changing the line of sight, a fluorescent image and a normal observation image can be switched for observation.

According to the fluorescence observation endoscope apparatus 400,
The following effects are obtained.

The fluorescence intensity was directly detected to By controlling the gain of I422, an accurate diagnosis can be always performed by always finding an appropriate ratio of the fluorescence intensity regardless of the state of the observation target site. For example, at the time of magnifying observation as shown in FIG. I. Since the control is performed so that saturation does not occur by lowering the gain of 422, accurate diagnosis can be performed.

By controlling with the wavelength λ1 for which the ratio is to be determined, the saturation of the ratio to be determined can be reliably prevented. Furthermore, S /
A good fluorescent image can be obtained without reducing N.

By displaying the image on the HMD 411, the fluorescent image and the normal observation image can always be seen even if the operator changes his / her posture, and the possibility of missing the lesion can be reduced.

Further, by providing a plurality of HMDs 411, even if there are a plurality of operators, all the members can always obtain good images. In other words, even if the posture or the position is changed, all the members can always observe a good image without being affected by the posture or the position.

[0319] If there is an assistant, the assistant also has an HMD.
By mounting each of the 411, the operator and all the assistants can always observe good images.

[0320] If the see-through function of the HMD 411 is used, the endoscope and the treatment tool can be easily operated, and the number of operators can be reduced.

[0321] For example, a wireless video signal transmitting unit is provided at the output unit of the image display control device 410, while the MH
A video signal receiving unit, a video signal reproduction circuit, and a power supply may be provided in D411 so that a person wearing the HMD 411 can wirelessly observe a normal image or a fluorescent image.

In this case, there is no need to connect a code to the image display control device 410, so that operability or workability can be further improved.

Although not shown in FIG. 39, a channel through which a treatment tool can be inserted is provided in the endoscope 401, and a treatment for treatment or the like is performed with the treatment tool through this channel as necessary. You may do it. In this case, a treatment for treatment or the like can be performed with a treatment tool passed through the channel while observing the fluorescent image.

FIG. 40 shows the configuration of an image display control system in a modification of the first embodiment. CC in FIG.
The output signals of U408 and the fluorescence image processing device 409 are input to the image switching means 466, and the image synthesizing device 46
7 is input.

The image synthesizing unit 467 superimposes the two input images into one synthesized image to change the image.
66 is output.

The image switching means 466 is provided with a selection switch 468.
By operating the selection switch 468, the image output to the image display means can be switched and the display mode can be selected and set. Other configurations are the same as those in FIG.

In this modification, for example, the selection switch 468
By the operation described above, for example, a fluorescent image can be output to the MHD 411 so as to be displayed on the right eye side of the HMD 411 and a normal observation image is displayed on the left eye side. The image synthesizing device 4
It is also possible to select to output the 67 output images to the MHD 411.

Further, switching control can be performed to output a normal image or a fluorescent image to the monitor 412. Other functions and effects are the same as those in FIG.

FIG. 41 shows the configuration of the fluorescence observation endoscope apparatus 440 of the second embodiment capable of obtaining a good fluorescence image suitable for diagnosis regardless of the distance. Since the second embodiment has almost the same configuration as the first embodiment, only different configurations will be described, and the same components will be denoted by the same reference numerals and description thereof will be omitted.

The fluorescence observation endoscope apparatus 440 shown in FIG.
In FIG. 39, the distance between the second adapter 405 and the fluorescent image capturing camera 407 (for example, the lens 405a and the lens 4
07a), a beam splitter 44 for separating the fluorescent image
1 and a part of the fluorescent light amount of the fluorescent light image separated by the beam splitter 441 is detected by the fluorescent light amount detecting device 442, and the display image is controlled by the image display control device 410 based on the detected fluorescent light amount. It is configured as follows.

As shown in FIG. 42, the fluorescent light amount detecting device 442 divides the fluorescent image into two wavelength bands λ 1 and λ 2 by a dichroic mirror 445, and outputs two wavelengths by high-sensitivity photodiodes (APDs) 446 and 447. Band λ1, λ
Sample and hold circuit (S / H)
Sampling is performed at 448 and 449. An arithmetic circuit 45 calculates the amount of fluorescent light in each of the sampled wavelength bands λ1 and λ2.
The timing controller 425 and the image display control device 410 are controlled by calculating with 0 and determining whether or not the amount of fluorescent light is indicative of a lesion.

When the fluorescent light amount indicating the lesion is not detected, the fluorescent light amount detecting device 442 extends the white light irradiation period from the normal observation light source 403 to the timing controller 425, and Control is performed to shorten the irradiation period of the excitation light. As a result, when there is no lesion, an observation image having sufficient brightness can be obtained, and the insertion procedure of the endoscope 401 becomes easy.

When the amount of fluorescent light indicating the lesion is detected, the irradiation period of the white light from the normal observation light source 403 is shortened to the timing controller 425, and the irradiation of the excitation light from the fluorescent laser device 404 is performed. Control to extend the period. As a result, when there is a lesion, a fluorescent image with sufficient brightness can be obtained, and diagnosis of the lesion can be facilitated.

In this embodiment, the normal image signal from the CCU 408 is input to the light amount control means 429, and the intensity of the excitation light source emitted from the laser device 404 is controlled.

The light amount control means 429 extracts a luminance signal from the normal image signal, and controls a laser beam serving as excitation light in accordance with the luminance level. The control is performed so that the fluorescence intensity is also in an appropriate intensity range by using the fact that the distance to the observation target site, the situation, and the like can be estimated from the level of the luminance signal of the normal image.

Alternatively, a portion where the level of the normal image signal falls within a desired range may be detected, and the laser light may be controlled based on the fluorescence intensity of the portion.

Alternatively, an input means for designating an observation target part to be dimmed may be provided. FIG. 43 shows a configuration of a fluorescence observation endoscope apparatus according to a modification of the second embodiment provided with this input means.

The CCD built into the TV camera 406
The output signal of 420 is integrated through a low-pass filter (abbreviated as LPF) 451 after the clock component is removed. The signal passed through the LPF 451 is supplied to the AGC circuit 45.
2. Processed by the process circuit 453 to become an NTSC signal.

Then, the image display control circuit 410
Desired display means (for example, monitor 412, HMD411)
Will be displayed. On the other hand, the output of the LPF 451 is input to the dimming signal generation circuit 453, and a drive voltage for the aperture motor 462 is generated by the aperture control circuit 461 of the normal illumination light source 403, and the amount of normal illumination light is controlled by controlling the aperture blades 463. Control.

Here, the amount of fluorescent light is controlled based on the luminance signal level of a specific portion, without using the average photometry of the entire screen. The output of the LPF 451 is sampled and held by a sample / hold circuit (S / H
If the output level at that time is larger than a predetermined value, the fluorescence amount detection circuit 442 is operated at the same timing, and I. The gain of the control means 422 is controlled.

By doing so, appropriate images can be obtained for both the normal observation image and the fluorescence observation image. When the output of the S / H 454 is smaller than a predetermined value, the timing is switched so that an appropriate fluorescent image can be obtained.

On the other hand, when the operator wants to observe a fluorescent image of a region of particular interest under better conditions, the external input means 4
The timing may be set by 57.

According to this embodiment, there is an effect that the normal observation image and the fluorescence observation image can always be observed in a good state.

Next, a third embodiment in which a fluorescent image suitable for diagnosis is obtained regardless of the distance will be described. FIG. 44 shows a state in which an operator performs an intraperitoneal surgical operation using the stereoscopic endoscope 471 and various treatment tools 470, and FIG. 45 shows a configuration of an optical system of the stereoscopic endoscope 471.

As shown in FIG. 45, the stereoscopic endoscope 471 according to the present embodiment is a rigid stereoscopic endoscope having two optical systems for the left eye and the right eye. Two eyepieces 473a and 473b are connected to the base end of the portion 472. Adapters 474a and 474b are connected to the eyepieces 473a and 473b. TV cameras (not shown) are connected to the eyepieces 473a and 473b so that a normal observation image and a fluorescence observation image of the subject obtained by the stereoscopic endoscope 471 can be captured. It has become.

The stereoscopic endoscope 471 has an insertion portion 472
Substantially L-shaped eyepieces 473 from both sides of the base end of the eyepiece 473
a, 473b have an extended shape. Adapters 474a, 474 connected to the eyepieces 473a, 473b
74b respectively have a CCU (not shown, but for convenience the CC
TV cameras (corresponding to, for example, the normal TV camera 406 in FIG. 39 and the fluorescent image capturing camera 407 in FIG. 39) connected to the UA and the CCU-B, respectively.

The CCU-A (and CCU-B) is shown in FIG.
CCU 408 and the fluorescence image processing device 409, and the CCU-A and the CCU-B
The HMD 411 is connected to a stereoscopic display device (not shown) for displaying the normal observation image and the fluorescence observation image with parallax obtained in Step 1 in a stereoscopically viewable manner.

[0348] The stereoscopic display device displays alternately left and right images respectively taken by two TV cameras on the HMD 411 alternately, and observes them with the left and right eyes, so that a subject having a stereoscopic effect can be displayed. The observation image and the fluorescence image can be observed.

As shown in FIG. 45, two objective optical systems 480a and 480b for forming a subject image are provided at the distal end of the insertion section 472 of the stereoscopic endoscope 471. Behind the systems 480a and 480b, relay optical systems 481a and 481b for transmitting a subject image, respectively.
Are arranged.

The relay optical systems 481a and 481b are on the rear end side, that is, from the base end of the insertion section 472 to the eyepiece 473.
A prisms 482, 483 and 484, 485 each reflecting the optical axis by 90 degrees are provided between a and 473b, and the eyepiece 4 behind the prisms 484, 485 is provided.
The eyepiece optical system 486 is provided in each of 73a and 473b.
a, 486b are provided, and imaging or visual observation can be performed from the eyepieces 473a, 473b. In addition,
The arrow in the figure indicates the direction of the image.

Although not shown, the stereoscopic endoscope 471 is not shown.
Is provided with an illumination optical system, which transmits illumination light and excitation light from a light source device (not shown) to the distal end portion and irradiates the object with the illumination light and excitation light.

The adapters 474a and 474b have the same configuration as, for example, the second adapter 405 in FIG.
The method of fluorescence observation is performed in exactly the same manner.

One of the eyepiece optical systems (ie, 486a)
Has a movable movable lens 4 for adjusting the magnification of the optical system.
A zoom optical system 487 including 87a is provided.

When performing stereoscopic vision, the eyepiece optical system 4
The zoom optical system 487 provided at 86a adjusts the magnification so that the magnifications of the two optical systems become equal. That is, in the zoom optical system 487, the movable lens 487
By moving a back and forth, the magnification of the optical system is changed, and the magnifications of the two optical systems are made to match. This allows
Observed images with good three-dimensional effect can be obtained.

As described above, by providing the zoom optical system in at least one of the two optical systems, it is possible to change the magnification of the optical system so that the magnifications of the left and right images in the stereoscopic observation image can be made equal. It is made possible to perform stereoscopic vision.

The stereoscopic endoscope 47 configured as described above
1, two objective optical systems 480a and 480 having parallax
b, the subject images are formed, and these subject images are converted into relay optical systems 481a and 481b and eyepiece optical systems 486a and 48.
6b to the eyepieces 473a, 473b at the rear end, and from the eyepieces 473a, 473b to the adapter 474.
a, and images are taken by a TV camera connected via 474b.

In the case where a TV camera is connected to the eyepieces 473a and 473b for image pickup, the image signals of the picked-up subject images are subjected to signal processing by the CCU-A and CCU-B, and the stereoscopic display device is used. Of the normal observation image and the fluorescent image.

As an effect of this embodiment, by performing the treatment in combination with various treatment tools 470, the treatment can be easily performed even during the fluorescence observation. In addition, when performing while observing a fluorescent image, it is possible to almost eliminate the possibility of erroneously treating normal tissue other than the affected part.

In the embodiments shown in FIGS. 39 to 45, the CCD 420 of the normal TV camera 406 is imaged based on white light. However, this CCD 420 is provided with a color mosaic filter on the incident surface to obtain a color image. CCD. Also, the white light is R, G,
By providing a color filter that separates B light, a normal TV camera that captures a color image may be used, or R, G, and B illumination light may be sequentially supplied from a normal illumination light source 436 and synchronized with the supply timing. May be used as a normal TV camera that captures a color image.

[Supplementary Note] (5-1) In a fluorescence observation apparatus for irradiating excitation light to a site to be observed of a living tissue and observing a fluorescent image by the excitation light, a light source for generating the excitation light, A fluorescence observation apparatus comprising: a detection unit for detecting the fluorescence in the above; and a control unit for controlling the output of the detection unit to a predetermined amount.

The fluorescence observation apparatus of Appendix 1 emits fluorescent light by irradiating the living tissue with excitation light, and the control means detects the fluorescent light quantity so that the fluorescent light quantity is always set to a desired fluorescent light quantity. Therefore, regardless of the distance to the living tissue, accurate fluorescence intensity can always be obtained without saturating the detection value of the fluorescence intensity, and accurate diagnosis can be performed.

(5-2) In a fluorescence observation apparatus for observing a normal observation image of a site to be observed of a living tissue with normal illumination light and a fluorescence image with excitation light, a normal light source for generating the normal illumination light, A fluorescence observation apparatus comprising: an excitation light source that generates light; and a control unit that detects a fluorescence amount of the fluorescence image and controls a light amount of the excitation light source or a fluorescence image detection unit.

Since the fluorescence observation apparatus of Appendix (5-2) illuminates a living tissue with normal illumination light in addition to Appendix 1, the normal observation image can be obtained in addition to the effect of Appendix (5-1). can get. Further, the positional relationship between the normal observation image and the fluorescent image can be easily grasped.

(5-3) In the supplementary note (5-1) or (5-2), the control means controls the amplification degree of the fluorescence image detecting high sensitivity camera.

[0365] In Appendix 1 or 2, the amount of fluorescence is controlled by controlling the degree of amplification of the high-sensitivity camera.

(5-4) In the supplementary note (5-1) or (5-2), the control means is provided on the incident side of the fluorescent image detecting high-sensitivity camera, and controls the stop device for stopping the fluorescent light beam.

In Appendix (5-1) or (5-2),
By controlling the aperture amount of the aperture device, the amount of fluorescence is controlled.

(5-5) In Supplementary Note (5-1), the detecting means detects the intensity of the fluorescence at a specific wavelength.

In Appendix (5-1), a specific fluorescence wavelength is detected, and control is performed based on this value.

(5-6) In Supplementary Note (5-1), the detecting means detects the ratio of the intensity of fluorescence at a plurality of specific wavelengths.

In Appendix (5-1), a plurality of specific fluorescence wavelengths are detected and controlled based on the detected values.

(5-7) In the supplementary note (5-1), the fluorescence observation device has an insertion portion inserted into a body cavity, and includes a light guide means for transmitting excitation light and an image guide means for transmitting fluorescence. The probe consists of

A fluorescent image of the living tissue in the body cavity is obtained.

(5-8) In the supplementary note (5-2), the fluorescence observation apparatus has an insertion portion inserted into a body cavity, means for transmitting normal illumination light and excitation light, normal observation image and fluorescence image And an endoscope comprising:

[0375] A fluorescence image and a normal observation image of the living tissue in the body cavity are obtained.

(5-9) In Supplementary Note (5-8), the endoscope has a channel.

While observing the fluorescent image, treatment can be performed with a treatment instrument passed through the channel.

(5-10) In Supplementary Note (5-1),
There is a display means for displaying the fluorescent image on the operator-mounted display device.

A fluorescent image can always be displayed in front of the surgeon's eyes, and a favorable fluorescent image can always be observed regardless of the posture of the surgeon.

(5-11) In Supplementary Note (5-10), a fluorescent image was displayed so as to be three-dimensionally observable using the display device.

A fluorescent image is displayed stereoscopically.

By the way, FIG. 46 shows the first and second embodiments of the fluorescence observation apparatus having a positioning function for easily and automatically positioning the normal observation image and the fluorescence observation image. This will be described with reference to FIG. This background will be described first.

In the case of performing percutaneous fluorescence observation in a body cavity, there is a method of combining an existing normal observation endoscope with an endoscope for fluorescence observation. In this case, if the position of the target portion of the normal image and the position of the fluorescent image are shifted, it becomes difficult to perform a diagnosis or a treatment, and there is a possibility that a misdiagnosis or an incorrect treatment may be performed on a normal portion. Becomes an issue.

For this reason, a fluorescence observation apparatus having a function of performing alignment easily or automatically is desired, and it is an object of this embodiment to provide a fluorescence observation apparatus having such a function. In the following embodiment, a fluorescence observation device 501 having a positioning function will be described.

A fluorescence observation device 501 having a positioning function shown in FIG. 46 includes a normal observation scope 502, a fluorescence observation scope 503, a light source device 504 for generating normal observation illumination light, and a fluorescence observation device. A laser device 505 for generating excitation light is connected to the light guide means of the normal observation scope 502, and the light guide means selectively guides normal illumination light from the light source device 504 or excitation light from the laser device 505. A light source adapter 506, a normal image pickup device 507 integrally connected to or detachably connected to the normal observation scope 502, and an integrally connected or detachably connected to the fluorescence observation scope 503. Fluorescent image pickup device 508 and a normal image CCU 50 for performing a video signal generation process on an output signal of the normal image pickup device 507 A fluorescent image processing device 510 that performs a video signal generation process on an output signal of the fluorescent image capturing device 508; a monitor 511 that displays an output signal from the normal image CCU 509 or the fluorescent image processing device 510; It has a monitor control unit 512 that outputs an output signal from the image CCU 509 or the fluorescence image processing device 510 to the monitor 511, and a timing controller 513 that controls the timing and the like of the entire fluorescence observation device 501.

[0386] The normal observation scope 502 has, for example, a rigid and elongated insertion portion 514, and a wide grip portion 515 is formed at the rear end of the insertion portion 514.
An eyepiece 516 is formed at the rear end. Insertion section 51
Reference numeral 4 denotes a trocar 51 that penetrates a hole in a body surface 517 of a patient or the like.
8 and is inserted into the body cavity 519.

A light guide 521 is inserted into the insertion portion 514, and the rear end of the light guide 521 is
Light guide cable 522 extended from 15 to the outside
The rear end is connected to the output of the light source adapter 506.

[0388] The two input portions of the light source adapter 506 are connected to the light source device 504 and the laser device 505. In the light source device 504, a lamp 5 for generating white normal illumination light is provided.
The normal illumination light of the lamp 523 is guided to the light source adapter 506 via the lens 524 arranged on the optical path.

In the light source adapter 506, the lens 52
A lens 525 and a light distribution light path changing mirror 526 are sequentially arranged on an optical path facing the light source 4, and when the mirror 526 is in a state indicated by a solid line, the light is reflected by the mirror 526 and is transmitted through the lens 527 to the light guide. Illumination light is supplied to the end face of 521. In this case, light on the side of the laser device 505 is blocked by the mirror 526.

The mirror 526 is rotationally driven by the control driver 528 to a position indicated by a solid line and a position indicated by a dotted line. A laser device 505 connected to the other input unit
A laser source 529 is disposed inside the laser source 529.
The laser light generated in step (1) is guided to the lens 527 through the lens 530 on the optical path of the laser light in the light source adapter 506.

When the mirror 526 is in the retracted state (relative to the laser source 529) indicated by the dotted line, the laser beam is not blocked by the mirror
7, the light is supplied to the end face of the light guide 521. In this case, the normal illumination light is shielded by the mirror 526.

For example, the normal illumination light guided by the light guide 521 is further emitted forward from the end face of the distal end portion of the insertion portion 514 through the lens 531, and is transmitted to the organ 5 in the body cavity 519.
32 is illuminated with normal light 533.

The illuminated part forms an image at the image forming position with an objective lens 534 attached to the observation window at the tip. The image of the objective lens 534 is transmitted to the eyepiece 516 side by an image transmission system 535 formed by a relay lens system or the like, and the image transmitted by the imaging lens 536 is converted to a normal image pickup device connected to the eyepiece 516. 507 is connected to a first normal image CCD 537.

A shutter 538 is disposed between the CCD 537 and the imaging lens 536, and is driven by a shutter control driver 539 to a retracted position indicated by a solid line and a light-shielded position indicated by a dotted line. The control driver 528 for driving the mirror 526 and the shutter control driver 539 for driving the shutter 538 are controlled by the timing controller 513. When the mirror 526 is at the position indicated by the solid line, the shutter 538 is also set at the position indicated by the solid line. .

Then, the normal image photoelectrically converted by the CCD 537 is input to the normal image CCU 509 to generate a standard video signal. The standard video signal is input to the monitor control unit 512.

On the other hand, the scope for fluorescence observation 503 has an elongated insertion portion 541 having flexibility, a wide grip portion 542 provided at the rear end of the insertion portion 541, and a grip portion 542.
2 at the rear end.

A bendable portion 544 is provided near the distal end of the insertion portion 541, and one end (tip) of the angle wire 545 inserted through the insertion portion 541 is fixed to a hard distal end. The end is connected to an angle wire control motor 559 that pulls and relaxes the angle wire 545. Then, the bending portion 544 can be bent toward the side where the angle wire 545 is pulled. FIG.
In FIG. 9, only one angle wire 544 is shown for simplicity, but actually four wires are inserted corresponding to four directions.

[0398] The insertion portion 451 is also inserted into the body cavity 519 via the trocar 546. An objective lens 547 is attached to the observation window at the distal end in the insertion portion 541,
At the image forming position of the objective lens 547, for example, a distal end surface of an image guide 548 is arranged as a flexible image transmission unit.

Then, an image of a subject or a fluorescent image illuminated around the optical axis of the objective lens 547, that is, the position in front of the observation axis (or visual axis) 549, is connected to the distal end face of the image guide 548. The image of this image guide 5
48, the light is transmitted to the end face on the eyepiece 543 side.

[0400] The transmitted image is formed by the imaging lens 5 arranged inside the fluorescent image pickup device 508 connected to the eyepiece 543.
The mirror 5 for changing the light receiving optical path (or the imaging optical path)
The second normal image CCD 553 according to the setting state of the
Alternatively, the image is captured by the fluorescence image CCD 554.

This mirror 552 is the mirror control driver 5
By 55, it is rotationally driven to a position shown by a solid line and a position shown by a dotted line. When the mirror 526 and the shutter 538 are set at the positions indicated by the solid lines, the mirror 552 is similarly set to the mirror control driver 555 by the timing controller 513 so that the mirror 552 is set at the position indicated by the solid lines.
Is synchronously controlled via

When the mirror 526 and the shutter 538 are set at the positions indicated by the dotted lines, the mirror 552 is similarly set at the position indicated by the dotted lines by the timing controller 513.
Is synchronously controlled via

For example, in the state shown by the solid line (the illumination by the ordinary light 533, and under this illumination), the ordinary observation image is reflected by the mirror 552 and becomes the second ordinary image C.
A normal image is formed on the CD 553. The image signal photoelectrically converted by the CCD 553 is input to the normal image processing device 556, and by detecting the maximum luminance position in the captured image, the light within the illumination range when the normal light 533 illuminates the organ 532 is detected. The maximum luminance part 557 is detected.

[0404] The detection result is input to the motor control device 558, and the motor control device 558 controls the rotation of the angle wire control motor 559 based on the detection result.
The angle wire 545 connected to the
The observation axis 549 is moved to the maximum brightness part 557 by bending the 44. Then, as shown in FIG. 46, the position is set such that the maximum brightness portion 557 is located on the observation axis 549, and the normal image and the fluorescent image are always set to a state in which almost the same position is imaged. Is provided.

When the mirror 552 is set in the state shown by the dotted line, the mirror 526 is also set in the state shown by the dotted line.
The laser light of No. 9 is irradiated as excitation light, and the fluorescent light emitted at the target site is guided to the fluorescent image pickup device 508 through the observation optical system of the fluorescent observation scope 503, that is, the objective lens 547 and the image guide 548.

Then, the light is not blocked by the mirror 552 in the retracted state, but passes through the filter of the rotary filter 562 driven to rotate by the rotary filter control motor 561. I.
After being optically amplified at 563, an image is formed on the fluorescent image CCD 554, and photoelectrically converted by the CCD 554.

Note that the CCD 553 and the I.D. I. The arrangement position of 563 is arranged at a conjugate position with respect to the lens 551, and C
CD553 image and I.P. I. CCD amplified by 563
The image 554 is a conjugate image (at least the same size).

[0408] The image signal picked up by the CCD 554 is input to the fluorescent image processing device 510, and after processing such as generation of a video signal such as a pseudo color or the following operation is performed,
It is output to the monitor control device 512.

The rotation filter 562 is provided with a plurality of filters having different transmission wavelength bands. The rotation filters 562 are sequentially picked up with fluorescent images of a plurality of wavelength bands, and the fluorescent image processing device 510 converts a fluorescent image of the plurality of wavelength bands into a pseudo A video signal for color display is generated, and for example, the video signal shown in FIG.
The ratio of the signal level corresponding to the same position of the fluorescence image in the two wavelengths λ1 and λ2 is calculated by calculation, and whether the value exceeds a predetermined value is compared by a comparator. A process for determining whether the region is normal is also performed.

When it is determined that there is a high possibility of a lesion site, the monitor control unit 51
2 to display a normal image on the right side of the monitor 511 and a pseudo-color fluorescent image on the left side, for example.

In this case, for example, video signals of wavelengths λ 1, λ 2 obtained by using a filter in a band transmitting two wavelengths λ 1, λ 2 for the rotation filter 562 are converted to R, G,
And outputs the determination signal as a B video signal so that the operator can easily identify which part is likely to be a lesion based on the presence or absence of the B color. May be.

[0412] The monitor control device 512 has manual display selection means such as a foot switch, and by operating this display selection means, an image displayed on the monitor 511 can be selected and displayed. For example, a normal image is displayed at the center of the monitor 511, or the monitor 51 is displayed.
1, a fluorescent image is displayed in the center of the monitor 511, a fluorescent image is displayed on the left of the monitor 511, a normal image is displayed on the right of the monitor 511, and a pseudo-color fluorescent light is displayed on the left. Images can be displayed in superimposed pose.

The rotation of the rotary filter control motor 561 is also controlled by the timing controller 513, and a plurality of filters are sequentially placed on the imaging optical path in synchronization with the timing at which the mirrors 526, 552 and the shutter 538 are set at the positions indicated by the dotted lines. It is arranged to be.

The imaging system on the normal observation scope 502 side and the imaging system on the fluorescence observation scope 503 side have almost the same characteristics. For example, an objective lens (534)
Or 547) are equal in distance to the subject, and when the same subject image is captured, an image signal of the same waveform (however, the signal level may be different) is applied to the CCD 537.
And 554. That is, when the images are captured under the same conditions, the subject images of the same size are obtained.

[0415] If this condition is not met and, for example, an image is picked up in a different size, the size may be adjusted (aligned) before or after the alignment. Further, even when this condition is satisfied, a process of making the sizes uniform may be performed as described later.

Next, the operation of the fluorescence observation device 501 will be described below.

[0417] The timing controller 513 includes a light distribution light path changing mirror 526 and an imaging light path changing mirror 552.
And the rotation filter 562 and the shutter 538 are synchronized. Accordingly, when the mirror 526 is at the position indicated by the solid line, the illumination light for normal observation from the lamp 523 is guided to the light guide 521, the shutter 538 is opened, and the normal observation image is formed on the CCD 537 via the image transmission system 535. .

Also, the imaging optical path changing mirror 552 is also at the position indicated by the solid line.
An ordinary observation image is led to 53.

On the other hand, when the light distribution light path changing mirror 526 is at the position indicated by the dotted line, the light source 529 is connected to the light guide 521.
Is guided, and the shutter 538 is closed.
The mirror 552 for changing the imaging optical path is also located at the position indicated by the dotted line. I. The fluorescence image is led to 563. At this time, the fluorescent image is rotated by the rotation filter 562.
Is divided into a plurality of images having different wavelength bands.

[0420] The timing controller 513 controls to switch between the two states described above at high speed. As a result, in this embodiment, both the normal image and the fluorescent image can always be captured. Next, a process until the normal image and the fluorescent image are displayed on the monitor 511 will be described.

First, the normal image is transferred from the CCD 537 to the CCU 5
09 and sent to the monitor control unit 512. On the other hand, a plurality of fluorescent images are I.P. I. 563, CCD5
The image data is sent to the fluorescence image processing device 510 via the monitor 54, subjected to a predetermined calculation, and is processed as a single fluorescence image by the monitor control device 512.
Sent to

The monitor controller 512 displays at least one of the normal image and the fluorescent image on the monitor 511.
As a display method, there is a method of displaying only one by manual switching, a method of displaying based on a calculation result in the fluorescent image processing device 510, a superimposition, a method of combining and displaying both images, and the like.

[0423] A method of aligning the normal image and the fluorescent image will be described below. At the time of normal light illumination, a normal image is guided to the normal image processing device 556 via the image guide 548, the mirror 552, and the CCD 553. The normal image processing device 556 detects the maximum brightness portion 557 under illumination of the normal light 533 on the organ 532.

[0424] Based on the detection result, the motor control device 5
58 drives the angle wire control motor 559 and controls the angle wire 545 to move the observation axis 549 of the fluorescence observation scope 503 to the maximum luminance position 557 and set the state as shown in FIG. As a result, the normal image and the fluorescent image are always kept in a state where they are imaged at substantially the same position.

As a method for moving the observation axis 549 of the fluorescence observation scope 503, there are a method using a shape memory member, a pneumatic bending means, and the like, in addition to a method using a wire.

According to this embodiment, the alignment between the normal image and the fluorescent image can be easily and automatically performed. Therefore, the surgeon can easily confirm the position on the other image corresponding to the position on the other image in the normal image and the fluorescent image, which facilitates diagnosis and treatment and performs diagnosis and treatment in a short time. Can be.

FIG. 47 shows a main part of a fluorescence observation apparatus 571 of the second embodiment having a function of automatically performing positioning.

This embodiment differs from the first embodiment shown in FIG. 46 in that a fluorescence observation scope 503 ′ having a configuration different from that of the fluorescence observation scope 503 is provided.
A fluorescent image capturing device 508 'connected to the rear end of the 3' image guide cable 572;
Manipulator 57 for moving observation axis 549 of 03 '
3 except that a mechanism for moving the observation shaft 549 is the same as that of the first embodiment shown in FIG.

In the fluorescence observation scope 503 ′, for example, an objective lens 576 and a relay lens system 577 are inserted into a rigid insertion section 575, and transmitted to the rear end side of the insertion section 575 by the relay lens system 577.

The optical image transmitted to the rear end side of the insertion section 575 is formed by the imaging lens 578 on the distal end surface of an image guide 579 as a flexible image transmission means.
The image guide 579 transmits the image guide cable 572 to the rear end face of the image guide cable 572, and inputs the image guide cable 572 to the fluorescent image pickup device 508 '.

[0431] The rear end of the insertion portion 575 of the fluorescence observation scope 503 'is a manipulator 573 having a plurality of axes.
The manipulator 573 is driven by rotation of a plurality of axes under the control of a manipulator control device 580 inside the fluorescence image pickup device 508 ′, and by changing the axial direction of the insertion portion 575, the direction of the observation axis 549 is changed. Is changing.

The manipulator control device 580 is normally controlled by the output of the image processing device 556.

In the first embodiment shown in FIG. 39, the angle wire 545 is pulled to bend the bending portion 544 so that the observation axis 5
49, but in this embodiment, the rigid insertion portion 5
Using a fluorescence observation scope 503 ′ having an optical axis 75, the manipulator 573 changes the axial direction of the insertion portion 575 to change the observation axis 549, and the alignment is performed so that the maximum luminance portion 557 is located on the observation axis 549. ing.

Next, the operation will be described. 39 except for the direction in which the observation axis 549 of the fluorescence observation scope 503 'is moved.
This is the same as the embodiment. At the time of normal light illumination, the normal image is sent to the normal image processing device 556 inside the fluorescent image pickup device 508 'connected to the rear end of the image guide cable 572 via the optical system of the fluorescence observation scope 503'.
As in the embodiment shown in FIG. 39, the normal light maximum luminance portion 557 on the organ 532 is detected.

Based on the detection result, the manipulator 573 is controlled via the manipulator control device 580 to move the insertion portion 575 of the fluorescence observation scope 503 ′ to move the observation axis 549 onto the normal light maximum luminance area 557. Perform positioning.

This embodiment is different from the embodiment of FIG. 39 in that a rigid insertion portion 575 is used to
75 is moved by the manipulator 573, so that the blurring of the observation optical system of the fluorescence observation scope 503 'is small, and the positioning accuracy can be increased. become.

Therefore, it is easy to confirm the corresponding position between the normal image and the fluorescent image as in the apparatus shown in FIG.
It is possible to provide an environment in which diagnosis and treatment can be appropriately performed easily and in a short time.

Although the manipulator 573 is connected to the rear end of the insertion section 575 in FIG. 47, a grip section or an operation section is provided on the rear end side of the insertion section 575, and the manipulator 573 is connected to the grip section or the operation section. The structure may be such that

Further, the present invention is not limited to the one in which the observation axis 549 is made to coincide with the maximum luminance portion 557 by moving the fluorescence observation scope 503 ′ by tilting the manipulator 573. For example, in FIG. Instead, one end of the arm is connected to the rear end of the insertion section 575, and the other end of the arm is rotated by a motor or the like to move the maximum brightness portion 5 on the observation shaft 549.
57 may be matched.

In this case, the locus of movement of the observation axis 549 moves in one plane (perpendicular to the rotation axis of the motor), and this plane includes the observation axis 549 and the optical axis of the lens 531. May be set in advance.

The fluorescence observation scope 50 shown in FIG.
At 3 ', the image transmitted by the relay lens system 577 is converted into a fluorescent image pickup device 50 by an image guide 579 inserted into a flexible image guide cable 572.
Although the configuration is such that data is transmitted to the 8 'side, the present invention is not limited to this configuration, and other configurations may be used.

For example, a fluorescent image pickup device 508 'may be housed or arranged at the rear end side of the insertion section 575 on the image forming position side of the lens 578. Further, instead of the flexible image guide cable 572, the image may be transmitted to the fluorescent image pickup device 508 'by a rigid image transmission unit such as a relay lens system.

Note that in FIG. 46 and FIG.
In the case of the illumination 3, the observation axis of the normal observation scope 50 is parallel to the optical axis of the lens 31, and the distance between them (for convenience, d) is the distance to the subject (FIG. 46 or FIG. 47).
(Distance to the maximum brightness part 557 on the organ 532).

The positioning may be performed as follows in consideration of the distance d. For example, when the two scopes 502 and 503 are inserted into the body cavity 519 in FIG. 46, the optical axis of the scope 503 (coincides with the observation axis 549) in a plane including the optical axis of the lens 531 and the optical axis of the lens 534.
Is set to exist.

This setting is performed by inserting the scope 502 into the insertion unit 514.
This can be easily done by rotating around the axis. FIG. 46 shows a state in which this setting has been performed (provided that the bending portion 544 is in a straightened state).

[0446] In this state, illumination with normal light 533 and CC
From the signal captured by D553, the maximum luminance portion 557
Is detected. Thereafter, the insertion portion 541 is moved forward (inserted) or moved backward by a predetermined length, and the maximum brightness portion 55 is again moved.
7 is calculated using the shift amount of the maximum luminance portion 557 on both images and the predetermined length amount, and is calculated to be adjacent to the moved maximum luminance portion 557 (in front of the optical axis of the lens 534). The position (on the organ 532) (in FIG. 39, the maximum brightness portion 557)
(A position shifted by d to the left from) is set as a target position where the observation axis 549 of the scope 503 is aligned with this position.

Then, based on the calculation result of the target position, the motor 559 is rotated to move the curved portion 544 (the observation axis 5).
When the observation shaft 549 reaches the target position, the rotation is stopped and the alignment is completed.

[0448] When the positioning is performed in this manner, the positioning can be performed with higher accuracy, and it becomes easier to confirm the corresponding positions on both the normal image and the fluorescent image.

After the alignment, for example, the insertion section 575 is moved in the direction of the observation axis 549 to change the size of the image picked up on the fluorescence observation scope 503 or 503 ′, and the normal observation is performed. A size adjustment process may be performed such that the movement is stopped when the size matches the size of the image captured on the scope 502 side (of course, by moving the scope 502 side in the axial direction of the insertion portion 502). Is also good).

Further, for example, the lens 551 of FIG. 46 or FIG. 47 may be moved in the direction of the optical axis to change the size and adjust the size.

When such size adjustment processing is performed, the correspondence between the positions of the normal observation image and the fluorescence image on each image is more accurately matched, so that it is possible to easily perform a treatment such as diagnosis or treatment. .

When the size adjustment processing is performed,
The normal observation scope 502 side and the fluorescence observation scope 50
When the imaging characteristics (focal length or angle of view, etc.) of the optical system on the 3 'side are different, the distance from the tip of the normal observation scope 502 to the subject and the distance from the tip of the fluorescence observation scope 503' to the subject are different. Even when the sizes of the two images are different due to differences or the like, the correspondence between the positions of the normal observation image and the fluorescence image on each image can be made to exactly match.

The size adjustment processing may be performed automatically, or may be performed manually by an operator or an operator. Further, the positioning may be set manually (manually). Further, it may be possible to select between automatic and manual.

The fluorescence observation device 5 shown in FIG. 46 or FIG.
01 or 571, the output of the CCD 553 is output to the second normal image CCU or the like, and the video signal generated by the second normal image CCU is output to the monitor control unit 512.
May be displayed on the monitor 511 via the.

In this case, the video signal generated by the normal image CCU 509 is alternately displayed on the monitor 511, and observation is performed using liquid crystal glasses for alternately transmitting and shielding the left and right liquid crystals in synchronization with the alternate display. By doing so, it becomes possible for an operator or the like to be able to view stereoscopically. Also, each video signal is displayed on the left and right liquid crystal display sections of the HMD, respectively,
It is also possible to allow the surgeon to view stereoscopically.

Also, the video signal generated by the second normal image CCU and the video signal generated by the normal image CCU 509 are input to a three-dimensional image synthesizing device to generate a three-dimensional image video signal. The video signal of this stereoscopic image is
The image may be displayed by image display means such as 11.

Note that the fluorescence observation device 5 shown in FIGS. 46 and 47 is used.
In the case of 01 or 571, when performing the alignment, the fluorescence observation scope 5 is detected such that the maximum luminance part is detected and the maximum luminance part (or the target position) is on the observation axis.
Although 03 or 503 'is moved so as to be tilted by bending or the like, it may be performed by detecting a luminance part of another level instead of a part of maximum luminance.

For example, a part having a luminance level slightly lower than the maximum luminance is detected by the fluorescence observation scope 503 or 503 ′, and the detected part is used as a reference part, and the fluorescence is set so that the reference part overlaps the image of the normal observation scope. Observation scope 5
03 or 503 'may be moved.

Also, one of the images is taken so that the correlation amount between the image picked up by the normal observation scope 502 and the image picked up by the fluorescence observation scope 503 or 503 '(for example, the image picked up by the CCD 553) is maximized. The alignment may be performed by moving the scope. In this case, in the two images, for example, one scope may be moved so that the position of the maximum luminance portion overlaps, or at least one scope may be moved so that another reference position or a plurality of reference positions overlap. May be.

In FIGS. 46 and 47, illumination such as alignment is performed by the illumination light emitted from the light guide 521 of the normal observation scope 502. However, the present invention is not limited to this. May be provided on the fluorescence observation scope 503 or 503 'side. In this case, the alignment may be performed by tilting the normal observation scope 502 with a manipulator or the like. In the case of a flexible endoscope in which a bending portion is provided in the insertion portion of the normal observation scope 502, the positioning of the bending portion may be controlled by controlling the bending of the bending portion.

In the embodiment shown in FIGS. 46 and 47, in order to obtain a video signal of the same level as the video signal of a normal image, an I.P. I. 563 is arranged to amplify the light. I. 563
Instead of using, for example, a two-dimensional lock-in amplifier may be provided in the fluorescence image processing device 510.

For example, the excitation light from the laser source 529 is
A predetermined cycle (for example, 1 / 60S) is performed by a rotary shutter or the like whose rotation is controlled by the timing controller 513.
The pulse light is set to 2T in a period of about several tenths of the above, and is irradiated to the organ 532 side (via the mirror 526, the light guide 521, and the like). In synchronism with the blinking of the pulse light, for example (wavelengths λ 1, λ
Through two filters)
An image is captured by a CD 554 (for example, the mirror 526 is 1/60
S switches to the position of the solid line and the position of the dotted line,
To obtain a fluorescent image and a normal image).

A drive signal is applied to the CCD 554 in synchronization with the period T of the pulse light, and read at a high speed and input to the two-dimensional lock-in amplifier. In this two-dimensional lock-in amplifier, first, A / D conversion is performed, and each image (hereinafter, referred to as an odd image and an even image) captured in the blinking period T is sequentially stored in two frame memories. After a process of extracting a difference in an image portion corresponding between the odd image and the even image is performed by the difference circuit, the difference image is input to the next-stage accumulation integration circuit, and the image passed through the difference circuit is accumulated.

This accumulation is performed for a period during which a filter transmitting light of wavelength λ1 is on the optical path of CCD 554, and then stored in a frame memory for storing an image of wavelength λ1 via a multiplexer as an output signal of a two-dimensional lock-in amplifier. Is stored. Thereafter, a process of extracting a similar difference and a process of accumulating the extracted images during a period when the filter transmitting the light of the wavelength λ2 is on the optical path of the CCD 554 are performed, and thereafter, the wavelength λ2 is passed through the multiplexer. Are stored in a frame memory that stores the image of

As described above, in synchronization with the flickering of the excitation light, the difference components of the respective image signals picked up by the two-dimensional lock-in amplifier are extracted, and the integration process for accumulating them is performed to generate the fluorescence image of each wavelength. By doing so, it is possible to obtain a fluorescent image having a large S / N (see II.423 in FIG. 32).
The two-dimensional lock-in amplifier can be applied instead of the above.)

It is to be noted that different configurations may be obtained by partially combining the above-described embodiments and the like.

[Supplementary Note] (6-1) The normal image and the fluorescent image are obtained by using a normal observation scope for obtaining a normal image by normal illumination light and a fluorescence observation scope for obtaining a fluorescent image based on excitation by excitation light. In a fluorescence observation device for displaying both at the same time or in a time-division manner, a detection means for detecting a portion having a predetermined luminance on a normally illuminated object, and the fluorescence observation scope in a direction of the detected portion. And a visual axis moving means for moving the visual axis.

[0468] This fluorescent observation apparatus detects a site having a predetermined luminance on a target illuminated with ordinary illumination light by detecting means, and moves the visual axis of the fluorescence observation scope to the detected site. Thus, the normal image obtained by the normal observation scope and the fluorescence image obtained by the fluorescence observation scope are aligned. Accordingly, the surgeon can easily confirm the corresponding positions on the normal image and the fluorescent image on the image, and can easily perform diagnosis and treatment.

(6-2) The predetermined luminance is
The fluorescence observation device according to supplementary note (6-1), which has the maximum luminance.

(6-3) The fluorescence observation device according to attachment (6-1), wherein the visual axis moving means is a bending means provided on a distal end side of the fluorescence observation scope.

(6-4) The fluorescence observation apparatus according to attachment (6-3), wherein the bending means includes means for driving a wire that is inserted into the fluorescence observation scope and has one end fixed at a distal end.

(6-5) The fluorescence observation apparatus according to attachment (6-1), wherein the visual axis moving means comprises a manipulator having a plurality of axes connected to a rear end side of the insertion section of the fluorescence observation scope. .

[0473]

As described above, according to the present invention, an accurate fluorescence intensity can always be obtained regardless of the distance to the observation target site, and it is suitable for performing a fluorescence diagnosis regardless of the distance of the observation target tissue. This has the effect that an accurate fluorescent image can be obtained and an accurate diagnosis can be made.

[Brief description of the drawings]

FIGS. 1 and 2 relate to a first embodiment of the present invention, and FIG. 1 is a configuration diagram showing a configuration of a first embodiment of a fluorescence endoscope apparatus.

FIG. 2 is a configuration diagram showing a configuration of a main part of a modified example of the fluorescence endoscope in FIG. 1;

FIG. 3 is a configuration diagram showing a configuration of an endoscope distal end portion of a fluorescence endoscope apparatus according to a second embodiment.

FIGS. 4 and 5 relate to a third embodiment, and FIGS.
Is a configuration diagram showing the configuration of the endoscope end portion of the fluorescent endoscope apparatus.

5 is a configuration diagram showing a configuration of a distal end portion of an endoscope of a modified example of the fluorescence endoscope device of FIG. 4;

6 to 8 relate to a fourth embodiment, and FIG. 6 is a configuration diagram showing a configuration of a fourth embodiment of a fluorescence endoscope apparatus.

FIG. 7 is a configuration diagram showing a configuration of a modified example of the fluorescent endoscope in FIG. 6;

8 is an explanatory diagram illustrating an example of the LUT correction method in FIG.

FIG. 9 is a configuration diagram showing a configuration of a main part of a fluorescent endoscope apparatus in which a fluorescent paint is applied to a tip of a forceps.

FIG. 10 is a characteristic diagram showing a fluorescent characteristic of the fluorescent paint of FIG. 9;

11 is an explanatory diagram illustrating an example of a pseudo color display using the fluorescent paint of FIG. 9;

FIG. 12 is a configuration diagram showing a configuration of a fluorescent endoscope capable of removing the influence of external illumination.

FIG. 13 is a configuration diagram showing a configuration of a fluorescent endoscope having a sterilized structure provided with a rigid endoscope.

FIGS. 14 to 16 show S / S in the fluorescence image.
FIG. 2-1 is a configuration explanatory view showing an overall configuration of a fluorescence observation apparatus according to an embodiment of a fluorescence observation apparatus capable of improving N.

FIG. 15 is a block diagram showing a configuration of a fluorescence image processing apparatus having the configuration shown in FIG. 14;

FIG. 16 is an explanatory diagram illustrating an operation of the fluorescent image processing apparatus when creating an image conversion table.

FIG. 17 is a configuration explanatory view showing a configuration example of a fluorescence observation device including two laser devices as light sources for fluorescence observation.

FIG. 18 is a configuration explanatory view showing a configuration example of a fluorescence observation device that enables normal endoscope observation and fluorescence observation with one light source device.

FIG. 19 is a configuration explanatory view showing the entire configuration of a fluorescence diagnostic treatment apparatus according to the first embodiment, which is capable of simultaneously performing fluorescence observation and laser treatment.

FIG. 20 is a configuration explanatory view showing the entire configuration of a device according to a second embodiment of the fluorescence diagnostic treatment apparatus capable of simultaneously performing fluorescence observation and laser treatment.

FIG. 21 is a configuration explanatory view showing the overall configuration of a device according to a third embodiment of the fluorescence diagnostic treatment apparatus capable of simultaneously performing fluorescence observation and laser treatment.

FIG. 22 is a configuration explanatory diagram showing a configuration example of a fluorescence observation apparatus using an infrared light source as a light source for generating an infrared image for correcting a fluorescence observation image.

FIG. 23 is a configuration explanatory view showing a configuration example of a fluorescence observation apparatus in which a light guide unit for exciting light is provided on a guide tube for guiding an endoscope for fluorescence observation to a target site.

FIG. 24 is a perspective view showing a configuration of a distal end portion of the guide tube shown in FIGS. 2-10.

FIG. 25 is a configuration explanatory view showing a configuration example of a fluorescence observation device using a parent-child scope type endoscope in which a small-diameter endoscope is inserted into a channel of the endoscope and used.

26 to 28 relate to an embodiment of a space forming means of the fluorescence observation device, and FIG. 26 is an explanatory view showing a schematic configuration of the fluorescence observation device.

FIG. 27 is an explanatory view showing a transparent cover as a space forming means attached to the distal end of the endoscope of the fluorescence observation apparatus.

FIG. 28 is an explanatory view showing the operation of an endoscope in which a transparent cover, which is space forming means, is attached to the end of the endoscope;

FIG. 29 is an explanatory view showing a transparent cover attached to the side-viewing type endoscope.

FIG. 30 is an explanatory view showing a transparent cover to be attached to a perspective endoscope.

FIG. 31 is an explanatory view showing the operation of an endoscope in which a transparent cover is attached to a distal end portion of a perspective endoscope.

FIG. 32 is an explanatory view of another space forming means attached to the distal end of the side-viewing endoscope and the oblique-viewing type endoscope.

FIG. 33 is an explanatory view of other space forming means attached to the distal end portions of the side-viewing endoscope and the oblique-viewing type endoscope.

FIG. 34 is an explanatory view of another space forming means attached to the distal end portions of the side-viewing endoscope and the oblique-viewing type endoscope.

FIG. 35 is an explanatory view showing the operation of the endoscope in which the other space portion forming means shown in FIG. 33 is attached to the distal end portion of a perspective endoscope.

FIGS. 36 and 37 relate to another embodiment of the space forming means provided in the endoscope of the fluorescence observation device, and FIGS.
FIG. 6 is an explanatory view showing an operation when a balloon which is a space forming means is provided in a direct-view endoscope.

FIG. 37 is an explanatory view showing an operation when a balloon which is a space forming means is provided in a front oblique type endoscope;

38 to 45 relate to first to third embodiments of a fluorescence observation apparatus for obtaining a fluorescence image suitable for performing a good diagnosis regardless of the distance, and FIG. 38 shows a distance to a target part. Explanatory diagram showing that part of the fluorescence intensity captured by

FIG. 39 is a configuration diagram of a first embodiment of a fluorescence observation device.

40 is a block diagram illustrating a configuration of an image display control system in a modification of FIG. 39.

FIG. 41 is a configuration diagram of a second embodiment of the fluorescence observation apparatus.

FIG. 42 is a block diagram showing a configuration of a fluorescence light amount detection device in FIG. 41;

FIG. 43 is a configuration diagram showing a configuration of a modification of the second embodiment.

FIG. 44 is an explanatory view showing a state in which an operator performs an operation;

FIG. 45 is a configuration diagram showing a configuration of a stereoscopic endoscope according to a third embodiment of the fluorescence observation device.

FIGS. 46 and 47 relate to the first and second embodiments of the fluorescence observation apparatus having the alignment function, and FIGS.
Is a configuration diagram showing the configuration of the first embodiment of the fluorescence observation apparatus.

FIG. 47 is a configuration diagram showing a configuration of a second embodiment of the fluorescence observation device.

FIG. 48 is a characteristic diagram showing a fluorescence characteristic of a tissue in a body cavity when the excitation light λ0 is irradiated by the fluorescence endoscope apparatus;

[Explanation of symbols]

 Reference numeral 401: fluorescent endoscope device 404: fluorescent laser device 407: fluorescent image capturing camera 409: fluorescent image processing device 410: image display control device 422: image intensifier 427 ... image intensifier control device 423: CCD

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[Procedure amendment]

[Submission date] February 2, 2001 (2001.2.2)

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] Claims

[Correction method] Change

[Correction contents]

[Claims]

[Procedure amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0008

[Correction method] Change

[Correction contents]

[0008]

According to a first aspect of the present invention, there is provided a fluorescence observation apparatus, comprising: a fluorescence observation light source for generating fluorescence of a portion to be observed; and a fluorescence observation light source. Optically amplifies the fluorescence of the observation target site based on the excitation by the excitation light from the optical amplification unit, an optical amplification unit capable of controlling the amplification factor, and an observation image by the fluorescence of the observation target site amplified by the optical amplification unit. Imaging means for fluorescence observation for imaging, detection means for detecting a signal representing the intensity of the fluorescence of the observation target site from the output of the imaging means for fluorescence observation, The gain of the optical amplifying means is controlled so as to have a size.
A fluorescence observation apparatus according to claim 2, wherein a fluorescence observation light source means for generating excitation light for obtaining fluorescence of a portion to be observed, fluorescence of a first wavelength and fluorescence of a second wavelength generated by the excitation light. A light amplifying means capable of optically amplifying the fluorescence of the first wavelength and the fluorescence of the second wavelength separated by the separation means and controlling the amplification factor; and a light amplifying means. Imaging means for fluorescence observation for capturing an observation image of the observation target site amplified by the fluorescence of the first wavelength and the fluorescence of the second wavelength, and the first wavelength of the output of the fluorescence observation imaging means Detecting means for detecting a signal representing the intensity of the fluorescence of the observation target site from the output based on the fluorescence of the above; Control means for controlling the rate. And wherein the door. A fluorescence observation apparatus according to claim 3, wherein a fluorescence observation light source means for generating excitation light for obtaining fluorescence of a portion to be observed, fluorescence of a first wavelength and fluorescence of a second wavelength generated by the excitation light. Separation means for separating fluorescence, fluorescence observation imaging means for capturing an observation image of the observation target site amplified by the separation means with the first wavelength fluorescence and the second wavelength fluorescence, and the fluorescence observation imaging Detecting means for detecting a signal representing the intensity of the fluorescence of the observation target site from an output based on the fluorescence of the first wavelength among the outputs of the means; Light quantity control means for controlling the intensity of the excitation light so that
The fluorescence observation device according to claim 4, wherein the irradiation part irradiates the observation part with excitation light for obtaining fluorescence of the observation target part or illumination light for normal observation, and the observation part via the irradiation part. Switching means for switching the irradiation light to irradiate the excitation light or the illumination light; a normal observation imaging means for imaging a normal observation image of an observation target site by the illumination light from the illumination means; and the illumination means A fluorescence observation imaging unit that captures a fluorescence observation image of the observation target site based on the excitation by the excitation light from the light source, and a fluorescence observation imaging unit provided in the fluorescence observation imaging unit. Possible variable means, detection means for detecting a signal representing the intensity of the fluorescence of the observation target site from the output of the fluorescence observation imaging means, and an output of a predetermined magnitude based on the output of the detection means. Control means for controlling the variable means so as to obtain a normal observation image processing means for processing an image signal from the normal observation imaging means to obtain a normal observation image; and Fluorescent image processing means for correcting the signal intensity of the observation image obtained by processing the image signal from the fluorescence imaging means by irradiating the image signal, the image by the normal observation processing means and the image by the fluorescence image processing means Output means for selectively outputting the normal observation image and the fluorescence observation image simultaneously or selectively by the switching means.

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Masaya Yoshihara, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Sakae Takebata 2-34-2 Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Inventor Yoshinao Daimei 2-43-2, Hatagaya, Shibuya-ku, Tokyo (72) Inside Olympus Optical Co., Ltd., Adult, Makai 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Industries, Ltd. (72) Inventor Kazunari Nakamura 2-43-2 Hatagaya, Shibuya-ku, Tokyo In-house Olympus Optical Industries Co., Ltd. (72) Nobuhiko Washizuka 2-43, Hatagaya, Shibuya-ku, Tokyo No. 2 Inside Olympus Optical Co., Ltd. (72) Inventor Masahiko Iida 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olimpas The Optical Industry Co., Ltd.

Claims (2)

[Claims] 1. A fluorescence observation apparatus for irradiating an observation target portion of a living tissue with excitation light and observing a fluorescence image by the excitation light, comprising: a light source for generating the excitation light; and a detection device for detecting fluorescence at the observation target portion. Means, and control means for controlling the output of the detection means to be a predetermined amount. 2. A fluorescence observation apparatus for observing a normal observation image of a site to be observed of a living tissue with normal illumination light and a fluorescent image with excitation light, comprising: a normal light source for generating the normal illumination light; A fluorescence observation apparatus comprising: an excitation light source to be generated; and a control unit that detects a fluorescence amount of the fluorescence image and controls a light amount of the excitation light source or a fluorescence image detection unit.