JP2005034653A - Treatment system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a treatment apparatus which can simplify an operation when a therapeutic applicator and an observation means such as an MR apparatus are used simultaneously and is free from the possibility that the difficulty in seeing an observation image by the observation means arises during the use of the therapeutic applicator. <P>SOLUTION: A control part 48 determines an operating status of the MR apparatus 3 depending on directions from a control part 6 of the MR apparatus. A microwave oscillator 17 is controlled by a control unit 21 in order to make an output of driving signals, generated from the microwave oscillator 17 depending on the result determined by the control part 48, variable. <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 an observation means such as an MRI apparatus are used in combination.

  In general, it is considered to use a therapeutic applicator such as a high-frequency treatment instrument in combination with an observation means such as an MR apparatus as a therapeutic apparatus. For example, when the therapeutic applicator is inserted into the patient's body, the therapeutic applicator is correctly positioned at the affected area in the body cavity by accurately detecting the position of the therapeutic applicator using observation means such as an MR device. It has been considered to effectively treat the affected area in the body cavity with high frequency.

  However, in the conventional treatment apparatus, the therapeutic applicator such as a high-frequency treatment instrument and the observation means such as the MR apparatus are independently driven independently, so that the therapeutic applicator and the observation means such as the MR apparatus are driven independently. Are used at the same time, it is necessary to check the operating states of the therapeutic applicator and the MR apparatus and control them. Therefore, there is a problem that the operation becomes complicated.

  Further, while the therapeutic applicator is being driven, an observation image by an observation means such as an MR apparatus may be disturbed due to the influence of noise of electromagnetic waves emitted from the therapeutic applicator. For this reason, there is also a problem that it is difficult to see the observation image of the treatment part during high frequency treatment of the affected part in the body cavity.

  The present invention has been made paying attention to the above circumstances, and its purpose is to simplify the operation when simultaneously using a therapeutic applicator and an observation means such as an MR apparatus. It is an object of the present invention to provide a treatment apparatus that does not make it difficult to see an image observed by the observation means during use.

  According to the first aspect of the present invention, a therapeutic applicator that applies therapeutic energy to a living body to treat a living tissue, and outputs a drive signal to the therapeutic applicator, whereby the therapeutic applicator is used for the therapeutic treatment. Drive signal generating means for generating energy, and image constructing means provided so as to be able to construct the status of the treatment site of the living body treated by the therapeutic energy generated from the therapeutic applicator as an image. A construction instructing unit for instructing the image construction unit to construct the image, an operation determining unit for determining an operation status of the image building unit according to an instruction from the construction instructing unit, and a determination by the operation determining unit Control means for controlling the drive signal generating means so that the output of the drive signal generated from the drive signal generating means is variable according to a result; A treatment system characterized by comprising.

  According to a second aspect of the present invention, there is provided a therapeutic applicator for treating a living tissue by applying therapeutic energy to a living body, and outputting a drive signal to the therapeutic applicator so that the therapeutic applicator can perform the treatment. Drive signal generating means for generating energy, and image constructing means provided so as to be able to construct the status of the treatment site of the living body treated by the therapeutic energy generated from the therapeutic applicator as an image. A construction instructing unit for instructing the image constructing unit to construct the image, an operation determining unit for determining an operation status of the image constructing unit according to an instruction from the construction instructing unit, and a drive signal generating unit. The output setting means provided so that the output of the generated drive signal can be set to a desired output, and according to the determination result of the operation determination unit, Output switching means provided so that the output of the drive signal generated from the drive signal generating means can be switched to the predetermined output set by the output setting means, and switched according to the output switching means And a control means for controlling the drive signal generating means so as to generate the output drive signal.

  Then, when observing the image of the image construction means (MR device, etc.), the noise of the image of the image construction means (MR device, etc.) is controlled by controlling the output of the therapeutic applicator (microwave applicator, etc.). It is intended to reduce this.

  According to the present invention, it is possible to simplify the operation when the therapeutic applicator and the observation means such as the MR apparatus are used at the same time, and it is difficult to see the observation image by the observation means while using the therapeutic applicator. There is no risk of becoming.

  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 the treatment apparatus 1 of the present embodiment. For example, a therapeutic microwave treatment device 2 for treating a living tissue by applying therapeutic energy to the living body, an MR device (observation means) 3 for MR (magnetic resonance) examination, and the like. Is provided.

  Here, the MR apparatus 3 is provided with an MR gantry 5 disposed in an MR examination chamber 4 for MR (magnetic resonance) examination which is magnetically shielded. A patient H is placed on the MR gantry 5. Further, the MR gantry 5 is connected to an MR apparatus controller 6 disposed outside the MR examination room 4.

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

  A second monitor 13 for displaying an endoscopic image is disposed in the MR examination room 4. The second monitor 13 is connected to the video processor 12. At the time of endoscopy, the illumination light from the light source device 11 is irradiated to the body of the patient H, for example, the treatment site in the abdominal cavity through the endoscope 9, and an image observed by the endoscope 9 is converted into a video processor. 12 is converted into a video signal and displayed on the screen of the second monitor 13 in the MR examination room 4.

  Note that the pneumoperitoneum 14 is driven when the endoscope 9 is used. The insufflation apparatus 14 is adapted to fill the abdominal cavity of the patient H with gas and to inhale.

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

  Furthermore, in the treatment apparatus 1 of the present embodiment, a control unit (control means) 21 that controls the operation of the microwave treatment apparatus 2 is disposed outside the MR examination room 4. The control unit 21 is connected to a microwave oscillator 17 outside the MR examination room 4, an MR device controller 6, a foot switch 18 inside the MR examination room 4, a display lamp 19, and a speaker 20.

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

  An inner conductor 26 is disposed at the center of the outer conductor 23 in the cylinder. The leading end portion of the inner conductor 26 is inserted into the center hole of the leading end conductor 25. Here, a hole 25a is formed in the outer peripheral surface of the tip conductor 25 toward the insertion hole side of the inner conductor 26 in the axial center. The hole 25a is filled with solder that also serves as the MR marker 27, and the inner conductor 26 and the tip conductor 25 are electrically connected to each other by the solder of the MR marker 27. It is embedded and fixed in the center hole of the tip conductor 25. A space between the outer conductor 23 and the inner conductor 26 is filled with a dielectric 28.

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

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

  A coaxial connector 33 is connected to the end edge of the applicator main body 22 on the base end side. Then, as shown in FIG. 2A, one end of the microwave relay cable 16 is detachably connected to the coaxial connector 33.

Furthermore, in this 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 solder material forming the MR marker 27 has 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 equal to or larger than the absolute value of the magnetic susceptibility of the material constituting the applicator main body 22 is installed in the applicator main body 22 of the present embodiment.

  2A, the abdominal wall Ha of the patient H is previously provided with the trocar 34a for the endoscope 9 and the trocar 34b for the microwave applicator 15 during the treatment by the treatment apparatus 1 of the present embodiment. Are inserted, and 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 the outside.

  The control unit 21 is provided with an operation panel 38 in the 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 unit 44, and a LOW output value display are displayed. A unit 45, HIGH output setting switches 46a and 46b, and LOW output setting switches 47a and 47b are provided.

  Further, inside the control unit 21, as shown in FIG. 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 A LOW output value setting unit 51 is provided. Here, HIGH output setting switches 46a and 46b are connected to the HIGH output value setting unit 50, respectively. Further, LOW output setting switches 47a and 47b are connected to the LOW output value setting unit 51, respectively.

  Further, a HIGH output switch 41 and a LOW output switch 42 are connected to the output switching unit 49, 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, a patient H is placed on the MR gantry 5 in the MR examination room 4 as shown in FIG. In this state, as shown in FIG. 2A, the trocar 34a for the endoscope 9 and the trocar 34b for the microwave applicator 15 are punctured in advance on the abdominal wall Ha of the patient H, respectively. 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 endoscopy, the illumination light from the light source device 11 is irradiated to the body of the patient H, for example, the treatment site in the abdominal cavity through the endoscope 9, and an image observed by the endoscope 9 is converted into a video processor. 12 is converted into a video signal and displayed on the screen of the second monitor 13 in the MR examination room 4.

  Further, during 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, as shown in FIGS. 6 and 7, the screen of the first monitor 7 displays the MR image of the patient H, and the treatment state by the microwave applicator 15 and the microwave applicator 15. 6 and 7, Hc is the liver of the patient H, 52 is an artifact caused by the MR marker 27 of the microwave applicator 15, and 53 is a coagulation region during microwave heating by the microwave applicator 15.

  In the present embodiment, when the microwave applicator 15 is used, an 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, HIGH output setting values are set by the HIGH output setting switches 46a and 46b, and LOW output setting values are set by the LOW output setting switches 47a and 47b. Further, the two output set values of HIGH and LOW are switched each time the HIGH output switch 41 and the LOW output switch 42 are pressed. In addition, you may make it the structure switched every time the output changeover switch which is not shown in figure is pushed.

  Further, after setting the output set value, when the treatment start switch 39 of the control unit 21 is operated to be pressed, an output start signal and an output set value are transmitted from the control unit 21 to the microwave treatment apparatus 2. At this time, a control signal corresponding to the output set value set in advance 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.

  Further, during the microwave therapy, the control unit 21 transmits a control signal to the microwave therapy apparatus 2 to perform output control. At this time, the control unit 21 transmits an imaging start signal to the MR apparatus 3. Therefore, the imaging operation inside the patient H by the MR apparatus 3 is performed simultaneously. Then, an output signal from the MR apparatus control unit 6 of the MR apparatus 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 apparatus 3.

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

  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 microwave applicator 15 is controlled by the control unit 21, it is first determined whether or not the stop switch 40 is being pressed (step S1).

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

  In 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 pressed, the process proceeds to the next step S4.

  In step S4, it is determined whether or not the setting switches (HIGH output setting switches 46a and 46b and 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. In step S5, each set value is changed, and then the process returns to step S1. Further, if it is determined in step S4 that the setting switch is not in the depressed state, the process returns to step S1 as it is.

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

  In step S7, the microwave output of the microwave oscillator 17 is switched to the LOW output. Thereafter, an imaging start signal is transmitted to the MR apparatus 3 in step S8. Therefore, when the MR imaging start switch 43 is pressed during the microwave treatment by the microwave applicator 15, the microwave treatment device 2 is set to LOW when the output state of the microwave oscillator 17 of the microwave treatment device 2 is HIGH. Then, it is controlled to transmit an imaging start signal to the MR apparatus 3.

  Further, after the imaging start signal is transmitted to the MR apparatus 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 apparatus 3. If the imaging end signal is not received from the MR apparatus 3 in step S9, the operation in step S9 is repeated. If it is determined in step S9 that an imaging end signal has been received from the MR apparatus 3, the process returns to step S1. Therefore, after the MR imaging is completed, the output of the microwave oscillator 17 is held in a state where it cannot be switched to HIGH until an imaging end signal is received from the MR apparatus 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 a HIGH output. Then, it 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 in the pressed state. 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 depressed state, the output of the microwave oscillator 17 is set to HIGH when the HIGH output switch 41 or an output changeover switch (not shown) is pressed after the MR imaging. The microwave therapy apparatus 2 is controlled.

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

  Therefore, the above configuration has the following effects. That is, in the present embodiment, when the microwave therapy device 2 and the MR device 3 are used simultaneously, 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 obtained. Since it 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 observation image by the MR apparatus 3 becomes difficult to see while using the microwave therapy apparatus 2. Furthermore, there is an effect that the treatment range by the microwave therapy apparatus 2 is not inadvertently expanded during MR imaging.

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

  Further, in the present embodiment, the control unit 21 automatically performs an operation for reducing 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. The operation when the wave therapy device 2 and the MR device 3 are used simultaneously can be simplified.

  Moreover, since all the outer surfaces of the applicator main body 22 of the microwave applicator 15 are covered with the transparent coating layer 30 made of a fluororesin, electrical insulation can be secured and biocompatibility can be secured. Furthermore, it is possible to prevent adhesion of living tissue on the outer surface of the applicator body 22 during cauterization.

  In the present embodiment, the tip of the inner conductor 26 of the applicator main body 22 and the tip conductor 25 are connected in a conductive state by the solder of the MR marker 27, so that the microwave applicator is used as shown in FIG. An artifact 52 caused by the MR marker 27 arranged slightly in front of the center of the 15 MW antennas can be shown as a mark on the MR image. Therefore, since it is easy to specify the position of the treatment energy emitting unit disposed at the center of the MW antenna of the microwave applicator 15, the operability, safety, and certainty of the treatment are improved. Further, since the MR marker 27 can be installed on the tip side from the center of the antenna of the microwave applicator 15, assembly is easy.

  Note that, 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. Furthermore, instead of the microwave therapy apparatus 2, a laser apparatus, an RF therapy apparatus, an HF therapy apparatus, or an ultrasound therapy apparatus may be used as the therapy apparatus. Further, at the end of the treatment by pressing the stop switch 40, a tissue dissociation current may be passed through the electrode or applicator 15 of the energy treatment device for a short time. Further, the surface of the microwave applicator 15 may have a scale display for visual observation.

  9 to 11 show a second embodiment of the present invention. In this 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, the first MR marker similar to that of the first embodiment is disposed on the tip side of the central portion of the MW antenna (the central portion of the insulator 24) in the applicator main body 22. 27 and solder which is the second MR marker 61 is arranged on the rear end side of the center portion of the MW antenna.

Here, the distance between the first MR marker 27 on the front side and the center of the MW antenna: La, and the distance between the second MR marker 61 on the rear side 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 having a magnetic susceptibility of −10 ⁻³ or less or +10 ⁻³ or more other than solder.

  In the present embodiment, the central point of the treatment energy release of the microwave applicator 15 is 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 apparatus 3, as shown in FIG. 10, an imaging cross section is taken so that artifacts 52 and 62 due to solder of the two markers 27 and 61 of the microwave applicator 15 enter the MR image. Yes.

  Therefore, the above configuration has the following effects. In other words, in the present embodiment, between the artifact 52 due to the solder of the first MR marker 27 on the front side displayed in the MR image by the MR apparatus 3 and the artifact 62 due to the solder of the second MR marker 61 on the rear side. The center point of the treatment energy emission of the microwave applicator 15 which is the center part of the MW antenna of the microwave applicator 15 is disposed. Therefore, as shown in FIG. 11, since there is no artifacts 52 and 62 of the markers 27 and 61 of the microwave applicator 15 at the site to be treated (coagulation region 53 at the time of microwave heating), the coagulation region 53 at the time of microwave heating. Are 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 this 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 that communicates with the inside of the cylinder of the outer 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. The tip of this is inserted.

  Therefore, in the present embodiment configured as described above, the distal end portion of the dielectric 28 is inserted into the hole 71 at the rear end portion of the distal end conductor 25, so that the distal end conductor 25 is supported only by the distal end portion of the internal conductor 26. As compared with the above, there is an effect that the support strength of the tip conductor 25 can be increased and the strength of the connecting portion between the tip conductor 25 and the insulator 24 having a relatively low strength can be increased.

  FIG. 13 shows a fourth embodiment of the present invention. In this 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.

  In other words, 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 tip 29 of the applicator main body 22 of the first embodiment are integrated, and the first embodiment. Instead of the coating layer 30 of the form of fluororesin, a titanium coat 82 is applied to each outer peripheral surface of the tip conductor portion 81 and the outer conductor 23.

  In addition, an insulating coating 83 is provided on the outer peripheral surface of the connecting portion between the rear end portion of the front end conductor portion 81, the insulator 24, and the front end portion 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-described configuration, the titanium coat 82 is provided on each of the outer peripheral surfaces of the tip conductor portion 81 and the outer conductor 23 in place of the coating layer 30 made of the fluororesin of the first embodiment. The outer diameter of the entire main body 22 can be made smaller than that in the first embodiment. Furthermore, there is an advantage that MR markers can be formed by the titanium coat 82 on the outer peripheral surfaces of the tip conductor portion 81 and the outer conductor 23.

  14 and 15 show a fifth embodiment of the present invention. This embodiment is provided with a flexible applicator (luminal organ applicator) 91 for esophageal veins, bile ducts and the like.

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

  The MW antenna 96 includes a tip conductor 98 that is conducted to the central conductor of the flexible coaxial cable 95, a rear conductor 99 that is conducted to the outer conductor of the flexible coaxial cable 95, and a gap between the tip conductor 98 and the rear conductor 99. And a dielectric 100 disposed on the substrate.

  Further, a ring-shaped MR marker 101 is disposed at the rear portion of the MW antenna 96 at the tip of the flexible coaxial cable 95. 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, as shown in FIG. 14, the insertion portion 94 of the MR compatible endoscope 92 is inserted in advance into the lumen of the patient, for example, the esophagus Hd, and the target treatment portion For example, it is guided to a 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 led out from 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 central portion of the coagulation / cauterization treatment for 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.

  Further, after setting the MW antenna 96 of the flexible applicator 91 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 according to the present embodiment, the ring-shaped MR marker 101 is disposed at the rear portion of the MW antenna 96 at the distal end portion of the insertion portion 94 of the flexible applicator 91, so that it is a treatment energy discharge portion. It is easy to specify the position of the MW antenna 96. Therefore, it is possible to accurately grasp the central part of the coagulation / cauterization treatment for the lumen wall and perform the coagulation / cauterization treatment while checking the depth of penetration at that position. Will improve. As a result, even when a treatment for coagulating necrosis is performed on a thin luminal organ, fistula formation can be prevented during tissue necrosis removal or absorption after surgery.

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

  That is, in the fifth embodiment, the configuration in which one ring-shaped MR marker 101 is disposed at the rear portion of the MW antenna 96 at the distal end portion of the insertion portion 94 of the flexible applicator 91 is shown. In the embodiment, the second MR marker 103 is disposed 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 part of the coagulation / cauterization treatment for the lumen wall by the MW antenna 96 and the front MR marker 101, and the distance between the two front and rear MR markers 101, 103 The distance Lb is set to La = Lb.

  When the flexible applicator 91 according to the present embodiment is used, the pitch of the distance Lb between the two front and rear MR markers 101 and 103 is determined from the lumen wall by the MW antenna 96 disposed in front of the front MR marker 101. It is possible to estimate the position of the dielectric 100 that is the treatment center of the coagulation / cauterization treatment.

  Therefore, in the present embodiment having the above-described configuration, the second MR marker 103 is disposed behind the MR marker 101 of the fifth embodiment, and the central portion of the coagulation / cauterization treatment for the lumen wall by the MW antenna 96 is performed. 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 -The position of the treatment center of the cauterization treatment can be made clearer.

  FIG. 17 shows a seventh embodiment of the present invention. The present embodiment is provided with a monopolar puncture applicator 111 using a parenchymal puncture type RF energy used in combination with an extracorporeal electrode. The monopolar puncture applicator 111 of the present embodiment is provided with a monopolar needle electrode 112 made of a titanium needle. A connector 113 is disposed at the proximal end of the needle electrode 112. A connector housing 114 is attached to the outer peripheral surface of the connector 113.

  In addition, a treatment portion 115 having an appropriate set length La is disposed at the foremost end portion of the needle electrode 112. Further, two ring-shaped MR markers 116 and 117 are arranged at the distal end portion of the needle electrode 112 at the rear portion of the treatment portion 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 two front and rear MR markers 116 and 117 is set to Lb = Lc. The entire outer peripheral surface 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 this embodiment is used, the distal end treatment portion of the needle electrode 112 disposed in front of the front MR marker 116 is determined from the pitch of the distance Lc between the two front and rear MR markers 116, 117. The tip position of 115 can be estimated.

  Therefore, in the present embodiment having the above-described configuration, the monopolar needle electrode 112 made of a titanium needle is provided, and the treatment portion 115 having an appropriate set length La is disposed at the foremost end portion of the needle electrode 112. The diameter can be further reduced, 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, the operation panel 38 of the control unit 21 of the first embodiment has an auto / manual switch 121 and an output HIGH output time setting display section 122. The output time setting switches 123a and 123b, the output time setting display section 124 of the output LOW, the output time setting switches 125a and 125b, the output HIGH total output time setting display section 126, and the output time setting switches 127a and 127b. Is added to each. In the present embodiment, the automatic control is performed based on the manual control function for performing the same control as in the first embodiment in accordance with the switching operation of the auto / manual switch 121 and the time set value set in advance on the operation panel 38. It is possible to selectively switch to an auto control function for performing control.

  In addition, as shown in FIG. 19, a time count unit 128 is connected to the control unit 48 inside the control unit 21. Further, a HIGH output time setting unit 129 and a LOW output time setting unit 130 are connected to the time counting unit 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 treatment apparatus 2 in accordance with the operation of the operation panel 38 of the control unit 21 in advance, that is, the output values 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 unit 122 of the output HIGH. Further, 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 unit 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 127 a and 127 b for setting the output HIGH total output time, and is displayed on the output HIGH total output time setting display unit 126.

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

  Further, when the automatic operation is selected here, the following automatic control is performed along the flowchart of FIG. 20 based on the time set value set in advance on the operation panel 38. 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, counting of HIGH output time is started simultaneously (step S21). Subsequently, it is determined whether or not the stop switch 40 is being pressed (step S22).

  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 step S24, the total HIGH output time is calculated. In the next step S25, it is determined whether or not the HIGH output total time has passed the set time. If it is determined in step S25 that the HIGH output total time has not elapsed, the process proceeds to the next step S26. In 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 step S27, each set value is changed, and then the process returns to step S22. Further, if it is determined in step S26 that the setting switch is not in the pressed state, the process returns to step S22 as it is.

  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, counting of the LOW output time is started at the same time.

  Thereafter, an imaging start signal is transmitted to the MR apparatus 3 in step S29. After the imaging start signal is transmitted to the MR apparatus 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 apparatus 3. If the imaging end signal is not received from the MR apparatus 3 in step S30, the operation in step S30 is repeated. Therefore, after the time of the output HIGH time set value has elapsed, imaging by the MR apparatus 3 is started with the output of the microwave oscillator 17 switched to LOW.

  If it is determined in step S30 that an imaging end signal has been received from the MR apparatus 3, the process proceeds to the next step S31. In this step S31, it is determined whether or not the LOW output elapsed time has passed the set time. If it is determined in step S31 that the set output time has not elapsed, the operation in step S31 is repeated. Further, if it is determined in step S31 that the set 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 HIGH again. However, if the MR imaging end signal is not 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, and when the total time of the output HIGH reaches the set value, the microwave output is stopped and the MR apparatus 3 performs the operation. MR imaging is performed and treatment is terminated.

  If the stop switch 40 is pressed during treatment, it is determined in step S22 that the stop switch 40 is in a pressed state. 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 apparatus 3, and MR imaging is performed.

  Therefore, in this embodiment, when the auto / manual switch 121 is provided on the operation panel 38 of the control unit 21 and manual operation is selected by the auto / manual switch 121, the time setting previously set on the operation panel 38 is set. Since the value becomes invalid and the same operation as that of the first embodiment is performed, the microwave application is performed during MR imaging by the MR apparatus 3 when the microwave treatment apparatus 2 and the MR apparatus 3 are used at the same time. The microwave output, which is the therapeutic energy applied to the living body from the data 15, can be automatically reduced. Therefore, since the influence of noise from the microwave therapy apparatus 2 on the MR apparatus 3 can be reduced, there is no possibility that an observation image by the MR apparatus 3 becomes difficult to see while using the microwave therapy apparatus 2.

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

  In the present embodiment, instead of the MR apparatus 3, an ultrasonic observation apparatus or an X-ray CT may be used. Furthermore, instead of the microwave therapy apparatus 2, a laser apparatus, an RF therapy apparatus, an HF therapy apparatus, or an ultrasound therapy apparatus may be used.

  Alternatively, a tissue dissociation current may be allowed to flow through the electrode or applicator 15 of the microwave treatment apparatus 2 for a short time when the treatment is terminated by pressing the stop switch 40. In this case, bleeding from the living tissue can be prevented when the electrode or applicator 15 is pulled out after the treatment.

  21 and 22 show a ninth embodiment of the present invention. In this 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 determination reference output unit 143 are provided inside the control unit 21 of the first embodiment.

  In the present embodiment, when the microwave treatment is performed by the microwave applicator 15 and MR imaging is repeatedly performed by the MR apparatus 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 apparatus 3 at a certain time interval (step S41). Subsequently, in step S42, the previous MR image is compared with the latest MR image, a difference amount 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, it is determined whether or not d> = d1 by comparing the image change amount d calculated in step S42 with a predetermined criterion for determining the lower limit value d1 of the appropriate difference amount. . If it is determined that d> = d1, the process proceeds to the next step S44. In this step S44, the image change amount d calculated in step S42 is compared with a predetermined criterion for determining the upper limit value d2 of the appropriate difference amount, and it is determined whether d <= d2. If it is determined that d <= d2, the process returns to step S41.

  (3) If the image change amount d is outside the range of the appropriate difference amount determined in advance based on the determination result of (2), the output of the microwave applicator 15 is changed as follows. That is, when it is determined in step S43 that d> = d1 is not satisfied, the treatment speed is low, and the first process of step S45 is performed. In the first process, one or more of the following (A) to (D) are performed. (A) increases the output. (B) makes the output time longer. (C) raises the set temperature. (D) makes the output waveform high in treatment speed.

  If it is determined in step S44 that d <= d2, the treatment speed is high, and the second process of step S46 is performed. In the second process, one or more of the following (A) to (D) are performed. (A) lowers the output. (B) shortens the output time. (C) lowers the set temperature. (D) makes the output waveform low in treatment speed.

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

  Instead of the MR apparatus 3, an ultrasonic observation apparatus or X-ray CT may be used. Furthermore, instead of the microwave therapy apparatus 2, a laser apparatus, an RF therapy apparatus, an HF therapy apparatus, or an ultrasound therapy apparatus may be used.

  23 and 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, two MR markers 151 and 152 are provided in the microwave applicator 15 of the first embodiment as shown in FIG. Further, inside the control unit 21, as shown in FIG. 24, a control unit 153 connected to the microwave treatment apparatus 2, a marker detection unit 154 connected to the MR apparatus control unit 6 of the MR apparatus 3, and these 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 the reference point 157 at an arbitrary position on the MR screen of the first monitor 7 that displays the MR image by the MR apparatus 3. Further, a movement allowable value setting unit 158 is further connected to the control unit 153. In FIG. 23, Hf is a treatment target organ image displayed on the MR screen of the first monitor 7.

  In this 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 shift of the microwave applicator 15 is detected by monitoring by the unit 153, and when the position shift 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 treatment target organ image Hf in the body of the patient H. Thereafter, MR imaging is performed by the MR apparatus 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 in a memory (not shown) of the control unit 153 as an initial value.

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

  If even 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 the output of.

  Therefore, in the above configuration, since the position shift of the microwave applicator 15 and the shift of the MR imaging surface are automatically detected and the output of the microwave oscillator 17 is stopped, under MR monitoring by the MR apparatus 3. The safety of the energy treatment by the microwave output of the microwave treatment apparatus 2 can be improved.

  Instead of the MR apparatus 3, an ultrasonic observation apparatus or X-ray CT may be used. Furthermore, instead of the microwave therapy apparatus 2, a laser apparatus, an RF therapy apparatus, an HF therapy apparatus, or an ultrasound therapy apparatus may be used.

  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 according to 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 in the control unit 21 between the control unit 153 and the marker detection unit 154 instead of the movement amount calculation unit 155 of the tenth embodiment. A part 161 is interposed.

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

  In addition, on the MR screen of the first monitor 7 that displays the MR image by the MR apparatus 3, for example, a monitoring marker 164 can be set in accordance with the protection region Hg of the organ image Hf to be treated, for example, at a place where damage is to be avoided. 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 treatment target organ image Hf in the body of the patient H. Thereafter, MR imaging is performed by the MR apparatus 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 position where damage is particularly desired in the protection region Hg of the treatment target organ image Hf displayed on the MR screen of the first monitor 7. 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.

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

  Therefore, in the case of the above-described configuration, the MR screen of the first monitor 7 for displaying the MR image by the MR apparatus 3 is used for monitoring in a location where damage is particularly desired to be avoided in accordance with the protection region Hg of the organ image Hf to be treated. Since the marker 164 can be set, the tissue change state of the important part can be automatically confirmed, which is safe.

  Instead of the MR apparatus 3, an ultrasonic observation apparatus or X-ray CT may be used. Furthermore, instead of the microwave therapy apparatus 2, a laser apparatus, an RF therapy apparatus, an HF therapy apparatus, or an ultrasound therapy apparatus may be used.

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

  That is, in this 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 interposed between the control unit 153 and the marker detection unit 154.

  In addition, a treatment target setting unit 173 is connected to the distance calculation unit 172. The treatment target setting unit 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 apparatus 3. is there. Further, a distance allowable value setting unit 175 is connected to the control unit 153. This distance tolerance setting unit 175 controls the applicator moving device 171 to control the operation of the applicator moving device 171 that moves the MR marker 151 to the next treatment point 174, and moves the MR marker 151 to the next treatment point 174. When moving, the allowable value of the moving distance of the microwave applicator 15 is set.

  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 treatment target organ image Hf in the body of the patient H. Thereafter, MR imaging is performed by the MR apparatus 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 a 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 is completed, the microwave output of the microwave applicator 15 is stopped. Thereafter, the microwave applicator 15 is moved so that the MR marker 151 moves to the next treatment point 174 by controlling the applicator moving device 171 while performing MR imaging with the MR device 3. The movement operation of the microwave applicator 15 at this time is performed according to the flowchart of FIG.

  Here, in the first step S <b> 61, the microwave applicator 15 is moved toward the next treatment point 174 by the applicator moving device 171. Subsequently, MR imaging is performed by the MR apparatus 3, and an MR image is acquired on the MR screen of the first monitor 7 (step S62).

  Thereafter, in the next step S63, the distance calculation unit 172 calculates the distance between the MR marker 151 and the next treatment target (treatment point 174). Further, in the next step S64, it is determined whether or not the distance calculated in step S63 is within an allowable value set by the distance allowable value setting unit 175. Here, when it is outside 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 step S65, an output start signal is transmitted to the microwave therapy apparatus 2, and microwave output from the microwave applicator 15 is started.

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

  If 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). If it is determined that there is an untreated target (therapeutic point 174), the process returns to the first step S61, and the same operation is repeated as many times as there are set therapeutic 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 on the MR screen of the first monitor 7 for displaying the MR image by the MR device 3. A plurality of treatment points 174 for moving the MR marker 151 of the microwave applicator 15 are set, and the applicator moves so that the MR marker 151 sequentially moves to each treatment point 174 during the microwave treatment by the microwave treatment apparatus 2. The operation of the device 171 is controlled. Therefore, in this 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 the microwave treatment apparatus 2 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 simultaneously can be simplified.

  Instead of the MR apparatus 3, an ultrasonic observation apparatus or X-ray CT may be used. Furthermore, instead of the microwave therapy apparatus 2, a laser apparatus, an RF therapy apparatus, an HF therapy apparatus, or an ultrasound therapy apparatus may be used.

  FIG. 30 shows a thirteenth embodiment of the present invention. In this 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 installed at a position that falls within the MR screen of the first monitor 7 that displays the MR image by the MR apparatus 3. Then, with the position of the reference point marker 181 as a reference point, the positional relationship between the MR markers 151 and 152 provided in the microwave applicator 15 and the reference point marker 181 is stored.

  When the treatment apparatus 1 of the present embodiment is used, the MR of the microwave applicator 15 is performed each time MR imaging is performed by the MR apparatus 3 after the treatment of the microwave treatment apparatus 2 is started, as in the tenth embodiment. The positional relationship between the markers 151 and 152 and the reference point marker 181 is measured. If this positional relationship displacement exceeds a preset specified value, it is determined that a positional deviation has occurred and the output of the microwave oscillator 17 is stopped.

  If even 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 the output of.

  Therefore, in the present embodiment, since the reference point marker 181 is installed at a position that falls within the MR screen of the first monitor 7 that displays the MR image by the MR apparatus 3, the tenth implementation is performed without affecting the patient's own deviation. The same effect as in the form of can be 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 therapeutic high-frequency energy in the microwave oscillator 17 disposed outside the MR examination room 4 which is an MRI magnetic shield room.

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

  As shown in FIG. 32, the coaxial filter 191 has a high-pass filter (HPF) characteristic having a transmission / cutoff switching value fc between the therapeutic 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 apparatus 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 that connects the magnetron in the microwave oscillator 17 and the microwave applicator 15 disposed in the MR examination chamber 4. Therefore, it is possible to cut noise before the microwave supplied from the magnetron in the microwave oscillator 17 enters the MRI observation space in the MR examination room 4. Therefore, treatment and imaging can be performed simultaneously by cutting noise that affects MRI tomographic imaging without any change in the therapeutic microwave. It is possible to simultaneously supply therapeutic high-frequency energy and obtain a tomographic image by the MR apparatus 3. Furthermore, this embodiment has an effect that a filter having a simple configuration such as a waveguide can be used.

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

  Therefore, since a band pass filter is used as the coaxial filter 191 in the present embodiment, the same filter can be used regardless of the imaging frequency of the MR apparatus 3. Further, when the 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 depending on the MR center frequency f2.

  FIG. 34 (B) shows a sixteenth embodiment of the present invention. This embodiment differs only in the filter characteristics of the coaxial filter 191 in the treatment apparatus 1 of the fourteenth embodiment (see FIGS. 31 to 33). That is, in this embodiment, as shown in FIG. 34B, a band cut filter (BCF) that blocks only the imaging frequency f2 of the MR apparatus 3 is used. In this band cut filter, if the upper limit value of the cut frequency is fcH and the lower limit value 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, so that heat generated in the filter 191 is small and the size of the filter 191 can be reduced. . Further, the same filter can be used regardless of the microwave frequency. The filter 191 may be a waveguide whose dimensions are simply adjusted and the cut-off frequency fc is adjusted as described above.

  FIGS. 35 and 36 show a seventeenth embodiment of the present invention. In this 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, such as an electric knife, that generates high-frequency energy for treatment within a high-frequency power source 204 disposed outside the MR examination room 4 that is a magnetic shield room for MRI. in use.

  Further, one end of each of the two transmission cables 201 and 202 is connected to a two-wire output high-frequency generator in the high-frequency power source 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 a two-wire output high-frequency generator in the high-frequency power source 204 and an active electrode and a return electrode (not shown) disposed in the MR examination chamber 4 are provided. A two-wire filter 203 is interposed in the middle. As shown in FIG. 36, the filter 203 has a low-pass filter (LPF) characteristic having a transmission / cutoff switching value fc between the therapeutic high-frequency frequency f1 and the MRI frequency f2.

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

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

FIG. 37B shows a nineteenth embodiment of the present invention. This embodiment differs only in the filter characteristics of the two-wire filter 203 in the treatment apparatus 1 of the seventeenth embodiment (see FIGS. 35 and 36). That is, in this embodiment, the two-wire output high-frequency generator in the high-frequency power supply 204 and the two transmission cables 201 and 202 that connect between the active electrode and the return electrode (not shown) in the MR examination room 4 are connected. A two-line filter 203 having a band cut filter characteristic for blocking only the imaging frequency of the MRI apparatus is provided in the middle.
As a result, the same filter can be used regardless of the therapeutic high frequency frequency. In addition, even in the case of a high-frequency treatment waveform having a harmonic frequency component such as a pulse waveform, noise cut that does not affect the waveform as much as possible is possible.

  FIG. 38 shows a twentieth embodiment of the present invention. In the present embodiment, a microwave applicator 15 is used as a therapeutic applicator for applying a therapeutic energy to a living body to treat a living tissue, and an ultra-diagnostic device is used as an observation means capable of recognizing the position of the microwave applicator 15. A sonic probe 212 is used. Here, the microwave applicator 15 is connected to the microwave generator 214 via a transmission relay coaxial cable 213. Further, the diagnostic ultrasonic probe 212 is connected to the ultrasonic imaging apparatus 215.

  A coaxial filter 216 is interposed in the middle of a transmission path for transmitting microwaves, which are therapeutic energy generated from the microwave generator 214, to the microwave applicator 15 using the transmission coaxial cable 213. . This 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 therapeutic microwave and the frequency for the ultrasonic imaging device 215.

  Therefore, in the above configuration, the coaxial filter 216 having the characteristics of a high-pass filter is interposed in the middle of the transmission coaxial cable 213 between the microwave generator 214 and the microwave applicator 15. Noise affecting sound image imaging can be cut before the microwave applicator 15 and the diagnostic ultrasonic probe 212 approach without changing the therapeutic microwave. Therefore, a beautiful ultrasonic image can be obtained even if the microwave treatment by the microwave applicator 15 and the imaging by the diagnostic ultrasonic probe 212 are performed simultaneously.

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

  FIG. 39 shows a twenty-first embodiment of the present invention. In the present embodiment, a reject scope 221 is used as a therapeutic applicator for applying a therapeutic 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 reject scope 221. A diagnostic ultrasonic probe 212 similar to the configuration (see FIG. 38) is used.

  Here, in the reject scope 221, a loop electrode 223, which is a high-frequency therapeutic electrode section, is disposed at the distal end of an elongated insertion section 222 that is inserted into the body cavity of a patient. Further, a high-frequency output is supplied to the loop electrode 223 of the reject scope 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 reject scope 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 interposed in the middle of the two transmission cables 225 and 226 that transmit the therapeutic energy generated from the two-wire output high-frequency generator 224. This filter 227 has the characteristics of a low-pass filter having a switching value between transmission and cutoff between the therapeutic high-frequency frequency and the ultrasonic imaging frequency.

  FIG. 39 shows an example in which the ultrasonic probe 212 is inserted into the patient's rectum Hh, and the insertion portion 222 and the loop electrode 223 of the reject scope 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 in the middle of the two transmission cables 225 and 226 that transmit the therapeutic energy generated from the high-frequency generator 224. Therefore, before the loop electrode 223 of the reject scope 221 and the diagnostic ultrasound probe 212 approach each other, noise that affects ultrasonic imaging can be cut without change to a therapeutic high frequency close to a sine wave waveform. . Therefore, a beautiful ultrasonic image can be obtained even if treatment and imaging are performed simultaneously.

  Note that the present invention is not limited to the combination of the present embodiment, and the present invention can be applied to all combinations of treatment with high-frequency energy and ultrasonic imaging that observes the treatment site.

  FIG. 40 shows a twenty-second embodiment of the present invention. In this embodiment, a puncture type bipolar electrode 231 is provided in place of the reject scope 221 of the twenty-first embodiment (see FIG. 39), and the puncture type bipolar electrode 231 and the ultrasonic probe 212 for rapa are combined. It is. In this embodiment, the same effect as that of the twenty-first embodiment can be obtained.

  FIG. 41 shows a twenty-third embodiment of the present invention. In this 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 that is a magnetic shield room for MRI, and a coaxial noise filter 243 is installed on the terminal board 242. The coaxial noise filter 243 is a transmission coaxial cable that connects between the microwave applicator 15 disposed in the MR examination room 4 and a microwave generator such as a magnetron in the microwave oscillator 17. It is provided 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 apparatus 3, a band cut filter or a high-pass filter is used.

  Therefore, in the case of the above configuration, by attaching the microwave relay cable 16 that 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 the present embodiment, as in the twenty-first embodiment (see FIG. 39), a receptscope 221 including a loop electrode 223 that is a high-frequency treatment electrode unit is used as a treatment applicator. A diagnostic ultrasonic probe 212 is used as an observation means capable of recognizing the position.

  In this embodiment, similarly to the 23rd embodiment (see FIG. 41), a terminal board 242 is provided on the side wall 241 of the MR examination room 4 which is a magnetic shield room for MRI, and the 21st embodiment (FIG. 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 is installed on the terminal board 242. 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 two high-frequency transmission cables 225 and 226 to the noise filter 251, imaging can be performed 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 of this embodiment is provided with an MRI imaging apparatus 262 and a treatment apparatus main body 263 that performs 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 apparatus main body 263 is provided with treatment energy generation means 268 and a treatment probe 270 (shown in FIG. 44) connected to the treatment energy generation means 268 via a treatment probe transmission cable 269. Yes.

  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 generating means 268 are connected to the recognition unit-treatment energy generation. They are connected via a signal cable 273 between means. In this embodiment, the treatment apparatus main body 263 performs treatment while observing in real time with the MRI imaging apparatus 262.

  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, the MRI gantry 264 is connected to the input side of the MRI control unit 274 via the MRI signal cable 266. Further, an image signal output unit 275 is connected to the output side of the MRI control unit 274.

  The therapeutic energy generation means 268 is provided with a therapeutic energy control unit 276, a therapeutic energy generation unit 277, and a therapeutic energy generation unit 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, an evaluation level setting unit 284, for example. An indicator lamp and a treatment end notification means 285 such as a buzzer are provided.

  Here, the recognition unit control unit 279 includes 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 to each other. Further, an image signal output unit 275 of the MRI controller 265 is connected to the image signal input unit 281 via a recognition unit-MRI controller signal cable 272. Furthermore, the therapeutic energy generating means signal input / output section 278 of the therapeutic energy generating means 268 is connected to the recognition unit signal input / output section 280 via a recognition unit-treatment energy generating means signal cable 273. Note that the display unit 282 is provided with a monitor 267 for displaying an MR image.

  Further, in the evaluation point setting means 283, as shown in FIG. 44, a plurality of treatment sites Hj in the MRI image by the MRI imaging apparatus 262 and its periphery are provided, and in this embodiment, four evaluation points a to d are assigned to the keyboard, mouse, track. It is set with a ball, a touch pen, or the like. Then, for example, luminance data at each of the four evaluation points a to d is displayed as a graph 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 four evaluation points a to d of the MRI image obtained by the MRI image pickup device 262, for example, a luminance setting level Ls, using a keyboard, mouse, trackball, touch pen, or the like. Yes. When all the luminance data at the four evaluation points a to d exceed the luminance setting level Ls set by the evaluation level setting means 284, the therapeutic energy is turned off.

  Next, the operation of the above configuration will be described. When the treatment apparatus 261 of the present embodiment is used, the operation according to the flowchart of the following FIG. 47 is performed. That is, before starting treatment by the treatment probe 270, an MRI image is picked up by the MRI image pickup device 262 in the first step S71. Subsequently, the image signal is transferred from the MRI controller 265 to the recognition unit 271 (step S72), and the MRI image by the MRI imaging device 262 is displayed on the display unit 282 of the recognition unit 271 (step S73).

  Thereafter, as shown in FIG. 44, the evaluation point setting means 283 in the recognition unit 271 includes a plurality of treatment sites Hj in the MRI image by the MRI imaging apparatus 262 and its surroundings, and four evaluation points a to d in this embodiment. It is set by a keyboard, mouse, trackball, touch pen, or the like (step S74). Further, in the next step S75, an evaluation level of luminance values, for example, a 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 device 262, is set by the evaluation level setting means 284. Set with a mouse, trackball, touch pen, etc. These settings are made while viewing the display content of the display unit 282 of the recognition unit 271.

  Thereafter, 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 treatment, an MRI image is first taken by the MRI imaging apparatus 262 (step S78). Subsequently, the image signal is transferred from the MRI controller 265 to the recognition unit 271 (step S79).

  Thereafter, the luminance levels at the four evaluation points a to d are monitored in step S80, and it is determined whether or not the luminances of all the evaluation points a to d have exceeded the evaluation level Ls in the next step S81. 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. 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 treatment end notification means 285 of the recognition unit 271 notifies the end of the treatment.

  Note that the brightness of the evaluation points a to d may be changed from white to black, or may be changed from black to white, for example, as treatment progresses by setting various parameters. And the case where the brightness | luminance of these evaluation points ad exceeds the evaluation level Ls has both cases.

  Therefore, the above configuration has the following effects. That is, in this embodiment, as shown in FIG. 44, the evaluation point setting means 283 assigns four evaluation points a to d to the treatment site Hj and its periphery in the MRI image by the MRI imaging apparatus 262, such as a keyboard, a mouse, a trackball, In addition to setting with a touch pen or the like, the evaluation level setting means 284 sets an evaluation level at four evaluation points a to d of the MRI image by the MRI imaging apparatus 262, for example, a luminance setting level Ls, and sets the evaluation level at four evaluation points a to d. Since the energy for treatment is turned off when each luminance data exceeds all the luminance setting levels Ls set by the evaluation level setting means 284, the treatment can be automatically terminated, and the treatment to the living body can be performed. The impact can be minimized. Furthermore, since the four evaluation points a to d are set around the treatment site Hj and its periphery in the MRI image, it is possible to definitely treat all the affected areas.

  In the present embodiment, either MRI tomographic image acquisition by the MRI imaging device 262 and therapeutic energy release by the therapeutic probe 270 may be performed simultaneously, or may be performed alternately.

  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) is changed as follows.

  That is, in this embodiment, when the treatment device 261 is used, control is performed in the same procedure as the 25th embodiment from step S71 to step S83 in the flowchart of FIG. 47 of the 25th embodiment. Then, after the notification of the end of treatment in step S83, as shown in the flowchart of FIG. 48, in the next step S84, transmission is performed from the recognition unit 271 to the therapeutic energy generating means 268, and the therapeutic energy generating means 268 performs the treatment end treatment. This is performed (step S85). Here, the treatment end treatment by the therapeutic energy generating means 268 is to automatically turn off the therapeutic energy output from the therapeutic probe 270 or to reduce the output value of the therapeutic energy.

  Therefore, in the above configuration, after the treatment of the treatment device 261 is completed, the treatment energy generation unit 268 automatically turns off the treatment energy from the treatment probe 270 or reduces the output value of the treatment energy. Therefore, 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 this embodiment, the configuration of the treatment apparatus 261 of the 25th embodiment (see FIGS. 43 to 47) is changed as follows.

  That is, in this embodiment, the evaluation ratio setting means 291 is newly provided in the recognition unit 271 of the 25th embodiment. When the treatment apparatus 261 is used, the treatment apparatus 261 is controlled according to the flowchart of FIG.

  Here, in the present embodiment, 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 the twenty-fifth embodiment. In step S75, after setting the luminance value setting level Ls for recognizing the end of treatment at the four evaluation points a to d of the MRI image, the process proceeds to the next new step S91.

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

  Thereafter, treatment is started as in the twenty-fifth embodiment (step S76). At the start of treatment, control is performed from step S76 to step S80 according to the same procedure as in the twenty-fifth embodiment. Then, 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 in the four evaluation points a to d have exceeded the evaluation level. Here, if it is determined that the evaluation score equal to or higher than the set ratio does not exceed the evaluation level, the process returns to step S78. If it is determined in step S92 that the evaluation score equal to or higher than the set ratio has exceeded the evaluation level, the treatment is terminated (step S82). Further, at the end of this treatment, in the next step 83, the treatment end notification means 285 of the recognition unit 271 notifies the end of the treatment.

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

  In this embodiment as well, 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 reduce the treatment energy. Good. Further, the evaluation ratio may be 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 action before treatment by the treatment probe 270 of the treatment apparatus 261 of the twenty-fifth embodiment (see FIGS. 43 to 47) is changed as follows.

  That is, in this embodiment, when the treatment apparatus 261 is used, control is performed in the same procedure as the 25th embodiment from step S71 to step S73 in the flowchart of FIG. 47 of the 25th 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 this step S101, the treatment site Hj that is the affected part 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 point setting means 283 adds an evaluation point, corrects the position of the automatically set evaluation points a to d, and the like.

  Thereafter, the process proceeds to step S75 similar to that in the twenty-fifth embodiment, and control is performed in steps similar to those in the twenty-fifth embodiment from step S75 to step S83.

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

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

  That is, in the present embodiment, when the treatment device 261 is used, control is performed in the same procedure as that of the 27th embodiment from step S71 to step S92 in the flowchart of FIG. 50 of the 27th embodiment. If it is determined in step S92 that the evaluation score equal to or higher than the set ratio has exceeded the evaluation level, the process proceeds to the next new step S111.

  In step S111, the treatment end notification unit 285 of the recognition unit 271 notifies the end of treatment. Thereafter, the process proceeds to step S81 in the flowchart of FIG. 47 in 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. 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 the treatment, the recognition unit 271 transmits to the treatment energy generating means 268 in the next step 112, and the treatment energy generating means 268 performs the treatment end treatment (step S113). Here, the treatment end treatment by the therapeutic energy generating means 268 is to automatically turn off the therapeutic energy output from the therapeutic probe 270 or to reduce the output value of the therapeutic energy.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, during the treatment end process by the treatment probe 270, the end of the treatment is notified at the first stage when the evaluation level of the evaluation points for the evaluation ratio is exceeded, and in the next stage all the evaluations are made. Since the two-stage processing for turning off or reducing the therapeutic energy is performed when the point evaluation level is exceeded, safety at the time of automatic termination can be improved.

  FIGS. 53 to 55 show a thirtieth embodiment of the present invention. In this embodiment, the configuration of the treatment apparatus 261 of the 25th embodiment (see FIGS. 43 to 47) is changed as follows.

  That is, in this embodiment, as shown in FIG. 54, reference point setting means 301 is newly provided in the recognition unit 271 of the 25th embodiment. 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. Furthermore, the evaluation ratio setting means 302 is provided so that the luminance setting level Ls, which is an evaluation level, is not set as an absolute value, but as a luminance ratio with respect to the reference point R.

  In addition, the reference point R is actually set by setting it at a place where it is considered that there is no influence of the therapeutic energy from the treatment probe 270 in the same organ Hk as the treatment site Hj in the MRI image by the MRI imaging device 262. You can get the street function. And when using the treatment apparatus 261, control of the treatment apparatus 261 is performed according to the flowchart of FIG.

  Here, in the present embodiment, 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 the twenty-fifth embodiment. In step S74, plural evaluation points a to d are set around the treatment site Hj and its periphery in the MRI image, and in the present embodiment, the process proceeds to the next new step S121. In step S121, the reference point marker R is set by the reference point setting means 301 by using a keyboard, a mouse, a trackball, a touch pen, etc. in addition to the four evaluation points a to d.

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

  Thereafter, treatment is started as in the twenty-fifth embodiment (step S76). At the start of this treatment, control from step S76 to step S80 is performed in the same procedure as in the twenty-fifth embodiment. Then, 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 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 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 have exceeded the evaluation ratio based on the reference point R, the treatment is ended (step S82). Further, at the end of this treatment, in the next step 83, the treatment end notification means 285 of the recognition unit 271 notifies the end of the treatment.

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

  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 30th embodiment (see FIGS. 53 to 55) is changed as follows.

  That is, in this embodiment, as shown in FIG. 56, instead of the reference points set by the reference point setting means 301 of the 30th embodiment in the recognition unit 271, the brightness of each evaluation point a to d is newly set. The initial value is used. And the memory | storage means 311 which memorize | stores the initial value of the brightness | luminance of each of the evaluation points ad is provided.

  Further, when the treatment apparatus 261 is used, the treatment apparatus 261 is controlled according to the flowchart of FIG. Here, in the present embodiment, control from step S71 to step S75 in the flowchart of FIG. 47 of the 25th embodiment (see FIGS. 43 to 47) is performed in the same procedure as that of the 25th embodiment. . Then, after the setting level Ls of the luminance 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 in step S75, the next new step Proceed to S131. In this step S131, the storage means 311 stores initial values of the luminance at the four evaluation points a to d of the MRI image.

  Thereafter, treatment is started in the same manner as in the 30th embodiment (step S76). At the start of this treatment, control is performed from step S76 to step S80 according to the same procedure as in the thirtieth embodiment. Then, 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 step S132, it is determined whether or not all of the four evaluation points a to d have exceeded 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 four evaluation points a to d have exceeded 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 treatment end notification means 285 of the recognition unit 271 notifies the end of the treatment.

  Therefore, in the present embodiment configured as described above, in place of the reference point setting means 301 of the thirtieth embodiment, a storage means 311 for newly storing initial values of the luminances of the respective evaluation points a to d is provided, and treatment is in progress. The treatment is terminated when it is determined that all of the four evaluation points a to d set around the treatment site Hj and its periphery in the MRI image have exceeded the evaluation ratio based on the initial value. Therefore, the same effect as that of the thirtieth embodiment can be obtained, and this embodiment can also be applied to the treatment of small organs in which the reference point R of the thirtieth embodiment is difficult to set.

  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 31st 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 in place of the evaluation ratio setting means 302 of the thirty-first embodiment. ing. Then, at the end of treatment, the end of treatment is determined not by the luminance at the evaluation points a to d but at the rate of change in the luminance at the evaluation points a to d.

  Further, when the treatment apparatus 261 is used, the treatment apparatus 261 is controlled according to the flowchart of FIG. Here, in the present embodiment, control from step S71 to step S74 in the flowchart of FIG. 47 of the 25th embodiment (see FIGS. 45 to 47) is performed in the same procedure as that of the 25th embodiment. . Then, in step S74, a plurality of, in the present embodiment, four evaluation points a to d are set around the treatment site Hj and its periphery in the MRI image, and then the process proceeds to the next new step S141. In this step S141, the luminance change rates of the four evaluation points a to d for determining the end of treatment are set by the evaluation change rate setting means 321 using a keyboard, mouse, trackball, touch pen, or the like.

  Thereafter, treatment is started as in the twenty-fifth embodiment (step S76). At the start of treatment, control is performed from step S76 to step S80 according to the same procedure as in the twenty-fifth embodiment. Then, 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 step S142, the luminance 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 calculation means 322 calculates the change rates of the respective evaluation points a to d. Thereafter, in the next step S144, it is determined whether or not the rate of change of all the evaluation points a to d is lower than the evaluation rate of change set by the evaluation rate of change setting means 321. Here, when it is determined that all the change rates of the four evaluation points a to d are not lower than the evaluation change rate, the process returns to step S78. If it is determined in step S144 that the rate of change of all evaluation points a to d is lower than the rate of change in evaluation, the treatment is terminated (step S82). Further, at the end of this treatment, in the next step 83, the treatment end notification means 285 of the recognition unit 271 notifies the end of the treatment.

  Therefore, in the present embodiment configured as described above, the end of treatment is determined based on the rate of change in the luminance of evaluation points a to d instead of the luminance of evaluation points a to d when determining the end of treatment. Here, when the therapeutic 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 moisture of the living tissue at the treatment site Hj is completely removed. Even if energy is further applied to the living tissue at the treatment site Hj, the water content does not change, and as a result, a phenomenon in which the luminance does not change occurs. Therefore, in the present embodiment, it is possible to reliably determine whether or not the living tissue at the treatment site Hj is completely killed by observing the rate of change in luminance at the evaluation points a to d and the living tissue at the treatment site Hj is completely dehydrated. There are advantages.

  FIGS. 60 to 63 show a thirty-third embodiment of the present invention. In this embodiment, the configuration of the treatment apparatus 261 of the 32nd embodiment (see FIGS. 58 and 59) is changed as follows.

  That is, in this embodiment, as shown in FIG. 60, an evaluation line setting unit 331 is newly provided in the recognition unit 271 instead of the evaluation point setting unit 283 of the thirty-second embodiment. In the thirty-second embodiment, the portion for evaluating the luminance is set as a plurality of points. In the present embodiment, as shown in FIG. 62, the treatment energy is supplied from the treatment probe 270 to the treatment site Hj. One reference line Lb extending in an appropriate direction from the radiation energy center O of treatment energy is set, and a plurality of points automatically set at regular intervals on this reference line Lb evaluate the luminance level. It is designed to be recognized as a point.

  Further, when the treatment apparatus 261 is used, the treatment apparatus 261 is controlled according to the flowchart of FIG. Here, in the present embodiment, control from step S71 to step S73 in the flowchart of FIG. 47 of the 25th embodiment (see FIGS. 45 to 47) is performed in the same procedure as that of the 25th 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, a portion for evaluating luminance is set as one reference line Lb by the evaluation line setting means 331 using a keyboard, mouse, trackball, touch pen or the like. Thereafter, in the next step S152, the luminance change rate of the evaluation reference line Lb set in step S151 is set by the evaluation change rate setting means 321 using a keyboard, mouse, trackball, touch pen, or the like.

  Thereafter, treatment is started as in the twenty-fifth embodiment (step S76). At the start of this treatment, control is performed from step S76 to step S79 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 step S153, the luminance levels at a plurality of set points on the evaluation reference line Lb are monitored. Thereafter, in the next step S154, the luminance level of each set point on the evaluation reference line Lb is stored in the storage means 311. Subsequently, in the next step S155, the change rate calculation means 322 calculates the change rate of the luminance level at each set point on the evaluation reference line Lb.

  Thereafter, in the next step S156, it is determined whether or not the change rate of all the set points on the evaluation reference line Lb is lower than the evaluation change rate. Here, when it is determined that the change rate of each set point on the evaluation reference line Lb is not in a state below the evaluation change rate, the process returns to step S78. If it is determined in step S156 that the change rate of each set point on the evaluation reference line Lb is less than the evaluation change rate, the treatment is terminated (step S82). Further, at the end of this treatment, in the next step 83, the treatment end notification means 285 of the recognition unit 271 notifies the end of the treatment.

  The graph shown in FIG. 63 shows an example of a graph of luminance change during treatment by the treatment probe 270, where the X axis is the distance on the line and the Y axis is the luminance. Here, by supplying energy from the treatment probe 270 during treatment, the luminance changes in numerical order from P1 to P5 according to the arrow as time passes. Eventually, there will be fewer changes. Instead of displaying this graph as it is, a configuration may be adopted in which several points on the line are adopted as representative values and displayed as a bar graph in FIG.

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

  Here, during the treatment, when the therapeutic energy is applied from the treatment probe 270 to the living tissue (the treatment site Hj) and the temperature rises, and the water in the treatment site Hj is completely drained, the living body at the treatment site Hj is removed. Even if more energy is applied to the tissue, the water content does not change, and as a result, the luminance does not change. And no matter how much energy you give, the effect will not spread. This is the limit of the treatment range. Therefore, in the present embodiment, by setting one reference line Lb passing through the position of the energy emission center O and evaluating the change rate of the luminance level at a plurality of set points on the reference line Lb, It is possible to reliably determine whether this therapeutic range limit 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 instead of the evaluation line setting unit 331 and the evaluation change rate setting unit 321 of the thirty-third embodiment. 341 is provided, and evaluation level setting means 284 is provided.

  Further, when the treatment apparatus 261 is used, the treatment apparatus 261 is controlled according to the flowchart of FIG. Here, in the present embodiment, control from step S71 to step S73 in the flowchart of FIG. 47 of the 25th embodiment (see FIGS. 45 to 47) is performed in the same procedure as that of the 25th 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 S161. In this step S161, the evaluation point setting means 341 based on lines and distances sets the luminance evaluation point X1 with a keyboard, mouse, trackball, touch pen or the like.

  Thereafter, treatment is started as in the twenty-fifth embodiment (step S76). At the start of treatment, control is performed from step S76 to step S80 according to 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 the line is displayed as shown in FIG. Thereafter, in the next step S163, it is determined whether or not the luminance at the evaluation point X1 has exceeded the evaluation level V1. Here, if it is determined that the brightness of the evaluation point X1 does not exceed the evaluation level V1, the process returns to step S78. If it is determined that the luminance of the evaluation point X1 exceeds the evaluation level V1, the treatment is terminated (step S82). Further, at the end of this treatment, in the next step 83, the treatment end notification means 285 of the recognition unit 271 notifies the end of the treatment.

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

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

  Therefore, the present embodiment having the above-described configuration is characterized in that the evaluation point setting method is performed using a line and a distance, and a luminance graph on the line is displayed. Therefore, there is an effect that it is easy to visually grasp the treatment end state by displaying the luminance graph on the line set by the evaluation point setting means 341 based on the line and the distance.

  67 to 69 show a thirty-fifth embodiment of the present invention. In this embodiment, the configuration of the treatment apparatus 261 of the 25th embodiment (see FIGS. 45 to 47) is changed as follows.

  That is, in this embodiment, for example, the twenty-second embodiment (see FIG. 40) replaces the MRI imaging apparatus 262 of the twenty-fifth embodiment as observation means that can recognize the position of the treatment probe 270 that is a therapeutic applicator. ) Is used.

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

  Further, when the treatment apparatus 261 of the present embodiment is used, an operation according to the flowchart of FIG. 69 is performed. That is, before starting treatment with the treatment probe 270, first, an ultrasonic image is taken with the diagnostic ultrasound probe 212 in step S171. Subsequently, an image signal is transferred from the ultrasound imaging apparatus 215 to the recognition unit 271 (step S172), and an ultrasound image by the ultrasound 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 includes a plurality of treatment sites Hj in the ultrasonic image by the ultrasonic probe 212 and the periphery thereof, and four evaluation points a to d in the present embodiment. Are set by a keyboard, mouse, trackball, touch pen, or the like (step S174). Further, in the next step S175, the evaluation level setting means 284 determines the evaluation level of the luminance value, for example, the luminance setting level Ls for recognizing the end of treatment at the four evaluation points a to d of the ultrasonic image by the ultrasonic probe 212. Set by keyboard, mouse, trackball, touch pen, etc. These settings are made while viewing the display content of the display unit 282 of the recognition unit 271.

  Thereafter, 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).

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

  Thereafter, the luminance levels at the four evaluation points a to d are monitored in step S180, and it is determined in the next step S181 whether or not the luminances of all the evaluation points a to d have 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 S178. Then, when it is determined that the brightness 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, in the next step 183, the treatment end is notified by the treatment end notification means 285 of the recognition unit 271.

  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 around and around the treatment site Hj in the ultrasonic image obtained by the ultrasonic probe 212, there is an effect that it is possible to definitely treat all the affected areas.

  In this embodiment, as an example, an ultrasonic image of the MRI imaging apparatus 262 of the 25th embodiment as an observation means capable of recognizing the position of the therapeutic applicator is shown in the 22nd embodiment (see FIG. 40). Although the configuration replaced with the device 215 is shown, it is obvious that the same can be easily performed in other embodiments.

  Furthermore, combinations between the above embodiments can be freely performed. For example, in the system using the ultrasonic imaging apparatus 215 of the 35th embodiment (see FIGS. 67 to 69), the output of the energy generating means 268 automatically as in the 26th embodiment (see FIG. 48). You may combine the structure which turns off or reduces.

Furthermore, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.
Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional Item 1) Diagnostic imaging apparatus, therapeutic applicator capable of recognizing position on diagnostic imaging apparatus, and control of therapeutic energy applied to living body via therapeutic applicator by receiving signal from diagnostic imaging apparatus Treatment system having a device to perform.

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

  (Additional Item 3) The system according to Additional Item 2, 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 Additional Item 2, wherein the diagnostic imaging apparatus has a function of starting observation when the output of the energy therapy apparatus is reduced or stopped.

  (Additional Item 5) The system according to Additional Item 2, which has 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 an imaging start and stop signal of the MR observation apparatus.

  (Additional Item 7) The system according to Additional Item 2, which mediates an imaging parameter signal 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 Additional Item 2, which mediates signals for starting and stopping the output of the energy therapy apparatus and setting an output level.

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

  (Additional Item 11) The system according to Additional Item 2, which optionally includes the functions of Additional Items 3 to 10.

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

  (Additional Item 13) In the system including the therapeutic energy generation means and the tomographic image acquisition means for observing the treatment site, a noise filter is provided in the middle of the energy transmission path means between the treatment energy generation unit and the treatment site. A therapeutic system that removes frequency components that affect the tomographic image acquisition means from the generated energy from the therapeutic energy generation means.

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

  (Additional Item 15) The system according to Additional Item 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 unit is MRI.

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

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

  (Additional Item 19) The system according to Additional Item 13, wherein the noise filter is a band cut filter corresponding to the 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 allows only the main frequency side of the energy generation unit to pass from the frequency between the main frequency of the energy generation unit and the reception frequency of the tomographic image acquisition unit. Additional note 13 system.

  (Additional Item 21) The system according to Additional Item 16, wherein the noise filter is provided in an input part of the magnetic shield room.

  (Additional Item 22) A treatment system having a control device for recognizing a marker attached to a treatment electrode or an applicator on the screen of an image diagnostic apparatus and controlling the energy treatment apparatus.

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

  (Additional Item 24) The system according to Additional Item 22, which has 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 Additional Item 22, which has a function of stopping output of the energy therapy apparatus when an image signal of a predetermined marker portion changes.

  (Additional Item 26) A treatment system having a control unit for recognizing a marker attached to a treatment electrode or an applicator on the screen of an image diagnostic apparatus and controlling the energy treatment apparatus and the treatment instrument moving apparatus.

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

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

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

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

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

  (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, in which an evaluation point or an evaluation line is automatically set from 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, in which 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 the comparison value of the luminance at the evaluation point with that before the supply of therapeutic energy is used as the image data value.

  (Additional Item 37) The system according to Additional Item 27, wherein the 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 image data values of all evaluation points have reached a predetermined threshold.

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

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

  (Additional Item 41) The system according to Additional Item 27, wherein the rate of change in 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 Additional Item 43, wherein an MR marker 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 base is installed.

  (Additional Item 45) The applicator according to Additional Item 44, which includes one or a plurality of MR markers.

  (Additional Item 46) The applicator according to Additional Item 44, wherein an MR marker is provided on the distal end side of the therapeutic energy output unit.

  (Additional Item 47) The applicator according to Additional Item 44, wherein an MR marker is provided on the rear end side of the therapeutic energy output unit.

  (Additional Item 48) The applicator according to Additional Item 44, wherein MR markers are provided on the front end side and the rear end side of the treatment energy output unit.

  (Additional Item 49) The applicator according to any one of the additional items 44 to 48, wherein the positions of the therapeutic 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 capturing an observation image of a biological tissue by the observation means of the biological tissue, and a position of the therapeutic applicator for treating the biological tissue by applying therapeutic energy to the living body from the observation image by the observation means. An applicator position recognizing step for recognizing, and a control step for controlling therapeutic energy applied to the living body from the therapeutic applicator based on position data of the therapeutic applicator recognized in the step. A method for controlling a therapeutic device.

BRIEF DESCRIPTION OF THE DRAWINGS The schematic block diagram of the whole system in the treatment apparatus of the 1st Embodiment of this invention. (A) is a schematic block diagram which shows the treatment state in the treatment apparatus of 1st Embodiment, (B) is a longitudinal cross-sectional view which shows a microwave applicator. The schematic block diagram which shows the connection state of the control unit in the treatment apparatus of 1st Embodiment. The block diagram which shows the connection state of the control part in the treatment apparatus of 1st Embodiment. The flowchart for demonstrating the effect | action of the treatment apparatus of 1st Embodiment. The longitudinal cross-sectional view which shows MR image when the applicator of the treatment apparatus of 1st Embodiment is inserted in the body. The longitudinal cross-sectional view which shows the MR image at the time of the microwave coagulation by the applicator of the treatment apparatus of 1st Embodiment. The characteristic view which shows the range of the magnetic susceptibility of an applicator and MR marker. The longitudinal cross-sectional view which shows the principal part structure of the applicator in the treatment apparatus of the 2nd Embodiment of this invention. The longitudinal cross-sectional view which shows MR image when the applicator of the treatment apparatus of 2nd Embodiment is inserted in the body. The longitudinal cross-sectional view which shows the MR image at the time of the microwave coagulation by the applicator of the treatment apparatus of 2nd Embodiment. The longitudinal cross-sectional view which shows the principal part structure of the applicator in the treatment apparatus of the 3rd Embodiment of this invention. The longitudinal cross-sectional view which shows the applicator in the treatment apparatus of the 4th Embodiment of this invention. The perspective view of the principal part which shows the use condition of the treatment apparatus of the 5th Embodiment of this invention. The perspective view which shows the principal part structure of the applicator in the treatment apparatus of 5th Embodiment. The perspective view which shows the principal part structure of the applicator in the treatment apparatus of the 6th Embodiment of this invention. The longitudinal cross-sectional view which shows schematic structure of the applicator in the treatment apparatus of the 7th Embodiment of this invention. The schematic block diagram of the whole treatment apparatus of the 8th Embodiment of this invention. The block diagram which shows the connection state of the control part in the treatment apparatus of 8th Embodiment. The flowchart for demonstrating the effect | action of the treatment apparatus of 8th Embodiment. The schematic block diagram of the whole treatment apparatus of the 9th Embodiment of this invention. The flowchart for demonstrating the effect | action of the treatment apparatus of 9th Embodiment. The schematic block diagram of the whole treatment apparatus of the 10th Embodiment of this invention. The block diagram which shows the connection state of the control part in the treatment apparatus of 10th Embodiment. The schematic block diagram of the whole treatment apparatus of the 11th Embodiment of this invention. The block diagram which shows the connection state of the control part in the treatment apparatus of 11th Embodiment. The schematic block diagram of the whole treatment apparatus of the 12th Embodiment of this invention. The block diagram which shows the connection state of the control part in the treatment apparatus of 12th Embodiment. The flowchart for demonstrating the effect | action of the treatment apparatus of 12th Embodiment. The schematic block diagram of the whole treatment apparatus of the 13th Embodiment of this invention. The schematic block diagram of the whole treatment apparatus of 14th Embodiment of this invention. The filter characteristic view of the treatment apparatus of 14th Embodiment. The top view which shows an example of the tomogram by the treatment apparatus of 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 block diagram of the whole treatment apparatus of the 17th Embodiment of this invention. The filter characteristic view of the treatment apparatus of a 17th embodiment. (A) is a filter characteristic diagram of the treatment apparatus in the eighteenth embodiment of the present invention, and (B) is a filter characteristic diagram of the treatment apparatus in the nineteenth embodiment of the present invention. The schematic block diagram of the whole treatment apparatus of the 20th Embodiment of this invention. The schematic block diagram of the whole system in the treatment apparatus of the 21st Embodiment of this invention. The schematic block diagram of the whole system in the treatment apparatus of the 22nd Embodiment of this invention. The longitudinal cross-sectional view of the principal part which shows the 23rd Embodiment of this invention. The longitudinal cross-sectional view of the principal part which shows 24th Embodiment of this invention. The schematic block diagram of the whole system in the treatment apparatus of the 25th Embodiment of this invention. The top view which shows the display content of the recognition unit in the treatment apparatus of 25th Embodiment. The figure which shows the display state of the measured temperature in the treatment apparatus of 25th Embodiment. The block diagram which shows schematic structure of the recognition unit in the treatment apparatus of 25th Embodiment. The flowchart for demonstrating the effect | action of the treatment apparatus of 25th Embodiment. The flowchart for demonstrating the principal part of an effect | action of the therapeutic apparatus of the 26th Embodiment of this invention. The block diagram which shows schematic structure of the recognition unit in the therapeutic apparatus of the 27th Embodiment of this invention. The flowchart for demonstrating the effect | action of the treatment apparatus of 27th Embodiment. The flowchart for demonstrating the effect | action in the therapeutic apparatus of the 28th Embodiment of this invention. The flowchart for demonstrating an effect | action of the treatment apparatus of the 29th Embodiment of this invention. The top view which shows the display content of the recognition unit in the treatment apparatus of the 30th Embodiment of this invention. The block diagram which shows schematic structure of the recognition unit in the treatment apparatus of 30th Embodiment. The flowchart for demonstrating the effect | action of the treatment apparatus of 30th Embodiment. The block diagram which shows schematic structure of the recognition unit in the therapeutic apparatus of the 31st Embodiment of this invention. The flowchart for demonstrating the effect | action of the treatment apparatus of 31st Embodiment. The block diagram which shows schematic structure of the recognition unit in the therapeutic apparatus of the 32nd Embodiment of this invention. The flowchart for demonstrating the effect | action of the treatment apparatus of 32nd Embodiment. The block diagram which shows schematic structure of the recognition unit in the therapeutic apparatus of the 33rd Embodiment of this invention. The flowchart for demonstrating the effect | action of the treatment apparatus of 33rd Embodiment. The top view which shows a part of display content of the recognition unit in the treatment apparatus of 33rd Embodiment. The characteristic view which shows the luminance change in the treatment apparatus of 33rd Embodiment. The block diagram which shows schematic structure of the recognition unit in the treatment apparatus of 34th Embodiment of this invention. The flowchart for demonstrating the effect | action of the treatment apparatus of 34th Embodiment. The top view which shows a part of display content of the recognition unit in the treatment apparatus of 34th Embodiment. The schematic block diagram of the whole system in the therapeutic apparatus of embodiment of the 35th therapeutic apparatus of this invention. The block diagram which shows schematic structure of the recognition unit in the treatment apparatus of 35th Embodiment. The flowchart for demonstrating the effect | action of the treatment apparatus of 35th Embodiment.

Explanation of symbols

    DESCRIPTION OF SYMBOLS 3 ... MR apparatus (image construction means), 6 ... MR apparatus control part (construction instruction means), 7 ... First monitor (display means), 15 ... Microwave applicator (treatment applicator), 17 ... Microwave Oscillator (drive signal generating means), 21... Control unit (control means), 48.

Claims (2)

A therapeutic applicator for applying therapeutic energy to a living body to treat living tissue;
Drive signal generating means for generating the treatment energy from the treatment applicator by outputting a drive signal to the treatment applicator;
Image constructing means provided so as to be able to construct as an image the status of the treatment site of the living body to be treated by the therapeutic energy generated from the therapeutic applicator;
Construction instruction means for instructing the image construction means to construct the image;
An operation discriminating unit for discriminating an operation status of the image construction unit according to an instruction of the construction instruction unit;
Control means for controlling the drive signal generating means so that the output of the drive signal generated from the drive signal generating means is variable according to the determination result of the operation determining section;
A treatment system comprising: A therapeutic applicator for applying therapeutic energy to a living body to treat living tissue;
Drive signal generating means for generating the treatment energy from the treatment applicator by outputting a drive signal to the treatment applicator;
Image constructing means provided so as to be able to construct as an image the status of the treatment site of the living body to be treated by the therapeutic energy generated from the therapeutic applicator;
Construction instruction means for instructing the image construction means to construct the image;
An operation discriminating unit for discriminating an operation status of the image construction unit according to an instruction of the construction instruction unit;
Output setting means provided so that the output of the drive signal generated from the drive signal generating means can be set to a desired output;
Output switching means provided so as to be able to switch the output of the drive signal generated from the drive signal generating means to a predetermined output set by the output setting means in accordance with the determination result of the operation determination unit When,
Control means for controlling the drive signal generating means so as to generate the drive signal of the output switched according to the output switching means;
A treatment system comprising:

Images