JP2007061513A - Puncture adapter and ultrasonic probe for puncturing - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a puncture adapter capable of keeping less blind in an insertion route in inserting a puncture needle, raising adhesion between a water bag and a needle guide, and easily cleaning and sterilizing the water bag, and to provide an ultrasonic probe for puncturing. <P>SOLUTION: The puncture adapter 50 is mounted on the ultrasonic probe 10 for scanning a subject with ultrasonic wave and guides the insertion to the subject of the puncture needle N to be inserted to the subject. The adapter 50 includes the flexible water bag 20 with a slit 21 formed therein; and a puncture guide 30 which adheres to the slit so as to guide the puncture needle into the scanning range of the ultrasonic wave in the subject. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a puncture adapter and a puncture ultrasonic probe used in a puncture technique in which a puncture needle is inserted into a subject to collect or treat an affected tissue, and particularly relates to a puncture adapter equipped with a water bag.

  Conventionally, an ultrasonic probe is brought into contact with the body surface of a living body as a subject, an ultrasonic beam is emitted into the living body, and a reflected wave generated by reflection at the boundary of the living tissue is received again by the ultrasonic probe. There is an ultrasonic diagnostic apparatus for reconstructing an in-vivo tomographic image used for diagnosis.

  The contact surface of the ultrasonic probe used in the ultrasonic diagnostic apparatus with the body surface is generally not elastic. For this reason, for example, if a gap is generated between the contact surface of the ultrasonic probe and the body surface due to the uneven shape of the body surface, the ultrasonic wave is not transmitted, and therefore an image of the portion where the gap is generated may not be obtained. It was. Therefore, in order not to create a gap with the body surface, for example, a water bag containing water is attached to the contact surface side of the ultrasonic probe, and the water bag is brought into contact with the body surface to perform scanning. There is something.

  Also, by attaching a water bag, it is possible to offset the focus point of the ultrasonic beam and improve the resolution near the body surface. Therefore, the water bag is also used when diagnosing the vicinity of the body surface.

  On the other hand, a puncture needle such as an injection needle is inserted into a living body, and examination such as collection of a tissue such as a tumor, thermal administration such as local administration of a drug or microwave or radio wave irradiation from the puncture needle, etc. A puncture is performed. Such puncture is generally performed by ultrasonic diagnosis in order to avoid blood vessels that may cause major bleeding due to damage or to reliably puncture a target tissue such as a tumor. This is performed while referring to a tomographic image generated by the apparatus. In puncture using such a tomographic image, the above-described water bag may be used for the ultrasonic probe. For example, there is one in which a puncture adapter for guiding a puncture needle is provided on the side surface of a water bag. However, when such a puncture adapter is used, the insertion start position is outside the range displayed as a tomographic image in the living body. Therefore, the insertion path from the insertion start position to the range of the living body displayed as the tomographic image is in a state where the image of the insertion needle is not displayed on the tomographic image (blind). In other words, since the presence of blood vessels or the like cannot be confirmed during that time, there may be a safety problem in performing puncture. Further, when the puncture target is close to the body surface, the puncture needle has to be greatly tilted, and it is difficult to insert.

  Therefore, some ultrasonic probes are provided with a puncture adapter in which a water bag is provided with a through hole, a needle guide is passed through the through hole, and a puncture needle is inserted into a hollow portion of the needle guide to perform puncture. (For example, refer to Patent Document 1).

JP 11-216137 A (paragraphs [0027]-[0032], FIGS. 7 to 10)

  However, the puncture adapter described in Patent Document 1 has the following problems because it is a through hole.

  First, when the through hole of the water bag comes into close contact with the needle guide, wrinkles are generated in the through hole and come into close contact. In some cases, the image is greatly deteriorated because the transmission of ultrasonic waves to the downstream side of the through hole is hindered by wrinkles. In addition, when puncturing in different puncturing directions, a water bag having a through hole corresponding to the angle is required, and in order to change the puncturing direction, a puncture adapter having water bags with different through hole directions is required. It was necessary to prepare several. In addition, cleaning and disinfection of the through hole after puncture has not been easy.

  The present invention has been made in view of the above circumstances, and an object thereof is to improve the adhesion between the water bag and the needle guide while keeping the insertion path blind in the insertion of the puncture needle. Another object of the present invention is to provide a puncture adapter and a puncture ultrasonic probe capable of easily cleaning and disinfecting a water bag.

  In order to solve the above-mentioned problem, the invention according to claim 1 is characterized in that a puncture needle that is attached to an ultrasonic probe that performs ultrasonic scanning on a subject and punctures the subject is inserted into the subject. A puncture adapter for guiding a flexible water bag having a slit formed therein, and in close contact with the slit, for guiding the puncture needle into the ultrasound scanning range in the subject. The guide member is provided.

  According to a second aspect of the present invention, the slit of the water bag is cut from one end side in the scanning direction in parallel with the scanning direction and into the ultrasonic scanning range, and the guide member cuts the slit into the one end. It penetrates from the side to the scanning range and to the subject side.

  Further, the invention according to claim 3 has the opening in which the water bag is surrounded and accommodated so as to be able to contact the subject side, the slit side is communicated with the outside, and the guide member can be inserted and removed. A holder is further provided.

  According to a fourth aspect of the present invention, the water bag has a water injection portion for injecting water, is accommodated in the holder in an empty state, and the guide member is inserted into the slit. The water is injected from the outside through the water injection section.

  The invention according to claim 5 is characterized in that a plurality of the guide members are prepared, and each guides the puncture needle into the ultrasonic scanning range in the subject at different angles.

  In the invention according to claim 6, the surface on the subject side of the water bag is inclined in the scanning direction, and the slit is between the surface on the subject side and the surface on the ultrasonic probe side. It is characterized in that it is formed on the side where the distance is large.

  The invention according to claim 7 is equipped with a puncture adapter for performing ultrasonic scanning on the subject and guiding a puncture needle that punctures the subject into the subject. An ultrasonic probe for puncturing, wherein the puncture adapter is in close contact with the flexible water bag formed with a slit and the slit, and the puncture needle is brought into the ultrasonic scanning range in the subject. And a guide member for guiding.

  According to the puncture adapter or the puncture ultrasonic probe of the present invention, the slit is formed in the water bag from the one end side in the ultrasonic scanning direction so as to be parallel to the scanning direction and cut into the ultrasonic scanning range. Since the guide member that passes through the slit from one end side to the scanning range and to the subject side, the insertion start position of the puncture needle is within the scanning range, so that the insertion path blinds can be kept small.

  Moreover, since the guide member penetrates through the slit and the water bag is flexible, the adhesion with the guide member is improved. As a result, it is possible to suppress deterioration in the image quality of the tomographic image. Moreover, since it is a slit shape, it can be expanded and cleaning and disinfection are easy.

[First Embodiment]
Hereinafter, various embodiments of an ultrasonic probe for puncture according to the present invention will be specifically described with reference to the drawings.

〔Constitution〕
FIG. 1 is a front view showing the overall configuration of the puncture ultrasonic probe in the present embodiment. As shown in FIG. 1, the ultrasonic probe for puncture includes a probe main body (ultrasonic probe) 10 for performing ultrasonic scanning and generating a tomographic image, and a puncture adapter 50.

  The probe main body 10 includes an ultrasonic transducer, and has a probe unit 11 having a probe surface 14 that performs ultrasonic scanning in the direction of an arrow, and an operator provided on the opposite side of the probe unit 11 holds the probe main unit 10. A connecting cable 13 is connected to the grip portion 12 and the end portion of the grip portion 12. The connection cable 13 is connected to an ultrasonic diagnostic apparatus (not shown). The ultrasonic diagnostic apparatus has a function of reconstructing a tomographic image from the reflected wave received by the probe main body 10 and displays it on a display means of a monitor of the ultrasonic diagnostic apparatus. The ultrasonic diagnostic apparatus has a function of generating a puncture guideline and displaying it on a monitor in a superimposed manner.

  The puncture adapter 50 includes a holder 40, a water bag 20, and a puncture guide 30. The puncture adapter 50 is mounted on the probe unit 11 side of the probe body 10 by a mounting mechanism (not shown) so as to contact the water bag 20 and the probe surface 14. The attachment mechanism of the puncture adapter 50 to the probe main body 10 includes, for example, a lock claw or the like provided on the puncture adapter 50, a concave portion formed in the probe main body 10 corresponding to the lock claw, and the lock claw being engaged with the concave portion. It's okay. N is a puncture needle which is guided by a puncture guide 30 provided in the puncture adapter 50 and protrudes from the puncture needle outlet 36.

  Next, the puncture adapter 50 will be described in detail with reference to FIGS. FIG. 2 is an exploded configuration diagram showing each part constituting the puncture adapter 50, and FIG. 3 is a cross-sectional view of the puncture adapter 50.

  The holder 40 has a box shape, and an upper side of the box has a mounting mechanism (not shown) for mounting on the probe main body 10. Further, an upper opening 41 substantially parallel to the probe surface 14 of the probe main body 10 is formed on the upper side, and the probe of the probe main body 10 in the ultrasonic scanning direction is formed on the lower side, that is, the body surface side of the living body that is the subject. A lower opening 42 is formed for bringing the lower surface 24 of the water bag 20 inclined with respect to the surface 14 into contact with the body surface of the subject. For example, it is molded by plastic or the like. A rib-like locking rib 43 is formed on the edge of the lower opening 42 inwardly. An attachment hole (opening) 45 for attaching the puncture guide 30 for guiding the puncture needle N is formed on one side surface in the scanning direction of the puncture adapter 50 mounted in the ultrasonic scanning direction of the probe body 10. ing. In this example, the attachment hole 45 is formed on the side surface having the larger distance from the body surface. The attachment hole 45 has a locking portion 47 for locking a lock claw 34 of the puncture guide 30 described later. In addition, a water injection port 46 is formed on the other side surface to enable water injection into the water bag 20 after the water bag 20 is accommodated. In this example, the lower opening 42 is inclined with respect to the probe surface 14, but may be parallel.

  The puncture guide (guide member) 30 includes a guide portion 31 and an attachment portion 33 on the upper end side of the guide portion 31. The guide portion 31 has a cylindrical shape, and a guide hole 32 for guiding the puncture needle N in the direction of the target (affected portion) is formed. A plurality of lock claws 34 are formed on the attachment portion 33. The guide portion 31 is inserted into the attachment hole 45 of the holder 40, the lock claw 34 is attached to the engagement portion 47 of the attachment hole 45, and penetrates from the attachment hole 45 side to the body surface in the ultrasonic scanning range. Then, the puncture needle N is guided to the body surface from the attachment hole 45 side. Moreover, it is possible to remove from the holder 40 by releasing the locking claw 34, that is, it can be inserted and removed. A flange 35 is formed at the lower end of the guide portion 31. In addition, the central axis of the guide hole 32 is set to the ultrasonic scanning position when attached to the holder 40.

  The water bag 20 is formed of a flexible material such as silicon rubber so that the outer shape of the holder 40 is substantially the same as the inner dimension of the portion excluding the mounting mechanism portion of the holder 40, and is accommodated in the holder 40. It has come to be. Further, when the puncture adapter 50 is attached to the probe main body 10, the upper surface 23 comes into contact with the probe surface 14. The lower surface 24 is a surface that is brought into contact with the body surface at the time of diagnosis. Therefore, the lower surface 24 has a sloped shape following the lower opening 42 of the holder 40. The water bag 20 is inserted from the upper opening 41 side of the holder 40, and the lower surface 24 end of the water bag 20 is locked by the locking rib 43. However, since the water bag 20 has flexibility, the water bag 20 The lower surface 24 and the lower opening 42 of the holder 40 are substantially the same surface. In addition, a slit 21 is provided on the side of the mounting hole 45 of the holder 40, that is, on the side of the side having a larger distance from the body surface. A valve (water injection part) 22 is provided at the position of the water injection port 46 of the holder 40 so as to communicate with the outside. The slit 21 wraps the puncture guide 30 as shown in FIG. Moreover, although the lower surface 24 side edge part of the slit 21 is latched by the flange 35 of the puncture guide 30, since the water bag 20 has flexibility, the lower surface 24 of the water bag 20 and the lower end of the guide part 31 of the puncture guide 30 Are almost the same surface.

  According to the puncture adapter 50 configured as described above, the puncture guide 30 is attached to the holder 40, and the empty water bag 20 is accommodated (if the water bag 20 can be accommodated in the holder 40, it enters the water bag 20). For example, when water is injected from the check valve 22 using a syringe or the like, the water bag 20 is filled with water, and when water is further injected, the check valve 22 does not leak water. As a result, the internal water pressure rises, the water bag 20 swells, the side faces are in close contact with the holder 40, and the puncture guide 30 is wrapped in close contact with the slit 21. Therefore, the occurrence of a gap between the water bag 20 and the puncture guide 30 can be suppressed, and the loss of images due to the gap can be suppressed. Further, by filling the guide hole 32 of the puncture guide 30 with an ultrasonic transmitting material such as acoustic jelly, the influence of the guide hole 32 on the tomographic image can be suppressed. Then, the probe surface 14 of the probe main body 10 is brought into contact with the upper surface 23 of the water bag 20, and the puncture adapter 50 is attached to the probe main body 10 (see FIG. 1) and used when performing puncture. Moreover, what is necessary is just the liquid which permeate | transmits an ultrasonic wave other than water. However, those set to match the acoustic impedance of the human body are preferable.

[Usage mode]
Next, the usage aspect of the ultrasonic probe for puncture in this embodiment comprised including the puncture adapter 50 and the probe main body 10 is demonstrated, referring FIG. FIG. 5 is an explanatory diagram for explaining a state in which the probe main body 10 to which the puncture adapter 50 is attached is used for puncture. The probe body 10 is connected to an ultrasonic diagnostic apparatus (not shown).

  First, the tomographic image in which the lower surface 24 side of the water bag 20 is brought into contact with the body surface so that the affected area of the puncture target falls within the image display range displayed on the monitor of the ultrasound diagnostic apparatus as a tomographic image is obtained. Projected on the monitor. In addition, a puncture guideline is generated by an ultrasonic diagnostic apparatus and superimposed on a tomographic image of a monitor, and the position of the probe is adjusted so that the guideline intersects the affected part as shown in FIG. Then, the puncture needle N is inserted into the guide hole 32 of the puncture guide 30 and insertion is performed under the guide by the guide hole 32.

  At this time, as shown in FIG. 5, since the insertion start position is in the image display range, there is no blind between the affected area. In addition, since there is no puncture adapter 50 between the end of the puncture adapter 50 and the affected part in the direction of the affected part, a clear tomographic image is displayed. Further, even in a range where the puncture adapter 50 is between the probe body 10 and the water bag 20 and the puncture guide 30 through the slit, the adhesion is improved, so that image degradation is suppressed.

  Further, since the focal point of the ultrasonic beam is offset by the water bag 20 due to the water bag 20, the resolution of the tomographic image immediately below the body surface is improved. Further, even when the affected part is located directly below the body surface as shown in FIG. 5, the insertion start position can be close to the affected part. Therefore, puncture for the affected part near the body surface is facilitated.

  Moreover, since the water bag 20 is not a through hole but a slit 21, it can be easily opened, so that cleaning and disinfection can be easily performed.

  Further, FIG. 8 shows an example of a slit different from the slit 21 of FIG. 2, but the slit 21 shape of the water bag 20 has a notch that becomes larger as it goes to the lower surface 24 side as shown in FIG. 8A. It may be formed in an oblique groove shape. Further, unlike the groove shape, a part (lower end in the figure) may be coupled as shown in FIG. 8B (in this case, after the bag 20 is mounted on the holder 40). A puncture guide 30 is attached.)

[Second Embodiment]
Next, a second embodiment of the present invention will be described with reference to the drawings. In the following, detailed description of the configuration substantially the same as that of the first embodiment will be omitted, and different points will be mainly described (the same applies to the following other embodiments).

  A feature of the present embodiment is that a plurality of puncture guides 30 having different angles with respect to the attachment portion 33 of the guide portion 31 are prepared, and puncture with different puncture angles is facilitated.

  For example, FIG. 6 shows an example of the puncture guide 30 having different angles with respect to the attachment portion 33 of the guide portion 31. FIGS. 6A and 6B show examples of the puncture guide 30 having angles A and B with respect to the attachment portion 33 of the guide portion 31. Hereinafter, the puncture guide with an angle A may be referred to as a puncture guide 30A, and the puncture guide with an angle B may be referred to as a puncture guide 30B.

  FIG. 7 is an explanatory diagram for explaining a state of puncturing using the puncture guide 30A and the puncture guide 30B. According to FIG. 7, the puncture guide 30A is used when puncturing the affected area directly under the body surface, and the puncture guide 30B is used when puncturing the affected area away from the body surface.

  In this example, the puncture guide 30A and the puncture guide 30B are attached by, for example, locking the lock claw 34 to the engaging portion 47 of the attachment hole 45, and therefore the puncture guide 30A to the puncture guide 30B, or the puncture guide 30B to the puncture guide In the case of replacement with 30A, the lock claw 34 of the puncture guide 30 that is already attached can be released and removed, and can be easily replaced with another puncture guide 30. Further, since the puncture guide 30 only changes its position in the slit 21 of the water bag 20, it is not necessary to replace the water bag 20 accompanying the replacement of the puncture guide 30. Therefore, the puncture guide 30 can be easily replaced, and different puncture angles can be accommodated only by replacing the puncture guide 30.

It is a front view which shows the whole structure of the ultrasonic probe for puncture in this embodiment. It is an exploded block diagram which shows each part which comprises the puncture adapter of this Embodiment. It is sectional drawing for demonstrating the structure of the puncture adapter of this Embodiment. It is a figure which shows the slit of a water bag and the puncture guide in the puncture adapter of this Embodiment. It is explanatory drawing for demonstrating a mode that the ultrasonic probe for puncture in this embodiment is used for puncture. It is sectional drawing of the puncture guide of 2nd Embodiment. It is explanatory drawing for demonstrating the mode of puncture using the puncture guide 30A and the puncture guide 30B of 2nd Embodiment. It is a figure which shows the example of a slit different from the slit of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Probe main body 11 Probe part 12 Grip part 13 Connection cable 14 Probe surface 20 Water bag 21 Slit 22 Check valve 23 Upper surface 24 Lower surface 30 Puncture guide 31 Guide part 32 Guide hole 33 Mounting part 34 Lock claw 35 Flange 36 Puncture needle Outlet 40 Holder 41 Upper opening 42 Lower opening 43 Locking rib 45 Mounting hole 46 Water inlet 47 Locking part 50 Puncture adapter N Puncture needle

Claims (7)

A puncture adapter that is attached to an ultrasonic probe that performs ultrasound scanning on a subject and guides the insertion of a puncture needle that punctures the subject into the subject,
A flexible water bag with slits formed therein;
A puncture adapter comprising: a guide member that is in close contact with the slit and guides the puncture needle into the ultrasound scanning range in the subject. The slit of the water bag cuts into the scanning range of the ultrasonic wave parallel to the scanning direction from one end side in the scanning direction,
The puncture adapter according to claim 1, wherein the guide member penetrates the slit from the one end side to the scanning range and to the subject side.   The holder further includes a holder that surrounds and accommodates the water bag so as to be in contact with the subject, and has an opening that allows the slit side and the outside to communicate with each other and that the guide member can be inserted and removed. Item 3. The puncture adapter according to Item 2. The water bag is
Has a water injection part for water injection,
The puncture adapter according to claim 3, wherein the puncture adapter is filled in from the outside through the water pouring section when the guide member is inserted into the slit while being accommodated in the holder in an empty state.   The puncture adapter according to any one of claims 1 to 4, wherein a plurality of the guide members are prepared, and each guides the puncture needle at different angles into the ultrasonic scanning range in the subject. The subject side surface of the water bag is inclined in the scanning direction;
The puncture adapter according to any one of claims 1 to 5, wherein the slit is formed on a side where a distance between the surface on the subject side and the surface on the ultrasonic probe side is large. A puncture ultrasound probe equipped with a puncture adapter for performing ultrasound scanning on a subject and guiding a puncture needle that punctures the subject into the subject,
The puncture adapter is
A flexible water bag with slits formed therein;
An ultrasound probe for puncture, comprising: a guide member that is in close contact with the slit and guides the puncture needle into the ultrasound scanning range in the subject.

Images