JP2012050619A - Probe pressing implement in image diagnostic system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a probe pressing implement in an image diagnostic system, which enables a relative position of a probe and a measurement object to surely and easily be fixed by using a balloon of a predetermined size without depending on the duct diameter of a measurement area, in measuring tomographic information by bringing the probe which protrudes at the tip of the insertion section of an endoscope into close contact with a measurement object along the longitudinal direction, and also, can easily positions the probe to the intended measurement area.SOLUTION: The probe pressing implement 710 is installed at the tip of the insertion section 144 of the endoscope 100. A frame body 720, a slit 760 and the balloon 780 are arranged around the OCT probe 600 which is led out of the insertion section distal end 144. Then, when the balloon 780 is inflated, the OCT probe 600 is pressed in close contact with the measurement object S through the slit 760.

Description

  The present invention relates to a probe pressing tool in an image diagnostic apparatus, and in particular, a tomographic image is generated by measuring tomographic information by bringing a probe derived from the distal end of an insertion portion of an endoscope into close contact with a measurement object along a longitudinal axis direction. The present invention relates to a probe pressing tool in an image diagnostic apparatus.

  Conventionally, as an endoscope apparatus for observing the inside of a body cavity of a living body, an electronic endoscope apparatus that irradiates illumination light inside the body cavity of a living body, captures an image of reflected light reflected, and displays it on a monitor or the like is widely spread. And used in various fields. In addition, many endoscope devices include a forceps channel in an insertion portion that is inserted into a body cavity, and a longitudinal probe of the diagnostic imaging device is inserted through the forceps channel and led out from the distal end of the insertion portion. Image diagnosis can be performed by acquiring tomographic information in the depth direction of a living tissue in a body cavity with a probe, imaging it, and displaying it on a monitor.

  As an image diagnostic apparatus using such an endoscope, in recent years, an optical tomographic imaging apparatus using an optical coherence tomography (OCT) measurement method using interference by low coherence light has been developed. (For example, see Patent Documents 1 and 2). The optical tomographic imaging apparatus, for example, divides low-coherence light emitted from a light source into measurement light and reference light, and measures biological tissue or the like from the tip of a probe derived from the measurement light at the distal end of an endoscope insertion portion. Irradiate the subject. Then, the reflected light from the portion irradiated with the measurement light is acquired from the tip of the probe, and the interference light obtained by causing the reflected light and the reference light to interfere with each other is electrically detected as an interference signal. By acquiring the tomographic information related to the structure in the depth direction of the measurement object by detecting the interference signal and imaging it, the imaged tomographic image is output to a monitor or the like. In addition, tomographic information (three-dimensional volume data) relating to a three-dimensional region can be acquired by changing the position where the measurement light is irradiated from the probe to the measuring object and acquiring the tomographic information. A tomographic image is generated.

  Similarly to the optical tomographic imaging apparatus, as an image diagnostic apparatus that acquires and images tomographic information in the depth direction of the measurement target using a probe derived from the distal end of the insertion portion of the endoscope, an ultrasonic wave is transmitted from the probe to the measurement target. 2. Description of the Related Art Conventionally, an ultrasonic diagnostic apparatus that obtains tomographic information in the depth direction of a measurement target by irradiating a beam and acquiring the reflected beam is also known (for example, see Patent Documents 10 and 11).

  As a probe used in the above-described diagnostic imaging apparatus (in the following, an optical tomographic imaging apparatus will be described as an example), a structure that emits measurement light in a direction inclined by a predetermined angle with respect to the longitudinal axis direction of the probe The position of the measurement target irradiated with the measurement light (measurement position for acquiring tomographic information) is moved by rotating the emission direction around the longitudinal axis of the probe, and the measurement light is emitted from the probe. By moving the position (measurement light emission position) in the longitudinal axis direction of the probe, the position of the measurement object irradiated with the measurement light is moved, and the tomographic information is acquired while changing the measurement position, thereby obtaining a three-dimensional volume. What gets the data is known. In this specification, rotating the measurement light around the probe longitudinal axis is referred to as radial scanning, and moving the measurement light in the probe longitudinal axis direction is referred to as linear scanning. Such radial scanning and linear scanning are performed simultaneously or alternately to acquire three-dimensional volume data of a desired region, and in particular, radial scanning and linear scanning are performed simultaneously to spirally measure the measurement light. Scanning that moves the irradiation direction is called spiral scanning.

  This type of probe is covered with, for example, a flexible long cylindrical probe outer tube (sheath), and an optical fiber accommodated and disposed along the longitudinal axis of the probe (sheath). And an optical system disposed at the tip of the optical fiber. The optical fiber of the probe is optically connected to the OCT processor that is the main body of the optical tomographic imaging apparatus, and the measurement light emitted from the OCT processor is transmitted through the optical fiber in the probe and After being emitted from the tip in the longitudinal direction of the probe, the measurement light is inclined by a predetermined angle with respect to the longitudinal direction of the probe due to the deflection and focusing of the optical system (for example, substantially orthogonal to the longitudinal axis of the probe). Direction) and irradiated (see, for example, Patent Document 3).

  The optical system arranged at the tip of the optical fiber of the probe is connected to, for example, an optical fiber. By rotating the optical fiber within the sheath, the optical system rotates in conjunction with this, and the measurement light The emission direction of the lens rotates around the longitudinal axis of the probe. Radial scanning is performed by the operation of this optical system. Further, by moving the optical fiber forward and backward in the axial direction, the optical system moves in the longitudinal direction of the probe in conjunction with this, and the emission position of the measurement light moves in the longitudinal direction of the probe. Yes. Linear scanning is performed by the operation of this optical system.

  By the way, in such a probe, if an air layer or other member is interposed between the probe and the measurement target, the measurement light is attenuated or disturbed. Therefore, the probe can be directly attached to the measurement target for measurement. This is necessary, and it is desirable to bring the outer peripheral surface of the probe into close contact with the object to be measured within the linear scanning range.

  In addition, if the relative position of the probe changes during measurement (during scanning), the probe generates a difference between the measurement position recognized by the device and the actual measurement position. A good tomographic image cannot be generated, for example, a disturbance such as blurring occurs in the tomographic image. Therefore, it is necessary to fix the relative position between the probe and the measurement object during measurement. When the probe is brought into close contact with the measurement target as described above, the relative position between the probe and the measurement target is fixed to some extent, but when the measurement target is a living tissue in a body cavity, breathing or Since the measurement object moves due to the influence of movement, the probe is simply not brought into contact with the measurement object and the relative position between the probe and the measurement object may change during measurement.

  Therefore, the probe is brought into close contact with the measurement object along the longitudinal axis direction so that the probe is not separated from the measurement object by movement of the measurement object (the probe longitudinal axis and the surface of the measurement object are in close contact with each other). ) It needs to be pressed.

  On the other hand, in order to set the probe derived from the distal end of the insertion portion of the endoscope to the measurement state as described above, the operator pushes and pulls the insertion portion of the endoscope, or curves the insertion portion by the hand operation portion. It is necessary to adjust the state of the probe by operation. However, in order to set the probe in such a measurement state for a target measurement site to be measured, a delicate operation is required and skill is required. Moreover, even a skilled person cannot easily grasp and adjust the pressing force of the probe on the object to be measured. If it is too strong, the probe will bend and become unsuitable for linear scanning. There is a possibility that the relative position with respect to the measurement object may fluctuate during measurement. In particular, since the probe is flexible and the tip side of the probe is not regulated at all, the probe is not bent without using an auxiliary tool, and the probe and the object to be measured are not bent. There is also a problem that it is difficult to press the probe against the measurement target so that the relative position does not change.

  On the other hand, as an auxiliary tool having an action of fixing the relative position between the probe and the measurement object, a device in which an inflatable / deflable balloon is installed at the distal end of the probe or endoscope insertion portion has been proposed. (For example, see Patent Documents 4 to 9). According to this, when a measurement is performed using a living tissue at a predetermined lumen in a body cavity as a measurement target, a balloon installed at the distal end of the insertion portion of the endoscope or a probe is inflated and brought into contact with the lumen wall. Thus, the position of the probe is fixed in the lumen, and the relative position to the measurement object is fixed.

JP-A-6-165784 JP 2001-255265 A JP 2009-098112 A JP-A-5-285141 JP 2000-329534 A JP 2007-075042 A Japanese Patent Laid-Open No. 2007-074403 JP 2010-125274 A JP 2010-142496 A Japanese Patent Laid-Open No. 06-133974 JP 11-137555 A

  However, there are those described in Patent Documents 4 to 9 in which the probe is brought close to the living tissue to be measured by inflating the balloon, but the probe that is pressed against the living tissue is disclosed. It has not been. Even if the balloon is inflated and brought into contact with the lumen wall as in Patent Documents 4 to 9, even if the probe is brought into close contact with the living tissue along the longitudinal axis direction and pressed, the lumen of the living body The size varies depending on the type of lumen and the site in the lumen, and it is necessary to select a balloon corresponding to the size of the lumen site to be measured. In addition, when measuring a living tissue in a luminal region having a large tube diameter, it is necessary to use a balloon that bulges correspondingly. Unfortunately, there is also a problem that the insertion portion of the endoscope is adversely affected when inserted into a body cavity. Furthermore, since the shape of the lumen wall varies depending on the part to be measured, when the balloon is inflated, the position of the balloon that first contacts the lumen wall is not determined, and the direction in which the probe is pressed by the balloon is predicted. Is difficult. Therefore, even if the balloon is inflated after the probe is arranged in the vicinity of the target measurement site, there is a problem that it is difficult to press the probe against the target measurement site.

  The present invention has been made in view of such circumstances, in the case of measuring tomographic information by closely contacting a probe that is arranged to protrude at the distal end of the insertion portion of the endoscope along the longitudinal axis direction, Regardless of the tube diameter of the measurement site, use a balloon of a certain size to ensure that the relative position of the probe and the measurement target can be fixed reliably and easily, and the intended measurement It is an object of the present invention to provide a probe pressing tool in an image diagnostic apparatus capable of easily positioning a probe to a site.

  In order to achieve the above object, a probe pressing tool in the diagnostic imaging apparatus according to claim 1 is configured such that a long probe protruding from the distal end of an insertion portion of an endoscope is closely attached to a measurement object along a longitudinal axis direction. A probe pressing tool in an image diagnostic apparatus that performs measurement and acquires and generates a tomographic image of a measurement object, and is supported at the distal end of the insertion portion and arranged in a direction perpendicular to the longitudinal axis of the probe And a balloon that is inflatable and inflatable disposed between the probe and the support, and by inflating the balloon, the balloon is brought into contact with the probe and the support, and The probe is pressed in close contact with the object to be measured along a longitudinal axis direction by a pressing force generated by inflation of a balloon.

  According to the present invention, since the relative position between the probe and the measurement target can be reliably fixed, even when there is a body movement such as breathing or pulsation during measurement of a living tissue, In this case, the relative position between the probe and the measurement object does not change, and it is possible to prevent problems such as disturbance in the tomographic image. In addition, since the balloon is not brought into contact with the wall surface of the lumen part or the like where the measurement is performed, but is brought into contact with the support supported at the distal end of the insertion portion, the size of the balloon depends on the size of the lumen part. The selection work is also unnecessary. Even when measuring a large tube diameter part, a small balloon can be used, and the burden on the subject when inserted into a body cavity can be reduced. Furthermore, since the balloon is brought into contact with the support body having a specific shape, the position where the probe is pressed can be predicted, and the probe can be pressed accurately to the target measurement site.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 2 is characterized in that, in the invention according to claim 1, the balloon is fixed to the support, the probe, or the distal end of the insertion portion.

  In the present invention, the part where the balloon is fixed is specified, and it is desirable to fix the part near the position where the balloon is arranged.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 3 is the invention according to claim 1 or 2, wherein the position of the probe in a direction orthogonal to the longitudinal axis direction of the probe and orthogonal to the measurement object is regulated. A slit member having a slit for performing is supported at the distal end of the insertion portion and is disposed in the vicinity of the measurement object between the balloon and the measurement object.

  According to the present invention, if the target measurement site to be measured is aligned with the position of the slit, the probe is pressed to the measurement site with higher accuracy. In addition, the probe is more reliably fixed to the measurement site during measurement.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 4 is the invention according to claim 3, wherein the width of the slit on the side where the balloon is disposed is shorter in the width direction of the slit on the side where the measurement object is disposed. It is characterized by being wider than the width in the short direction.

  The present invention shows a mode in which when the balloon is inflated, the probe can easily enter the slit, and the position where the balloon is restricted from being pushed by the slit member is adjusted.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 5 is the invention according to any one of claims 1 to 4, wherein a concave portion that engages with the probe when the balloon is inflated is formed in the balloon. It is characterized by that.

  According to the present invention, it becomes easier to predict the position where the probe is pressed by the action of the concave portion of the balloon, and the probe can be pressed to the target measurement site with high accuracy.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 6 is the invention according to claim 1 or 2, wherein the support is an overtube attached to an insertion portion of the endoscope, or of the endoscope. It is characterized by being provided at the tip of a hood attached to the tip of the insertion portion.

  The probe pressing tool in the diagnostic imaging apparatus according to a seventh aspect is the invention according to the sixth aspect, wherein the support is integrally formed with the overtube or the hood.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 8 is the invention according to claim 3, 4 or 5, wherein the support and the slit member are overtubes attached to an insertion portion of the endoscope. Alternatively, it is provided at the tip of a hood attached to the tip of the insertion portion of the endoscope.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 9 is characterized in that, in the invention according to claim 8, the support and the slit member are integrally formed on the overtube or the hood.

  The invention which concerns on Claims 6-9 has shown the aspect which provided the support body and the slit member in the overtube or the hood.

  The probe pressing tool in the diagnostic imaging apparatus according to claim 10 is the optical scanner according to any one of claims 1 to 9, wherein the probe measures tomographic information by optical coherence tomography. It is an optical probe used in the apparatus. An optical probe of an optical tomographic imaging apparatus is an effective probe for using the probe pressing tool according to the present invention.

  According to the present invention, when measuring the tomographic information by closely contacting the measurement object along the longitudinal axis direction with the probe protrudingly disposed at the distal end of the insertion portion of the endoscope, regardless of the tube diameter of the measurement site, Using a balloon of a certain size, the relative position between the probe and the measurement object can be fixed reliably and easily, and the probe can be easily positioned at the intended measurement site. To be able to do that.

1 is an external view showing the overall configuration of a diagnostic imaging apparatus to which the present invention is applied. The block diagram which shows the internal structure of the OCT processor of FIG. Sectional drawing which shows the front-end | tip cross section containing the longitudinal axis of the OCT probe of FIG. Sectional drawing which shows the structure of the optical rotary joint which connects the rotation side optical fiber FB1 of FIG. Side sectional view showing the configuration of the probe pressing tool AA arrow sectional view in FIG. Bottom view showing the configuration of the probe pressing tool Explanatory drawing used to explain the pressing amount Explanatory drawing used to explain the pressing amount Side sectional view which shows the structure of the probe pressing tool of other embodiment. The figure corresponding to FIG. 6 which showed the structure of other embodiment regarding a balloon shape. The figure which showed the basic composition of this invention

  Hereinafter, the best mode for carrying out the probe pressing tool in the diagnostic imaging apparatus according to the present invention will be described.

  As shown in FIG. 1, an image diagnostic apparatus 10 according to the present embodiment mainly includes an endoscope 100, an endoscope processor 200, a light source apparatus 300, an OCT processor 400 as a three-dimensional image construction apparatus, and a monitor apparatus. The display unit 500 is configured. The endoscope processor 200 may be configured to incorporate the light source device 300.

  The endoscope 100 includes a hand operation unit 112 and an insertion unit 114 that is connected to the hand operation unit 112. The surgeon grasps and operates the hand operation unit 112 and performs observation by inserting the insertion unit 114 into the body of the subject.

  The hand operation unit 112 is provided with a forceps insertion portion (forceps introduction port) 138, and the forceps insertion portion 138 is connected to the distal end portion 144 via a forceps channel (not shown) provided in the insertion portion 114. The forceps port (forceps outlet port) 156 communicates with the forceps port. In the diagnostic imaging apparatus 10, the distal end portion of the OCT probe 600 is led out from the forceps port 156 by inserting an OCT probe (optical probe) 600 as a probe from the forceps insertion portion 138 and inserting the forceps channel. A proximal end portion of the OCT probe 600 is connected to an operation unit 604 for an operator to operate the OCT probe 600, and the operation unit 604 is connected to the OCT processor 400 through a cable 606 by a connector 410. When using the probe pressing tool according to the present invention, the overtube 700 provided with the probe pressing tool 710 is attached to the insertion portion 114, which will be described later.

  At the distal end portion 144 of the endoscope 100, an observation optical system 150, an illumination optical system 152, and a CCD (not shown) are disposed.

  The observation optical system 150 forms an image of a subject on a light receiving surface (not shown) of the CCD, and the CCD converts the subject image formed on the light receiving surface into an electric signal by each light receiving element.

  The light source device 300 causes visible light to enter a light guide (not shown) (inserted into the cable 116 of the endoscope 100). One end of the light guide is connected to the light source device 300 via the LG connector 120, and the other end of the light guide faces the illumination optical system 152. The light emitted from the light source device 300 is emitted from the illumination optical system 152 via the light guide, and illuminates the visual field range of the observation optical system 150.

  An image signal output from the CCD via the cable 116 of the endoscope 100 is input to the endoscope processor 200 via the electrical connector 110. The analog image signal is converted into a digital image signal in the endoscope processor 200, and necessary processing for displaying on the screen of the image display unit 500 is performed.

  In this manner, observation image data obtained by the endoscope 100 is output to the endoscope processor 200, and an image is displayed on the image display unit 500 connected to the endoscope processor 200.

  Next, details of the OCT processor 400 of FIG. 1 will be described with reference to FIG. 2 showing an internal configuration of the OCT processor 400.

  The OCT processor 400 is for acquiring an optical tomographic image of an object to be measured by an optical coherence tomography (OCT) measurement method, and a method classified as SS-OCT (Swept Source OCT) in OCT measurement. Adopted.

  The OCT processor 400 emits a wavelength-scanning light source 12 that emits light La for measurement, and splits the emission light La emitted from the wavelength-swept light source 12 into measurement light L1 and reference light L2, and a measurement target that is a subject. The return light (reflected light) L3 from the light and the reference light L2 reflected by the reference mirror 11 are combined to generate an interference light L4, and the measurement light L1 branched by the optical coupler 14 is measured. The rotation-side optical fiber FB1 provided in the OCT probe 600 that guides the reflected light L3 from the measurement target and the measurement light L1 is guided to the rotation-side optical fiber FB1 and guided by the rotation-side optical fiber FB1. A fixed-side optical fiber FB2 that guides the reflected light L3 that has been waved and a rotation-side optical fiber FB1 are rotatably connected to the fixed-side optical fiber FB2, and the measurement light L1 The optical rotary joint 18 that transmits the reflected light L3, the interference signal detection unit 20 that detects the interference light L4 generated by the optical coupler 14 as an interference signal, and the interference signal Sb detected by the interference signal detection unit 20 And a signal processing unit 22 for processing to acquire tomographic information. An image generated based on the tomographic information acquired by the signal processing unit 22 is displayed on the image display unit 500.

  In the OCT processor 400 shown in FIG. 2, various lights including the above-described emission light La, measurement light L1, reference light L2, reflected light L3, and the like are guided between components such as optical devices and transmitted. Various optical fibers (not shown) including the rotation-side optical fiber FB1 and the fixed-side optical fiber FB2 are used as light paths for the purpose.

  The wavelength swept light source 12 emits light for OCT measurement (for example, laser light having a wavelength of 1.3 μm or low coherence light). The wavelength swept light source 12 sweeps the frequency at a constant period. It is a light source that emits a laser beam La centered at a wavelength of 1.3 μm, for example, in the infrared region. Although not shown, the wavelength swept light source 12 includes a light source unit that emits laser light or low-coherence light La and a lens that collects the light La emitted from the light source unit. The light La is split by the optical coupler 14 into measurement light L1 and reference light L2, and the measurement light L1 is input to the optical rotary joint 18. The wavelength sweep light source 12 outputs a wavelength sweep synchronization signal Sc synchronized with the wavelength sweep cycle to the signal processing unit 22 and is used for processing the interference signal Sb.

  The optical rotary joint 18 guides the measurement light L1 to the rotation side optical fiber FB1 in the OCT probe 600.

  The optical coupler 14 divides the light La from the wavelength swept light source 12 into measurement light L1 and reference light L2, makes the measurement light L1 incident on the fixed-side optical fiber FB2, and adjusts the optical path length of the reference light L2. 11 is incident.

  Further, the optical coupler 14 receives the reference light L2 that has been frequency-shifted and changed the optical path length by the reference mirror 11, and the reflected light L3 that is acquired by the OCT probe 600 described later and guided from the fixed-side optical fiber FB2. Are combined to generate interference light L4, and the interference light L4 is output to the interference signal detection unit 20.

  The OCT probe 600 is connected to the fixed side optical fiber FB2 via the optical rotary joint 18, and the measurement light L1 enters the rotation side optical fiber FB1 via the optical rotary joint 18 from the fixed side optical fiber FB2. Then, the measurement light L1 is transmitted by the rotation side optical fiber FB1, and is irradiated to the measurement object S (see FIG. 3). And the reflected light L3 from the measuring object S is acquired, the acquired reflected light L3 is transmitted by the rotation side optical fiber FB1, and is emitted to the fixed side optical fiber FB2 through the optical rotary joint 18. .

  The interference signal detection unit 20 detects the interference light L4 generated by combining the reference light L2 and the reflected light L3 by the optical fiber coupler 14 as an interference signal Sb. The interference signal is subjected to fast Fourier transform (FFT) to detect the intensity (tomographic information) of reflected light (or backscattered light) at each depth position of the measuring object S.

  The signal processing unit 22 acquires tomographic information from the interference signal detected by the interference signal detection unit 20, generates three-dimensional tomographic information (three-dimensional volume data) based on the acquired tomographic information, and performs this three-dimensional A three-dimensional tomographic image obtained by performing various processing on the volume data is output to the image display unit 500.

  The reference mirror 11 is disposed on the emission side of the reference light L2, and the reference light L2 is converted into parallel light and condensed on the mirror, and reflected by the mirror. The mirror is adjusted in the optical path length of the reference light L2 by moving in a direction parallel to the optical axis direction by a mirror moving mechanism.

  The optical rotary joint 18 rotates the rotation-side optical fiber FB1 in the OCT probe 600 to rotate the emission direction of the measurement light L1 emitted from the OCT probe 600 around the longitudinal axis of the OCT probe 600 (for radial scanning). (2) The rotational position of the measurement light L1 emitted from the OCT probe 600 by moving the rotational drive unit 24 as the transmission / reception wave rotating means and the rotation-side optical fiber FB1 in the OCT probe 600 in the axial direction is the longitudinal axis of the OCT probe 600. It is controlled by an axial movement drive unit 25 as a transmission / reception wave moving means (for linear scanning) for moving forward and backward in the direction.

  Specifically, the rotation driving unit 24 outputs to the signal processing unit 22 a motor 24a that rotates the rotation-side optical fiber FB1, and one pulse (one pulse / rotation) pulse signal Sa for each rotation of the motor 24a. And a rotation detection unit 24b as rotation detection means. The axial movement drive unit 25 includes a motor 25a, and the motor 25a moves the rotation side optical fiber FB1, the optical rotary joint 18, and the rotation drive unit 24 forward and backward in the longitudinal axis direction of the OCT probe 600. The optical rotary joint 18 and the rotation drive unit 24 are provided in the operation unit 604 (see FIG. 1).

  FIG. 3 is a cross-sectional view of the OCT probe 600 of FIG. 1 cut along a plane including the longitudinal axis. FIG. 4 is a cross-sectional view showing the configuration of the optical rotary joint 18 that connects the rotation-side optical fiber FB1 of FIG.

  As shown in FIG. 3, the distal end portion of the OCT probe 600 includes a substantially cylindrical sheath (probe outer tube) 620 whose distal end is closed, a rotation-side optical fiber FB1, a flexible shaft (torque transmission coil) 624, And an optical lens 628 as wave transmitting / receiving means.

  The sheath 620 is a long cylindrical member having flexibility, and is made of a material that transmits the measurement light L1 and the reflected light L3. It should be noted that the sheath 620 has a part on the entire circumference where the measurement light L1 and the reflected light L3 pass (the tip of the rotation side optical fiber FB1 opposite to the optical rotary joint 18, hereinafter referred to as the tip of the sheath 620). What is necessary is just to be formed with the material (transparent material) which permeate | transmits light.

  The rotation-side optical fiber FB1 is a linear member, and is accommodated in the sheath 620 along the longitudinal axis of the sheath 620, which is the longitudinal axis of the OCT probe 600. The rotation side optical fiber FB1 guides the measurement light L1 emitted from the fixed side optical fiber FB2 to the optical lens 628, and reflects the reflected light L3 from the measurement target S acquired by the optical lens 628 on the fixed side optical fiber. Waveguided to FB2.

  The optical lens 628 is fixed to the tip of the rotation-side optical fiber FB1 by a fixing member 626, and the measurement light L1 emitted from the rotation-side optical fiber FB1 in the longitudinal direction of the OCT probe 600 is used as the longitudinal axis of the OCT probe 600. The light is deflected and condensed toward the condensing point F in the direction inclined by a predetermined angle (the peripheral surface direction of the sheath 620), and the measurement object S is irradiated, and the reflected light L3 from the measurement object S is condensed. The light enters the rotation side optical fiber FB1.

  The rotation-side optical fiber FB1 and the flexible shaft 624 are connected to a rotation cylinder 656, which will be described later. By rotating the rotation-side optical fiber FB1 and the flexible shaft 624 by the rotation cylinder 656, the optical lens 628 is moved to the sheath 620. On the other hand, it is rotated in the direction of arrow R.

  As shown in FIG. 4, the rotation side optical fiber FB1 and the fixed side optical fiber FB2 are connected by the optical connector 18a, and the rotation of the rotation side optical fiber FB1 is not transmitted to the fixed side optical fiber FB2. Connected. The rotation-side optical fiber FB1 is disposed so as to be rotatable with respect to the sheath 620 and movable in the longitudinal axis direction of the sheath 620 (OCT probe 600).

  The flexible shaft 624 is fixed to the outer periphery of the rotation side optical fiber FB1. The rotation side optical fiber FB1 and the flexible shaft 624 are connected to the optical rotary joint 18.

  Further, the rotation-side optical fiber FB1, the flexible shaft 624, and the optical lens 628 are moved inside the sheath 620 by arrows S1 (forceps opening direction) and S2 ( It is configured to be movable in the direction of the distal end of the sheath 620.

  The sheath 620 is fixed to the fixing member 670. On the other hand, the rotation side optical fiber FB1 and the flexible shaft 624 are connected to a rotating cylinder 656, and the rotating cylinder 656 is configured to rotate via a gear 654 in accordance with the rotation of the motor 24a. The rotary cylinder 656 is connected to the optical connector 18a of the optical rotary joint 18, and the measurement light L1 and the reflected light L3 are transmitted between the rotation side optical fiber FB1 and the fixed side optical fiber FB2 through the optical connector 18a. .

  Further, the frame 650 containing these includes a support member 662, and the support member 662 has a screw hole (not shown). The optical rotary joint 18 has a screw hole engaged with a ball screw 664 for advancing / retreating, and a motor 25a is connected to the ball screw 664 for advancing / retreating, and the shaft is driven by the screw hole, the ball screw 664 for advancing / retreating, and the motor 25a. The direction movement drive unit 25 is configured. Therefore, the axial movement drive unit 25 rotates and drives the motor 25a to move the frame 650 forward and backward, whereby the rotation side optical fiber FB1, the flexible shaft 624, the fixing member 626, and the optical lens 628 are connected to the OCT probe 600. It can be moved in the longitudinal axis direction (directions S1 and S2 in FIG. 3).

  With the configuration as described above, the OCT probe 600 has the measurement light L1 emitted from the optical lens 628 when the rotation-side optical fiber FB1 and the flexible shaft 624 are rotated in the direction of arrow R in FIG. Is rotated in the direction of arrow R (circumferential direction of the sheath 620), and radial scanning is performed.

  When acquiring three-dimensional volume data to generate a three-dimensional tomographic image, the optical lens 628 is moved to the end of the movable range in the direction of the arrow S1 by the axial movement driving unit 25, and then tomographically scanned. While repeating the acquisition of information and the movement in the S2 direction (linear scanning) alternately or simultaneously, it moves to the end of the movable range. Note that the rotation direction of the optical lens 628 during radial scanning and the movement direction of the optical lens 628 during linear scanning may be opposite to those described above.

  Here, as shown in FIG. 3, the OCT probe 600 has a short distance from the outer surface of the sheath 620 to the condensing point F, and performs measurement by bringing the outer surface of the sheath 620 into close contact with the measuring object S along the longitudinal axis direction. It has the characteristic to make it an optimal measurement state. In the measurement state, by rotating the optical lens 628 and rotating the emission direction of the measurement light L1 around the longitudinal axis of the OCT probe 600, that is, by performing radial scanning, the condensing point F of the measurement light L1 is changed. It moves in the circumferential direction in the vicinity of the outer surface of the sheath 620. Then, by bringing the outer surface of the sheath 620 into close contact with the measurement target S, the tomographic information of the region of the measurement target S that overlaps the path along which the condensing point F moves and the vicinity thereof is effectively acquired. Become. Similarly, by moving the optical lens 628 forward and backward to move the emission position of the measurement light L1 forward and backward in the longitudinal axis direction of the OCT probe 600, that is, by performing linear scanning, the condensing point F of the measurement light L1 is changed to the sheath. 620 moves in the longitudinal direction near the outer surface. The outer surface of the sheath 620 is brought into close contact with the measuring object S along the longitudinal axis direction, so that the tomographic information of the area of the measuring object S that overlaps the path along which the condensing point F moves and the vicinity thereof is effective. Get to get to.

  Next, the probe pressing tool according to the present invention will be described.

  The probe pressing tool according to the present invention is disposed in front of the insertion portion distal end 144 of the endoscope 100 and is derived from the distal end portion 144 (hereinafter referred to as the insertion portion distal end 144) of the insertion portion 114 of the endoscope 100. This is an auxiliary tool for pressing the OCT probe 600 in close contact with the measuring object S along the longitudinal axis direction as shown in FIG. As a result, even if the measuring object S is moved by breathing or pulsation as in the case where the measuring object S is a living tissue in the body cavity, the relative relationship between the OCT probe 600 and the measuring object S at the time of measurement (scanning). A tomographic image free from disturbance such as blurring can be acquired by the OCT probe 600 without causing a change in position. In addition, the probe pressing tool according to the present invention has an effect that the positioning operation for accurately positioning the OCT probe 600 at the measurement site intended by the operator is also easy. Note that the pressing of the OCT probe 600 in close contact with the measuring object S along the longitudinal axis direction means that when the measuring object S is deformed, the OCT probe over a predetermined range in the longitudinal axis direction of the OCT probe 600. The OCT probe 600 is further pushed toward the measuring object S with respect to the state in which the outer surface of 600 (the outer surface of the sheath 620) is in contact with or close to the measuring object S with little pressure, and the measuring object S is deformed. The measurement object S is in a state where there is substantially no gap over a predetermined range in the longitudinal axis direction of the OCT probe 600 and a wide range in the circumferential direction of the outer surface of the OCT probe 600. When the target S is hard and hardly deformed even by a large pressing force, the OCT is performed over a predetermined range in the longitudinal axis direction of the OCT probe 600. The outer surface of the OCT probe 600 over a predetermined range in the longitudinal axis direction of the OCT probe 600 with respect to the state in which the outer surface of the lobe 600 (outer surface of the sheath 620) is in contact with or close to the measuring object S with little pressure. The outer surface of the sheath 620 is pressed against the measuring object S with a pressing force of a predetermined size or more. The probe pressing tool according to the present invention is effective in both meanings, but in the following description, the former measurement object S is assumed.

  The probe pressing tool 710 according to the present embodiment is a mode in which the distal end portion of the overtube 700 that covers the entire insertion portion 114 of the endoscope 100 is provided as shown in FIG. In use, before inserting the insertion portion 114 of the endoscope 100 into the body cavity of the subject, the overtube 700 having the probe pressing tool 710 is put on the insertion portion 114 and the probe pressing tool 710 is attached. It is installed on the front side of the insertion portion distal end 144.

  FIG. 5 is a cross-sectional view showing the configuration of the probe pressing tool 710 of the present embodiment disposed at the insertion portion distal end 144 of the endoscope 100, and the central axis Ax1 of the insertion portion distal end 144 of the endoscope 100 and FIG. 5 is a cross-sectional view taken along a plane including a central axis of a forceps port 156 (a central axis of a forceps channel in the forceps port 156) Ax2. FIG. 6 is a cross-sectional view taken along line AA in FIG. 5, and FIGS. 6A and 6B show different states as described later. FIG. 7 is a bottom view showing the probe pressing tool 710 and the like of FIG. 5 from the lower side.

  Here, in the following, as a wording indicating the direction and position in the space around the insertion portion distal end 144, the direction orthogonal to the paper surface of FIG. 5 is the left-right direction (X), and the left-right direction (insertion) on the paper surface of FIG. The center axis Ax1 direction of the front end 144 is defined as the front-rear direction (Y), and the vertical direction (the direction perpendicular to the left-right direction (X) and the front-rear direction (y)) in FIG. With respect to the front-rear direction (Y), the right side of the paper surface is the front side, the left side of the paper surface is the rear side, and for the vertical direction (Z), the upper side and the lower side of the paper surface are the upper side and the lower side.

  As shown in FIGS. 5 to 7, the probe pressing tool 710 of this embodiment includes a frame 720, a probe insertion hole 740, a slit 760, and a balloon 780.

  The frame 720 arranges the probe insertion hole 740, the slit 760, and the balloon 780 of the probe pressing tool 710 at predetermined positions in front of the insertion portion distal end 144 of the endoscope 100, and at the distal end side of the overtube 700. The part formed in the range which becomes the front side of the front-back direction (Y) rather than the front surface of the insertion part front-end | tip 144 is shown, and is formed from the cylindrical part 722, the flat plate part 724, the base end part 726, and the cavity part 728. In addition, the frame body 720 according to the present embodiment including these components is integrally formed with the overtube 700 and formed at the distal end as a part of the overtube 700. However, part or all of the frame body 720 may be composed of one or a plurality of separate members from the overtube 700 and connected by bonding or the like.

  As apparent from FIG. 6, the cylindrical portion 722 has a shape obtained by cutting a cylindrical member along a plane parallel to the axis, and has an arc shape on a cross section orthogonal to the front-rear direction (Y). is doing. As will be described later, a contact surface with which the balloon 780 contacts is arranged near the OCT probe 600 by the cylindrical portion 722.

  The flat plate portion 724 indicates a portion that is closed by connecting the end portions in the front-rear direction (Y) on both the left and right sides of the cylindrical portion 722 in a flat shape, and a slit 760 is formed in the flat plate portion 724.

  The base end portion 726 has a substantially semicircular shape when viewed from the front side, and is connected to the rear end portion of the cylindrical portion 722 and the rear end portion of the flat plate portion 724. A probe insertion hole 740 is formed in the base end portion 726. The proximal end portion 726 has an action of arranging the probe pressing tool 710 in a specified state with respect to the insertion portion distal end 144 of the endoscope 100, and is inserted when the insertion portion 114 is inserted into the overtube 700. When the front surface of the distal end 144 is inserted to a position where it contacts the rear surface of the base end portion 726, the probe pressing tool 710 in the front-rear direction (Y) is set at a specified position. Further, by aligning the opening position of the rear side of the probe insertion hole 740 formed in the base end portion 726 with the position of the forceps port 156 from which the OCT probe 600 is led out, the rotational position of the insertion portion distal end 144 around the central axis Ax1 In this case, the probe pressing tool 710 is installed at a predetermined position. The base end portion 726 covers, for example, the entire front surface of the insertion portion distal end 144 with a transparent member, and a through hole is formed in a necessary portion according to the components arranged on the front surface of the insertion portion distal end 144. You may make it provide. Conversely, the base end portion 726 may be omitted except for the portion where the probe insertion hole 740 is provided, and viewed from the front side in the front-rear direction (Y) so as not to hinder the action of the components arranged on the front surface of the insertion portion distal end 144. It may be fan-shaped or belt-shaped.

  The hollow portion 728 indicates a space surrounded by the cylindrical portion 722, the flat plate portion 724, and the base end portion 726, and a balloon 780 that can be inflated and contracted is accommodated in the hollow portion 728. The front side of the hollow portion 728, that is, the front end side of the frame body 720 is opened, but may be closed by a member that is connected to the front end portions of the cylindrical portion 722 and the flat plate portion 724.

Subsequently, before explaining the details of the probe insertion hole 740, the slit 760, and the balloon 780, in order to make the explanation easy to understand, the OCT is brought into the state at the time of measurement (scanning) as shown in FIGS. An example of procedures and operations until the probe 600 is set is shown in the following (1) to (6).
(1) The balloon 780 of the cavity 728 is set in a contracted state as shown in FIG.
(2) By manipulating the posture of the insertion portion distal end 144, the measurement target S of the target measurement site is set in a state of being arranged near the lower side of the slit 760 of the flat plate portion 724.
(3) The OCT probe 600 is inserted from the forceps insertion portion 138 of the endoscope 100, the forceps channel in the insertion portion 114 is inserted, and the OCT probe 600 is led out from the forceps port 156 of the insertion portion distal end 144.
(4) The OCT probe 600 led out from the forceps port 156 is led into the cavity part 728 through the probe insertion hole 740 of the base end part 726 as shown in FIG. Is done.
(5) The balloon 780 in the cavity 728 is inflated as shown in FIGS. 5 and 6B.
(6) The OCT probe 600 arranged in the cavity portion 728 as shown in FIG. 6A is pushed down by the expansion of the balloon 780, and the slit 760 of the flat plate portion 724 is opened as shown in FIGS. Then, it is pressed closely against the measuring object S along the longitudinal axis direction (during measurement or in a measurable state).

  Now, the probe insertion hole 740 formed in the base end portion 726 of the frame 720 is a hole that penetrates in the front-rear direction (Y). The forceps at the distal end 144 of the insertion portion 144 of the endoscope 100 through the probe insertion hole 740. The OCT probe 600 led out from the mouth 156 is led out from the front surface of the base end portion 726 to the front side (inside the hollow portion 728 of the frame 720 when the balloon 780 is deflated). In addition, the probe insertion hole 740 has an action of regulating the position in the left-right direction (X) on the rear side of the OCT probe 600 guided into the cavity 728 of the frame 720 at the front end portion thereof. The size (width) of the probe insertion hole 740 in the left-right direction (X) is formed so as to substantially match the diameter of the OCT probe 600 or the diameter of the forceps port 156 that is substantially the same size as the OCT probe 600.

  Here, when a portion on the distal end side of the OCT probe 600 that is inserted in the probe insertion hole 740 and is disposed in a region in front of the front surface of the base end portion 726 of the frame 720 is referred to as a lead-out portion 600A, the lead-out portion is derived. The portion 600A is pushed down by the expansion of the balloon 780 and protrudes below the slit 760 (below the lower surface of the flat plate portion 724) as shown in FIGS. 5 and 6B, and the longitudinal direction of the slit 760 (forceps) It is arranged substantially in parallel with the central axis Ax2) of the mouth 156. At this time, the lead-out portion 600A of the OCT probe 600 is below the position of the OCT probe 600 at the forceps port 156. Therefore, it is necessary to bend the OCT probe 600 at least at any part in front of the forceps opening 156. Therefore, it is desirable that the probe insertion hole 740 is expanded to a position where the lead-out portion 600A of the OCT probe 600 is arranged at the time of measurement with respect to the size of the hole in the vertical direction (Z). As a result, bending of the OCT probe 600 is likely to occur at the probe insertion hole 740, and the lead-out portion 600A of the OCT probe 600 can be straightened to a position close to the front surface of the insertion portion tip 144. Good measurement can be performed in substantially the entire area in the front-rear direction (Y). At this time, when the probe insertion hole 740 is viewed from the front side, it becomes a long hole having the vertical direction (Z) as the longitudinal direction, and the rear end portion of the lead-out portion 600A of the OCT probe 600 is regulated in the horizontal direction (X). (Z) is guided.

  The range in the vertical direction (Z) of the probe insertion hole 740 includes the opening range of the forceps port 156 and the position where the lead-out portion 600A of the OCT probe 600 is to be disposed at the time of measurement. The frame body 720 (base end portion 726) may penetrate to one or both ends in the vertical direction (Z). Further, the position where the lead-out portion 600A of the OCT probe 600 is disposed at the time of measuring the lower surface of the probe insertion hole 740 in the vertical direction (Z) from the position below the opening range of the forceps port 156. You may make it incline toward. At this time, by adjusting the design value of the thickness in the front-rear direction (Y) of the base end portion 726 to adjust the degree of inclination of the lower surface of the probe insertion hole 740, the OCT probe 600 is excessively (rapidly) ) Can be prevented.

  The action of the probe insertion hole 740 that restricts the position of the rear end of the lead-out part 600A of the OCT probe 600 in the left-right direction (X) can also be obtained by the forceps port 156, the slit 760, and the like. Therefore, a mode in which the probe insertion hole 740 is not necessary is easily possible. At this time, the arrangement of the probe pressing tool 710, which the base end portion 726 of the frame 720 has as its action as described above, at the specified position is in operation when the overtube 700 is attached to the insertion portion 114. It can be replaced with other means such as visual inspection as a matter, and the base end portion 726 can also be made unnecessary. In addition, the base end portion 726 may simply contact the probe pressing tool 710 in a slight range around the front surface of the insertion portion distal end 144, assuming that the probe pressing tool 710 is disposed at a specified position in the front-rear direction (Y).

  The slit 760 formed in the flat plate portion 724 of the frame 720 is a hole that penetrates in the vertical direction (Z) with the front-rear direction (Y) as the longitudinal direction, and the lead-out portion 600A of the OCT probe 600 is passed through the slit 760. Is pressed against the measuring object S arranged on the lower side of the frame body 720 (flat plate portion 724) by inflation of a balloon 780 described later.

  In the present embodiment, the lower surface of the flat plate portion 724 is formed so that the position of the lower surface of the forceps opening 156 substantially coincides with the vertical direction (Z), and the lower opening of the slit 760 is formed. Is formed so that it substantially coincides with the position of the lowest point of the forceps opening 156. Accordingly, the lead-out portion 600A of the OCT probe 600 that is led out from the forceps port 156 and inserted through the probe insertion hole 740 when the balloon 780 is deflated is arranged such that the upper surface side is disposed in the cavity portion 728 and the lower surface side is disposed in the slit 760. It has become.

  As shown in FIG. 7, the slit 760 is formed with a restricting portion 762 having a width that substantially matches the diameter of the OCT probe 600 in the left-right direction (X) at the front end portion in the front-rear direction (Y). A wide portion 764 that is sufficiently wider than the diameter of the OCT probe 600 is formed. As a result, the leading end portion of the lead-out portion 600 </ b> A of the OCT probe 600 is disposed at the restriction portion 762, and the position in the left-right direction (X) is restricted by the restriction portion 762. On the other hand, the position in the left-right direction (X) of the rear portion of the lead-out portion 600A is restricted by the probe insertion hole 740 as described above. Therefore, for example, when the balloon 780 is deflated, the operator adjusts the target measurement site to be measured to the position of the slit 760 while viewing the observation image taken by the observation optical system 150 at the insertion portion distal end 144, and then If the OCT probe 600 is led out from the forceps port 156 and placed in the cavity 728 and the slit 760, and the balloon 780 is inflated, the lead 600A is reliably and accurately measured without being displaced in the left-right direction (X). It is designed to be pressed against the part.

  In addition, as shown in FIGS. 6A and 6B, the slit 760 is formed such that the side wall surface 766 in the left-right direction (X) is tapered (the upper slit width is enlarged). In the present embodiment, as described above, the lead-out portion 600A of the OCT probe 600 is in a state in which the lower surface side enters the slit 760 even when the balloon 780 is deflated. The portion 600A is not formed in a tapered shape for the purpose of making it easy to enter the slit 760. However, when the balloon 780 is deflated, the portion 600A is detached from the slit 760 due to the curvature of the lead-out portion 600A (cavity portion 728). When the balloon 780 is inflated, the lead-out portion 600 </ b> A that is disengaged from the slit 760 has an effect of easily entering the slit 760. Also, unlike the present embodiment, the same effect can be obtained when the OCT probe 600 led out from the forceps opening 156 is disposed within the cavity 728 that is completely removed from the slit 760 when the balloon 78 is deflated. Have. Furthermore, the wide portion 764 formed in the slit 760 as shown in FIG. 7 is also effective when the lead-out portion 600A is detached from the slit 760, but is not necessarily required in the present embodiment. It may consist of only the above-mentioned restricting part 762. The operation when the slit 760 is tapered will be described later.

  The balloon 780 disposed in the cavity portion 728 of the frame body 720 is freely expandable / contractable, and the uppermost portion on the inner surface side of the cylindrical portion 722 where a part of the upper surface side of the balloon 780 becomes the upper surface of the cavity portion 728 of the frame body 720. It is fixed to a nearby surface and supported by a cylindrical portion 722. At the time of contraction, as shown in FIG. 6 (A), it is accommodated in a partial region in the cavity portion 728 along the upper surface in the cylindrical portion 722. On the other hand, when inflated, the balloon swells in a columnar shape as shown in FIGS. 5 and 6B, and when maximally inflated, the balloon 780 is in contact with the upper surface of the cavity portion 728 (inner surface of the cylindrical portion 722). The lower surface side of 780 expands to a state where it abuts on the upper edge of slit 760 (the upper edge of side wall surface 766).

  The balloon 780 is connected to an injection device for injecting a fluid that is a gas or a liquid into the balloon 780 and sucking the fluid in the balloon 780 through an injection tube (not shown). The device allows the operator to manipulate the inflation and deflation of the balloon 780. The injection tube is inserted from the injection device into the over tube 700 attached to the insertion portion 114 of the endoscope 100 or a treatment instrument channel other than the forceps channel through which the OCT probe 600 is inserted. It is guided to the tip end 144 and is connected to the balloon 780 through an insertion hole (not shown) formed in the cylindrical portion 722 of the frame body 720 or an opening on the front end side of the frame body 720.

  According to the balloon 780 that expands and contracts in this manner, the OCT probe 600 is led out from the forceps port 156 without being blocked by the balloon 780 by deflating the balloon 780 as shown in FIG. The lead-out portion 600 </ b> A of the OCT probe 600 can be disposed in the cavity 728 and the slit 760 of the frame 720. In addition, an imaging field of view of the observation optical system 150 disposed in front of the insertion portion distal end 144 of the endoscope 100 is also ensured.

  Then, after the lead-out portion 600A of the OCT probe 600 is disposed in the cavity portion 728 and the slit 760, when the balloon 780 is gradually inflated from the contracted state, the balloon 780 expands toward the upper surface side of the cylindrical portion 722 of the frame 720. Therefore, after the lower surface side of the balloon 780 comes into contact with substantially the entire lead portion 600A of the OCT probe 600 disposed in the cavity portion 728 and the slit, the lead portion of the OCT probe 600 is inflated with the expansion of the balloon 780. 600A is pushed downward. At this time, the lower surface side of the lead-out portion 600A of the OCT probe 600 is gradually led out to the lower side of the slit 760 (below the lower surface of the flat plate portion 724) and comes into contact with the measurement target S. Pushed in. Finally, as shown in FIGS. 5 and 6B, the balloon expands until the lower surface side of the balloon 780 contacts the upper edge of the slit 760 (the upper edge of the side wall surface 766), and the OCT probe 600 is The position of the derivation unit 600A is fixed. At this time, the longitudinal axis of the lead-out portion 600A of the OCT probe 600 is substantially parallel to the longitudinal direction of the slit 760, that is, the central axis Ax21 of the forceps port 156.

  As a result, the lead-out portion 600A of the OCT probe 600 is brought into close contact with the measurement target S of the target measurement site arranged close to the lower side of the slit 760 along the longitudinal axis direction. The relative position between the derivation unit 600A of the OCT probe 600 and the measurement target S (the measurement site to which the derivation unit 600A is in close contact) is securely fixed, and the measurement target S moves due to respiration or pulsation. However, their relative positions are not changed, which is suitable for measurement. Thereafter, measurement is started in this state, and the measurement light L1 is supplied from the OCT processor 400 to the rotation side optical fiber FB1 of the OCT probe 600 to perform radial scanning, linear scanning, or simultaneous or alternating scanning thereof. As a result, the tomographic information of the measurement target S at the site where the deriving unit 600A of the OCT probe 600 is in close contact is acquired. In addition, since the derivation part 600A is arranged linearly over substantially the whole, it is within a range that substantially matches the length in the front-rear direction (Y) of the derivation part 600A determined by the length of the slit 760 in the front-rear direction (Y). , It is possible to perform a good measurement in the front-rear direction (Y).

  Here, as the amount by which the lead-out portion 600A of the OCT probe 600 is pushed down by the balloon 780, the lead-out portion 600A is displaced by the inflation of the balloon 780 from the position where the lead-out portion 600A is disposed when the balloon 780 is deflated in the vertical direction (Z). If the amount of displacement up to the position is referred to as the amount of pressing, the amount of pressing can be adjusted by the amount of fluid injected into the balloon 780 at the time of maximum inflation, but the amount of pressing increases. The adjustment in the direction in which the balloon 780 is in contact with the upper edge of the left and right of the slit 760 with which the balloon 780 abuts (the upper edge of the side wall surface 766) even if the amount of fluid injected into the balloon 780 or the size of the balloon 780 itself is changed. It is limited by the distance in the left-right direction (X) (upper slit width) and the position in the up-down direction (Z). Therefore, when the pressing amount is insufficient, the interval in the left-right direction (X) and the position in the up-down direction (Z) of the upper edge of the slit 760 may be changed. For example, FIGS. 8A and 8B show an aspect in which the side wall surfaces 766 and 766 of the slit 760 are tapered as in the above embodiment, and FIG. FIG. 5B shows the positions of the cavity 728 of the frame 720 and the lead-out portion 600A of the OCT probe 600 disposed in the slit 760. FIG. 5B shows the balloon 780 until it comes into contact with the upper edge of the slit 760. The position of the lead-out part 600A of the OCT probe 600 pushed down by the balloon 780 when inflated is shown. As shown in the figure, the hold-down amount ΔZ1 due to the expansion of the balloon 780 is a displacement amount from the lowest point of the derivation part 600A in the same figure (A) to the lowest point of the derivation part 600A in the same figure (B). . For example, the length of the slit 760 in the vertical direction (Z) (thickness of the flat plate portion 724) is set to about the radius of the OCT probe 600, and the balloon 780 is sufficiently larger than the upper slit width of the slit 760 (the range of the slit 760). If the balloon 780 is regarded as flat, the pressing amount ΔZ1 is determined by the position in the vertical direction (Z) of the upper edges 766A and 766A of the slit 760 with which the balloon 780 abuts, and is substantially equal to the probe radius R.

  On the other hand, in FIGS. 9A and 9B, the side wall surfaces 766 and 766 of the slit 760 are cut in the vertical direction (Z) (cut surface parallel to the YZ plane), and the shapes of the upper edges 766B and 766B. FIG. 9A shows a mode in which the amount of pressing is increased by changing the above, and FIG. 9A shows the derivation of the OCT probe 600 disposed in the cavity 728 and the slit 760 of the frame 720 when the balloon 780 is deflated. The position of the portion 600A is shown, and FIG. 5B shows the position of the lead-out portion 600A of the OCT probe 600 pushed down by the balloon 780 when the balloon 780 is inflated until it abuts on the upper edge of the slit 760. . As shown in the figure, the upper edges 766B and 766B of the slit 760 are chamfers that substantially coincide with the inclination angle of the portion with which the balloon 780 abuts when inflated (or an angle closer to parallel to the left-right direction (X) than that). In the case of FIG. 9, the upper edge 766B, 766B of the slit 760 with which the balloon 780 abuts is positioned in the vertical direction (Z) (the position of the lowest point) as shown in FIG. Is on the lower side. Therefore, in the above assumption, the pressing amount ΔZ2 in the mode of FIG. 9 can be increased more than the pressing amount ΔZ1 in the mode of FIG. 8, and the pressing amount ΔZ2 is made larger than the probe radius R (rather than the probe diameter 2R). Small). However, when the curvature of the balloon 780 is taken into consideration, the amount of pressing changes depending on the upper slit width. In the aspect in which the side wall surfaces 766 and 766 of the slit 760 are formed in a tapered shape as in the present embodiment, the side wall surfaces 766 and 766 are taken into account in consideration of this and the side wall surfaces 766 and 766 are parallel to the cut surface in the vertical direction (Z) The amount of pressing is increased as compared to the case of a simple cut surface).

  As described above, according to the probe pressing tool 710 of the present embodiment, when the balloon 780 is inflated, the OCT probe 600 can be pressed against the measurement object along the longitudinal axis direction, and the measurement object moves. Even in this case, a good tomographic image can be generated without changing the relative position between the OCT probe 600 and the measurement target at the time of measurement (scanning). Then, when the balloon 780 is inflated, the OCT probe 600 is not pressed against the measurement object by being brought into contact with the lumen wall or the like of the lumen part where the measurement object exists, as in the related art. Since the OCT probe 600 is pressed against the measurement object by being brought into contact with the frame body 720 disposed at the insertion portion distal end 144, a balloon 780 having a constant size can be used regardless of the tube diameter of the measurement site. In addition, since the frame body 720 with which the balloon 780 abuts is disposed at a position close to the OCT probe 600, a small balloon 780 can be used, and the accommodation property is excellent.

  An expandable / contractible balloon is provided in the insertion portion 114 such as the insertion portion distal end 144 of the endoscope 100, and the balloon is inflated so that the balloon is applied to the lumen wall of the lumen portion where the measurement target exists. When the insertion portion distal end 144 is fixed with respect to the luminal site by contact, the OCT probe 600 can be fixed in a more stable state with respect to the measurement target.

  Furthermore, since the shape and position of the frame 720 with which the balloon 780 abuts are also constant, the direction in which the OCT probe 600 is pressed by the balloon 780 when the balloon 780 is inflated is also determined. The OCT probe 600 can be pressed with high accuracy. In particular, since means for restricting the position where the OCT probe 600 abuts on the measurement object such as the slit 760 is provided, the accuracy is improved.

  As described above, in the probe pressing tool 710 of the above embodiment, the balloon 780 is fixed near the uppermost part on the inner surface side of the cylindrical portion 722 of the frame 720. However, the balloon 780 may be fixed to other portions of the frame 720. Alternatively, it may be fixed to any part of the insertion portion distal end 144 of the endoscope 100 or the OCT probe 600.

  The balloon 780 of the above embodiment uses one balloon that expands in a columnar shape, but as shown in FIG. 10 (the same members as those in FIG. 5 are given the same reference numerals), two balloons 781A and 781B may be arranged, and the shape thereof may not be cylindrical, but may be spherical. Further, three or more balloons may be arranged, and the shape at the time of inflation is not limited to a cylindrical shape or a spherical shape.

  Further, in the probe pressing tool 710 of the above embodiment, the position of the OCT probe 600 in the left-right direction (X) is regulated by the slit 760, but as shown in FIG. 11 (same as FIG. 6B) The members are given the same reference numerals), and the balloon 782 may also have the function. In the balloon 782 in the figure, a concave portion 782A is formed at a portion where the OCT probe 600 (leading portion 600A) contacts when inflated, and the OCT probe 600 is in a state where the OCT probe 600 is engaged with the concave portion 782A. By being pushed down, the position in the left-right direction (X) is pressed against the measurement object in a state where the position is restricted. At this time, the width of the slit 760 may be sufficiently larger than the diameter of the OCT probe 600.

  In addition, the probe pressing tool 710 of the above embodiment has various components, but not all the components are necessary. For example, as shown in FIG. 12, the distal end of the insertion portion of the endoscope 100 144 and supported by a support body 783 arranged at the periphery of the OCT probe 600 led out from the insertion portion distal end 144, and a balloon 784 arranged between the OCT probe 600. . The support body 783 is a member that abuts when the balloon 784 is inflated. The support body 783 may not have a plate shape but may have a rod shape or other shapes, and the front surface of the insertion portion distal end 144 is not used. It may be derived from the channel. As described above, the balloon 784 may be fixed to any part of the support body 783, the OCT probe 600, the insertion portion distal end 144, and the like.

  The definition of the X, Y, and Z directions used in the above embodiment is an example, and the direction of the central axis Ax2 of the forceps port 156 is the Y direction (the central axis Ax2 is the forceps port 156 of the OCT probe 600). When taking into account the case where the probe is placed near the distal end 144 of the insertion part except for the lead-out, the longitudinal axis of the OCT probe 600 when the probe pressing tool 710 is not used is used. The plane including the center axis Ax1 of the distal end 144 and the center axis Ax2 of the forceps port 156 is a YZ plane, and the main components of the probe pressing tool 710 are the above-described embodiments with respect to the center axis Ax2 of the forceps port 156. By changing the position of the insertion portion distal end 144, the central axis Ax2 of the forceps port 156 is changed to be approximately parallel to the measurement target S at the site where measurement is desired. In addition, the OCT probe 600 is pressed in close contact with the region to be measured when it is in the closest state, and the probe pressing tool 710 is symmetrical with respect to the YZ plane. It is to become. Therefore, the structure of the probe pressing tool 710 also depends on the posture of the endoscope insertion portion 144 and the state of the central axis Ax2 of the forceps port 156 with respect to the measurement target S of the site to be measured. Basically, each configuration of the probe pressing tool 710 is set such that the direction of the central axis Ax2 of the forceps port 156 is the Y direction, the X and Z directions are orthogonal to each other, and any direction orthogonal to Y If the elements are arranged in the same positional relationship as in the above-described embodiment, and if changes are made as appropriate in design, the OCT probe is placed on the measurement target S arranged in a specific direction with respect to the central axis Ax2 of the forceps port 156. 600 may be pressed. Then, the posture of the endoscope insertion unit 144 may be operated so that the measurement target S of the part that the operator wants to measure in such a specific direction is arranged.

  Moreover, although the probe pressing tool 710 of the said embodiment showed the aspect provided in the front-end | tip of the overtube 700, it does not restrict to this but is provided in the hood with which the insertion part front-end | tip 144 of the endoscope 100 is mounted | worn. As long as each component of the probe pressing tool 710 as in the above embodiment is arranged at the insertion portion distal end 144 of the endoscope 100, any means may be used.

  Moreover, although the probe pressing tool 710 of the said embodiment showed the aspect applied to the OCT probe of the optical tomographic imaging apparatus used as an image diagnostic apparatus, this invention is not limited to this, Ultrasonic diagnosis A longitudinal probe used for measurement of an apparatus used together with an endoscope apparatus as an image diagnostic apparatus for generating a tomographic image of a measurement object, such as an ultrasonic probe used in the apparatus, in the longitudinal axis direction Any probe can be used as long as it is in close contact with the measurement target along the line.

  DESCRIPTION OF SYMBOLS 10 ... Diagnostic imaging apparatus, 11 ... Reference mirror, 12 ... Wavelength insertion light source, 18 ... Optical rotary joint, 20 ... Interference signal detection part, 22 ... Signal processing part, 24 ... Rotation drive part, 25 ... Axial direction movement drive part DESCRIPTION OF SYMBOLS 100 ... Endoscope, 112 ... Hand operation part, 114 ... Insertion part, 138 ... Forceps insertion part (forceps inlet), 144 ... Tip part (insertion part front end), 150 ... Observation optical system, 152 ... Illumination optical system DESCRIPTION OF SYMBOLS 156 ... Forceps opening (forceps derivation opening), 200 ... Endoscope processor, 300 ... Light source device, 400 ... OCT processor, 500 ... Image display part, 600 ... OCT probe (optical probe), 600A ... Derivation part, 604 ... Operation unit 620 ... sheath (probe outer cylinder), 624 ... flexible shaft, 626 ... fixing member, 628 ... optical lens, 700 ... overtube, 710 ... probe pressing tool, 7 0 ... frame, 740 ... probe insertion hole 760 ... slit, 762 ... restricting portion 764 ... wide portion, 780,781A, 781B, 782,784 ... balloon

Claims (10)

A probe pressing tool in an image diagnostic apparatus that performs measurement by bringing a longitudinal probe that protrudes from the distal end of an insertion portion of an endoscope into close contact with a measurement object along the longitudinal axis direction, and acquires and generates a tomographic image of the measurement object Because
A support that is supported at the distal end of the insertion section and is disposed in a direction perpendicular to the longitudinal axis of the probe;
An inflatable balloon that is disposed between the probe and the support;
With
By inflating the balloon, the balloon is brought into contact with the probe and the support, and the probe is brought into close contact with the object to be measured along the longitudinal axis direction by a pressing force due to the expansion of the balloon. A probe pressing tool in a diagnostic imaging apparatus.   The probe pressing tool in the diagnostic imaging apparatus according to claim 1, wherein the balloon is fixed to the support, the probe, or the distal end of the insertion portion.   A slit member having a slit for regulating the position of the probe in a direction perpendicular to the longitudinal axis direction of the probe and perpendicular to the measurement object is supported at the distal end of the insertion portion, and the balloon and the measurement The probe pressing tool in the diagnostic imaging apparatus according to claim 1, wherein the probe pressing tool is disposed in the vicinity of the measurement object between the objects.   4. The diagnostic imaging apparatus according to claim 3, wherein a width of the slit on a side where the balloon is disposed is wider than a width of the slit on a side where the measurement target is disposed. 5. Probe pressing tool.   The probe pressing tool in the diagnostic imaging apparatus according to any one of claims 1 to 4, wherein a concave portion that engages with the probe when the balloon is inflated is formed in the balloon.   The said support body was provided in the front-end | tip of the overtube with which the insertion part of the said endoscope is mounted | worn, or the hood with which the insertion part front-end | tip of the said endoscope is mounted | worn, or The probe pressing tool in 2 image diagnostic apparatuses.   The probe pressing tool in the diagnostic imaging apparatus according to claim 6, wherein the support is integrally formed with the overtube or the hood.   The support member and the slit member are provided at a distal end of an overtube attached to an insertion portion of the endoscope or a hood attached to a distal end of the insertion portion of the endoscope. Item 6. A probe pressing tool in the diagnostic imaging apparatus according to item 3, 4, or 5.   The probe pressing tool in the diagnostic imaging apparatus according to claim 8, wherein the support body and the slit member are integrally formed with the overtube or the hood.   The diagnostic imaging apparatus according to any one of claims 1 to 9, wherein the probe is an optical probe used in an optical tomographic imaging apparatus that measures tomographic information by optical coherence tomography measurement. Probe pressing tool.

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