JP2004351230A - Medical treatment system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical treatment system capable of simplifying operation when using an applicator for medical treatment and an observing means such as an MR device at the same time and capable of improving safety of medical treatment. <P>SOLUTION: Distance between positions of MR markers 151 and 152 of the microwave applicator 15 on an image displayed in a first monitor 7 and a preset reference point 157 of the image displayed in the first monitor 7 is measured, and a movement quantity computing unit 155 determines position of the microwave applicator 15, and a control unit 153 controls a microwave generating unit 17 in response to the result of the determination by the movement quantity computing unit 155. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a treatment system in which a treatment applicator inserted into a living body and observation means such as an MRI apparatus are used in combination.

  In general, for example, it is considered that a therapeutic applicator such as a high-frequency treatment tool and an observation device such as an MR device are used in combination as a therapeutic device. For example, when the treatment applicator is inserted into a patient's body, the position of the treatment applicator is accurately detected by observation means such as an MR device, so that the treatment applicator can be correctly positioned at the position of the diseased part in the body cavity. It has been considered to guide the patient and effectively treat the affected area in the body cavity with high frequency.

  However, in the conventional treatment apparatus, the treatment applicator such as the high-frequency treatment tool and the observation means such as the MR apparatus are independently driven independently, so that the treatment applicator and the observation means such as the MR apparatus are independently driven. When using both at the same time, it is necessary to confirm the operating state of each of the therapeutic applicator and the MR device and control them. Therefore, there is a problem that the operation becomes complicated.

  The present invention has been made in view of the above circumstances, and its object is to simplify the operation when using a treatment applicator and observation means such as an MR device at the same time, and to improve the safety of treatment. It is an object of the present invention to provide a treatment system that can enhance the treatment.

  The invention according to claim 1 includes a treatment applicator for applying treatment energy to a living body to treat a living tissue, a marker provided at the predetermined position of the treatment applicator, and a treatment applicator. By outputting a drive signal, a drive signal generating means for generating the treatment energy from the treatment applicator, and a treatment site of the living body to be treated by the treatment energy generated from the treatment applicator. Display means provided so as to be able to display a situation as an image, a position of the marker displayed on the display means on the image, and a reference for the image set on the image displayed on the display means in advance A position determining means for measuring a distance from the position and determining an installation position of the therapeutic applicator; and A treatment system characterized by comprising control means for controlling the driving signal generating means.

  The invention according to claim 2 is a treatment applicator for applying treatment energy to a living body to treat a living tissue, a marker provided at the predetermined position of the treatment applicator, and the treatment applicator. By outputting a drive signal, a drive signal generating means for generating the treatment energy from the treatment applicator, and a treatment site of the living body to be treated by the treatment energy generated from the treatment applicator. Display means provided so that the situation can be displayed as an image, the position of the marker displayed on the display means on the observation image, and the position of the image previously set on the image displayed on the display means Distance measuring means for measuring a distance from a reference position; and a distance for comparing the distance measured by the distance measuring means with a predetermined distance set in advance. A comparison unit, in accordance with the comparison result of the distance comparison unit, a treatment system characterized by comprising a control means for controlling the drive signal generating means.

  Then, the position deviation of the treatment applicator is monitored based on the observation image, and when there is a position deviation, control for stopping the output of the treatment applicator can be performed.

  ADVANTAGE OF THE INVENTION According to this invention, the operation at the time of using a medical applicator and observation means, such as an MR apparatus, simultaneously can be simplified and the safety of a medical treatment can be improved.

  Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of the entire system in a treatment apparatus 1 of the present embodiment. The treatment apparatus 1 according to the present embodiment includes, for example, a microwave treatment apparatus 2 for treatment, which gives treatment energy to a living body to treat a living tissue, and an MR apparatus (observation means) 3 for MR (magnetic resonance) examination. Is provided.

  Here, the MR apparatus 3 is provided with an MR gantry 5 disposed in an MR examination room 4 for a magnetically shielded MR (magnetic resonance) examination. The patient H is placed on the MR gantry 5. Further, the MR gantry 5 is connected to an MR device control unit 6 provided outside the MR examination room 4.

  Further, a first monitor 7 for displaying an MR image is provided in the MR examination room 4. The first monitor 7 is connected to the MR device controller 6. Then, during the MR examination, the MR image of the patient H on the MR gantry 5 is displayed on the screen of the first monitor 7 in the MR examination room 4.

  Further, an indicator lamp 8 is provided on the MR gantry 5, and a holder 10 for an endoscope (or an ultrasonic endoscope) 9 for abdominal cavity inspection, for example, is mounted. Here, a light source device 11 and a video processor 12 disposed outside the MR examination room 4 are connected to the endoscope 9 of the present embodiment.

  Further, a second monitor 13 for displaying an endoscope image is provided in the MR examination room 4. This second monitor 13 is connected to the video processor 12. At the time of endoscopic examination, illumination light from the light source device 11 is applied to the inside of the patient H, for example, a treatment target in the abdominal cavity, via the endoscope 9, and an image observed by the endoscope 9 is converted into a video processor. The image signal is converted into a video signal by 12 and displayed on the screen of the second monitor 13 in the MR examination room 4.

  When the endoscope 9 is used, the insufflation device 14 is driven. The abdominal cavity of the patient H is filled with gas by the insufflation device 14 to cause insufflation.

  Further, the microwave therapy apparatus 2 of the present embodiment is provided with a microwave applicator (treatment applicator) 15 inserted into the abdominal cavity of the patient H. The microwave applicator 15 is connected via a microwave relay cable 16 to a microwave oscillator 17 disposed outside the MR examination room 4. The microwave oscillator 17 is connected to a foot switch 18, a display lamp 19, and a speaker 20 provided in the room of the MR examination room 4.

  Further, a control unit (control means) 21 for controlling the operation of the microwave treatment apparatus 2 is provided outside the MR examination room 4 in the treatment apparatus 1 of the present embodiment. The control unit 21 is connected to the microwave oscillator 17 outside the MR examination room 4, the MR device control section 6, and the foot switch 18, display lamp 19, and speaker 20 inside the MR examination room 4.

  The microwave applicator 15 is provided with a substantially rod-shaped applicator main body 22 as shown in FIG. The applicator body 22 is provided with a substantially cylindrical outer conductor 23. Further, a tip conductor 25 is connected to a tip portion of the outer conductor 23 via an insulator 24. In the microwave applicator 15 of the present embodiment, the center of the MW antenna of the microwave applicator 15 is disposed at the center of the insulator 24 between the tip of the outer conductor 23 and the tip conductor 25. I have.

  Further, an inner conductor 26 is provided at a central portion of the outer conductor 23 in the cylinder. The tip of the internal conductor 26 is inserted into the center hole of the tip conductor 25. Here, a hole 25a is formed in the outer peripheral surface of the tip conductor 25 toward the insertion hole of the internal conductor 26 at the axial center. The hole 25a is filled with solder that also serves as an MR marker 27, and the tip of the internal conductor 26 is connected to the tip of the internal conductor 26 in a state where the solder between the MR marker 27 allows conduction between the internal conductor 26 and the tip conductor 25. It is embedded and fixed in the center hole of the tip conductor 25. The space between the outer conductor 23 and the inner conductor 26 is filled with a dielectric 28.

  Further, a tip 29 is screwed to the tip of the tip conductor 25. A sharp puncture portion 29a sharpened in a substantially conical shape is formed at the tip of the tip 29.

  Further, a transparent coating layer 30 made of a fluororesin is formed on the outer peripheral surface of the applicator body 22. Further, a cylindrical resin cylinder 31 for grip is mounted on the outer peripheral surface on the base end side of the applicator body 22. A resin coating layer 32 is further formed on the outer peripheral surface of the resin cylinder 31.

  Further, a coaxial connector 33 is connected to an end portion on the base end side of the applicator main body 22. As shown in FIG. 2A, one end of the microwave relay cable 16 is detachably connected to the coaxial connector 33.

Further, in the present embodiment, the outer conductor 23, the tip conductor 25, and the inner conductor 26 of the applicator body 22 are made of a material having a magnetic susceptibility of −10 ⁻³ to +10 ⁻³ , for example, Cu, as shown in FIG. It is configured. Here, the material of the solder forming the MR marker 27 is set to have a magnetic susceptibility of −10 ⁻⁵ or less or +10 ⁻⁵ or more. That is, the MR marker 27 made of a material having a magnetic susceptibility having an absolute value greater than or equal to the absolute value of the magnetic susceptibility of the material constituting the applicator main body 22 is provided on the applicator main body 22 of the present embodiment.

  2A, a trocar 34a for the endoscope 9 and a trocar 34b for the microwave applicator 15 are previously placed on the abdominal wall Ha of the patient H during treatment with the treatment apparatus 1 of the present embodiment. Are respectively punctured, the insertion portion of the endoscope 9 is inserted into the abdominal cavity Hb of the patient H through the trocar 34a, and the microwave applicator 15 is inserted into the abdominal cavity Hb of the patient H through the trocar 34b. ing. Here, an air supply tube 35 is connected to the trocar 34a. Further, an ultrasonic probe 36 is applied to the abdominal wall Ha of the patient H from outside.

  Further, the control unit 21 is provided with an operation panel 38 in a unit case 37 as shown in FIG. On the operation panel 38, a treatment start switch 39, a treatment stop switch 40, a HIGH output switch 41, a LOW output switch 42, an MR imaging start switch 43, a HIGH output value display section 44, and a LOW output value display A section 45, HIGH output setting switches 46a and 46b, and LOW output setting switches 47a and 47b are provided, respectively.

  4, a control unit 48, an output switching unit 49 connected to the control unit 48, a HIGH output value setting unit 50 connected to the output switching unit 49, and the like, as shown in FIG. A LOW output value setting unit 51 is provided. Here, the HIGH output value setting section 50 is connected to HIGH output setting switches 46a and 46b, respectively. Further, the LOW output value setting section 51 is connected to LOW output setting switches 47a and 47b, respectively.

  The output switching section 49 is connected to a HIGH output switch 41 and a LOW output switch 42, respectively. Further, a treatment start switch 39, a treatment stop switch 40, an MR imaging start switch 43, a HIGH output value display unit 44, and a LOW output value display unit 45 are connected to the control unit 48, respectively.

  Next, the operation of the above configuration will be described. At the time of treatment by the treatment apparatus 1 of the present embodiment, the patient H is placed on the MR gantry 5 in the MR examination room 4 as shown in FIG. In this state, the trocar 34a for the endoscope 9 and the trocar 34b for the microwave applicator 15 are respectively punctured into the abdominal wall Ha of the patient H in advance as shown in FIG. Subsequently, the insertion portion of the endoscope 9 is inserted into the abdominal cavity Hb of the patient H through the trocar 34a, and the microwave applicator 15 is inserted into the abdominal cavity Hb of the patient H through the trocar 34b. Further, an ultrasonic probe 36 is applied to the abdominal wall Ha of the patient H from the outside as necessary.

  At the time of endoscopic examination, illumination light from the light source device 11 is applied to the inside of the patient H, for example, a treatment target in the abdominal cavity, via the endoscope 9, and an image observed by the endoscope 9 is converted into a video processor. The image signal is converted into a video signal by 12 and displayed on the screen of the second monitor 13 in the MR examination room 4.

  At the time of MR examination, an MR image of the patient H on the MR gantry 5 is displayed on the screen of the first monitor 7 in the MR examination room 4. At this time, the microwave applicator 15 and a treatment state by the microwave applicator 15 are displayed on the screen of the first monitor 7 together with the MR image of the patient H as shown in FIGS. 6 and 7, Hc is the liver of the patient H, 52 is an artifact by the MR marker 27 of the microwave applicator 15, and 53 is a coagulation region at the time of microwave heating by the microwave applicator 15.

  In the present embodiment, when the microwave applicator 15 is used, the output set value is set in advance by the control unit 21. There are two output setting values set here: HIGH and LOW. That is, a HIGH output setting value is set by the HIGH output setting switches 46a and 46b, and a LOW output setting value is set by the LOW output setting switches 47a and 47b. The HIGH and LOW output setting values are switched each time the HIGH output switch 41 and the LOW output switch 42 are pressed. Note that a configuration may be employed in which the output is switched each time an output switch (not shown) is pressed.

  When the treatment start switch 39 of the control unit 21 is pressed down after setting the output set value, the output start signal and the output set value are transmitted from the control unit 21 to the microwave therapy apparatus 2. At this time, a control signal corresponding to the output set value previously set in the control unit 21 is output to the microwave therapy apparatus 2, and the microwave therapy apparatus 2 is driven. Thereby, the microwave output from the microwave applicator 15 is started, and the microwave treatment is started.

  During the microwave treatment, the control unit 21 transmits a control signal to the microwave treatment device 2 to perform output control. At this time, the control unit 21 transmits an imaging start signal to the MR device 3. Therefore, the imaging operation of the inside of the patient H by the MR device 3 is performed at the same time. Then, an output signal from the MR device control unit 6 of the MR device 3 is input to the control unit 48 of the control unit 21, and the position of the microwave applicator 15 is recognized by the MR device 3.

  Further, based on the position data of the microwave applicator 15 observed by the MR device 3, the control unit 21 controls the microwave output which is the treatment energy given to the living body from the microwave applicator 15.

  Next, the control state of the microwave applicator 15 by the control unit 21 at this time will be described with reference to the flowchart of FIG. When the control unit 21 controls the microwave applicator 15, it is first determined whether or not the stop switch 40 is pressed (step S1).

  Here, if it is determined that the stop switch 40 is not in the pressed state, the process proceeds to the next step S2. In this step S2, it is determined whether or not the HIGH output switch 41 and the LOW output switch 42 of the output switching section 49 are in a pressed state. If it is determined in step S2 that the switch 41 or 42 of the output switching unit 49 is not in the pressed state, the process proceeds to the next step S3.

  In this step S3, it is determined whether or not the imaging start switch 43 is pressed. If it is determined in step S3 that the imaging start switch 43 is not in the pressed state, the process proceeds to the next step S4.

  In this step S4, it is determined whether or not the setting switches (the HIGH output setting switches 46a and 46b and the LOW output setting switches 47a and 47b) are pressed. If it is determined in step S4 that the setting switch has been pressed, the process proceeds to the next step S5. After each set value is changed in this step S5, the process returns to step S1. Further, when it is determined in step S4 that the setting switch is not in the pressed state, the process returns to step S1.

  If it is determined in step S2 that one of the switches 41 and 42 of the output switching unit 49 is in the pressed state, the process proceeds to the next step S6. In this step S6, it is determined whether or not the microwave output of the microwave oscillator 17 is HIGH. When the microwave output is determined to be HIGH in step S6, the process proceeds to the next step S7.

  Further, in step S7, the microwave output of the microwave oscillator 17 is switched to the LOW output. Thereafter, in step S8, an imaging start signal is transmitted to the MR device 3. Therefore, when the MR imaging start switch 43 is pressed during the microwave therapy by the microwave applicator 15, the microwave therapy apparatus 2 is set to be LOW when the output state of the microwave oscillator 17 of the microwave therapy apparatus 2 is HIGH. The control is then performed so that an imaging start signal is transmitted to the MR device 3.

  After the imaging start signal is transmitted to the MR device 3 in step S8, the process proceeds to the next step S9. In this step S9, it is determined whether or not an imaging end signal has been received from the MR device 3. If the imaging end signal has not been received from the MR device 3 in step S9, the operation of step S9 is repeated. If it is determined in step S9 that the imaging end signal has been received from the MR device 3, the process returns to step S1. Therefore, after the end of the MR imaging, the output of the microwave oscillator 17 is maintained so as not to be switched to HIGH until the imaging end signal is received from the MR device 3.

  If the microwave output is not determined to be HIGH in step S6, the process proceeds to the next step S10. Further, in step S10, the microwave output of the microwave oscillator 17 is switched to the HIGH output. Then, the process returns to step S1.

  If the stop switch 40 is pressed while the microwave therapy apparatus 2 is being driven, it is determined in step S1 that the stop switch 40 is pressed. In this case, an output stop signal is transmitted from the control unit 21 to the microwave therapy apparatus 2. Thereby, the driving of the microwave oscillator 17 is stopped, and the microwave output from the microwave applicator 15 is stopped, so that the microwave treatment by the microwave applicator 15 is stopped.

  If it is not determined in step S1 that the stop switch 40 is in the pressed state, after the MR imaging is completed, when the HIGH output switch 41 or an output switch (not shown) is pressed, the output of the microwave oscillator 17 is set to HIGH. The microwave therapy device 2 is controlled.

  Further, when the microwave output of the microwave oscillator 17 of the microwave therapy apparatus 2 is switched to LOW by pressing the LOW output switch 42 during the output at HIGH, or when the microwave output of the microwave oscillator 17 is stopped by pressing the treatment stop switch 40. , An imaging start signal is transmitted to the MR device 3, and MR imaging is performed.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, when the microwave therapy apparatus 2 and the MR apparatus 3 are used at the same time, the microwave output which is the therapeutic energy given to the living body from the microwave applicator 15 during the MR imaging by the MR apparatus 3 is output. Since the temperature is automatically lowered, the influence of noise from the microwave therapy apparatus 2 on the MR apparatus 3 can be reduced. Therefore, there is no possibility that the image observed by the MR device 3 becomes difficult to see during use of the microwave therapy device 2. Further, there is an effect that the treatment range by the microwave therapy apparatus 2 is not inadvertently expanded during the MR imaging.

  In addition, since the treatment by the microwave therapy apparatus 2 can be continued during the MR imaging, the temperature of the living tissue can be prevented from lowering during the MR imaging. Therefore, there is an effect that the therapeutic effect is not impaired.

  Further, in the present embodiment, the operation of lowering the microwave output, which is the therapeutic energy given to the living body from the microwave applicator 15 during the MR imaging by the MR device 3, is automatically performed by the control unit 21. The operation when the wave therapy device 2 and the MR device 3 are used at the same time can be simplified.

  Further, since the entire outer surface of the applicator main body 22 of the microwave applicator 15 is covered with the transparent covering layer 30 made of a fluororesin, electrical insulation and biocompatibility can be ensured. Furthermore, it is possible to prevent the adhesion of the living tissue to the outer surface of the applicator body 22 during cauterization.

  In the present embodiment, the distal end portion of the internal conductor 26 of the applicator body 22 and the distal end conductor 25 are connected in a conductive state by the solder of the MR marker 27, so that the microwave applicator as shown in FIG. An artifact 52 due to the MR marker 27 disposed slightly ahead of the center of the 15 MW antenna can be displayed as a mark on the MR image. For this reason, the position of the treatment energy emitting unit disposed at the center of the MW antenna of the microwave applicator 15 can be easily specified, and the operability, safety, and reliability of the treatment are improved. Furthermore, since the MR marker 27 can be installed on the distal end side of the microwave applicator 15 from the center of the antenna, assembly is easy.

  In addition, as an observation means capable of recognizing the position of the microwave applicator 15, an ultrasonic observation apparatus or an X-ray CT may be used instead of the MR apparatus 3 of the present embodiment. Further, as the treatment device, a laser device, an RF treatment device, an HF treatment device, or an ultrasonic treatment device may be used instead of the microwave treatment device 2. Further, at the end of treatment by pressing the stop switch 40, a tissue dissociation current may be caused to flow for a short time to the electrode or the applicator 15 of the energy treatment device. Further, a scale display for visual observation may be provided on the surface of the microwave applicator 15.

  FIG. 9 to FIG. 11 show a second embodiment of the present invention. In the present embodiment, the configuration of the microwave applicator 15 in the treatment apparatus 1 of the first embodiment (see FIGS. 1 to 8) is changed as follows.

  That is, in the microwave applicator 15 of the present embodiment, a first MR marker similar to that of the first embodiment is provided on the tip side of the center of the MW antenna (the center of the insulator 24) in the applicator body 22. 27, and solder, which is the second MR marker 61, is arranged at the rear end side of the center of the MW antenna.

Here, the distance between the front first MR marker 27 and the center of the MW antenna: La, and the distance between the rear second MR marker 61 and the center of the MW antenna: Lb. May be any of La> Lb, La <Lb, and La = Lb. The second MR marker 61 may be formed of a material other than solder having a magnetic susceptibility of −10 ⁻³ or less or +10 ⁻³ or more.

  In the present embodiment, the center point of the treatment energy emission of the microwave applicator 15 is located at the center of the MW antenna between the first MR marker 27 on the front side and the second MR marker 61 on the rear side. Be placed. Therefore, at the time of MR imaging by the MR device 3, as shown in FIG. 10, an imaging cross section is taken such that artifacts 52 and 62 due to soldering of the two markers 27 and 61 of the microwave applicator 15 enter the MR image. I have.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, between the artifact 52 due to the soldering of the first MR marker 27 on the front side and the artifact 62 due to the soldering of the second MR marker 61 on the rear side displayed on the MR image by the MR device 3. The center point of the treatment energy emission of the microwave applicator 15, which is the center of the MW antenna of the microwave applicator 15, is located at the center. For this reason, as shown in FIG. 11, since there are no artifacts 52 and 62 of the markers 27 and 61 of the microwave applicator 15 in the region to be treated (the coagulation region 53 during microwave heating), the coagulation region 53 during microwave heating is used. Is not hidden by the artifacts 52, 62 of the markers 27, 61. As a result, since the coagulation change of the living tissue is easy to see, the progress of the degeneration of the living tissue can be confirmed from the initial stage of the treatment by the microwave applicator 15, and the safety of the treatment can be improved.

  FIG. 12 shows a third embodiment of the present invention. In the present embodiment, the configuration of the microwave applicator 15 in the treatment apparatus 1 of the first embodiment (see FIGS. 1 to 8) is changed as follows.

  That is, in the microwave applicator 15 of the present embodiment, a hole 71 communicating with the inside of the cylinder of the external conductor 23 is provided at the rear end of the tip conductor 25 of the applicator main body 22, and the dielectric 28 is provided in the hole 71. Is inserted.

  Therefore, in the present embodiment having the above-described configuration, the distal end of the dielectric 28 is inserted into the hole 71 at the rear end of the distal conductor 25, so that the distal conductor 25 is supported only by the distal end of the internal conductor 26. This has the effect of increasing the supporting strength of the tip conductor 25 and increasing the strength of the connection between the tip conductor 25 and the insulator 24, which have relatively low strength.

  FIG. 13 shows a fourth embodiment of the present invention. In the present embodiment, the configuration of the microwave applicator 15 in the treatment apparatus 1 of the first embodiment (see FIGS. 1 to 8) is changed as follows.

  That is, the microwave applicator 15 of the present embodiment is provided with the tip conductor portion 81 in which the tip conductor 25 and the tip 29 of the applicator main body 22 of the first embodiment are integrated, and Instead of the covering layer 30 made of the fluororesin, a titanium coat 82 is applied to each of the outer peripheral surfaces of the tip conductor 81 and the outer conductor 23.

  Further, an insulating coating 83 is provided on an outer peripheral surface of a connecting portion between the rear end of the distal conductor 81, the insulator 24, and the front end of the external conductor 23. Further, an insulating cover 84 is provided on the outer peripheral surface of the coaxial connector 33.

  Therefore, in the present embodiment having the above configuration, the titanium coat 82 is provided on each of the outer peripheral surfaces of the tip conductor 81 and the outer conductor 23 instead of the fluororesin coating layer 30 of the first embodiment. The outer diameter of the entire main body 22 can be made smaller than in the first embodiment. Further, there is an advantage that a marker for MR can be formed by the titanium coat 82 on each outer peripheral surface of the tip conductor 81 and the outer conductor 23.

  FIGS. 14 and 15 show a fifth embodiment of the present invention. In this embodiment, a flexible applicator (applicator for luminal organ) 91 for esophageal vein, bile duct, and the like is provided.

  That is, as shown in FIG. 14, the flexible applicator 91 of the present embodiment has an elongated insertion portion 94 which is introduced into the body through the treatment tool insertion channel 93 of the MR compatible endoscope (or MR endoscope) 92. Is provided. As shown in FIG. 15, an MW antenna 96 which is a treatment energy emission unit is provided at the front end of the flexible coaxial cable 95 in the insertion unit 94. Here, an insulating coating 97 is provided on the outer peripheral surface of the flexible coaxial cable 95.

  The MW antenna 96 has a tip conductor 98 conducted to the center conductor of the flexible coaxial cable 95, a rear conductor 99 conducted to the outer conductor of the flexible coaxial cable 95, and a portion between the tip conductor 98 and the rear conductor 99. And a dielectric body 100 disposed in the same.

  Further, a ring-shaped MR marker 101 is provided at the distal end of the flexible coaxial cable 95 at a position behind the MW antenna 96. Note that a fluororesin coating 102 is attached to the outer peripheral surface of the insertion portion 94 of the flexible applicator 91 over the entire length.

  Then, when the flexible applicator 91 of the present embodiment is used, the insertion section 94 of the MR compatible endoscope 92 is inserted in advance into the lumen of the patient, for example, into the esophagus Hd as shown in FIG. , For example, to the position near the varicose vein He. In this state, the insertion portion 94 of the flexible applicator 91 is inserted through the treatment instrument insertion channel 93 of the endoscope 92, and is led out of the distal end opening of the treatment instrument insertion channel 93 into the esophagus Hd. At this time, by confirming the position of the MR marker 101 of the flexible applicator 91, the treatment center of the coagulation / cauterization treatment on the lumen wall by the MW antenna 96 is aligned with the position of the varicose vein He in the esophagus Hd. Can be set.

  After the MW antenna 96 of the flexible applicator 91 is set in accordance with the position of the varicose vein He in the esophagus Hd, the varicose vein He in the esophagus Hd is coagulated and cauterized by the MW antenna 96.

  Therefore, the above configuration has the following effects. That is, in the flexible applicator 91 of the present embodiment, since the ring-shaped MR marker 101 is provided at the distal end of the insertion portion 94 of the flexible applicator 91 behind the MW antenna 96, the flexible applicator 91 is a treatment energy emitting unit. The position of the MW antenna 96 can be easily specified. As a result, it is possible to accurately grasp the treatment center of the coagulation / cauterization treatment on the lumen wall and perform the coagulation / cauterization treatment while confirming the depth of penetration at that position, so that the operability, safety, and reliability of the treatment are ensured. Is improved. As a result, even in the case of performing a treatment for coagulating necrosis on a thin luminal organ, it is possible to prevent the occurrence of a slim hole in the case of tissue necrosis falling off or absorption after surgery.

  FIG. 16 shows a sixth embodiment of the present invention. In the present embodiment, the configuration of the flexible applicator 91 of the fifth embodiment (see FIGS. 14 and 15) is changed as follows.

  That is, in the fifth embodiment, a configuration is shown in which one ring-shaped MR marker 101 is provided at the distal end of the insertion portion 94 of the flexible applicator 91 at a position behind the MW antenna 96. In this embodiment, a second MR marker 103 is provided behind the MR marker 101 of the fifth embodiment. Here, the distance La between the position of the dielectric 100, which is the treatment center of the coagulation / cauterization treatment on the lumen wall by the MW antenna 96, and the front MR marker 101, and the distance La between the front and rear two MR markers 101, 103 Is set to La = Lb.

  When the flexible applicator 91 of the present embodiment is used, the pitch of the distance Lb between the two front and rear MR markers 101 and 103 causes the MW antenna 96 disposed in front of the front MR marker 101 to move toward the lumen wall. The position of the dielectric 100, which is the treatment center of the coagulation / cauterization treatment, can be estimated.

  Therefore, in the present embodiment having the above configuration, the second MR marker 103 is disposed behind the MR marker 101 of the fifth embodiment, and the MW antenna 96 treats the central portion of the coagulation / cauterization treatment on the lumen wall. Since the relationship between the distance La between the position of the dielectric 100 and the front MR marker 101 and the distance Lb between the two MR markers 101 and 103 is set to La = Lb, the solidification of the MW antenna 96 is performed. -The position of the treatment center of the cautery treatment can be made clearer.

  FIG. 17 shows a seventh embodiment of the present invention. In the present embodiment, a monopolar puncture applicator 111 using RF energy of a puncture type for a solid organ used in combination with an extracorporeal electrode is provided. Monopolar puncture applicator 111 of the present embodiment is provided with monopolar needle electrode 112 made of a titanium needle. At the base end of the needle electrode 112, a connector 113 is provided. A connector housing 114 is mounted on an outer peripheral surface of the connector 113.

  Further, a treatment section 115 having an appropriate set length La is provided at the forefront end of the needle electrode 112. Further, two ring-shaped MR markers 116 and 117 are disposed at the distal end of the needle electrode 112 at a position behind the treatment section 115. Here, the relationship between the distance Lb between the distal end position of the treatment section 115 and the front MR marker 116 and the distance Lc between the front and rear MR markers 116 and 117 is set to Lb = Lc. The entire outer peripheral surface of the portion of the needle electrode 112 other than the distal treatment section 115 is covered with a fluororesin coating 118.

  When the monopolar puncture applicator 111 of the present embodiment is used, the distal treatment section of the needle electrode 112 disposed in front of the front MR marker 116 from the pitch of the distance Lc between the front and rear MR markers 116 and 117. 115 can be estimated.

  Therefore, in the present embodiment having the above configuration, the monopolar needle electrode 112 made of a titanium needle is provided, and the treatment section 115 having an appropriate set length La is provided at the forefront end of the needle electrode 112. Can be further reduced in diameter, and the burden on the patient can be reduced.

  18 to 20 show an eighth embodiment of the present invention. In the present embodiment, the configuration of the control unit 21 in the treatment apparatus 1 of the first embodiment (see FIGS. 1 to 8) is changed as follows.

  That is, in the control unit 21 of the present embodiment, as shown in FIG. 18, an operation panel 38 of the control unit 21 of the first embodiment has an auto / manual switch 121 and an output time setting display section 122 of output HIGH. And output time setting switches 123a and 123b, an output time setting display section 124 for output LOW and output time setting switches 125a and 125b, a total output time setting display section 126 for output HIGH and output time setting switches 127a and 127b. Are added respectively. In the present embodiment, a manual control function for performing the same control as that of the first embodiment in accordance with the switching operation of the auto / manual switch 121 and an automatic operation based on a time set value set in the operation panel 38 in advance. It can be selectively switched to an automatic control function for controlling.

  Further, as shown in FIG. 19, a time counting unit 128 is connected to the control unit 48 inside the control unit 21. Further, a HIGH output time setting section 129 and a LOW output time setting section 130 are connected to the time counting section 128, respectively.

  Next, the operation of the above configuration will be described. In the present embodiment, the operation state of the microwave applicator 15 of the microwave therapy apparatus 2 in advance in response to the operation of the operation panel 38 of the control unit 21, that is, each output value of the output HIGH and the output LOW, the output time, and the total output time Is set. Here, the output time of the output HIGH is set according to the operation of the output time setting switches 123a and 123b of the output HIGH, and is displayed on the output time setting display section 122 of the output HIGH. The output time of the output LOW is set in accordance with the operation of the output time setting switches 125a and 125b of the output LOW, and is displayed on the output time setting display section 124 of the output LOW. Further, the output HIGH total output time is set in accordance with the operation of the output time setting switches 127a and 127b for setting the output HIGH total output time, and displayed on the output HIGH total output time setting display section 126.

  Subsequently, by operating the auto / manual changeover switch 121 of the operation panel 38, the mode is selectively switched to either the manual control function or the automatic control function. Here, when the manual operation is selected by the auto / manual changeover switch 121, the time set value set in the operation panel 38 in advance becomes invalid, and the same operation as in the first embodiment is performed.

  When the automatic operation is selected here, the following automatic control is performed according to the flowchart of FIG. 20 based on the time setting value set in the operation panel 38 in advance. First, when the treatment start switch 39 of the control unit 21 is operated to be pressed, the output set value of the output HIGH is transmitted from the control unit 21 to the microwave treatment apparatus 2, and the microwave output from the microwave applicator 15 is transmitted. Be started. At this time, the counting of the HIGH output time is started at the same time (step S21). Subsequently, it is determined whether or not the stop switch 40 has been pressed (step S22).

  Here, if it is determined that the stop switch 40 is not in the pressed state, the process proceeds to the next step S23. In this step S23, it is determined whether or not the HIGH output time has passed the set time. If it is determined in step S23 that the HIGH output time has not elapsed, the process proceeds to the next step S24.

  In this step S24, the total time of the HIGH output is calculated. Then, in the next step S25, it is determined whether or not the HIGH output total time has elapsed the set time. If it is determined in step S25 that the total HIGH output time has not elapsed, the process proceeds to the next step S26. In this step S26, it is determined whether or not the setting switch is pressed. If it is determined in step S26 that the setting switch has been pressed, the process proceeds to the next step S27. In this step S27, after each set value is changed, the process returns to step S22. If it is determined in step S26 that the setting switch is not in the pressed state, the process returns to step S22.

  If it is determined in step S23 that the HIGH output time has elapsed, the process proceeds to the next step S28. In this step S28, the output set value of the output LOW is transmitted from the control unit 21 to the microwave therapy apparatus 2, and the microwave output from the microwave applicator 15 is switched to the LOW output. At this time, the counting of the LOW output time is started at the same time.

  Thereafter, in step S29, an imaging start signal is transmitted to the MR device 3. After the imaging start signal is transmitted to the MR device 3 in step S29, the process proceeds to the next step S30. In this step S30, it is determined whether or not an imaging end signal has been received from the MR device 3. If the imaging end signal has not been received from the MR device 3 in step S30, the operation of step S30 is repeated. Therefore, after the elapse of the output HIGH time set value, the imaging by the MR device 3 is started with the output of the microwave oscillator 17 switched to LOW.

  If it is determined in step S30 that the imaging end signal has been received from the MR device 3, the process proceeds to the next step S31. In this step S31, it is determined whether or not the elapsed time of the LOW output has elapsed. If it is determined in step S31 that the LOW output time has not elapsed, the operation of step S31 is repeated. Further, if it is determined in step S31 that the LOW output time has elapsed, the process returns to step S21. Therefore, when the time of the output LOW time set value has elapsed, the output is switched to the output HIGH again. However, if the MR imaging end signal has not been received, switching is not performed until it is received.

  Then, the switching operation between the microwave output of the output HIGH and the microwave output of the LOW output is repeated. When the total time of the output HIGH reaches the set value, the microwave output is stopped and the MR device 3 performs the operation. The MR imaging is performed, and the treatment ends.

  If the stop switch 40 is pressed during the treatment, it is determined in step S22 that the stop switch 40 is pressed. In this case, an output stop signal is transmitted from the control unit 21 to the microwave therapy apparatus 2. Thereby, the driving of the microwave oscillator 17 is stopped, and the microwave output from the microwave applicator 15 is stopped (step S32). Furthermore, when the microwave output from the microwave applicator 15 is stopped by pressing the treatment stop switch 40, an imaging start signal is transmitted to the MR device 3, and MR imaging is performed.

  Therefore, in the present embodiment, the operation panel 38 of the control unit 21 is provided with an auto / manual changeover switch 121, and when manual operation is selected by the auto / manual changeover switch 121, the time setting previously set on the operation panel 38 is set. The value becomes invalid and the same operation as in the first embodiment is performed. Therefore, when the microwave therapy apparatus 2 and the MR apparatus 3 are used simultaneously, the microwave application during the MR imaging by the MR apparatus 3 is performed. It is possible to automatically lower the microwave output, which is the therapeutic energy given to the living body from the data 15. Therefore, the influence of the noise from the microwave therapy apparatus 2 on the MR apparatus 3 can be reduced, so that the observation image by the MR apparatus 3 does not become difficult to see during use of the microwave therapy apparatus 2.

  Furthermore, in the present embodiment, when the auto operation is selected by the auto / manual changeover switch 121, the output switching of the microwave applicator 15 and the repetition of the MR imaging by the MR device 3 can be performed automatically. The same effect as the embodiment can be obtained.

  In the present embodiment, instead of the MR device 3, an ultrasonic observation device or an X-ray CT may be used. Further, instead of the microwave treatment device 2, a laser device, an RF treatment device, an HF treatment device, or an ultrasonic treatment device may be used.

  Further, when the treatment is terminated by pressing the stop switch 40, a tissue dissociation current may be caused to flow for a short time to the electrode or the applicator 15 of the microwave therapy apparatus 2. In this case, it is possible to prevent bleeding from the living tissue when the electrode or the applicator 15 is pulled out after the treatment.

  FIGS. 21 and 22 show a ninth embodiment of the present invention. In the present embodiment, the configuration of the control unit 21 in the treatment apparatus 1 of the first embodiment (see FIGS. 1 to 8) is changed as follows.

  That is, in the control unit 21 of the present embodiment, the MR image processing unit 141, the treatment device control unit 142, and the criterion output unit 143 are provided inside the control unit 21 of the first embodiment.

  Then, in the present embodiment, when the microwave treatment by the microwave applicator 15 is performed and the MR imaging is repeatedly performed by the MR device 3 at a certain time interval, the processing shown in the flowchart of FIG. 22 is performed.

  (1) MR imaging is repeatedly performed by the MR device 3 at certain time intervals (step S41). Subsequently, in step S42, the previous MR image is compared with the latest MR image, a difference d between the previous MR image and the latest MR image is calculated, and a changed portion of the treatment range is extracted.

  (2) In the next step S43, the image change amount d calculated in step S42 is compared with a predetermined criterion for a lower limit value d1 of an appropriate difference amount to determine whether d> = d1. . Here, when it is determined that d> = d1, the process proceeds to the next step S44. In step S44, the image change amount d calculated in step S42 is compared with a predetermined criterion for the upper limit value d2 of the appropriate difference amount to determine whether d <= d2. If it is determined that d <= d2, the process returns to step S41.

  (3) If the image change amount d is out of the range of the predetermined appropriate difference amount as a result of the determination in the above (2), the output of the microwave applicator 15 is changed as follows. That is, when it is determined in step S43 that d> = d1, the processing speed is low, and the first process in step S45 is performed. In the first process, one or more of the following processes (A) to (D) are performed. (A) increases the output. (B) increases the output time. (C) raises the set temperature. (D) makes the output waveform have a high treatment speed.

  If it is determined in step S44 that d <= d2 is not satisfied, the treatment speed is high, and the second processing in step S46 is performed. In the second process, one or more of the following processes (A) to (D) are performed. (A) lowers the output. (B) shortens the output time. (C) lowers the set temperature. (D) makes the output waveform a low treatment speed.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, since the treatment speed of the microwave therapy by the microwave therapy device 2 can be controlled, the safety and effectiveness of the microwave therapy by the microwave therapy device 2 can be improved.

  Note that, instead of the MR device 3, an ultrasonic observation device or an X-ray CT may be used. Further, instead of the microwave treatment device 2, a laser device, an RF treatment device, an HF treatment device, or an ultrasonic treatment device may be used.

  FIG. 23 and FIG. 24 show a tenth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 1 of the first embodiment (see FIGS. 1 to 8) is changed as follows.

  That is, in the present embodiment, the microwave applicator 15 of the first embodiment is provided with two MR markers 151 and 152 as shown in FIG. Further, inside the control unit 21, as shown in FIG. 24, a control unit 153 connected to the microwave therapy apparatus 2, a marker detection unit 154 connected to the MR apparatus control unit 6 of the MR apparatus 3, and A movement amount calculation unit 155 provided between the control unit 153 and the marker detection unit 154 is provided.

  Further, a reference point setting unit 156 is connected to the movement amount calculation unit 155. The reference point setting unit 156 sets a reference point 157 at an arbitrary position on the MR screen of the first monitor 7 displaying the MR image by the MR device 3. Further, a movement allowable value setting unit 158 is further connected to the control unit 153. In FIG. 23, Hf is a target organ image displayed on the MR screen of the first monitor 7.

  In the present embodiment, the control unit 21 controls the positional relationship between the two MR markers 151 and 152 of the microwave applicator 15 displayed on the MR screen of the first monitor 7 and the reference point 157. The position of the microwave applicator 15 is detected by monitoring by the unit 153, and when the position of the microwave applicator 15 is detected, the output of the microwave oscillator 17 is stopped.

  Next, the operation of the above configuration will be described. When using the treatment apparatus 1 of the present embodiment, first, the microwave applicator 15 is inserted into the image of the organ Hf to be treated in the body of the patient H. Thereafter, MR imaging is performed by the MR device 3 and a reference point 157 is set on the MR screen of the first monitor 7. At this time, the positional relationship between the two MR markers 151 and 152 of the microwave applicator 15 and the reference point 157 is stored as an initial value in a memory (not shown) of the control unit 153.

  Further, after the start of the treatment, each time the MR imaging is performed, the positional relationship between the two MR markers 151 and 152 of the microwave applicator 15 and the reference point 157 is measured. If the displacement of the positional relationship measured at this time exceeds the specified value of the movement allowable value setting unit 158, it is determined that the displacement of the microwave applicator 15 has occurred, and the output of the microwave oscillator 17 is stopped. I do.

  If at least one of the two MR markers 151, 152 of the microwave applicator 15 cannot be recognized on the MR screen of the first monitor 7, it is determined that the MR imaging section has shifted, and the microwave oscillator 17 Stop output of

  Therefore, in the above configuration, the output of the microwave oscillator 17 is stopped by automatically detecting the displacement of the microwave applicator 15 and the displacement of the MR imaging surface. In addition, the safety of energy treatment using the microwave output of the microwave treatment device 2 can be improved.

  Note that, instead of the MR device 3, an ultrasonic observation device or an X-ray CT may be used. Further, instead of the microwave treatment device 2, a laser device, an RF treatment device, an HF treatment device, or an ultrasonic treatment device may be used.

  FIGS. 25 and 26 show an eleventh embodiment of the present invention. In the present embodiment, the configuration of the control unit 21 of the treatment apparatus 1 of the tenth embodiment (see FIGS. 23 and 24) is changed as follows.

  That is, in the present embodiment, as shown in FIG. 26, the signal change amount calculation is performed between the control unit 153 and the marker detection unit 154 in the control unit 21 instead of the movement amount calculation unit 155 of the tenth embodiment. A part 161 is provided.

  Further, an initial signal value output unit 162 is connected to the signal change amount calculation unit 161. Further, the control unit 153 is further connected to a change amount allowable value setting unit 163. In FIG. 25, Hg is a protection area of the target organ image Hf displayed on the MR screen of the first monitor 7.

  In addition, for example, a monitoring marker 164 can be set on the MR screen of the first monitor 7 displaying the MR image by the MR device 3 at a position where it is desired to avoid damage, for example, in accordance with the protection area Hg of the target organ image Hf. It has become. Here, the monitoring marker 164 can be set at an arbitrary position on the MR screen of the first monitor 7 by operating an appropriate input device such as a keyboard key or a mouse.

  Next, the operation of the above configuration will be described. When using the treatment apparatus 1 of the present embodiment, first, the microwave applicator 15 is inserted into the image of the organ Hf to be treated in the body of the patient H. Thereafter, MR imaging is performed by the MR device 3, and a monitoring marker 164 is set on the MR screen of the first monitor 7. In this case, the monitoring marker 164 is set in accordance with a part of the protection region Hg of the target organ image Hf displayed on the MR screen of the first monitor 7 where damage is particularly to be avoided. Then, the image signal luminance of the portion of the monitoring marker 164 at this time is set as an initial value and stored in a memory (not shown) of the control unit 153.

  Further, after the start of the treatment, the image signal luminance of the monitoring marker 164 is measured every time the MR imaging is performed. Here, the allowable value of the change amount of the image signal luminance with respect to the initial value of the image signal luminance is set in advance in the change amount allowable value setting unit 163 of the control unit 153. If the value of the image signal luminance measured at the time of MR imaging has changed beyond the allowable value of the change amount set with respect to the initial value, it is determined that some tissue change has occurred, and the output of the microwave oscillator 17 is determined. To stop.

  Therefore, in the above-described configuration, the monitoring is performed on the MR screen of the first monitor 7 that displays the MR image by the MR device 3 at a position where it is particularly desired to avoid damage in accordance with the protection area Hg of the target organ image Hf. Since the marker 164 can be set, it is possible to automatically confirm the tissue change state of the important part, and it is safe.

  Note that, instead of the MR device 3, an ultrasonic observation device or an X-ray CT may be used. Further, instead of the microwave treatment device 2, a laser device, an RF treatment device, an HF treatment device, or an ultrasonic treatment device may be used.

  27 to 29 show a twelfth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 1 of the tenth embodiment (see FIGS. 23 and 24) is changed as follows.

  That is, in the present embodiment, an applicator moving device 171 that moves the microwave applicator 15 in the axial direction is provided. The applicator moving device 171 is connected to the control unit 153 of the control unit 21 as shown in FIG. Further, a distance calculation unit 172 is provided between the control unit 153 and the marker detection unit 154.

  Further, a treatment target setting unit 173 is connected to the distance calculation unit 172. The treatment target setting section 173 sets a plurality of treatment points 174 for moving the MR marker 151 of the microwave applicator 15 on the MR screen of the first monitor 7 displaying the MR image by the MR device 3. is there. Furthermore, a distance allowable value setting unit 175 is connected to the control unit 153. The distance allowable value setting unit 175 controls the applicator moving device 171 to control the operation of the applicator moving device 171 in which the MR marker 151 moves to the next treatment point 174 and controls the MR marker 151 to the next treatment point 174. This is to set the allowable value of the moving distance of the microwave applicator 15 when moving.

  Next, the operation of the above configuration will be described. When using the treatment apparatus 1 of the present embodiment, first, the microwave applicator 15 is inserted into the image of the organ Hf to be treated in the body of the patient H. Thereafter, MR imaging is performed by the MR device 3. In this state, a plurality of treatment points 174 for moving the MR marker 151 of the microwave applicator 15 are set on the MR screen of the first monitor 7.

  Further, after setting the plurality of treatment points 174, the microwave treatment by the microwave applicator 15 is performed at the first treatment point 174. After the treatment at the first treatment point 174, the microwave output of the microwave applicator 15 is stopped. Thereafter, the applicator moving device 171 is controlled while performing MR imaging by the MR device 3, and the microwave applicator 15 is moved so that the MR marker 151 moves to the next treatment point 174. The moving operation of the microwave applicator 15 at this time is performed according to the flowchart of FIG.

  Here, in the first step S61, the microwave applicator 15 is moved in the direction of the next treatment point 174 by the applicator moving device 171. Subsequently, MR imaging is performed by the MR device 3 and an MR image is obtained on the MR screen of the first monitor 7 (step S62).

  Then, in the next step S63, the distance between the MR marker 151 and the next treatment target (treatment point 174) is calculated by the distance calculation unit 172. Further, in the next step S64, it is determined whether or not the distance calculated in step S63 is within the allowable value set by the distance allowable value setting unit 175. Here, when it is out of the allowable value, the process returns to the first step S61.

  If it is determined in step S64 that the value is within the allowable value, it is confirmed that the MR marker 151 matches the next treatment point 174. In this case, the process proceeds to the next step S65. In this step S65, an output start signal is transmitted to the microwave therapy apparatus 2, and the microwave output from the microwave applicator 15 is started.

  Thereafter, in the next step S66, it is determined whether or not the microwave output of the microwave therapy apparatus 2 has passed a predetermined time set in advance. Here, if it is determined that the predetermined set time has not elapsed, the process returns to step S66.

  When it is determined in step S66 that the predetermined set time has elapsed, an output stop signal is transmitted to the microwave therapy apparatus 2 in the next step S67.

  Thereafter, in the next step S68, it is determined whether or not there is an untreated target (treatment point 174). Here, when it is determined that there is an untreated target (the treatment point 174), the process returns to the first step S61, and the same operation is repeated by the number of the set treatment points 174. If it is determined in step S68 that there is no untreated target (treatment point 174), the moving operation of the microwave applicator 15 is terminated.

  Therefore, in the above configuration, an applicator moving device 171 for moving the microwave applicator 15 in the axial direction is provided, and an MR image of the MR device 3 is displayed on the MR screen of the first monitor 7. A plurality of treatment points 174 for moving the MR marker 151 of the microwave applicator 15 are set, and the applicator is moved so that the MR marker 151 sequentially moves to each treatment point 174 during microwave treatment by the microwave treatment device 2. The operation of the device 171 is controlled. For this reason, in the present embodiment, the microwave applicator 15 is continuously moved while confirming the positions of the plurality of treatment points 174 set in advance on the MR screen of the first monitor 7, and Since the microwave treatment can be automatically performed sequentially at each treatment point 174, the operation when the microwave treatment device 2 and the MR device 3 are used at the same time can be simplified.

  Note that, instead of the MR device 3, an ultrasonic observation device or an X-ray CT may be used. Further, instead of the microwave treatment device 2, a laser device, an RF treatment device, an HF treatment device, or an ultrasonic treatment device may be used.

  FIG. 30 shows a thirteenth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 1 of the tenth embodiment (see FIGS. 23 and 24) is changed as follows.

  That is, in the present embodiment, the reference point marker 181 is set at a position within the MR screen of the first monitor 7 for displaying the MR image by the MR device 3. Then, using the position of the reference point marker 181 as a reference point, the positional relationship between the MR markers 151 and 152 provided on the microwave applicator 15 and the reference point marker 181 is stored.

  Then, when the treatment apparatus 1 of the present embodiment is used, similarly to the tenth embodiment, after the treatment of the microwave treatment apparatus 2 is started, every time the MR apparatus 3 performs MR imaging, the MR applicator 15 uses the MR applicator 15. The positional relationship between the markers 151 and 152 and the reference point marker 181 is measured. If the displacement of the positional relationship exceeds a preset specified value, it is determined that a positional shift has occurred, and the output of the microwave oscillator 17 is stopped.

  If at least one of the two MR markers 151, 152 of the microwave applicator 15 cannot be recognized on the MR screen of the first monitor 7, it is determined that the MR imaging section has shifted, and the microwave oscillator 17 Stop output of

  Therefore, in the present embodiment, the reference point marker 181 is set at a position within the MR screen of the first monitor 7 for displaying the MR image by the MR device 3, so that the tenth embodiment is performed without affecting the displacement of the patient himself. The same effect as in the embodiment is obtained.

  FIGS. 31 to 33 show a fourteenth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 1 of the first embodiment (see FIGS. 1 to 8) is changed as follows.

  That is, in the present embodiment, a magnetron is used as a microwave generator for generating high-frequency therapeutic energy in a microwave oscillator 17 provided outside the MR examination room 4 which is a magnetically shielded room for MRI.

  Further, a microwave relay cable 16 which is a transmission coaxial cable connecting the magnetron in the microwave oscillator 17 and the microwave applicator 15 disposed inside the MR examination room 4, for example, a magnetron. A coaxial filter 191 is provided between the output unit and the input end of the MR examination room 4 in the MRI shield room.

  As shown in FIG. 32, this coaxial filter 191 has the characteristics of a high-pass filter (HPF) having a switching value fc between transmission and cutoff between the treatment microwave frequency f1 and the MR center frequency f2. . Here, f1> fc> f2. FIG. 33 shows an example of a tomographic image obtained by the MR device 3.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, the coaxial filter 191 is provided in the middle of the microwave relay cable 16 for connecting the magnetron in the microwave oscillator 17 and the microwave applicator 15 disposed inside the MR examination room 4. The noise can be cut before the microwave supplied from the magnetron in the microwave oscillator 17 enters the MRI observation space in the MR examination room 4. Therefore, the treatment microwave can be performed at the same time by cutting the noise that affects MRI tomographic imaging without any change in the treatment microwave. Thus, supply of high-frequency energy for treatment and acquisition of a tomographic image by the MR device 3 can be performed simultaneously. Further, the present embodiment has an effect that a filter having a simple configuration such as a waveguide can be used.

  FIG. 34A shows a fifteenth embodiment of the present invention. This embodiment is different from the fourteenth embodiment (see FIGS. 31 to 33) only in the filter characteristics of the coaxial filter 191 in the treatment apparatus 1. That is, in the fourteenth embodiment, the coaxial filter 191 having the filter characteristics of the high-pass filter (HPF) is used, but in the present embodiment, only the microwave frequency f1 is transmitted as shown in FIG. This uses a band pass filter (BPF). In this bandpass filter, if the upper limit of the cut frequency is fcH and the lower limit is fcL, f1> fcH> f2> fcL.

  Therefore, in the present embodiment, a band-pass filter is used as the coaxial filter 191, so that the same filter can be used regardless of the imaging frequency of the MR device 3. Furthermore, when a band-pass filter is used, only the vicinity of the original frequency f1 of the energy treatment is transmitted, so that the same filter can be used without much dependence on the center frequency f2 for MR.

  FIG. 34B shows a sixteenth embodiment of the present invention. This embodiment is different from the fourteenth embodiment (see FIGS. 31 to 33) only in the filter characteristics of the coaxial filter 191 in the treatment apparatus 1. That is, in the present embodiment, as shown in FIG. 34B, a band cut filter (BCF) that blocks only the imaging frequency f2 of the MR device 3 is used. In this band cut filter, if the upper limit of the cut frequency is fcH and the lower limit is fcL, f1> fcH> f2> fcL.

  Therefore, in the present embodiment, a band-cut filter that cuts only the minimum necessary frequency band is used as the coaxial filter 191. Therefore, heat generated in the filter 191 is small, and the size of the filter 191 can be reduced. . In addition, the same filter can be used regardless of the frequency of the microwave. The filter 191 may be a waveguide in which the cutoff frequency fc is adjusted as described above by simply adjusting the dimensions.

  FIGS. 35 and 36 show a seventeenth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 1 of the fourteenth embodiment (see FIGS. 31 to 33) is changed as follows.

  That is, in the present embodiment, a two-wire output high-frequency generator, for example, an electric scalpel that generates high-frequency therapeutic energy in a high-frequency power supply 204 disposed outside the MR examination room 4 that is a magnetically shielded room for MRI is used. It is used.

  Further, one end of each of two transmission cables 201 and 202 is connected to a two-wire output high frequency generator in the high frequency power supply 204. Here, one transmission cable 201 is formed by an active electrode type transmission cable, and the other transmission cable 202 is formed by a return electrode type transmission cable.

  Further, two transmission cables 201 and 202 for connecting between a two-wire output high-frequency generator in the high-frequency power supply 204 and an active electrode and a return electrode (not shown) disposed inside the MR examination room 4. A two-line filter 203 is provided on the way. As shown in FIG. 36, the filter 203 has the characteristics of a low-pass filter (LPF) having a switching value fc between transmission and cut-off between the high frequency frequency f1 for treatment and the frequency f2 for MRI.

  Therefore, in the above configuration, two transmission cables 201 for connecting between a two-wire output high-frequency generator in the high-frequency power supply 204 and an active electrode and a return electrode (not shown) in the MR examination room 4. , 202, a two-line filter 203 having the characteristics of a low-pass filter (LPF) is provided, so that the noise affecting MRI tomographic imaging is not changed without any change in the therapeutic high frequency close to the sine wave waveform. be able to. Therefore, treatment and imaging can be performed simultaneously.

FIG. 37A shows an eighteenth embodiment of the present invention. This embodiment differs from the seventeenth embodiment (see FIGS. 35 and 36) only in the filter characteristics of the two-line filter 203 in the treatment apparatus 1. That is, in the seventeenth embodiment, a two-wire output high-frequency generator in the high-frequency power supply 204 and two transmission cables 201, which connect between an active electrode and a return electrode (not shown) in the MR examination room 4. While a two-wire filter 203 having the characteristics of a low-pass filter (LPF) is provided in the middle of 202, in the present embodiment, a two-wire filter 203 having the characteristics of a band-pass filter that transmits only the therapeutic high-frequency frequency is provided. It was established.
Thus, the same two-line filter 203 can be used regardless of the imaging frequency of the MR device 3.

FIG. 37 (B) shows a nineteenth embodiment of the present invention. This embodiment differs from the seventeenth embodiment (see FIGS. 35 and 36) only in the filter characteristics of the two-line filter 203 in the treatment apparatus 1. That is, in the present embodiment, a two-wire output high-frequency generator in the high-frequency power supply 204 and two transmission cables 201 and 202 connecting the active electrode and the return electrode (not shown) in the MR examination room 4 are connected. A two-line filter 203 having the characteristic of a band cut filter that cuts off only the imaging frequency of the MRI apparatus is provided on the way.
As a result, the same filter can be used regardless of the therapeutic high frequency. Also, in the case of a high-frequency treatment waveform having a harmonic frequency component such as a pulse waveform, noise can be cut without affecting the waveform as much as possible.

  FIG. 38 shows a twentieth embodiment of the present invention. In the present embodiment, a microwave applicator 15 is used as a treatment applicator that applies treatment energy to a living body to treat a living tissue, and a diagnostic supersonic device is used as observation means that can recognize the position of the microwave applicator 15. An acoustic probe 212 is used. Here, the microwave applicator 15 is connected to a microwave generator 214 via a relay coaxial cable 213 for transmission. Further, the diagnostic ultrasonic probe 212 is connected to the ultrasonic imaging device 215.

  In addition, a coaxial filter 216 is provided in the middle of a transmission path for transmitting microwaves, which are therapeutic energies generated from the microwave generator 214, to the microwave applicator 15 via the transmission coaxial cable 213. . The filter 216 has the characteristics of a high-pass filter (see FIG. 32) having a switching value between transmission and cutoff between the center frequency of the treatment microwave and the frequency for the ultrasonic imaging device 215.

  Therefore, in the above configuration, a coaxial filter 216 having the characteristics of a high-pass filter is provided in the middle of the transmission coaxial cable 213 between the microwave generator 214 and the microwave applicator 15, so that the Noise affecting the imaging of the acoustic image can be cut before the microwave applicator 15 and the diagnostic ultrasonic probe 212 approach each other without changing the treatment microwave. Therefore, even when the microwave treatment by the microwave applicator 15 and the imaging by the diagnostic ultrasonic probe 212 are performed at the same time, a beautiful ultrasonic image can be obtained.

  Note that the filter characteristics of the coaxial filter 216 may be the filter characteristics of the high-pass filter of FIG. 34A or the filter characteristics of the band cut filter of FIG.

  FIG. 39 shows a twenty-first embodiment of the present invention. In the present embodiment, the resectoscope 221 is used as a treatment applicator for applying treatment energy to a living body to treat a living tissue, and the twentieth embodiment is used as an observation means capable of recognizing the position of the resectoscope 221. A diagnostic ultrasonic probe 212 similar to that of the embodiment (see FIG. 38) is used.

  Here, a loop electrode 223, which is an electrode part for high-frequency treatment, is provided on the distal end of the elongated insertion part 222 inserted into the body cavity of the patient in the resectoscope 221. Furthermore, a high-frequency output is supplied to the loop electrode 223 of the resectoscope 221 from a two-wire output high-frequency generator 224.

  An active electrode type transmission cable 225 and a return electrode type transmission cable 226 are connected to the high frequency generator 224. The loop electrode 223 of the resectoscope 221 is connected to the active electrode type transmission cable 225 of the high frequency generator 224. A return electrode (not shown) is connected to the return electrode type transmission cable 226 of the high frequency generator 224.

  A two-wire filter 227 is provided in the middle of the two transmission cables 225 and 226 for transmitting the therapeutic energy generated from the two-wire output high frequency generator 224. The filter 227 has the characteristics of a low-pass filter having a switching value between transmission and cutoff between a treatment high-frequency frequency and an ultrasonic imaging frequency.

  FIG. 39 shows an example in which the ultrasonic probe 212 is inserted into the rectum Hh of the patient, and the insertion section 222 and the loop electrode 223 of the resectoscope 221 are inserted into the urethra Hi.

  Therefore, in the above configuration, a two-wire filter 227 having a low-pass filter characteristic is interposed between two transmission cables 225 and 226 for transmitting the therapeutic energy generated from the high-frequency generator 224. Therefore, before the loop electrode 223 of the resectoscope 221 and the diagnostic ultrasonic probe 212 approach each other, it is possible to cut the noise affecting the ultrasonic image imaging without change in the therapeutic high frequency close to the sine wave waveform. . Therefore, a beautiful ultrasonic image can be obtained even when the treatment and the imaging are performed at the same time.

  The present invention is not limited to the combination of the present embodiment, but can be applied to all combinations of treatment with high-frequency energy and imaging of an ultrasonic image for observing the treatment site.

  FIG. 40 shows a twenty-second embodiment of the present invention. In this embodiment, a puncturing bipolar electrode 231 is provided in place of the resectoscope 221 of the twenty-first embodiment (see FIG. 39), and the puncturing bipolar electrode 231 is combined with a lapper ultrasonic probe 212. It is. In this embodiment, the same effects as those of the twenty-first embodiment can be obtained.

  FIG. 41 shows a twenty-third embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 1 of the fourteenth embodiment (see FIGS. 31 to 33) is changed as follows.

  That is, in this embodiment, a terminal board 242 is provided on the side wall 241 of the MR examination room 4 which is a magnetically shielded room for MRI, and a coaxial noise filter 243 is provided on the terminal board 242. The coaxial noise filter 243 is a transmission coaxial cable for connecting a microwave applicator 15 disposed inside the MR examination room 4 to a microwave generator such as a magnetron in the microwave oscillator 17. It is interposed in the middle of the wave relay cable 16. Furthermore, in the present embodiment, since the noise filter 243 is specialized for the imaging frequency of the MR device 3, a band cut filter or a high-pass filter is used.

  Therefore, in the above configuration, by attaching the microwave relay cable 16 which is a microwave transmission coaxial cable to the noise filter 243, it is possible to perform imaging simultaneously with treatment regardless of the frequency of the microwave generator. Become.

  FIG. 42 shows a twenty-fourth embodiment of the present invention. In this embodiment, as in the twenty-first embodiment (see FIG. 39), a resectoscope 221 having a loop electrode 223 which is an electrode part for high-frequency treatment is used as a treatment applicator. The diagnostic ultrasonic probe 212 is used as observation means capable of recognizing the position of the diagnostic ultrasonic probe.

  In the present embodiment, a terminal board 242 is provided on the side wall 241 of the MR examination room 4, which is a magnetically shielded room for MRI, as in the twenty-third embodiment (see FIG. 41). 39) A two-wire noise filter 251 interposed between two transmission cables 225 and 226 for transmitting therapeutic energy generated from the high-frequency generator 224 as shown in FIG. It is. Since the two-line noise filter 251 is specialized for the imaging frequency of the MRI apparatus, a band cut filter or a low-pass filter is used.

  Therefore, in the present embodiment, by attaching the two high-frequency transmission cables 225 and 226 to the noise filter 251, it is possible to perform imaging simultaneously with treatment regardless of the frequency of the high-frequency generator 224.

  FIGS. 43 to 47 show a twenty-fifth embodiment of the present invention. FIG. 43 shows a schematic configuration of the entire system of the treatment apparatus 261 of the present embodiment. The treatment apparatus 261 according to the present embodiment includes an MRI imaging apparatus 262 and a treatment apparatus main body 263 for performing treatment.

  Further, the MRI imaging apparatus 262 is provided with an MRI gantry 264 and an MRI controller 265. Here, the MRI gantry 264 and the MRI controller 265 are connected via an MRI signal cable 266.

  The treatment device main body 263 is provided with a treatment energy generating means 268 and a treatment probe 270 (shown in FIG. 44) connected to the treatment energy generating means 268 via a treatment probe transmission cable 269. I have.

  Further, the MRI controller 265 and the therapeutic energy generating means 268 are connected via the recognition unit 271. Here, the recognition unit 271 and the MRI controller 265 are connected via a recognition unit-MRI controller signal cable 272, and the recognition unit 271 and the treatment energy generation means 268 are connected between the recognition unit 271 and the treatment energy generation means 268. They are connected via a signal cable 273 between means. In the present embodiment, a system in which treatment is performed by the treatment apparatus main body 263 while observing in real time by the MRI imaging apparatus 262 is provided.

  As shown in FIG. 46, the MRI controller 265 is provided with an MRI control unit 274 and an image signal output unit 275. Here, an MRI gantry 264 is connected to an input side of the MRI control unit 274 via an MRI signal cable 266. Further, an image signal output unit 275 is connected to the output side of the MRI control unit 274.

  The treatment energy generating means 268 includes a treatment energy control unit 276, a treatment energy generation unit 277, and a treatment energy generation means signal input / output unit 278. Here, a treatment probe 270 is connected to the treatment energy generation unit 277 via a treatment probe transmission cable 269.

  The recognition unit 271 includes a recognition unit control unit 279, a recognition unit signal input / output unit 280, an image signal input unit 281, a display unit 282, an evaluation point setting unit 283, and an evaluation level setting unit 284. An indicator lamp and a treatment end notification means 285 such as a buzzer are provided.

  Here, the recognition unit control unit 279 has a recognition unit signal input / output unit 280, an image signal input unit 281, a display unit 282, an evaluation point setting unit 283, an evaluation level setting unit 284, and a treatment end notification unit 285. And are connected respectively. Furthermore, an image signal output unit 275 of the MRI controller 265 is connected to the image signal input unit 281 via a signal cable 272 between the recognition unit and the MRI controller. Further, the recognition unit signal input / output unit 280 is connected to the treatment energy generation unit signal input / output unit 278 of the treatment energy generation unit 268 via the recognition unit-treatment energy generation unit signal cable 273. The display 282 is provided with a monitor 267 for displaying an MR image.

  Further, as shown in FIG. 44, the evaluation point setting means 283 sets a plurality of evaluation points a to d around the treatment site Hj in the MRI image by the MRI imaging apparatus 262 and its periphery, and in this embodiment, four evaluation points a to d using a keyboard, a mouse, and a track. The setting is made by a ball, a touch pen, or the like. For example, the data of the respective luminances at the four evaluation points a to d are graphically displayed on the display unit 282 of the recognition unit 271 as shown in FIG. 45, for example.

  Further, the evaluation level setting means 284 sets an evaluation level at the four evaluation points a to d of the MRI image by the MRI imaging device 262, for example, a luminance setting level Ls using a keyboard, a mouse, a trackball, a touch pen, or the like. I have. When the luminance data at the four evaluation points a to d all exceed the luminance setting level Ls set by the evaluation level setting means 284, the treatment energy is turned off.

  Next, the operation of the above configuration will be described. When using the treatment apparatus 261 of the present embodiment, an operation is performed according to the following flowchart of FIG. That is, before the treatment by the treatment probe 270 is started, the MRI imaging apparatus 262 first captures an MRI image in the first step S71. Subsequently, an image signal is transferred from the MRI controller 265 to the recognition unit 271 (step S72), and an MRI image by the MRI imaging device 262 is displayed on the display unit 282 of the recognition unit 271 (step S73).

  Then, as shown in FIG. 44, a plurality of evaluation points a to d in the present embodiment and a plurality of evaluation points a to d around the treatment site Hj in the MRI image by the MRI imaging apparatus 262 are displayed by the evaluation point setting means 283 in the recognition unit 271. The setting is made by a keyboard, a mouse, a trackball, a touch pen or the like (step S74). Further, in the next step S75, the evaluation level of the luminance value for recognizing the end of the treatment at the four evaluation points a to d of the MRI image by the MRI imaging device 262, for example, the luminance setting level Ls is determined by the evaluation level setting means 284 using the keyboard. , A mouse, a trackball, a touch pen, and the like. These settings are made while viewing the display contents of the display unit 282 of the recognition unit 271.

  Thereafter, the treatment is started (step S76). At this time, a treatment start signal is transmitted from the treatment energy generation means 268 to the recognition unit 271 (step S77).

  Further, at the start of the treatment, an MRI image is first captured by the MRI imaging device 262 (step S78). Subsequently, the image signal is transferred from the MRI controller 265 to the recognition unit 271 (Step S79).

  Thereafter, in step S80, the luminance levels at the four evaluation points a to d are monitored, and in the next step S81, it is determined whether or not the luminance of all the evaluation points a to d exceeds the evaluation level Ls. If it is determined that all the evaluation points a to d do not exceed the evaluation level Ls, the process returns to step S78. Then, when it is determined that the luminance of all the evaluation points a to d exceeds the evaluation level Ls, the treatment is ended (step S82). Further, at the end of this treatment, in the next step 83, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271.

  Note that the luminance of the evaluation points a to d may change from white to black, or change from black to white as the treatment progresses, depending on the setting of various parameters. Both cases exist when the luminance of the evaluation points a to d exceeds the evaluation level Ls.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, as shown in FIG. 44, the evaluation point setting means 283 sets four evaluation points a to d around the treatment site Hj in the MRI image by the MRI imaging apparatus 262 and the periphery thereof, using a keyboard, a mouse, a trackball, The evaluation level is set by a touch pen or the like, and the evaluation level setting unit 284 sets the evaluation level at the four evaluation points a to d of the MRI image by the MRI imaging device 262, for example, the luminance setting level Ls, and sets the evaluation level at the four evaluation points a to d. The treatment energy is turned off when all the luminance data exceed the luminance set level Ls set by the evaluation level setting means 284, so that the treatment can be automatically terminated and the treatment of the living body can be performed. The effect is minimized. Furthermore, since the four evaluation points a to d are set on the treatment site Hj and its surroundings in the MRI image, it is possible to treat all affected parts without doubt.

  In the present embodiment, the MRI tomographic image acquisition by the MRI imaging device 262 and the treatment energy release by the treatment probe 270 may be a simultaneous treatment method or a treatment method in which these are alternately performed.

  FIG. 48 shows a twenty-sixth embodiment of the present invention. In the present embodiment, the operation of the treatment apparatus 261 of the twenty-fifth embodiment (see FIGS. 43 to 47) after the treatment is completed is changed as follows.

  That is, in the present embodiment, when the treatment apparatus 261 is used, the control from step S71 to step S83 in the flowchart of FIG. 47 of the twenty-fifth embodiment is performed in the same procedure as in the twenty-fifth embodiment. Then, after the notification of the end of the treatment in step S83, as shown in the flowchart of FIG. 48, the transmission is performed from the recognition unit 271 to the treatment energy generation means 268 in the next step S84, and the treatment end treatment is performed by the treatment energy generation means 268. (Step S85). Here, the treatment end treatment by the treatment energy generating means 268 automatically turns off the treatment energy output from the treatment probe 270 or lowers the output value of the treatment energy.

  Therefore, in the above configuration, after the treatment of the treatment device 261 is completed, the treatment energy from the treatment probe 270 is automatically turned off by the treatment energy generating means 268, or the output value of the treatment energy is decreased. , The treatment can be automatically terminated, and the effect of the treatment on the living body can be minimized.

  FIGS. 49 and 50 show a twenty-seventh embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 261 of the twenty-fifth embodiment (see FIGS. 43 to 47) is changed as follows.

  That is, in this embodiment, the evaluation unit 291 is newly provided in the recognition unit 271 of the twenty-fifth embodiment. When the treatment device 261 is used, the treatment device 261 is controlled according to the flowchart of FIG.

  Here, in the present embodiment, the control from step S71 to step S75 in the flowchart of FIG. 47 of the twenty-fifth embodiment is performed in the same procedure as in the twenty-fifth embodiment. Then, after the set level Ls of the luminance value for recognizing the end of the treatment at the four evaluation points a to d of the MRI image is set in step S75, the process proceeds to the next new step S91.

  In this step S91, the evaluation ratio at the four evaluation points a to d is set by the evaluation ratio setting means 291 using a keyboard, a mouse, a trackball, a touch pen, or the like.

  Thereafter, the treatment is started in the same manner as in the twenty-fifth embodiment (step S76). Then, at the start of this treatment, control is performed from step S76 to step S80 in the same procedure as in the twenty-fifth embodiment. After the luminance levels at the four evaluation points a to d are monitored in step S80, the process proceeds to the next new step S92.

  In this step S92, it is determined whether or not the evaluation points equal to or higher than the set ratio among the four evaluation points a to d have exceeded the evaluation level. Here, when it is determined that the evaluation points equal to or higher than the set ratio do not exceed the evaluation level, the process returns to step S78. Then, if it is determined in step S92 that the evaluation points equal to or higher than the set ratio have exceeded the evaluation level, the treatment is terminated (step S82). Further, at the end of this treatment, in the next step 83, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, the evaluation point is set outside the treatment site, and it is possible to determine that the treatment is completed even when the general treatment is completed. Therefore, the treatment is continued until all the evaluation points a to d exceed the evaluation level. Overtreatment can be prevented.

  In this embodiment, as in the twenty-sixth embodiment (see FIG. 48), a treatment end signal is transmitted to the treatment energy generating means 268 to automatically turn off or lower the treatment energy. Good. Further, the configuration may be such that the evaluation ratio is fixedly set without providing the evaluation ratio setting means 291.

  FIG. 51 shows a twenty-eighth embodiment of the present invention. In the present embodiment, the operation of the treatment apparatus 261 of the twenty-fifth embodiment (see FIGS. 43 to 47) before treatment by the treatment probe 270 is changed as follows.

  That is, in the present embodiment, when the treatment apparatus 261 is used, control is performed in the same procedure as in the twenty-fifth embodiment from step S71 to step S73 in the flowchart in FIG. 47 of the twenty-fifth embodiment. Then, after the MRI image is displayed on the display unit 282 of the recognition unit 271 in step S73, the process proceeds to the next new step S101.

  In step S101, the treatment site Hj, which is the diseased site, is recognized by automatic diagnosis from the tomographic image of the MRI image on the display unit 282, and evaluation points a to d are set around the treatment site Hj. Further, after the automatic setting of the evaluation points a to d, in the next step S102, the evaluation points are added by the evaluation point setting means 283, and the positions of the automatically set evaluation points a to d are corrected.

  Thereafter, the process proceeds to step S75 similar to that of the twenty-fifth embodiment, and the control from step S75 to step S83 is performed in the same procedure as that of the twenty-fifth embodiment.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, the treatment site Hj, which is the diseased site, is recognized by the automatic diagnosis from the tomographic image of the MRI image on the display unit 282, and the evaluation points a to d are set around the treatment site Hj. The operation when using the treatment probe 270 and the MRI imaging apparatus 262 at the same time can be simplified.

  FIG. 52 shows a twenty-ninth embodiment of the present invention. In the present embodiment, the action of the treatment device 261 of the twenty-seventh embodiment (see FIGS. 49 and 50) after treatment by the treatment probe 270 is changed as follows.

  That is, in the present embodiment, when the treatment apparatus 261 is used, the control from step S71 to step S92 in the flowchart of FIG. 50 of the twenty-seventh embodiment is performed in the same procedure as in the twenty-seventh embodiment. If it is determined in step S92 that the evaluation points equal to or higher than the set ratio have exceeded the evaluation level, the process first proceeds to the next new step S111.

  In this step S111, the end of treatment is notified by the treatment end notification means 285 of the recognition unit 271. Thereafter, the process proceeds to step S81 in the flowchart in FIG. 47 of the twenty-fifth embodiment (see FIGS. 43 to 47). In this step S81, it is determined whether or not the luminance of all the evaluation points a to d has exceeded the evaluation level Ls. If it is determined that all the evaluation points a to d do not exceed the evaluation level Ls, the process returns to step S78. Then, when it is determined that the luminance of all the evaluation points a to d exceeds the evaluation level Ls, the treatment is ended (step S82). Further, at the end of this treatment, the recognition unit 271 transmits to the treatment energy generation means 268 in the next step 112, and the treatment energy generation means 268 performs treatment termination treatment (step S113). Here, the treatment end treatment by the treatment energy generating means 268 automatically turns off the treatment energy output from the treatment probe 270 or lowers the output value of the treatment energy.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, at the time of processing of the treatment end by the treatment probe 270, the end of the treatment is notified at the first stage when the evaluation level of the evaluation point for the evaluation ratio exceeds the evaluation level. When the point evaluation level is exceeded, a two-step process of turning off or lowering the therapeutic energy is performed, so that the safety at the time of automatic termination can be improved.

  FIGS. 53 to 55 show a thirtieth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 261 of the twenty-fifth embodiment (see FIGS. 43 to 47) is changed as follows.

  That is, in this embodiment, as shown in FIG. 54, a reference point setting means 301 is newly provided in the recognition unit 271 of the twenty-fifth embodiment. Then, as shown in FIG. 53, the reference point R can be set by the reference point setting means 301 separately from the four evaluation points a to d of the MRI image by the MRI imaging apparatus 262. Further, an evaluation ratio setting means 302 is provided so that the luminance setting level Ls, which is the evaluation level, is not set as an absolute value but is set as a ratio of the luminance to the reference point R.

  It should be noted that the reference point R is planned to be set at a place where it is considered that there is no influence of the treatment energy from the treatment probe 270 within the same organ Hk as the treatment part Hj in the MRI image by the MRI imaging apparatus 262. You get the same functionality. When the treatment device 261 is used, the control of the treatment device 261 is performed according to the flowchart of FIG.

  Here, in the present embodiment, the control from step S71 to step S74 in the flowchart of FIG. 47 of the twenty-fifth embodiment is performed in the same procedure as in the twenty-fifth embodiment. Then, after a plurality of, in this embodiment, four evaluation points a to d are set at and around the treatment site Hj in the MRI image in step S74, the process proceeds to the next new step S121. In this step S121, the reference point setting means 301 sets a reference point marker R separately from the four evaluation points a to d using a keyboard, a mouse, a trackball, a touch pen, or the like.

  Further, in the next step S122, the evaluation ratio setting means 302 sets the luminance setting level Ls, which is the evaluation level, as a luminance ratio with respect to the reference point R by using a keyboard, a mouse, a trackball, a touch pen, or the like.

  Thereafter, the treatment is started in the same manner as in the twenty-fifth embodiment (step S76). At the start of this treatment, control is performed from step S76 to step S80 in the same procedure as in the twenty-fifth embodiment. After the luminance levels at the four evaluation points a to d are monitored in step S80, the process proceeds to the next new step S123.

  In this step S123, it is determined whether or not all of the four evaluation points a to d exceed the evaluation ratio based on the reference point R. If it is determined that all of the four evaluation points a to d do not exceed the evaluation ratio based on the reference point R, the process returns to step S78. If it is determined in step S123 that all of the four evaluation points a to d exceed the evaluation ratio based on the reference point R, the treatment is terminated (step S82). Further, at the end of this treatment, in the next step 83, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271.

  Thus, in the present embodiment having the above configuration, the reference point R is set by the reference point setting means 301 separately from the treatment site Hj and the four evaluation points a to d set around the treatment site Hj in the MRI image by the MRI imaging apparatus 262. Since the evaluation level is set as the ratio of the luminance to the reference point R by the evaluation ratio setting means 302, it is possible to absorb the influence of the luminance due to the individual difference and the parameter setting of the MRI image capturing at the reference point R. it can. Therefore, the treatment end recognition operation can be performed more stably.

  FIGS. 56 and 57 show a thirty-first embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 261 of the thirtieth embodiment (see FIGS. 53 to 55) is changed as follows.

  That is, in this embodiment, as shown in FIG. 56, the brightness of each of the evaluation points a to d is newly added in the recognition unit 271 instead of the reference point set by the reference point setting means 301 of the thirtieth embodiment. Initial values are used. Then, a storage means 311 for storing an initial value of the luminance of each of the evaluation points a to d is provided.

  When the treatment device 261 is used, the control of the treatment device 261 is performed according to the flowchart of FIG. Here, in the present embodiment, from step S71 to step S75 in the flowchart of FIG. 47 of the twenty-fifth embodiment (see FIGS. 43 to 47), control is performed in the same procedure as in the twenty-fifth embodiment. . Then, in step S75, after the luminance setting level Ls for recognizing the end of treatment at the four evaluation points a to d of the MRI image by the MRI imaging apparatus 262 is set by the evaluation level setting means 284, the next new step Proceed to S131. In this step S131, the initial values of the luminance of the four evaluation points a to d of the MRI image are stored by the storage unit 311.

  Thereafter, the treatment is started in the same manner as in the thirtieth embodiment (step S76). Then, at the start of this treatment, control is performed from step S76 to step S80 in the same procedure as in the thirtieth embodiment. After the luminance levels at the four evaluation points a to d are monitored in step S80, the process proceeds to the next new step S132.

  In this step S132, it is determined whether or not all of the four evaluation points a to d exceed the evaluation ratio based on the initial value. Here, when it is determined that all of the four evaluation points a to d do not exceed the evaluation ratio based on the initial value, the process returns to step S78. If it is determined in step S132 that all of the four evaluation points a to d exceed the evaluation ratio based on the initial value, the treatment is terminated (step S82). Further, at the end of this treatment, in the next step 83, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271.

  Therefore, in the present embodiment having the above configuration, a storage unit 311 for newly storing the initial value of the luminance of each of the evaluation points a to d is provided in place of the reference point setting unit 301 of the thirtieth embodiment. Is set so that the treatment is terminated when it is determined that all of the four evaluation points a to d set in the MRI image and around the treatment site Hj exceed the evaluation ratio based on the initial value. Therefore, the same effects as those of the thirtieth embodiment can be obtained, and the present embodiment can be further applied to the treatment of a small organ in which it is difficult to set the reference point R of the thirtieth embodiment.

  FIGS. 58 and 59 show a thirty-second embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 261 of the thirty-first embodiment (see FIGS. 56 and 57) is changed as follows.

  That is, in this embodiment, as shown in FIG. 58, an evaluation change rate setting means 321 and a change rate calculation means 322 are newly provided in the recognition unit 271 instead of the evaluation ratio setting means 302 of the thirty-first embodiment. ing. Then, at the time of judging the end of the treatment, the end of the treatment is judged not by the luminance of the evaluation points a to d but by the change rate of the luminance of the evaluation points a to d.

  When the treatment device 261 is used, the control of the treatment device 261 is performed according to the flowchart of FIG. Here, in the present embodiment, from step S71 to step S74 in the flowchart of FIG. 47 of the twenty-fifth embodiment (see FIGS. 45 to 47), control is performed in the same procedure as in the twenty-fifth embodiment. . Then, after a plurality of, in this embodiment, four evaluation points a to d are set at and around the treatment site Hj in the MRI image in step S74, the process proceeds to the next new step S141. In this step S141, the rate of change in the luminance of the four evaluation points a to d for determining the end of the treatment is set by the evaluation change rate setting means 321 using a keyboard, a mouse, a trackball, a touch pen, or the like.

  Thereafter, the treatment is started in the same manner as in the twenty-fifth embodiment (step S76). Then, at the start of this treatment, the control from step S76 to step S80 is performed in the same procedure as in the twenty-fifth embodiment. After the luminance levels at the four evaluation points a to d are monitored in step S80, the process proceeds to the next new step S142.

  In this step S142, the brightness levels of the four evaluation points a to d are stored in the storage unit 311. Subsequently, in the next step S143, the change rate of each of the evaluation points a to d is calculated by the change rate calculating means 322. Then, in the next step S144, it is determined whether or not the change rates of all the evaluation points a to d are lower than the evaluation change rate set by the evaluation change rate setting means 321. Here, when it is determined that all of the change rates of the four evaluation points a to d are not lower than the evaluation change rates, the process returns to step S78. If it is determined in step S144 that the change rates of all the evaluation points a to d are lower than the evaluation change rates, the treatment is ended (step S82). Further, at the end of this treatment, in the next step 83, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271.

  Therefore, in the present embodiment having the above-described configuration, the end of the treatment is determined based on the rate of change in the luminance of the evaluation points a to d instead of the luminance of the evaluation points a to d when the end of the treatment is determined. Here, when the treatment energy output from the treatment probe 270 is given to the living tissue (the treatment site Hj), the temperature of the treatment site Hj rises, and the water in the living tissue at the treatment site Hj is completely drained. Even if more energy is applied to the living tissue at the treatment site Hj, there is no change in the water content, and as a result, a phenomenon occurs in which the luminance does not change. Therefore, in the present embodiment, it is possible to reliably determine whether or not the living tissue at the treatment site Hj has completely lost water due to the lack of water in the living tissue at the treatment site Hj by observing the rate of change in luminance at the evaluation points a to d. There are advantages.

  FIGS. 60 to 63 show a thirty-third embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 261 of the thirty-second embodiment (see FIGS. 58 and 59) is changed as follows.

  That is, in this embodiment, as shown in FIG. 60, an evaluation line setting means 331 is newly provided in the recognition unit 271 instead of the evaluation point setting means 283 of the thirty-second embodiment. In the thirty-second embodiment, the portion for evaluating the luminance is set as a plurality of points, whereas in the present embodiment, the treatment energy is supplied from the treatment probe 270 to the treatment site Hj as shown in FIG. One reference line Lb extending in an appropriate direction from the radiation center O of the treatment energy is set, and a plurality of points automatically set at regular intervals on the reference line Lb evaluate the luminance level. It is made to be recognized as a point.

  When the treatment device 261 is used, the control of the treatment device 261 is performed according to the flowchart of FIG. Here, in the present embodiment, from step S71 to step S73 in the flowchart of FIG. 47 of the twenty-fifth embodiment (see FIGS. 45 to 47), control is performed in the same procedure as in the twenty-fifth embodiment. . Then, after the MRI image by the MRI imaging device 262 is displayed on the display unit 282 of the recognition unit 271 in step S73, the process proceeds to the next new step S151. In this step S151, the portion for evaluating the luminance is set as one reference line Lb by the evaluation line setting means 331 using a keyboard, a mouse, a trackball, a touch pen, or the like. Thereafter, in the next step S152, the rate of change in the luminance of the evaluation reference line Lb set in step S151 is set by the evaluation change rate setting means 321 using a keyboard, a mouse, a trackball, a touch pen, or the like.

  Thereafter, the treatment is started in the same manner as in the twenty-fifth embodiment (step S76). Then, at the start of this treatment, the control from step S76 to step S79 is performed in the same procedure as in the twenty-fifth embodiment. Then, after the image signal is transferred from the MRI controller 265 to the recognition unit 271 in step S79, the process proceeds to the next new step S153.

  In this step S153, the luminance levels of a plurality of set points on the evaluation reference line Lb are monitored. Thereafter, in the next step S154, the brightness level of each set point on the evaluation reference line Lb is stored in the storage unit 311. Subsequently, in the next step S155, the change rate calculating unit 322 calculates the change rate of the luminance level at each set point on the evaluation reference line Lb.

  Then, in the next step S156, it is determined whether or not the change rates of all the set points on the evaluation reference line Lb are lower than the evaluation change rates. Here, when it is determined that all the change rates of the respective set points on the evaluation reference line Lb are not lower than the evaluation change rate, the process returns to step S78. If it is determined in step S156 that all the change rates of the respective set points on the evaluation reference line Lb are lower than the evaluation change rate, the treatment is ended (step S82). Further, at the end of this treatment, in the next step 83, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271.

  The graph shown in FIG. 63 is an example of a graph of a change in luminance during treatment by the treatment probe 270, where the X-axis is distance on a line and the Y-axis is luminance. Here, during treatment, by supplying energy from the treatment probe 270, the luminance changes in the numerical order from P1 to P5 according to the arrow with the passage of time. And eventually, the change will decrease at some point. Instead of displaying the graph as it is, several points on the line may be adopted as representative values, and the graph may be displayed as a bar graph in FIG.

  Therefore, in the present embodiment having the above configuration, as shown in FIG. 62, one reference line Lb extending in an appropriate direction from the radiation center O of the treatment energy when supplying the treatment energy from the treatment probe 270 to the treatment site Hj. And a plurality of points are automatically set at regular intervals on the reference line Lb, and the plurality of set points set here are recognized as points for evaluating the rate of change of the luminance level. Thus, the end of treatment is determined based on the rate of change in luminance at each set point.

  Here, during the treatment, when treatment energy is given to the living tissue (the treatment site Hj) from the treatment probe 270 and the temperature rises, and the water in the living tissue at the treatment site Hj is completely drained, the living body at the treatment site Hj is removed. Applying more energy to the tissue will result in no change in the water content, resulting in no change in brightness. And no matter how much energy is given at a certain point, the effect will not spread. This limits the therapeutic range. Therefore, in the present embodiment, one reference line Lb passing through the position of the energy emission center O is set, and the rate of change of the luminance level is evaluated at a plurality of set points on the reference line Lb. It can be reliably determined whether the limit of the therapeutic range has been reached.

  FIGS. 64 to 66 show a thirty-fourth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 261 of the 33rd embodiment (see FIGS. 60 to 63) is changed as follows.

  That is, in this embodiment, as shown in FIG. 64, an evaluation point setting unit based on a line and a distance is newly provided in the recognition unit 271 in place of the evaluation line setting unit 331 and the evaluation change rate setting unit 321 of the 33rd embodiment. 341 are provided, and an evaluation level setting means 284 is provided.

  When the treatment device 261 is used, the control of the treatment device 261 is performed according to the flowchart of FIG. Here, in the present embodiment, from step S71 to step S73 in the flowchart of FIG. 47 of the twenty-fifth embodiment (see FIGS. 45 to 47), control is performed in the same procedure as in the twenty-fifth embodiment. . Then, after the MRI image of the MRI imaging device 262 is displayed on the display unit 282 of the recognition unit 271 in step S73, the process proceeds to the next new step S161. In this step S161, the evaluation point X1 of the luminance is set by a keyboard, a mouse, a trackball, a touch pen or the like by the evaluation point setting means 341 based on the line and the distance.

  Thereafter, the treatment is started in the same manner as in the twenty-fifth embodiment (step S76). Then, at the start of this treatment, the control from step S76 to step S80 is performed in the same procedure as in the twenty-fifth embodiment.

  In step S80, the luminance level at the evaluation point X1 is monitored, and in the next step S162, a luminance graph on a line is displayed as shown in FIG. Thereafter, in the next step S163, it is determined whether or not the luminance of the evaluation point X1 has exceeded the evaluation level V1. Here, when it is determined that the luminance of the evaluation point X1 does not exceed the evaluation level V1, the process returns to step S78. Then, when it is determined that the luminance of the evaluation point X1 exceeds the evaluation level V1, the treatment is ended (step S82). Further, at the end of this treatment, in the next step 83, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271.

  During treatment, when the treatment energy is supplied from the treatment probe 270 to the living tissue (the treatment site Hj), the influence of the treatment energy in the treatment site Hj spreads almost concentrically from the energy emission center O in the MRI tomographic image. Go. Therefore, in the present embodiment, the evaluation point X1 is specified by the distance from the energy emission center O by the evaluation point setting means 341 based on the line and the distance, and the luminance of the evaluation point X1 is evaluated by the evaluation point setting means 341. By comparing with the level V1, the treatment state of the treatment site Hj can be confirmed.

  Further, by displaying a luminance graph on the line set by the evaluation point setting means 341 based on the line and the distance, it is easy to visually grasp the extent of the influence of the energy (that is, the extent of the treatment range). For example, in the state of the graph P1 in FIG. 66, the luminance of the evaluation point at the place of the set distance X1 is higher than the evaluation level V1, and it is recognized that the treatment is still continued. Since the luminance of the evaluation point at the location of X1 is lower than the evaluation level V1, in this case, it is recognized as the treatment end state.

  Therefore, the present embodiment having the above configuration is characterized in that the method of setting the evaluation points is performed using the line and the distance, and a luminance graph on the line is displayed. Therefore, displaying the brightness graph on the line set by the evaluation point setting means 341 based on the line and the distance has an effect of easily visually grasping the treatment end state.

  67 to 69 show a thirty-fifth embodiment of the present invention. In the present embodiment, the configuration of the treatment apparatus 261 of the twenty-fifth embodiment (see FIGS. 45 to 47) is changed as follows.

  That is, in the present embodiment, instead of the MRI imaging apparatus 262 of the twenty-fifth embodiment, for example, a twenty-second embodiment (see FIG. 40) is used as the observing means capable of recognizing the position of the treatment probe 270 which is a treatment applicator. ) Uses an ultrasonic imaging device 215 shown in FIG.

  Here, the ultrasound imaging device 215 is provided with an ultrasound imaging device unit 351 and an image signal output unit 352 as shown in FIG. The diagnostic ultrasound probe 212 is connected to the input side of the ultrasound imaging unit 351. Further, an image signal input unit 281 of the recognition unit 271 is connected to the image signal output unit 352 via a signal cable 353 between the recognition unit and the ultrasonic imaging apparatus.

  In addition, when the treatment device 261 of the present embodiment is used, the operation according to the flowchart of FIG. 69 is performed. That is, before the treatment by the treatment probe 270 is started, an ultrasonic image is captured by the diagnostic ultrasonic probe 212 in the first step S171. Subsequently, an image signal is transferred from the ultrasonic imaging apparatus 215 to the recognition unit 271 (step S172), and an ultrasonic image by the ultrasonic probe 212 is displayed on the display unit 282 of the recognition unit 271 (step S173).

  Thereafter, as shown in FIG. 44, the evaluation point setting means 283 in the recognition unit 271 sets a plurality of, in this embodiment, four evaluation points a to d at and around the treatment site Hj in the ultrasonic image by the ultrasonic probe 212. Is set using a keyboard, a mouse, a trackball, a touch pen or the like (step S174). Further, in the next step S175, the evaluation level of the luminance value for recognizing the end of the treatment at the four evaluation points a to d of the ultrasonic image by the ultrasonic probe 212, for example, the luminance setting level Ls is determined by the evaluation level setting means 284. The setting is made by a keyboard, a mouse, a trackball, a touch pen, or the like. These settings are made while viewing the display contents of the display unit 282 of the recognition unit 271.

  Thereafter, the treatment is started (step S176). At this time, a treatment start signal is transmitted from the treatment energy generation means 268 to the recognition unit 271 (step S177).

  Further, at the start of treatment, first, an ultrasonic image is captured by the ultrasonic probe 212 (step S178). Subsequently, an image signal is transferred from the ultrasonic imaging device 215 to the recognition unit 271 (step S179).

  Then, in step S180, the luminance levels at the four evaluation points a to d are monitored, and in the next step S181, it is determined whether or not the luminance of all the evaluation points a to d exceeds the evaluation level Ls. Here, when it is determined that all the evaluation points a to d do not exceed the evaluation level Ls, the process returns to step S178. Then, when it is determined that the luminance of all the evaluation points a to d exceeds the evaluation level Ls, the treatment is ended (step S182). Further, at the end of this treatment, the end of the treatment is notified by the treatment end notifying means 285 of the recognition unit 271 in the next step 183.

  Therefore, even in the above configuration, the treatment can be automatically terminated similarly to the twenty-fifth embodiment, and the influence of the treatment on the living body can be minimized. Furthermore, since the four evaluation points a to d are set at the treatment site Hj and its surroundings in the ultrasonic image by the ultrasonic probe 212, there is an effect that all the affected parts can be definitely treated.

  In the present embodiment, as an example, the MRI imaging apparatus 262 of the twenty-fifth embodiment is used as an observation unit capable of recognizing the position of the therapeutic applicator, and an ultrasonic image shown in the twenty-second embodiment (see FIG. 40). Although the configuration in which the device 215 is replaced is shown, it is apparent that the same can be easily performed in other embodiments.

  Further, the combinations between the above embodiments can be freely performed. For example, the system using the ultrasonic imaging apparatus 215 of the thirty-fifth embodiment (see FIGS. 67 to 69) automatically outputs the output of the energy generation means 268 as in the twenty-sixth embodiment (see FIG. 48). May be combined or turned off or reduced.

Furthermore, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention.
Next, other characteristic technical matters of the present application will be additionally described as follows.
Record
(Additional Item 1) An image diagnostic apparatus, a therapeutic applicator capable of recognizing a position on the image diagnostic apparatus, and controlling a therapeutic energy given to a living body through a therapeutic applicator by receiving a signal from the image diagnostic apparatus. Therapeutic system having a device to perform.

  (Additional Item 2) In a treatment system including an image diagnosis device and an energy treatment device, a treatment system including a control device that mediates a signal between the image diagnosis device and the energy treatment device.

  (Additional Item 3) The system according to Additional Item 2 above, which has a function of reducing or stopping the output of the energy therapy apparatus during observation of the diagnostic imaging apparatus.

  (Additional Item 4) The system according to the additional item 2, having a function of causing the diagnostic imaging apparatus to start observation when the output of the energy therapy apparatus is reduced or stopped.

  (Additional Item 5) The system according to the additional item 2, having a function of determining a treatment speed from an image change of the diagnostic imaging apparatus and changing various setting values of the energy therapy apparatus accordingly.

  (Additional Item 6) The system according to Additional Item 2, which mediates a signal for starting and stopping imaging of the MR observation apparatus.

  (Additional Item 7) The system according to Additional Item 2, which mediates a signal of an imaging parameter of the MR observation apparatus.

  (Additional Item 8) The system according to Additional Item 2, which mediates a signal of a captured image of the MR observation apparatus.

  (Additional Item 9) The system according to the additional item 2, which mediates signals for starting and stopping the output of the energy therapy device and setting the output level.

  (Additional Item 10) The system according to the additional item 2, having a function of flowing a tissue dissociation current at the end of the treatment.

  (Supplementary note 11) The system according to Supplementary note 2 including any of the functions of Supplementary notes 3 to 10 above.

  (Additional Item 12) The system according to Additional Item 11, which includes an applicator having MR compatibility.

  (Supplementary Item 13) In a system including a treatment energy generation unit and a tomographic image acquisition unit for observing a treatment site, a noise filter is provided in the energy transmission path unit between the treatment energy generation unit and the treatment site. A therapy system, wherein a frequency component affecting a tomographic image acquisition unit is removed from energy generated from a treatment energy generation unit.

  (Appendix 14) The system according to Appendix 13, wherein the therapeutic energy generating means is a microwave generator.

  (Appendix 15) The system according to Appendix 13, wherein the therapeutic energy generating means is a high-frequency generator.

  (Additional Item 16) The system according to Additional Item 13, wherein the tomographic image acquisition means is an MRI.

  (Additional Item 17) The system according to Additional Item 13, wherein the tomographic image acquiring means is an ultrasonic imaging apparatus.

  (Additional Item 18) The system according to Additional Item 13, wherein the noise filter is a band-pass filter corresponding to a main frequency of the energy generating means.

  (Item 19) The system according to item 13, wherein the noise filter is a band cut filter corresponding to a reception frequency of the tomographic image acquisition unit.

  (Additional Item 20) The noise filter is a low-pass filter or a high-pass filter that passes only the main frequency side of the energy generating unit from the frequency between the main frequency of the energy generating unit and the reception frequency of the tomographic image acquiring unit. Item 13. The system according to Item 13.

  (Additional Item 21) The system according to Additional Item 16, wherein the noise filter is provided at an input portion of the magnetically shielded room.

  (Additional item 22) A treatment system having a control device that recognizes a marker attached to a treatment electrode or an applicator on a screen of an image diagnostic device and controls the energy treatment device.

  (Additional Item 23) The system according to Additional Item 22, having a function of stopping the output of the energy therapy device when the positional relationship between the plurality of markers changes.

  (Additional Item 24) The system according to Additional Item 22, having a function of stopping the output of the energy therapy apparatus when some markers cannot be recognized on the screen.

  (Additional Item 25) The system according to the additional item 22, having a function of stopping the output of the energy therapy apparatus when the image signal of the predetermined marker portion changes.

  (Supplementary Item 26) A treatment system having a control unit that recognizes a marker attached to a treatment electrode or an applicator on a screen of an image diagnostic apparatus and controls an energy treatment apparatus and a treatment tool moving apparatus.

  (Additional Item 27) In a system including a treatment energy generating unit, a tomographic image acquiring unit for observing a treatment site, and a recognition unit for recognizing the progress of treatment, one or more evaluation points or evaluation lines are displayed on the tomographic image. A treatment system having a function of being settable and having a function of recognizing a treatment state based on image data values of the evaluation points or the evaluation lines.

  (Additional Item 28) The system according to Additional Item 27, comprising means for notifying the level according to the recognition of the treatment status.

  (Additional Item 29) The system according to Additional Item 28, wherein the recognized treatment status is treatment completion.

  (Additional Item 30) The system according to Additional Item 27, which has a function of stopping or decreasing the output of the therapeutic energy generating means according to the recognition of the treatment status.

  (Additional Item 31) The system according to Additional Item 30, wherein the recognized treatment status is treatment end.

  (Additional Item 32) The system according to Additional Item 27, in which an evaluation point or an evaluation line can be manually set in an image.

  (Additional Item 33) The system according to Additional Item 27, wherein the evaluation point or the evaluation line is automatically set from the tomographic image data.

  (Additional Item 34) The system according to Additional Item 27, wherein the luminance absolute value of the set evaluation point is used as an image data value.

  (Additional Item 35) The system according to Additional Item 27, wherein one reference point can be further set, and a relative value of luminance between the reference point and the evaluation point is used as an image data value.

  (Additional Item 36) The system according to Additional Item 27, wherein a comparison value between the luminance of the evaluation point and the value before the supply of therapeutic energy is used as an image data value.

  (Additional Item 37) The system according to Additional Item 27, wherein a rate of change in luminance at the evaluation point is used as an image data value.

  (Additional Item 38) The system according to Additional Item 27, which has a function of recognizing that the image data values of all the evaluation points have reached a predetermined threshold.

  (Additional Item 39) The system according to Additional Item 27, having a function of recognizing that a plurality of evaluation points are set, and that image data values of a predetermined percentage of the evaluation points have reached a predetermined threshold.

  (Additional Item 40) When it is recognized that the image data value of the first predetermined ratio of the evaluation points among the plurality of evaluation points has reached the predetermined threshold, the fact is notified, and the second predetermined ratio is notified. 28. The system of claim 27 having the function of stopping or reducing the output of the therapeutic energy generating means when the image data value of the percentage evaluation point reaches a predetermined threshold.

  (Additional Item 41) The system according to Additional Item 27, wherein a change rate of luminance at a plurality of points on the setting line is used as an image data value.

  (Additional Item 42) The system according to Additional Item 27, wherein an evaluation point is set by setting a line and setting a distance.

(Additional Item 43) An applicator made of a material having a magnetic susceptibility of −10 ⁻³ to +10 ⁻³ .

  (Additional Item 44) The applicator according to the additional item 43, wherein an MR marker made of a material having a magnetic susceptibility having an absolute value equal to or greater than the absolute value of the magnetic susceptibility of the material constituting the applicator base is installed.

  (Appendix 45) The applicator according to Appendix 44, wherein the applicator has one or more MR markers.

  (Additional Item 46) The applicator according to the additional item 44, further including an MR marker on a distal end side of the treatment energy output unit.

  (Additional Item 47) The applicator according to the additional item 44, further comprising an MR marker on a rear end side of the treatment energy output unit.

  (Additional Item 48) The applicator according to the above additional item 44, wherein the applicator has an MR marker on a front end side and a rear end side of the treatment energy output unit.

  (Additional Item 49) The applicator according to the additional items 44 to 48, wherein the positions of the treatment energy output unit and the MR marker are separated by 10 mm or more in the axial direction.

  (Additional Item 50) An imaging step of imaging an observation image of the living tissue by the observation means of the living tissue, and a position of the treatment applicator for treating the living tissue by applying treatment energy to the living body from the observation image by the observation means. An applicator position recognizing step of recognizing, and a control step of controlling therapeutic energy given to a living body from the therapeutic applicator based on the position data of the therapeutic applicator recognized in the step. A method of controlling a treatment device.

FIG. 1 is a schematic configuration diagram of an entire system in a treatment apparatus according to a first embodiment of the present invention. (A) is a schematic configuration diagram showing a treatment state in the treatment device of the first embodiment, and (B) is a longitudinal sectional view showing a microwave applicator. FIG. 2 is a schematic configuration diagram illustrating a connection state of a control unit in the treatment apparatus according to the first embodiment. FIG. 3 is a block diagram illustrating a connection state of a control unit in the treatment apparatus according to the first embodiment. 5 is a flowchart for explaining the operation of the treatment apparatus according to the first embodiment. FIG. 3 is a longitudinal sectional view showing an MR image when the applicator of the treatment apparatus according to the first embodiment is inserted into a body. FIG. 3 is a longitudinal sectional view showing an MR image at the time of microwave coagulation by the applicator of the treatment apparatus according to the first embodiment. FIG. 4 is a characteristic diagram showing a range of magnetic susceptibility of an applicator and an MR marker. The longitudinal section showing the important section composition of the applicator in the treatment device of a 2nd embodiment of the present invention. FIG. 10 is a longitudinal sectional view showing an MR image when an applicator of the treatment apparatus according to the second embodiment is inserted into a body. FIG. 10 is a longitudinal sectional view showing an MR image at the time of microwave coagulation by the applicator of the treatment apparatus according to the second embodiment. FIG. 13 is a longitudinal sectional view showing a main configuration of an applicator in a treatment apparatus according to a third embodiment of the present invention. The longitudinal section showing the applicator in the treatment device of a 4th embodiment of the present invention. The perspective view of the principal part showing the use condition of the treatment device of a 5th embodiment of the present invention. The perspective view showing the important section composition of the applicator in the treatment device of a 5th embodiment. FIG. 19 is a perspective view showing a main configuration of an applicator in a treatment apparatus according to a sixth embodiment of the present invention. The longitudinal section showing the schematic structure of the applicator in the treatment device of a 7th embodiment of the present invention. FIG. 19 is a schematic configuration diagram of an entire treatment apparatus according to an eighth embodiment of the present invention. The block diagram showing the connection state of the control part in the treatment device of an 8th embodiment. 19 is a flowchart for explaining the operation of the treatment apparatus according to the eighth embodiment. The schematic structure figure of the whole treatment device of a 9th embodiment of the present invention. 19 is a flowchart for explaining the operation of the treatment device according to the ninth embodiment. The schematic structure figure of the whole treatment device of a 10th embodiment of the present invention. The block diagram showing the connection state of the control part in the treatment device of a 10th embodiment. The schematic structure figure of the whole treatment device of an 11th embodiment of the present invention. The block diagram showing the connection state of the control part in the treatment device of an eleventh embodiment. The schematic structure figure of the whole treatment device of a 12th embodiment of the present invention. FIG. 21 is a block diagram showing a connection state of a control unit in a treatment device according to a twelfth embodiment. 28 is a flowchart for explaining the operation of the treatment apparatus according to the twelfth embodiment. The schematic structure figure of the whole treatment device of a 13th embodiment of the present invention. The schematic structure figure of the whole treatment device of a 14th embodiment of the present invention. The filter characteristic figure of the treatment device of a 14th embodiment. The top view showing an example of the tomographic image by the treatment device of a 14th embodiment. (A) is a filter characteristic diagram of the treatment device in the fifteenth embodiment of the present invention, and (B) is a filter characteristic diagram of the treatment device in the sixteenth embodiment of the present invention. The schematic structure figure of the whole treatment device of a 17th embodiment of the present invention. The filter characteristic figure of the treatment device of a 17th embodiment. (A) is a filter characteristic diagram of the treatment device according to the eighteenth embodiment of the present invention, and (B) is a filter characteristic diagram of the treatment device according to the nineteenth embodiment of the present invention. The schematic structure figure of the whole treatment device of a 20th embodiment of the present invention. The schematic structure figure of the whole system in the treatment device of a 21st embodiment of the present invention. The schematic structure figure of the whole system in the treatment device of a 22nd embodiment of the present invention. The longitudinal section of the important section showing a 23rd embodiment of the present invention. The longitudinal section of the important section showing a 24th embodiment of the present invention. The schematic structure figure of the whole system in the treatment device of a 25th embodiment of the present invention. The top view showing the display contents of the recognition unit in the treatment device of a 25th embodiment. The figure which shows the display state of the measured temperature in the treatment apparatus of 25th Embodiment. The block diagram showing the schematic structure of the recognition unit in the treatment device of a 25th embodiment. 33 is a flowchart for explaining the operation of the treatment apparatus according to the twenty-fifth embodiment. 39 is a flowchart for explaining a main part of the operation of the treatment apparatus according to the twenty-sixth embodiment of the present invention. The block diagram showing the schematic structure of the recognition unit in the treatment device of a 27th embodiment of the present invention. 33 is a flowchart for explaining the operation of the treatment apparatus according to the twenty-seventh embodiment. 48 is a flowchart for explaining the operation of the treatment apparatus according to the twenty-eighth embodiment of the present invention. 51 is a flowchart for explaining the operation of the treatment apparatus according to the twenty-ninth embodiment of the present invention. FIG. 51 is a plan view showing display contents of a recognition unit in a treatment device according to a thirtieth embodiment of the present invention. FIG. 39 is a block diagram showing a schematic configuration of a recognition unit in a treatment device according to a thirtieth embodiment. 33 is a flowchart for explaining the operation of the treatment apparatus according to the thirtieth embodiment. The block diagram showing the schematic structure of the recognition unit in the treatment device of a 31st embodiment of the present invention. 33 is a flowchart for explaining the operation of the treatment apparatus according to the thirty-first embodiment. FIG. 39 is a block diagram showing a schematic configuration of a recognition unit in a treatment apparatus according to a thirty-second embodiment of the present invention. 33 is a flowchart for explaining the operation of the treatment apparatus according to the thirty-second embodiment. FIG. 39 is a block diagram illustrating a schematic configuration of a recognition unit in a treatment apparatus according to a thirty-third embodiment of the present invention. 33 is a flowchart for explaining the operation of the treatment apparatus according to the thirty-third embodiment. FIG. 39 is a plan view showing a part of the display contents of the recognition unit in the treatment apparatus according to the thirty-third embodiment. FIG. 47 is a characteristic diagram showing a change in luminance in the treatment apparatus according to the thirty-third embodiment. FIG. 39 is a block diagram showing a schematic configuration of a recognition unit in a treatment apparatus according to a thirty-fourth embodiment of the present invention. 48 is a flowchart for explaining the operation of the treatment apparatus according to the thirty-fourth embodiment. FIG. 47 is a plan view showing a part of the display contents of the recognition unit in the treatment apparatus according to the thirty-fourth embodiment. The schematic structure figure of the whole system in the treatment device of an embodiment of the 35th treatment device of the present invention. FIG. 39 is a block diagram illustrating a schematic configuration of a recognition unit in a treatment apparatus according to a thirty-fifth embodiment. 39 is a flowchart for explaining the operation of the treatment apparatus according to the thirty-fifth embodiment.

Explanation of reference numerals

    3 MR apparatus (observation means), 7 first monitor (display means), 15 microwave applicator (treatment applicator), 17 microwave oscillator (drive signal generation means), 151, 152 MR Marker, 157: Reference point (reference position), 155: Movement amount calculation unit (position determination unit), 153: Control unit (control unit).

Claims (2)

A treatment applicator for applying treatment energy to a living body to treat living tissue,
A marker provided at the predetermined position of the therapeutic applicator,
By outputting a drive signal to the therapeutic applicator, a drive signal generating means for generating the therapeutic energy from the therapeutic applicator,
Display means provided so as to be able to display the state of the treatment site of the living body to be treated by the treatment energy generated from the treatment applicator as an image,
Measuring a distance between a position on the image of the marker displayed on the display means and a reference position of the image set on the image displayed on the display means in advance, and Position determining means for determining the installation position of the
Control means for controlling the drive signal generation means in accordance with a result of the determination by the position determination means;
A treatment system comprising: A treatment applicator for applying treatment energy to a living body to treat living tissue,
A marker provided at the predetermined position of the therapeutic applicator,
By outputting a drive signal to the therapeutic applicator, a drive signal generating means for generating the therapeutic energy from the therapeutic applicator,
Display means provided so as to be able to display the state of the treatment site of the living body to be treated by the treatment energy generated from the treatment applicator as an image,
Distance measurement means for measuring a distance between the position of the marker displayed on the display means on the observation image and a reference position of the image set on the image previously displayed on the display means,
The distance measured by the distance measuring means, a distance comparing means for comparing a predetermined distance set in advance,
Control means for controlling the drive signal generation means according to the comparison result of the distance comparison means;
A treatment system comprising:

Images