JP2010063839A - Endoscopic apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To simply specify a lesioned part of the pulsating heart and to simply analyze the tissue of the lesioned part by spectroscopy. <P>SOLUTION: An endoscopic apparatus 1 is equipped with: an insertion part 2 to be inserted in the body; an illumination means 3 for emitting illumination light, which comprises the near infrared rays irradiating the heart B through the heart sac A, from the leading end of the insertion part 2; an imaging means 5 for photographing the return light, which comprises the near infrared rays thrown on the heart B from the illumination means 3 and returning to the leading end of the insertion part 2 from the heart B, to acquire the two-dimensional image of the heart B; a spectral probe 8 for emitting the near infrared rays applied to the heart B through the heart sac A while detecting the near infrared rays reflected and/or scattered from the heart B to return; and irradiation restricting means 13 and 14 for restricting an illumination range so that the region around the leading end of the spectral probe 8 is not irradiated with the illumination light from the illumination means 3 while the near infrared rays are detected by the spectral probe 8. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an endoscope apparatus.

Conventionally, as a method for identifying a lesion in an organ, a fluorescent probe that specifically accumulates in a lesion such as cancer is administered, and excitation light is irradiated under endoscopic observation to detect fluorescence emitted by the fluorescence probe. Observation methods are known.
In addition, it is also known to perform spectroscopic analysis of a tissue in order to examine a disease (for example, see Patent Documents 1 to 4).

JP-A-9-248281 JP 10-337274 A JP 2003-35666 A JP 2004-150984 A

  However, when identifying a lesion in the heart, the endoscope cannot be fixed to the lesion because the heart is pulsating, and it is difficult to identify the lesion. There is also a problem that it is difficult to perform spectroscopic analysis of the tissue of the lesioned part.

  The present invention has been made in view of the above-described circumstances, and provides an endoscope apparatus that can easily identify a lesion part of a beating heart and easily perform spectral analysis of the tissue. The purpose is that.

In order to achieve the above object, the present invention provides the following means.
The present invention includes an insertion portion that is inserted into the body, illumination means that emits near-infrared light that irradiates the heart via the pericardium from the distal end of the insertion portion, and irradiation from the illumination means to the heart. An imaging means for capturing a two-dimensional image of the heart by imaging return light comprising near-infrared light returning from the heart to the distal end of the insertion portion; and near-infrared incident on the heart via the pericardium A spectroscopic probe for detecting near-infrared light that is reflected and / or scattered from the heart while emitting light, and a tip of the spectroscopic probe when the near-infrared light is detected by the spectroscopic probe An endoscope apparatus is provided that includes irradiation limiting means for limiting an illumination range so that illumination light from the illuminating means is not irradiated to a nearby region.

  According to the present invention, with the distal end of the insertion portion inserted into the body and facing the heart via the pericardium, the illumination means is operated to irradiate the heart with illumination light comprising near infrared light, By capturing the return light composed of near infrared light returning from the pericardium, it is possible to acquire a two-dimensional image of the heart through the pericardium from the outside of the pericardium. On the other hand, near-infrared light is incident on the heart from the tip of the spectroscopic probe facing the heart via the pericardium and reflected from the heart surface, or near-infrared scattered back inside the heart. By detecting light, it becomes possible to perform spectroscopic analysis of the surface of the heart and the internal state.

  In this case, according to the present invention, when the near-infrared light is detected by the spectroscopic probe by the operation of the irradiation restricting means, the illumination light from the illuminating means is not irradiated to the region near the tip of the spectroscopic probe. Thus, since the illumination range is limited, it is possible to prevent the occurrence of inconvenience that the near infrared light from the illumination means is detected by the spectroscopic probe. Thereby, it is possible to spectroscopically analyze the heart surface and the tissue inside the heart while confirming the state of the heart surface using the image acquired by the imaging means.

  In the above invention, the illumination means includes a light source unit disposed on a proximal end side of the insertion portion, and a light guide member that guides illumination light from the light source portion to a distal end of the insertion portion, and the irradiation restriction A means may be provided in the light source unit, and may comprise a switching means for switching the incident range of the illumination light to the light guide member.

  By doing in this way, the near infrared light emitted from the light source part arrange | positioned at the base end side of an insertion part is light-guided by the light guide member to the front-end | tip of an insertion part, and is irradiated toward the heart. When performing observation using a spectroscopic probe, irradiation of illumination light near the tip of the spectroscopic probe is easily restricted by switching the incident range of the illumination light to the light guide member by operating the switching means, and the image is displayed. The cardiac surface and internal tissue can be spectroscopically analyzed without being affected by the illumination light for acquisition.

  Further, in the above invention, an instrument channel for inserting the spectroscopic probe along the longitudinal direction into the insertion portion and causing the tip end portion of the spectroscopic probe to protrude and retract from the opening of the spectroscopic probe is provided. A shielding member that is movably disposed at the tip of the part so as to open and close a part of the exit of the illumination light from the illuminating means, and the shielding member in conjunction with the protruding operation from the tip opening of the spectroscopic probe. And an interlocking mechanism that increases a closing amount of the injection port.

  By doing so, when the spectroscopic probe is projected from the distal end opening of the instrument channel of the insertion portion, the closing amount of the exit port by the shielding member is increased by the operation of the interlocking mechanism, Irradiation of illumination light is limited, and more accurate spectroscopic analysis of the inside of the heart can be performed without being affected by illumination light for acquiring an image. Conversely, when the spectroscopic probe is retracted from the opening of the tip into the instrument channel, the closing amount of the exit port by the shielding member is reduced by the operation of the interlocking mechanism. A wide range of observations can be made.

  According to the present invention, it is possible to easily specify a lesioned part of a beating heart and easily perform spectroscopic analysis of the tissue.

An endoscope apparatus 1 according to an embodiment of the present invention will be described below with reference to FIGS.
As shown in FIGS. 1 and 2, an endoscope apparatus 1 according to the present embodiment includes an insertion portion 2 that is inserted into the body, a light source portion 3 that emits illumination light including near infrared light, and an insertion device. A fiber bundle 4 that is arranged along the longitudinal direction of the portion 2 and guides the illumination light emitted from the light source portion 3 to the distal end of the insertion portion 2; an imaging device 5 that is disposed at the distal end of the insertion portion 2; Spectral probe that is projected and retracted from the distal end of the insertion portion 2 via a fixing means 6 for fixing the distal end of the portion 2 to the pericardium A and a forceps channel (instrument channel) 7 provided in the insertion portion 2 along the longitudinal direction. 8, a signal processing unit 9 that processes signals acquired by the imaging device 5 and the spectral probe 8, and a display unit 10 that displays an image generated by processing by the signal processing unit 9.

  The light source unit 3 includes a near-infrared light source 11 that generates illumination light including near-infrared light, and a coupling lens that condenses the near-infrared light emitted from the near-infrared light source 11 on the end face of the fiber bundle 4. 12, a mask 13 provided so as to be able to advance and retreat on the optical path of near infrared light collected by the coupling lens 12, and a mask position control unit 14 for advancing and retreating the mask 13 on the optical path of near infrared light It has.

The mask 13 has a retracted position where the entire near-infrared light collected by the coupling lens 12 is incident on the fiber bundle 4 and an advanced position where the incidence of a part of the near-infrared light on the fiber bundle 4 is restricted. It can be moved.
When the mask 13 is moved to the retracted position, as shown in FIG. 3A, near-infrared light is irradiated to the entire visual field range. On the other hand, when the mask 13 is moved to the forward position, as shown in FIG. 3B, the near infrared light is irradiated to a part of the field of view range, and the peripheral position of the distal end surface 8a of the spectroscopic probe 8 is irradiated. Is not irradiated.

  The fixing means 6 sucks the air in the suction cap 15 through a cylindrical suction cap 15 attached to the distal end of the insertion portion 2 and a channel 16 provided in the insertion portion 2 as shown in FIG. And a suction means (not shown). The suction cap 15 is made of a flexible material at least at the distal end that is brought into close contact with the pericardium A. The suction means is operated with the distal end of the suction cap 15 in close contact with the pericardium A to suck the air in the suction cap 15, thereby reducing the pressure in the suction cap 15, so that the distal end of the insertion portion 2 is moved to the pericardium. It can be adsorbed and fixed to the pericardium A in a state of being opposed to A.

The spectroscopic probe 8 irradiates near-infrared light L from the distal end surface 8a to the heart B, and detects near-infrared light L that is reflected and scattered on the surface and inside of the heart B. The spectroscopic probe 8 is provided with a probe moving mechanism 17 that moves the spectroscopic probe 8 in the longitudinal direction and a probe position control unit 18 that controls the probe moving mechanism 17. The probe position control unit 18 is connected to the mask position control unit 14.
When the distal end surface 8a of the spectroscopic probe 8 is protruded from the distal end opening of the forceps channel 7 by the operation of the probe position control unit 18, the mask 13 is moved to the advanced position by the operation of the mask position control unit 14, and the spectroscopic probe. When the distal end face 8a of 8 is retracted into the distal end opening of the forceps channel 7, the mask 13 is moved to the retracted position.

  The signal processing unit 9 processes an image of the surface of the heart B photographed by the imaging device 5 to generate an image, and spectroscopic analysis for spectral analysis of the near infrared light L detected by the spectroscopic probe 8. The analysis unit 20 includes a storage unit 21 that stores the image generated by the image generation unit 19 and the analysis result of the spectral analysis unit 20 in association with each other.

The imaging device 5 and the spectroscopic analysis unit 20 are configured to simultaneously perform imaging of the heart B and detection of the near infrared light L with a predetermined time interval.
The spectroscopic probe 8 is projected and retracted from the forceps channel 7 to perform spectroscopic analysis of the tissue of the heart B at a predetermined position within the angle of view of the image acquired by the image sensor 5.

The image processing unit 22 extracts a feature point P by processing a plurality of images generated by the image generation unit 19. As the feature point P, for example, a high luminance region on the image can be cited.
When a plurality of feature points P are extracted, a feature point P common to the most images is selected from the feature points P. Then, the image processing unit 22 calculates the detection position coordinates by the spectroscopic probe 8 in each image with the position of the selected common feature point P as a reference.

The storage unit 21 stores the analysis result by the spectroscopic analysis unit 20 and the detected position coordinates by the spectroscopic probe 8 calculated by the image processing unit 22 in association with each other.
Further, the image processing unit 22 selects one of the images stored in the storage unit 21, synthesizes the analysis result with the selected image, and outputs it to the display unit 10. .
In other words, the image processing unit 22 synthesizes the analysis result to be pasted on the detection position coordinates with the feature point P as a reference, using the feature point P existing in the selected image as a clue.

The operation of the endoscope apparatus 1 according to the present embodiment configured as described above will be described below.
In order to observe the heart B using the endoscope apparatus 1 according to this embodiment, the distal end of the insertion portion 2 having the suction cap 15 attached to the distal end is inserted into the body, the light source portion 3 is operated, and the heart The surface of the heart B is illuminated through the film A, and the return light from the surface of the heart B is imaged by the image sensor 5. Since near-infrared light is emitted as illumination light from the light source unit 3, an image of the surface of the heart B can be acquired from the outside of the pericardium A.

  At this time, the mask position control unit 14 arranges the mask 13 in the retracted position so that the mask 13 does not enter the field of view. Therefore, as shown in FIG. 3A, an image Ga of the entire field of view whose field of view is not limited by the mask 13 is acquired.

Then, in the state where the range to be observed of the heart B is confirmed, the tip of the suction cap 15 is brought into close contact with the pericardium A, and the suction cap 15 is decompressed by operating the suction means, and the insertion portion 2 is inserted by the suction cap 15. Is adsorbed and fixed to the pericardium.
In this state, the tip of the spectroscopic probe 8 is protruded from the forceps channel 7 of the insertion portion 2, and the tip surface 8 a of the spectroscopic probe 8 is brought into close contact with the pericardium A.

  Then, the illumination means illuminates the surface of the heart B through the pericardium A, and images the return light from the surface of the heart B by the imaging device 5, and the near-infrared light from the distal end surface 8 a of the spectroscopic probe 8. The step of emitting L, entering the heart B, and detecting the near-infrared light L reflected and scattered on the surface and inside of the heart B is simultaneously performed.

At this time, the mask position control unit 14 is set so that the mask 13 is disposed at the forward position, and the near infrared light from the light source unit 3 is not irradiated to the vicinity region including the distal end surface 8 a of the spectroscopic probe 8. Therefore, as shown in FIG. 3B, an image Gb whose field of view is limited by the mask 13 is acquired. In the figure, the symbol C is a shadow by the mask 13.
And since the near infrared light from the light source part 3 is not irradiated to the area | region near the front end surface 8a of the spectroscopic probe 8, the near infrared light L detected by the spectroscopic probe 8 was emitted from the spectroscopic probe 8. Only near-infrared light L can be used.

  In this way, a large number of images of the outer surface of the heart B are generated by the image generation unit 19 and stored in the storage unit 21, and a common feature point P in a plurality of images is detected by the image processing unit 22. The On the other hand, the spectroscopic analysis unit 20 performs spectroscopic analysis of the near-infrared light L detected simultaneously with the acquisition of each image.

In addition, since the position of the spectral probe 8 within the angle of view of each image is fixed, the position coordinates of the spectral probe 8 with the detected feature point P as a reference are used as detection position coordinates, and the near-proximity detected simultaneously with each image. The spectral analysis results of the infrared light L are associated and stored in the storage unit 21.
Then, in the image processing unit 22, any image stored in the storage unit 21 and the spectral analysis result stored in the storage unit 21 are combined.

  That is, in the image processing unit 22, the detected coordinate position stored in the storage unit 21 is associated with the detected coordinate position using the common feature point P in the image stored in the storage unit 21 as a reference. Then, it is synthesized by pasting it to the stored spectral analysis result. As a result of spectroscopic analysis, as a result of statistical analysis such as chemometrics, calculated values such as amounts and ratios of constituent components such as collagen and lipid in the heart tissue can be used.

For example, by repeating imaging and detection at predetermined time intervals, as shown in FIGS. 4A to 4E, a plurality of images and a spectral analysis result at the tip position of the spectral probe 8 are obtained. .
A common feature point P is extracted by processing each image, and the spectral analysis result is obtained with the coordinates of the tip position of the spectroscopic probe 8 as relative coordinates (ΔXn, ΔYn) (n is 1 to 4) from the feature point P. And stored in the storage unit 21.

In this state, when any one image is selected by the observer's designation or automatically by the image processing unit 22, as shown in FIG. 5, the features included in the image are included in the image. The spectroscopic analysis result is pasted at the position of the relative coordinates (ΔXn, ΔYn) with respect to the point P. For example, the spectral analysis result is displayed in a color corresponding to the luminance (in the figure, the hatching density indicates a difference in color, that is, a difference in the spectral analysis result).
Further, by setting the time interval sufficiently small, it is possible to display the spectroscopic analysis result in a specific continuous area in a still image.

  Thus, according to the endoscope apparatus 1 according to the present embodiment, since the distal end of the insertion portion 2 is fixed to the pericardium A, there is no need to fix it to the beating heart B, and There is an advantage that it is not necessary to follow the lesioned part moving the tip. As a result, the heart B can be easily observed, and the heart B can be observed over a wide range using the pulsation of the heart B.

  Then, since the analysis result is pasted to any one still image selected from the acquired images, the observer does not observe the moving image of the beating heart B, but displays it on the display unit 10. The displayed still image has an advantage that a lesioned part can be easily specified and spectral analysis of the tissue can be easily performed.

  Further, according to the endoscope apparatus 1 according to the present embodiment, the near-infrared light from the light source unit 3 is not irradiated on the region near the distal end surface 8a of the spectroscopic probe 8 at the time of spectroscopic measurement by the spectroscopic probe 8. It is not necessary to mix near infrared light from the light source unit 3 into near infrared light detected by the spectroscopic probe 8. As a result, the spectroscopic analysis can be performed with high accuracy, and the spectroscopic analysis can be performed while viewing the image of the heart B acquired at the same time.

  In the present embodiment, the mask 13 is moved back and forth in the light source unit 3 to switch the irradiation range of the near-infrared light from the near-infrared light source 11, but instead, as shown in FIG. Alternatively, the movable member 23 that can be made to appear and retract in front of the fiber bundle 4 may be provided in the suction cap 15, and the movable member may be made to appear and appear in front of the fiber bundle 4 as the spectroscopic probe 8 advances and retreats.

  In the example shown in FIG. 6, the movable member 23 is movably provided on the suction cap 15 and is urged in a direction of retreating from the front of the fiber bundle 4 by an elastic member such as a spring (not shown). Further, the movable member 23 is provided with an inclined surface 23 a that contacts the spectroscopic probe 8.

As shown in FIG. 6A, the irradiation range of the near infrared light from the fiber bundle 4 is not limited by the movable member 23 in a state where the spectroscopic probe 8 is retracted into the insertion portion 2. On the other hand, as shown in FIG. 6B, when the spectroscopic probe 8 is protruded from the insertion portion 2 and spectroscopic measurement is performed, the movable member 23 is moved in the direction indicated by the arrow, and the fiber bundle 4 is moved. The near-infrared light projected forward from the fiber bundle 4 is limited so as not to be irradiated in the vicinity of the distal end surface 8 a of the spectroscopic probe 8. Thus, as described above, there is an advantage that spectroscopic analysis can be performed with high accuracy while observing the outer surface of the heart B.
Instead of providing the movable member 23 on the suction cap 15, the movable member 23 may be provided on a cap (not shown) separate from the suction cap 15.

It is a block diagram which shows the endoscope apparatus which concerns on one Embodiment of this invention. It is a partial longitudinal cross-sectional view explaining the fixing method to the pericardium in the endoscope apparatus of FIG. It is an example of an image acquired by the endoscope apparatus of FIG. 1 and shows a case where (a) spectroscopic measurement is not performed and (b) spectroscopic analysis is performed. It is a figure which shows the example of (a)-(d) image acquired by the endoscope apparatus of FIG. 1, and (e) the example of a spectral analysis result. It is a figure which shows the synthesized image which affixed the spectral analysis result of FIG. 4 on the selected one still image. It is a modification of the endoscope apparatus of FIG. 1, Comprising: It is a partial longitudinal cross-sectional view which respectively shows the case where (a) the spectroscopic measurement is not performed and (b) the spectroscopic analysis is performed.

Explanation of symbols

A pericardium B heart L near-infrared light P feature point 1 endoscope apparatus 2 insertion part 3 light source part (illumination means)
4 Fiber bundle (light guide member)
5 Image sensor (imaging means)
7 Forceps channel (instrument channel)
8 Spectroscopic probe 13 Mask (Irradiation limiting means)
14 Mask position controller (irradiation limiting means: switching means)
23 Movable member (irradiation limiting means: shielding member)
23a Inclined surface (interlocking mechanism)

Claims (3)

An insertion part to be inserted into the body,
Illuminating means for emitting illumination light consisting of near-infrared light that irradiates the heart via the pericardium from the distal end of the insertion portion;
An imaging unit that irradiates the heart from the illumination unit and captures a return light composed of near-infrared light returning from the heart to the distal end of the insertion unit, and acquires a two-dimensional image of the heart;
A spectroscopic probe that detects near-infrared light that is reflected and / or scattered from the heart while emitting near-infrared light incident on the heart via the pericardium;
Irradiation limiting means for limiting an illumination range so that illumination light from the illumination means is not irradiated to a region near the tip of the spectral probe when near-infrared light is detected by the spectral probe. Endoscopic device. The illumination means includes a light source unit disposed on the proximal end side of the insertion unit, and a light guide member that guides illumination light from the light source unit to the distal end of the insertion unit,
The endoscope apparatus according to claim 1, wherein the irradiation limiting unit includes a switching unit that is provided in the light source unit and switches an incident range of illumination light to the light guide member. The insertion part is provided with a channel for an instrument that allows the spectroscopic probe to be inserted along the longitudinal direction and causes the tip of the spectroscopic probe to protrude and retract from the tip opening thereof,
The irradiation restricting means is configured to protrude from the distal end opening of the spectroscopic probe, and a shielding member that is movably disposed at the distal end of the insertion portion so as to open and close a part of the exit of the illumination light from the illumination means. The endoscope apparatus according to claim 1, further comprising an interlocking mechanism that interlocks and increases a closing amount of the injection port by the shielding member.

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