JP2005125058A - X-ray diagnostic apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an X-ray diagnostic apparatus which enables X-ray fluoroscopy at a free angle around the iso-center, prevents operator's access to the subject from being disturbed, and is easily manufactured and set. <P>SOLUTION: This X-ray diagnostic apparatus comprises an X-ray generation mechanism 2 to expose an X-ray to a subject 1, an X-ray detector 3 to detect an X-ray transmitting through the subject 1, a C-arm bent in an almost C-shape for attaching the X-ray generation mechanism 2 and the X-ray detector 3 to both ends, an almost arc shape guide mechanism 5 set on a floor surface, and a support part 6 set movable along the guide mechanism 5 to support the C-arm 4. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

The present invention relates to a medical X-ray diagnostic apparatus, and more particularly to an X-ray diagnostic apparatus including a C-arm arranged so that an X-ray irradiation means and an X-ray detection means face each other.

The X-ray diagnostic apparatus transmits X-rays into a subject and images the captured image. X-ray diagnostic apparatuses have a wide range of applications, and various apparatuses have been developed for different diagnostic purposes.

For example, an X-ray diagnostic apparatus for a circulatory system uses an angiographic examination by injecting a contrast medium from a catheter inserted into a blood vessel, or an IVR (I
nterventional radiology).

For example, when there is a diseased part in the head, the IVR or contrast examination proceeds to the head while inserting a catheter from the femoral artery and confirming it by X-ray fluoroscopy. In particular, since a blood vessel for advancing a catheter is selectively inserted in the head, heart, and abdomen, it is difficult to understand a complicated blood vessel running state only by fluoroscopy in one direction. Therefore, it is necessary to change the fluoroscopy direction, confirm the running of the blood vessel in three dimensions from various directions, and proceed with treatment.

Therefore, in order to perform X-ray fluoroscopy rich in stereoscopic effect, it is necessary to be able to change the X-ray fluoroscopy angle with respect to the subject freely and easily. For example, if the X-ray fluoroscopic angle can be freely changed with respect to three orthogonal axes, any X-ray fluoroscopic angle can be set for the subject, and a disease can be quickly and accurately detected.

A conventional X-ray diagnostic apparatus based on such circumstances will be described below. FIG. 6 is a block diagram showing an example of a conventional X-ray diagnostic apparatus. This X-ray diagnostic apparatus includes an X-ray generation mechanism 102 for exposing the subject 101 to X-rays, and an X-ray detector 103 for detecting X-rays transmitted through the subject 101.
And a C-arm 104 that is attached to both ends of the X-ray generation mechanism 102 and the X-ray detector 103 and is curved in a substantially C shape, and a support portion 106 that supports the C-arm 104.

The X-ray diagnostic apparatus further includes a bed mechanism 108 having a couch 107 that slides in the body axis direction of the subject 101, an operation unit 109, and an X-ray image monitor (not shown) that displays the obtained image. Have. The C arm 104 is supported by the support portion 106 so as to be rotatable around the Y axis. The C-arm 104 has a mechanism that causes the X-ray detector 103 and the X-ray generation mechanism 102 to rotate around the X axis by sliding along the bending direction.

Further, the support portion 106 is substantially L-shaped and has a structure that is rotatably installed on the floor surface on a vertical line that is lowered from the isocenter 101a to the floor. In such a conventional X-ray diagnostic apparatus,
X-ray radiation can be performed at any angle with respect to the three orthogonal axes of XYZ shown in the figure. Therefore, X-ray fluoroscopy with a rich stereoscopic effect is possible. An X-ray diagnostic apparatus having this type of configuration is disclosed in Patent Document 1, for example.

In addition to such a configuration, there is an X-ray diagnostic apparatus provided with an offset unit for preventing contact between the subject and the apparatus. By providing the offset portion, even a relatively small C-arm can emit X-rays from any direction as long as it is from the head to the heart region.

By the way, in general, when performing an IVR or contrast examination, at least three operators of an X-ray diagnostic apparatus engineer, a doctor who operates a catheter and the like and an anesthesiologist are required. That is, three or more surgeons are in contact with each patient. For this reason, it is preferable that the X-ray diagnostic apparatus has a configuration that allows the operator's work space to be as wide and free as possible.

However, in the conventional X-ray diagnostic apparatus as described above, since the support portion 106 is L-shaped, a portion corresponding to the bottom of the L-shape of the support portion 106 exists on the floor near the imaging region. As a result, the range in which the surgeon can approach the subject 101 is limited by the apparatus. For example, an operator who is in charge of anesthesia needs to pay attention to the facial expression of the subject, the inhalation mask, and the like. Therefore, it is easier to perform the operation if the operator is located near the head of the subject. However, when the support part 106 is arranged on the body axis of the subject 101 as shown in the figure, the surgeon stands up straddling the support part 106 and cannot be said to be a suitable environment.

Further, since the rotation mechanism 110 of the support unit 106 must be provided in the installation unit on the floor, the mechanism unit 110 having a certain size exists on the vertical line that is lowered from the isocenter 101a to the floor. For this reason, in order to freely rotate the C-arm 104, the installation positions of the C-arm 104 and the top plate 107 become high, making it difficult for the subject 101 to move smoothly to the top plate 107, and also for the operator. There is a disadvantage that it is difficult to work. This is particularly noticeable and important for a short surgeon.

In particular, in the treatment by IVR, it is often a delicate and long-time treatment as compared with the contrast examination, and it is important to secure a work space suitable for the operator. However, as described above, the X-ray diagnostic apparatus having such a substantially L-shaped support portion does not satisfy such a situation.

This not only hinders the efficiency of currently available IVR and contrast examinations, but also restricts the possibility of various IVR and contrast examination procedures to be developed in the future.

In addition, an X-ray diagnostic apparatus disclosed in Patent Document 2 includes a support unit that supports a C-arm so as to be rotatable about two axes orthogonal to each other, and a rail that is laid obliquely with respect to the body axis of the subject on the floor surface. And a mechanism for moving the support portion along the rail.

Further, Patent Document 2 also shows an X-ray diagnostic apparatus having a structure suspended from a ceiling so that a support portion for connecting a C-arm so as to be rotatable around two axes in a horizontal plane can be moved along the rail. ing.

In such an X-ray diagnostic apparatus, the operator's approach to the subject is not hindered by the support portion. Moreover, since there is nothing blocking the rotation of the C-arm below the isocenter, the top plate can be installed low.

However, in such a conventional X-ray diagnostic apparatus, no consideration is given to the case of performing X-ray fluoroscopy from free angles around three axes passing through the isocenter. In order to rotate the photographing mechanism around the Z axis in FIG. 1, a complicated control mechanism is required.

In addition, the X-ray diagnostic apparatus having a structure in which the support part is suspended is difficult to construct because it requires both ceiling and floor construction, and is suspended from the structure of the installed building. It has the disadvantage that it may not be possible.
JP 62-167536 A Japanese Patent Laid-Open No. 10-43168

An X-ray diagnostic apparatus has been required to have a high degree of freedom in imaging angle when performing X-ray fluoroscopy, easy access to the subject and the operator's top plate, and a sufficient working space. Yes. However, in the conventional X-ray diagnostic apparatus disclosed in Patent Document 1 described above, the operator's feet are blocked by the bottom of the substantially L-shaped support part, or the top plate is raised due to the mechanism part for rotation. In other words, there is a drawback that the access to the subject and the operator is greatly hindered. Moreover, in the conventional X-ray diagnostic apparatus shown in Patent Document 2, free X-ray fluoroscopy around the isocenter is not taken into consideration, and it takes time for manufacturing and installation.

Therefore, the present invention provides an X-ray diagnostic apparatus capable of X-ray fluoroscopy from a free angle around an isocenter, having little trouble in accessing an operator's subject, and easy to manufacture and install. Objective.

In order to achieve the above object, an X-ray diagnostic apparatus according to the present invention comprises a placement means for placing a subject, an X-ray irradiation means for irradiating the subject with X-rays, and the subject. X that passed through
X-ray detecting means for detecting a line, and a substantially arc-shaped C-shaped portion in which the X-ray irradiating means and the X-ray detecting means are arranged to face each other are slid and rotated around the subject. A C-arm, a support portion for supporting the C-arm so as to be rotatable about a horizontal axis orthogonal to the central axis of the sliding rotation, and a rotation about the central axis of the sliding rotation and the horizontal axis A substantially arc-shaped guide mechanism having a radius of curvature centering on a vertical axis passing through an isocenter that is an intersection with the center axis of the guide, and a guide mechanism having a substantially arc shape for guiding the movement of the support portion, and slidably engaged with the guide mechanism. And an engaging part that supports the supporting part.

According to the present invention, it is possible to perform X-ray fluoroscopy around an isocenter from a free angle, there is little trouble in accessing an operator's subject, and it is easy to install at a production and use place. An X-ray diagnostic apparatus can be provided.

  Embodiments of an X-ray diagnostic apparatus according to the present invention will be described below with reference to FIGS.

FIG. 1 is a configuration diagram of an embodiment of an X-ray diagnostic apparatus according to the present invention. The X-ray diagnostic apparatus of the present embodiment is suitable for use in, for example, a circulatory system, and includes an X-ray generation mechanism 2 that is an X-ray irradiation unit for the subject 1 and an X-ray detection unit that transmits the subject 1. A certain X-ray detector 3, a C-arm 4 having a substantially C-shaped curved portion for attaching the X-ray generation mechanism 2 and the X-ray detector 3 to both ends, and a substantially arc-shaped facility provided on the floor surface The guide mechanism 5 is configured to be movable using the guide mechanism 5 and includes a support portion 6 for supporting the C arm 4.

The X-ray diagnostic apparatus also includes a bed mechanism 8 having a top plate 7 on which the subject 1 is placed, an operation unit 9 for an operator to operate each unit, and an image obtained from the X-ray detector 3. It comprises an X-ray image monitor (not shown) for display.

  Hereinafter, the structure of each part of the X-ray diagnostic apparatus in a present Example is demonstrated concretely.

The X-ray detector 3 is an I.D. I. (Image Intensifier),
Even if it is comprised from the combination of an optical system and TV camera, you may be comprised by FPD (Flat Panel Detector: Flat Panel Detector). Note that even if the FPD is a direct conversion type in which the charge generated when the photoconductor absorbs X-rays is directly used as a signal, the X-ray is once absorbed by the phosphor and the generated light is charged by the photodiode. It may be either an indirect conversion type that converts the signal into a signal.

It is assumed that the X-ray image monitor is placed in a place where the operator can easily see. Moreover, in order to display a some image simultaneously, or since it can visually recognize from every operator, you may be comprised from the some monitor apparatus.

The top plate 7 is arranged so that the subject 1 on the top plate 7 comes near the isocenter 1a. The bed mechanism 8 has a mechanism for sliding the top board 7 in the direction of the subject axis, and can move the subject 1 in the direction of the body axis. Furthermore, in order to raise the freedom degree of imaging | photography, you may have a mechanism which performs a vertical movement and a movement parallel to a floor surface.

The C arm 4 is supported by the support portion 6 so as to be rotatable around the Y axis shown in FIG. The C arm 4 has a sliding rotation mechanism along the bending direction. Thereby, the X-ray detector 3 and the X-ray generation mechanism 2 can be rotated around the X axis. The intersection of the X axis and the Y axis, which are the two rotation axes described above, is defined as an isocenter 1a.

Further, the C arm 4 is rotatably supported by the support portion 6 via a substantially L-shaped offset portion 4a to prevent contact with the subject, and the central axis of the rotation of the C arm 4 and the X-ray generation mechanism. The X-ray detector 3 and the X-ray generation mechanism 2 are arranged so that regions where X-ray emission from 2 is overlapped. In the case of such a shape, when the support unit 6 is positioned in the body axis direction of the subject 1 as shown in FIG. Therefore, even if the C arm 4 is relatively small, the C arm 4 can be moved at a free angle in the heart region.

The C arm 4 needs to have a certain size in order to avoid contact with a device such as the bed mechanism 8. On the other hand, the position of the isocenter 1a needs to be lowered to some extent in order to improve the operator's access to the subject 1 and to make the subject 1 get on and off the top plate 7 smoothly. Therefore, the C arm 4 is arranged at a position as low as possible within a range in which the C arm 4 can freely rotate.

The guide mechanism 5 is installed so as to have a radius of curvature with the isocenter 1a as the center. Therefore, the angle of X-ray radiation is added to the X axis and Y axis around the isocenter 1a,
A mechanism capable of changing also with respect to the three orthogonal axes of the Z axis is provided. The guide mechanism 5 only needs to have a structure for guiding the movement of the support portion 6. For example, a rail mechanism based on a well-known mechanical contact may be used.

As an example, an example of a rail-type guide mechanism 5 is shown in FIG. FIG. 2 is a cross-sectional view showing an example of the guide mechanism 5. The rail portion 11 is a rod-like rigid body curved in an arc shape with a substantially square cross section, and is fixed to the floor. The stage portion 12 uses a rigid body having a substantially Ω-shaped cross section so as to engage with the rail portion 11. The stage unit 12 is connected to the rail unit 1 via a rotatable ball 13.
1 is supported. As a result, friction due to movement of the stage portion 12 can be reduced, and the stage portion 12 and the rail portion 11 can be brought into close contact with each other and stably engaged. This stage part 1
2 is fixed to the support portion 6 and further fitted into the rail portion 11. According to such a mechanism, there is no wobbling of the support portion 6 in a direction perpendicular to the arc, and the support portion 6 and the C arm 4 can be supported only by the guide mechanism 5. In addition, by using the ball 13, the guide mechanism 5 can be easily moved in the arc direction of the guide mechanism 5 even manually. Here, the ball 13
In addition to the above, a cylindrical roller or the like may be used.

Further, it is assumed that the support 6 can be moved electrically by remote control. An example of the moving mechanism will be described with reference to FIGS. FIG. 3 is a view showing an example of a moving mechanism for moving the support portion 6, and FIG. 4 is an enlarged view of FIG. 3 showing an example of a moving mechanism provided in the support portion.
The belt 14 is fixed to both ends of the rail portion 11, and is provided in the support portion 6 along the belt 14.
By driving the motor / reduction gear 15 shown in FIG.
The belt 14 is guided to the motor / reduction gear 15 by using two pulleys 16.
Here, since the stage part 12 is provided between the two pulleys 16, the belt and the stage part 12 do not interfere with each other. Further, a moving mechanism may be provided in which a tooth portion is provided on the rail portion 11 and a gear meshing with the tooth portion and a motor / reduction gear that rotates the gear are installed on the support portion 6. further,
Such a moving mechanism may be configured using a rail different from the guide mechanism 5.

In addition, in order to quickly find the target X-ray radiation angle, and to facilitate three-dimensional grasp of the fluoroscopic region by freely changing various X-ray radiation angles, the three axes described above are used. The rotation of the X-ray generation mechanism 2 and the X-ray detector 3 and the movement of the top plate 7 can be performed in parallel as necessary.

Moreover, it is preferable that the operation part 9 is easy to perform an operation in which a plurality of motion mechanisms as described above are linked. For example, an operation stick having a mechanism that can be tilted freely in the front-rear and left-right oblique directions and twisted in the horizontal direction may be provided on the operation panel in the vicinity of the bed mechanism 8. When the operation stick is tilted to the left or right, the sliding rotation mechanism of the C arm 4 is driven. When the operation stick is tilted back and forth, the C arm 4 rotates. When twisted in the horizontal direction, the support portion 6 is moved. It is preferable that an operator who can determine the speed of each exercise according to the angle to be operated can be easily operated sensuously.

This operation stick can simultaneously perform three types of exercises by, for example, tilting it while twisting. Furthermore, since this operation stick can be operated with only one hand,
By providing the operation switch and the like of the top plate 7 on the same operation panel, all attitude control relating to X-ray emission can be performed simultaneously. The operation unit 9 can include various accompanying devices such as a terminal for controlling the entire system, in addition to the operation panel provided accompanying the bed mechanism 8.

Since X-ray radiation is possible from various angles, the X-ray detector 3 is rotatably supported in a plane perpendicular to the X-ray radiation direction. Here, by linking the movement of the support unit 6 and the rotation of the X-ray detector 3, the direction of the image displayed on the X-ray image monitor can be kept constant. This mechanism can be realized using a simple mechanism because the relationship between the rotation angle of the X-ray detector 3 and the position of the support portion 6 may be determined in advance.

Next, the operation of the X-ray diagnostic apparatus according to this embodiment will be described with reference to FIG. Here, a case will be described in which the X-ray diagnostic apparatus of the present embodiment shown in FIG. 1 is used to insert a catheter from the femoral artery and perform a contrast examination or IVR of the head.

First, an operation example when the catheter is inserted from the femoral artery to the target site of the head will be described.
FIG. 5 is a diagram showing an example of the arrangement and use method of the X-ray diagnostic apparatus at the time of catheter insertion from a general artery. As shown in a in the figure, the support 6 is arranged on the guide mechanism 5 in advance.
Next, the subject 1 lies on the top board 7. The operator anesthetizes the subject 1 and the other operator slides the top plate 7 in the directions of arrows R1 and R2 so that the isocenter 1a is positioned in the femoral artery of the subject 1. Further, another operator inserts the catheter while performing fluoroscopy. The operator who inserts the catheter always moves the top 7 to the front, back, left and right according to the process in which the catheter approaches the head of the subject 1 so that the tip of the catheter is always displayed on the X-ray image monitor. Manipulate.

When the catheter reaches the vicinity of the target site on the head of the subject 1, the C arm 4 is rotated, slid along the curve of the C arm 4, or the support portion 6 is moved along the guide mechanism 5. Thus, the posture of the apparatus is searched for obtaining an image that best represents the target site and for appropriately arranging various equipment and operators. At this time, the X-ray detector 3 is rotated in conjunction with the movement of the support unit 6 to prevent the image on the X-ray image monitor from being displayed obliquely. When the posture of the apparatus is determined, IVR treatment and contrast examination are performed.

Here, in the diagnosis from the heart region to the head region, as shown by b in the figure, the position of the C-arm 4 is positioned so that the support portion 6 is positioned on the body axis of the subject 1. The degree of freedom increases, which is preferable. The rotation of the C arm 4 by the sliding rotation mechanism along the bending direction has only a degree of freedom of rotation of about 45 ° around the isocenter due to its shape. On the other hand, the rotation around the installation part with the support part 6 can be a rotation of nearly 360 °. However, as shown in FIG. 1, when the support portion 6 is positioned beside the subject 1, it cannot be freely rotated in order to avoid contact with the subject 1.

When contrast examination of the lower limbs of the subject 1 is performed, the support unit 6 is arranged as shown in b in the figure, the top plate 7 is moved toward the head of the subject 1, and the end of the C arm 4 is moved. It is arranged so that the part is located on the lower limb part of the subject 1.

In this way, in this embodiment, the support portion 6 is moved by the guide mechanism 5 installed on the floor, so that a region where the operator and the equipment can be arranged can be widened. For example, L shown in FIG.
In a conventional X-ray diagnostic apparatus having a letter-shaped support part, when the support part 6 is arranged in the body axis direction of the subject 1 and the head is examined, the operator is positioned with a posture straddling the support part. Must.

However, in the X-ray diagnostic apparatus according to the present embodiment, when such an arrangement is taken, the operator can access the head of the subject 1 with an unreasonable posture at the offset portion 4a of the C arm 4. Thus, a more favorable medical environment is realized compared to the conventional case.

Furthermore, in the present embodiment, there is nothing that obstructs the rotation of the C arm 4 below the isocenter 1a, so that the C arm 4 can be arranged low. Therefore, the top plate 7 can also be arranged low. Considering that the height of the top plate in the conventional X-ray diagnostic apparatus having an L-shaped support portion is not suitable for manual operation depending on the operator, according to the present embodiment, it is more suitable for the operator. A suitable work space can be realized. Moreover, the burden at the time of getting on and off of the top plate 7 of the subject 1 can also be reduced.

Further, even when considering the case where only the support portion 6 is moved without moving the isocenter 1a,
As indicated by an arrow R3 in FIG. 5, the conventional X-ray diagnostic apparatus is simply moved along the guide mechanism 5 on the arc embedded in the floor surface, so that the mechanism is simple. The rotation angle of the X-ray detector 3 is also related to a mechanism that keeps the direction of the image displayed on the X-ray image monitor constant by interlocking the movement of the support unit 6 and the rotation of the X-ray detector 3. Since the relationship between the position of the support portion 6 and the position of the support portion 6 may be determined in advance, this can be realized using a simple mechanism.

Further, in this embodiment, it is possible to make a diagnosis from the lower limb portion to the head portion of the subject by driving the bed mechanism 8 and the support portion 6. This widens the range of use of the X-ray diagnostic apparatus.

Further, according to the present embodiment, the conventional manufacturing process can be greatly utilized in that the conventional X-ray diagnostic apparatus can be used as it is, except that the support portion 6 is set to be movable along the guide mechanism 5. There are also advantages. These things lead to low construction costs.

Further, in the installation of the guide mechanism 5 as well, it is easier to install than the conventional X-ray diagnostic apparatus having an L-shaped support part and the X-ray diagnostic apparatus in which the support part is a suspension type. Construction costs can also be kept low.

In addition, by using the operation panel of the operation unit 9 described above, a more sensuous operation is possible, and the operation is easier and preferable than the prior art.

The block diagram which shows one Example of the X-ray diagnostic apparatus which concerns on this invention. Sectional drawing which shows an example of a structure of a guide mechanism. Explanatory drawing which shows an example of the mechanism for moving a support part. The figure which expands and shows a part of FIG. The figure which shows the arrangement | positioning and usage example of an X-ray diagnostic apparatus at the time of catheter insertion from a general artery. The block diagram which shows an example of the conventional X-ray diagnostic apparatus.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Subject 2 X-ray generation mechanism 3 X-ray detector 4 C arm 5 Guide mechanism 6 Support part 7 Top plate 8 Bed mechanism 9 Operation part 10 Rotation mechanism 11 Rail part 12 Stage part 13 Ball 14 Belt 15 Motor / Speed reducer 16 pulley

Claims (5)

Mounting means for mounting the subject;
X-ray irradiation means for irradiating the subject with X-rays;
X-ray detection means for detecting X-rays transmitted through the subject;
A C-arm for sliding and rotating a substantially arc-shaped C-shaped portion in which the X-ray irradiating means and the X-ray detecting means are arranged to face each other;
A support portion for rotatably supporting the C-arm around a horizontal axis perpendicular to the central axis of the sliding rotation;
A substantially circular arc having a radius of curvature centering on a vertical axis passing through an isocenter that is an intersection of the central axis of the sliding rotation and the central axis of rotation around the horizontal axis, and for guiding the movement of the support portion A shape guide mechanism;
An engagement portion slidably engaged with the guide mechanism and supporting the support portion;
An X-ray diagnostic apparatus comprising: The C-arm is
2. The X-ray diagnostic apparatus according to claim 1, wherein the C-shaped portion is slid and rotated at a position separated from the central axis of rotation about the horizontal axis by a predetermined distance. The X-ray diagnostic apparatus according to claim 1, further comprising a first driving unit configured to move the support unit along the guide mechanism. 4. The X-ray diagnosis according to claim 3, further comprising second drive means for rotating the C-arm, wherein the first drive means and the second drive means are operable in parallel. apparatus.   The X-ray diagnostic apparatus according to claim 1, wherein the guide mechanism is provided on a floor surface.

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