JP2015104602A - Intracavitary probe and ultrasonic diagnostic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a transrectal probe capable of obtaining an image which can be compared with an image in different modality without increasing distress of a patient or the like receiving inspection.SOLUTION: An intracavitary probe includes an insertion part. The insertion part is provided with a plurality of ultrasonic vibrators on the tip, and includes a first curved portion whose tip curves toward a prescribed direction with respect to the insertion direction. The plurality of ultrasonic vibrators are arranged so that a scan surface formed with emitted ultrasonic waves intersects a surface containing the insertion direction and the prescribed direction.

Description

  Embodiments described herein relate generally to a body cavity probe and an ultrasonic diagnostic apparatus including the same.

  A body cavity that transmits ultrasonic waves into the human body, receives reflected waves thereof, and measures the shape and function of the organ by directly inserting the ultrasonic diagnostic apparatus into the human body. There is an inner probe.

  Examples of the intracavity probe include a transrectal probe for viewing an ultrasonic tomographic image of the prostate or the like. The transrectal probe is configured by connecting and combining a rod-shaped insertion portion that is inserted into a body cavity such as the rectum and a grip portion that is held by an operator.

  Examples of the transrectal probe include a so-called endfire type in which an ultrasonic transducer array is provided at the distal end of the insertion portion, and an ultrasonic transducer array provided on a side surface of the insertion portion. The transrectal probe is, for example, an “axial type” in which an ultrasonic transducer array is formed by arranging ultrasonic transducers in the axial direction, and an ultrasonic vibration by arranging transducers in a direction orthogonal to the axial direction. Examples include a “cross-sectional type” in which a child array is formed.

  For example, the insertion portion is provided with a puncture tool for performing biopsy (biopsy tissue diagnosis) or the like on the affected area. This puncture device is provided with a puncture needle. By puncturing the affected area with the puncture needle while depicting the affected area with an ultrasonic diagnostic apparatus, the speed and accuracy of reaching the puncture target are improved.

  In recent years, since it is easy to grasp the three-dimensional position of the treatment target region, images of the affected area drawn by the ultrasonic diagnostic apparatus and different modalities such as CT and MRI are superimposed on each other. A comparison has been made. For example, puncture or the like is performed with reference to the positional relationship between the images determined by the image comparison.

JP-A-7-194594

  However, in the conventional transrectal probe, in particular, the endfire type transrectal probe, the ultrasonic transducer array is located at the end of the linear insertion portion. Therefore, in order to make the scanning plane by this ultrasonic transducer array correspond to the imaging cross section such as CT and MRI, it is necessary to squeeze the inserted probe and press the shaft of the transrectal probe into the body cavity such as the prostate. there were. In addition, this has caused pain for patients undergoing examination with a transrectal probe.

  This embodiment has been made in view of the above circumstances, and can be applied to a transrectal probe that can obtain an image that can be compared with an image in different modalities without increasing the pain of the patient undergoing the examination. It is an object of the present invention to provide a simple intracavity probe and an ultrasonic diagnostic apparatus including the same.

  In order to achieve the above object, the body cavity probe according to the embodiment includes an insertion portion, and the insertion portion includes a plurality of ultrasonic transducers at the distal end, and the distal end is curved toward a predetermined direction with respect to the insertion direction. A first curved portion. The plurality of ultrasonic transducers are arranged so that the scanning plane formed by the emitted ultrasonic waves is orthogonal to the plane including the insertion direction and the predetermined direction.

It is the side view which showed the transrectal probe concerning 1st Embodiment. It is the top view which showed the transrectal probe concerning 1st Embodiment. It is the perspective view which showed the transrectal probe concerning 1st Embodiment. It is the cross-sectional schematic diagram which showed an example which inserted the transrectal probe concerning 1st Embodiment in the rectum. It is the perspective view which showed an example of the ultrasonic irradiation to the prostate by the transrectal probe concerning 1st Embodiment. It is the functional block diagram which showed the function of the ultrasound diagnosing device. It is the side view which showed the transrectal probe concerning 2nd Embodiment. It is the top view which showed the transrectal probe concerning 2nd Embodiment. It is the perspective view which showed the transrectal probe concerning 2nd Embodiment. It is the perspective view which showed the mode of removal | desorption of the puncture tool in the transrectal probe concerning 2nd Embodiment. It is the side view which showed the transrectal probe concerning the modification of 2nd Embodiment. It is the top view which showed the transrectal probe concerning the modification of 2nd Embodiment. It is the perspective view which showed the transrectal probe concerning the modification of 2nd Embodiment. It is the perspective view which showed the mode of removal | desorption of the puncture tool in the transrectal probe concerning the modification of 2nd Embodiment. It is the cross-sectional schematic diagram which showed an example which inserted the transrectal probe concerning 2nd Embodiment in the rectum. It is the perspective view which showed an example of the ultrasonic irradiation and puncture to the prostate by the transrectal probe concerning 2nd Embodiment. It is the top view which showed an example of the cross-sectional image of the prostate displayed on the display part, and a puncture image.

<First Embodiment>
[Transrectal probe]
1A to 1C are a top view, a side view, and a perspective view showing a transrectal probe 10 according to a first embodiment. As shown in FIGS. 1A to 1C, the transrectal probe 10 includes an ultrasonic transducer array 2 at the tip 1a, and includes a head portion 1b including the tip 1a, a curved portion 1c, and a shaft portion 1d. This is a so-called endfire type transrectal probe including an insertion portion 1 configured to be inserted into the rectum and a grip portion 3 held by an operator outside the body cavity. The insertion portion 1 has a bending portion 1c in which the distal end 1a is curved toward a predetermined direction with respect to the insertion direction 4.

  The transrectal probe 10 is one form of a body cavity probe. What is described below for the transrectal probe 10 can be appropriately selected and applied to other types of intracavity probes as necessary. The type of body cavity probe and usage pattern may be any ones that can be inserted into a living body and can transmit and receive ultrasonic waves. Examples of the intracavity probe include those capable of transmitting and receiving ultrasonic waves close to a diagnostic site in a living body. Specific examples include a transesophageal probe, a transrectal probe, a transurethral probe, and a transvaginal probe. Etc.

[Overall structure of transrectal probe]
The transrectal probe 10 has a rod-like shape so that it can be inserted into the rectum, and is provided with an insertion portion 1 having a curved portion 1c that is curved so that the distal end 1a faces a predetermined direction, and a body cavity. And a grip portion 3 held by an operator outside. The distal end 1a of the insertion portion 1 is provided with an ultrasonic transducer array 2 formed by arranging a plurality of ultrasonic transducers 2a in parallel. The ultrasonic beam irradiated from the ultrasonic transducer array 2 is reflected by a boundary surface of an organ or the like and is received by the ultrasonic transducer array 2 again. From the ultrasonic transducer array 2, the scanning plane 6 is formed by sequentially emitting ultrasonic waves from the respective ultrasonic transducers 2 a.

[Insertion section]
The insertion portion 1 has a rod shape having a curved portion, a head portion 1b having an ultrasonic transducer array 2 at the tip, a curved portion 1c having a curved shape, and a shaft portion 1d connected to the grip portion 3. And have. The insertion portion 1 is configured by being gently connected so as not to have a step portion in the order of the head portion 1b, the bending portion 1c, and the shaft portion 1d, and has a curved shape having a large curvature as a whole. The insertion part 1 is integrally formed, for example. Moreover, the cross-sectional shape of the insertion part 1 in the radial direction has a gentle shape that does not have, for example, a corner that gives pain to the subject. Examples of this shape include a circular shape, a circular shape at least partially flattened, and a non-circular shape such as an ellipse. Moreover, the insertion part 1 is formed as a fixed shape which does not have a movable part.

(Head)
The head portion 1b is a distal end portion of the insertion portion 1, and an ultrasonic transducer array 2 is provided so that an ultrasonic beam can be emitted from the distal end 1a. The ultrasonic transducer array 2 has, for example, a convex shape configured to be able to form an ultrasonic scanning surface in one direction. The head portion 1b is provided so as to cover the ultrasonic transducer array 2, for example. At this time, for example, a head portion 1b that functions as an acoustic lens that focuses an ultrasonic beam using refraction is known.

  The tip 1a has, for example, a curved surface shape that is convex in the bending direction 5, and the ultrasonic transducer array 2 is provided along this curved surface shape to form a convex shape. The curved surface shape is, for example, symmetrical with respect to the central axis of the head portion 1b.

(Shaft part)
The shaft portion 1 d constitutes a portion connected to the grip portion 3 in the insertion portion 1. The shaft portion 1d and the grip portion 3 are coupled so that the second axis a2 that is the central axis of the shaft portion 1d and the third axis a3 that is the central axis of the grip portion 3 are substantially parallel. Further, for example, the upper surface portion 1d1 of the shaft portion 1d on the bending direction 5 side and the upper surface portion 3a of the grip portion 3 are connected so as to be a continuous surface. Preferably, the connection surfaces are substantially the same plane or substantially the same. They are connected to form a curved surface. An angle θ formed by the head portion 1b and the shaft portion 1d is an angle formed by the first axis a1 and the second axis a2, and a complementary angle φ = 180 ° −θ of the angle θ is, for example, 10 It is in the range of not less than 70 ° and not more than 70 °, or in the range of not less than 45 ° and not more than 60 °. The reason why the angle φ is set within the range shown above is that the distal end 1a can be opposed to the prostate when the insertion portion 1 configured as described above is inserted horizontally into the anus, for example. is there. The angle θ may be set as an angle formed by the insertion direction 4 and the bending direction 5 corresponding to the direction in which each axis extends, for example.

(Curved part)
The bending portion 1c is provided in the insertion portion 1 so as to connect both the head portion 1b and the shaft portion 1d. The head portion 1b and the bending portion 1c and / or the bending portion 1c and the shaft portion 1d are connected without having a step portion. In addition, the form of bending in the bending portion 1c is not limited to linear bending, for example, from the viewpoint of smoothly inserting into the rectum, and may be gently bent so as to have a predetermined curvature. The curved portion at this time has a certain curvature, for example, and the radius of curvature is, for example, 20 mm. For example, a plurality of curvatures may be combined.

[Grip part]
The shape of the gripping part 3 is not particularly limited as long as it is easy for an operator to grip, and is, for example, a rod-like shape having a certain thickness. As the cross-sectional shape of the grip portion 3, for example, a polygonal shape or the like can be appropriately selected in addition to the shape mentioned as the cross-sectional shape of the insertion portion 1.

  The grip portion 3 preferably has a predetermined thickness so that the operator can easily grip it, and is formed thicker than the insertion portion 1. At this time, the grip portion 3 is connected so that the upper surface portion 3a which is the surface on the bending direction 5 side is continuous with the upper surface portion 1d1 of the shaft portion 1d. The third axis a3 is offset and connected to the second axis a2, which is the central axis of the shaft portion 1d. The upper surface portion 3a of the grip portion 3 is provided with a flat portion 3d for facilitating grasping of the probe direction when the operator grips the grip portion 3, for example.

  Further, the surface facing the surface on the bending direction 5 side, that is, the surface continuing to the insertion portion 1 in the offset portion 3b of the grip portion 3 reduces, for example, the burden on the anus 26 when contacting the anus 26. For this purpose, there is provided an inclined portion 3c whose cross-sectional area increases at a predetermined rate in the direction from the insertion portion 1 toward the grip portion 3. Similarly, the side surface corresponding to the inclined portion 3c is provided with a wing portion 3e having an inclination for reducing a burden on the anus 26 when contacting the anus 26.

[Ultrasonic transducer array]
For example, the ultrasonic transducer array 2 is provided on a backing material (not shown) formed in a convex arc shape in cross section. The backing material is made of a material having viscoelasticity such as rubber, for example, and ferrite, ceramics, and the like are added in order to attenuate the ultrasonic waves efficiently. Moreover, an acoustic matching layer, an acoustic lens, and the like are provided on the ultrasonic transducer array 2 as necessary.

  For example, the ultrasonic transducers 2a are arranged in a one-dimensional array at a predetermined interval. For example, when the ultrasonic transducer 2a has a long shape such as a rectangular parallelepiped, the ultrasonic transducer 2a is arranged in parallel with the short direction of the ultrasonic transducer 2a. The ultrasonic transducer 2a is formed along the shape of the tip 1a of the head portion 1b. That is, the ultrasonic transducer array 2 is configured by arranging the ultrasonic transducers 2a so as to have a curved surface shape convex in the bending direction 5 described above.

  At this time, the ultrasonic transducer array 2 is arranged in a radial pattern so that, for example, the normal vector of the ultrasonic wave emission surface of each of the ultrasonic transducers 2a that constitutes is along the curved surface shape with the bending direction 5 as the center. Be placed. By sequentially emitting ultrasonic waves from the respective ultrasonic transducers 2a, the ultrasonic waves are scanned radially along the curved surface shape with the bending direction 5 as the center, and are, for example, regions indicated by broken lines in FIG. 1C. A substantially fan-shaped scanning surface 6 is formed.

  As the ultrasonic transducer 2a, conventionally known materials and structures can be appropriately selected and used as the ultrasonic transducer. For example, a piezoelectric material thickness such as PZT (titanium zirconate) or PVDF (polyvinylidene fluoride) is used. It has a configuration in which electrodes are arranged on both sides of the film. For example, one of the electrodes is an electrode common to all the ultrasonic transducers 2a, and the other is an individual electrode independent for each ultrasonic transducer 2a.

  In the ultrasonic transducer array 2, a plurality of ultrasonic transducers 2a are provided in parallel at a predetermined interval in a direction substantially orthogonal to a plane including the first axis a1 and the second axis a2. Composed. Further, the plurality of ultrasonic transducers 2a are arranged along the curved surface shape of the tip 1a described above, whereby the ultrasonic transducer array 2 forms a convex shape. An ultrasonic beam can be scanned on a scanning plane 6 that is orthogonal to a plane that includes the first axis a1 and the second axis a2 and that includes the first axis a1. In this case, the first axis a1 can also be read as the bending direction 5 and the second axis a2 as the insertion direction 4.

[Operation of transrectal probe]
The transrectal probe 10 inserts the insertion portion 1 into the rectum, transmits ultrasonic waves from the ultrasonic transducer array 2 provided at the distal end 1a, and receives the reflected waves, so that the vicinity of the rectum such as the prostate can be obtained. Obtain a cross-sectional image of the organ.

  FIG. 2 shows a state in which the insertion portion 1 of the transrectal probe 10 is inserted into the rectum 27 of the human body 20 indicated by the median sagittal plane, and the ultrasound transducer array 2 provided at the distal end 1 a is directed toward the prostate 28. FIG. 6 is a schematic cross-sectional view illustrating a state in which reflected waves in a transverse section of the prostate 28 are acquired by irradiating ultrasonic waves. Here, the width direction in the human body 20 is defined as the x direction, the thickness direction is defined as the y direction, and the height direction is defined as the z direction. That is, the sagittal plane is a cross section cut by the yz plane, the coronal plane is a cross section cut by the xz plane, and the cross section is a cross section cut by the xy plane. In FIG. 2, the direction from the front side to the back side is the x direction, the direction from the right side to the left side is the z direction, and the direction from the bottom to the top side is the y direction.

  As shown in FIG. 2, the human body 20 includes a bladder 23, a penis 24, a testis 25, an anus 26, a rectum 27, a prostate 28, and a urethra 29, and the opening direction of the anus 26 is the z direction, which is the horizontal direction. Facing. The transrectal probe 10 is inserted in the z direction, which is the insertion direction 4, from the anus 26 so that the distal end 1a faces the penis 24 side. By contacting the intestinal wall 27a on the prostate 28 side, the distal end 1a faces the prostate 28 via the intestinal wall 27a. The tip 1a may be directed in a direction facing the prostate 28 when inserted into the anus 26, or may be directed in a direction facing the prostate 28 after insertion into the rectum 27.

  With respect to the intestinal wall 27a, the prostate 28 is located at a position facing the tip 1a. Ultrasonic waves are irradiated from the ultrasonic transducer array 2 toward the prostate 28 via the intestinal wall 27a. The ultrasonic wave is emitted as a scanning plane 6 along an AA plane that is parallel to the bending direction 5 and orthogonal to a plane that includes the insertion direction 4 and the bending direction 5. Thereby, the ultrasonic transducer array 2 scans the cross section of the prostate 28.

  The transrectal probe 10 is normally inserted into the rectum 27 so that the shaft portion 1d is parallel to the z direction, but may be inserted at an appropriate angle according to the position of the prostate 28, the examination position, and the like. Further, the direction in which the insertion portion 1 advances until the bending portion 1 c of the insertion portion 1 passes through the anus 26 may be a direction perpendicular to the cross section of the insertion portion 1. At the time of insertion of the insertion portion 1 into the rectum 27, a protective material (not shown) such as a condom is attached so as to cover the entire insertion portion 1 as necessary.

  FIG. 3 is a perspective view showing a state in which ultrasonic waves are irradiated toward the prostate 28. In this figure, a bladder 23, a prostate 28 and a urethra 29 are shown as a human body 20 for clarity of the figure. Other portions are the same as those shown in FIG. Further, the transrectal probe 10 is inserted into the rectum 27 in the same manner as shown in FIG. 2, and the prostate 28 is irradiated with ultrasonic waves through the intestinal wall 27a.

  As shown in FIG. 3, the plurality of ultrasonic transducers 2 a constituting the ultrasonic transducer array 2 sequentially emits ultrasonic beams, whereby a fan-shaped scanning surface 6 is formed. When the subject intersects the scanning surface 6, the reflected wave from the subject is received by the vibrator provided at the tip 1a. The prostate 28 as the subject in this case intersects the scanning plane 6, and the intersecting plane 6a mainly includes x and y components, and an image close to the xy plane can be displayed on the display unit or the like. Yes.

[Ultrasonic diagnostic equipment]
FIG. 4 shows a functional configuration of the ultrasonic diagnostic apparatus 50 and its peripheral devices. At this time, the ultrasound probe 60 uses, for example, at least one transrectal probe 10 of this embodiment.

  The echo information received by the receiving unit (not shown) provided in the transrectal probe 10 is processed by the ultrasonic diagnostic apparatus 50 having a functional configuration as shown in FIG. And displayed as a cross-sectional image of the prostate 28.

  This cross-sectional image is, for example, a B-mode image. Specifically, in the ultrasonic diagnostic apparatus 50, echo information received by the ultrasonic probe that is the transrectal probe 10 is transmitted to the ultrasonic diagnostic apparatus 50, and the echo information is received by the transmission / reception unit 51. The

  Next, in response to an instruction input from the operation unit 56 for displaying the B-mode image, the control unit 55 operates the processing unit 52 to process the echo information received by the transmission / reception unit 51 to generate B-mode data. The data is sent to the display control unit 53. The display control unit 53 receives the B-mode data and displays a B-mode image of the transverse section of the prostate 28 on the display unit 54.

  In this way, when the prostate 28 is irradiated with ultrasonic waves with the transrectal probe 10 as described above, image data such as B-mode image data in the transverse section of the prostate 28 can be obtained, and a B-mode image is displayed. It can be displayed on the part.

[Action and effect of transrectal probe]
There is a demand to compare the cross-sectional images obtained by other modalities such as CT and MRI with the cross-sectional images obtained by the ultrasonic diagnostic apparatus, and use them for interpretation, diagnosis, and the like. However, conventionally, it has been difficult to take a correspondence between the two cross-sectional images. The reason for this is that cross-sectional images taken in CT, MRI, etc. are very often cross-sectional images, but are obtained by an ultrasonic diagnostic apparatus, particularly using an intra-cavity probe such as a transrectal probe. In many cases, the obtained cross-sectional image is a sagittal plane image.

  In a conventional transrectal probe, it has not been possible to obtain a cross-sectional image of the prostate 28. However, in this method, in order to obtain a cross-sectional image of the prostate 28, the inserted probe is greatly squeezed, and the burden on the patient, such as pressing the axis of the transrectal probe into a body cavity such as the prostate, is imposed.

  On the other hand, in the transrectal probe 10 of this embodiment, the insertion portion 1 having the curved portion 1c is inserted into the rectum 27 through the anus 26, and the distal end 1a of the insertion portion 1 is placed on the intestinal wall 27a side on the prostate 28 side. By facing it, it faces the prostate 28 through the intestinal wall 27a of the rectum 27. At this time, the bending direction 5 is set to be a direction along the transverse section of the prostate 28. When this prostate 28 is irradiated with ultrasonic waves from the ultrasonic transducer array 2 provided at the tip 1a, the scanning plane 6 includes the bending direction 5 and is orthogonal to the plane including the insertion direction 4 and the bending direction 5. A cross section of the prostate 28 can be obtained.

  Therefore, when an image of a cross section of the prostate 28 is obtained with the transrectal probe 10 of this embodiment, the insertion portion 1 does not have to be greatly increased because the insertion portion 1 has the curved portion 1c. That is, only by directing the distal end 1a toward the intestinal wall 27a on the prostate 28 side, the ultrasound can be scanned with the scanning plane 6 close to the xy plane with respect to the prostate 28. Further, the bending by the bending portion 1 c of the insertion portion 1 becomes “escape” with respect to the convex surface 27 b on the y direction side from the anus 26 to the rectum 27 when the rectum 27 is inserted. Therefore, when the insertion portion 1 is inserted into the rectum 27, the distal end 1a does not have to be pressed against the intestinal wall 27a of the rectum. By these things, the pain which a subject receives by this test | inspection can be reduced. In addition, information on the cross section of the prostate 28 can be obtained smoothly by ultrasonic irradiation with a transrectal probe.

Second Embodiment
[Transrectal probe]
5A to 5D are a top view, a side view, and a perspective view showing the transrectal probe 10 of the second embodiment. In the transrectal probe 10 of this embodiment, a puncture device 11 including a puncture needle 12 is newly provided in the transrectal probe 10 of the first embodiment. The puncture tool 11 is provided in the insertion portion 1 or the like so that the puncture needle 12 extends along the scanning surface of the ultrasonic wave emitted from the ultrasonic transducer array 2. Here, the hatched portion of the puncture device 11 in the figure is for distinguishing between the main body portion 10a and the puncture device 11, and does not indicate a cross section.

[Overall structure of transrectal probe]
The transrectal probe 10 includes a main body portion 10a and a puncture device 11 that is detachably provided on the main body portion 10a. The main body 10a of the transrectal probe 10 has the same configuration as the transrectal probe 10 of the first embodiment. The puncture tool 11 is provided on the surface of the insertion part 1 along the curved shape of the insertion part 1, for example. Further, the puncture needle 12 is provided so as to protrude in the bending direction 5 from the position of the distal end 1 a of the insertion portion 1. The tip 12a of the puncture needle 12 moves along the scanning surface 6.

[Puncture tool]
The puncture device 11 has side portions 11c that face each other at a constant interval. The two side surface portions 11c are connected by the upper surface portion 11e or the lower surface portion 11f. Thereby, the puncture device 11 has a cross-sectional shape of a square shape or a rectangular shape, for example. In addition, the fixed interval corresponds to the width of the insertion portion, so that the puncture tool 11 can be attached to the insertion portion 1. Moreover, the upper surface part 11e or the lower surface part 11f may be formed by one surface or may be formed by a plurality of divided surfaces. As shown in FIG. 5D, the puncture device 11 is detachably provided on the insertion portion 1 of the main body portion 10a.

  Further, the shape of the side surface portion 11c corresponds to the curved shape of the insertion portion 1 in the front-rear direction. In this case, for example, the shape of the side surface portion 11 c is similar to the curved shape of the insertion portion 1. The puncture device 11 is attached to the insertion portion 1 so as to cover the tip portion 1a toward the shaft portion 1d, for example. Further, when the puncture device 11 has, for example, one of the upper surface portion 11e and the lower surface portion 11f, the puncture device 11 is mounted so as to cover the upper surface or the lower surface of the insertion portion 1. The puncture device 11 is fixedly attached to the insertion portion 1. The insertion portion 1 is provided with a hole (not shown) or the like provided on one or both of the upper surface and the lower surface, for example. The puncture device 11 is fixed by, for example, stoppers 11g and 11h fitted into the holes.

  The side surface portion 11c has a thickness in the side surface direction so that the puncture needle 12 can pass therethrough. Each of the left and right side portions 11c has a puncture needle guide 11d. The puncture needle guide 11d is a hollow portion formed so that the puncture needle 12 can be passed by being inserted from the back surface portion 11a and protruding from the front surface portion 11b. The puncture device 11 includes, for example, a pair of puncture needle guides 11d on the side surface 1f of the insertion section 1, and the insertion sections are arranged so that each puncture needle 12 protrudes from a position facing through the ultrasonic transducer array 2. 1 is attached. Further, the puncture device 11 may be configured by a surface in which the front surface portion 11b and the side surface portion 11c are continuous in order to eliminate a corner portion formed by the front surface portion 11b and the side surface portion 11c.

(Puncture needle guide)
The puncture needle guide 11d is configured to guide the puncture needle 12 traveling inside. The puncture needle guide 11d includes an insertion port 11d1 into which the puncture needle is inserted, a travel path 11d2 through which the inserted puncture needle 12 travels, and a projection port 11d3 from which the tip 12a of the puncture needle 12 projects. The form of the puncture needle guide 11d is configured such that the tip 12a of the puncture needle 12 is movable along the ultrasonic scanning surface described above. In this case, the shape of the traveling path 11d2 may be a second curved portion that curves along the first curved portion, with the curved shape of the insertion portion 1 being the first curved portion. At this time, the puncture needle 12 travels within the puncture needle guide 11d along the second curved portion.

  The radius of curvature of the second curved portion is preferably larger than the radius of curvature of the first curved portion. For example, the radius of curvature of the second curved portion is set to 1 of the radius of curvature of the first curved portion. .3 or so. This is because by increasing the radius of curvature, the bending of the puncture needle 12 is relaxed, the burden due to stress is reduced, and plastic deformation and the like are prevented. The radius of curvature of the puncture needle guide 11d is formed, for example, such that the radius of curvature of the second curved portion is smaller than the radius of curvature of the first curved portion.

  Further, the insertion port 11d1 is provided on the upper side of the back surface portion 11a in order to avoid interference between the puncture needle 12 and the wing portion 3e. The insertion port 11d1 is formed so that the rear end portion 12b of the puncture needle 12 protrudes in the upper surface direction. Further, the protrusion 11d3 is provided so that the puncture needle 12 can move along the scanning surface 6 described above. For example, when the puncture tool 11 includes the front surface portion 11b, a configuration in which the front surface portion 11b is orthogonal to the scanning surface 6 and a configuration in which the central axis of the front surface portion 11b is on the scanning surface 6 are exemplified.

  Examples of the material constituting the puncture tool 11 include materials that can be easily attached to the insertion portion 1 by being made of a deformable material, and materials that have high biocompatibility. Examples of the material constituting the puncture device 11 include a metal material and a resin material.

[Puncture needle]
The puncture needle 12 is provided so as to be able to protrude from both side portions of the distal end 1a of the insertion portion 1. That is, either or both of the two puncture needles 12 protrude from the protrusion 11d3 in a form that sandwiches the ultrasonic transducer array 2. The tip 12a protruding from the tip 1a moves along the scanning surface 6.

  The puncture needle 12 has, for example, a linear shape, and travels while being curved in the puncture needle guide 11d. The puncture needle 12 may be formed of a material having high toughness that hardly causes plastic deformation due to this curvature.

  Examples of the material constituting the puncture needle 12 include materials having high toughness as described above. Examples of the material constituting the puncture needle 12 include various metal materials such as superelastic alloys such as stainless steel, titanium or titanium alloy, Ni-Ti alloy, and various hard resin materials such as polyphenylene sulfide.

(Modification)
[Transrectal probe]
6A to 6D are a top view, a side view, and a perspective view showing a transrectal probe 10 which is a modification of the second embodiment. Here, the hatched portion of the puncture device 11 in the drawing is for clearly distinguishing the main body portion 10a and the puncture device 11 and does not indicate a cross section.

  The transrectal probe 10 which is a modification of this embodiment is configured such that the puncture needle 12 protruding from the back surface portion 11a of the puncture device 11 is along the side surface portion 3f of the main body portion 10a. The insertion port 11d1 is provided at a center portion of the back surface portion 11a, for example, at a position parallel to the central axis of the grip portion 3, and the insertion port 11d1 is formed so that the rear end portion 12b of the puncture needle 12 protrudes in the horizontal direction. It is formed.

  Since the side surface portion 3f of the transrectal probe 10 is not provided with the wing portion 3e, the rear end portion 12b of the puncture needle 12 protruding from the insertion port 11d1 extends along the side surface portion 3f. In addition, at the rear end portion 12b of the puncture needle 12, for example, a cushioning material 12c is provided so that the side surface portion 3f is not damaged by the puncture needle 12 that moves along the side surface portion 3f.

  Other configurations of this modification are the same as those of the transrectal probe 10 described above in this embodiment. Further, the operation, action, and effect of the transrectal probe described below are examples of the transrectal probe 10 described above in this embodiment, but can be similarly applied to this modified example.

[Operation of transrectal probe]
The transrectal probe 10 inserts the insertion portion 1 into the rectum, transmits ultrasonic waves from the ultrasonic transducer array 2 provided at the distal end 1a, and receives the reflected waves, so that the vicinity of the rectum such as the prostate can be obtained. Obtain a cross-sectional image of the organ. Next, using this cross-sectional image as a guide, a puncture needle 12 punctures a desired organ. In this case, the advancing direction of the puncture needle 12 is forced by the puncture needle guide 11d, so that the tip 12a is sent out in a direction along the scanning surface 6.

  FIG. 7 is a schematic cross-sectional view showing an example of a state in which the insertion portion 1 of the transrectal probe 10 is inserted into the rectum 27 of the human body 20 and the prostate 28 is punctured with the puncture needle 12. In this puncture, after inserting the insertion portion 1 into the rectum 27, ultrasonic waves are irradiated toward the prostate 28 from the ultrasonic transducer array 2 provided at the distal end 1a, and a reflected wave in the transverse section of the prostate 28 is acquired. Then, an image obtained by processing this reflected wave is used as a guide.

  As shown in FIG. 7, the human body 20 is in a so-called crushed position (carrying position), lying on its back so that the opening direction of the anus 26 is the z direction. The transrectal probe 10 is inserted into the rectum 27 in the same manner as in the first embodiment, and the puncture needle 12 is punctured into the prostate 28 by operating the puncture tool 11. At this time, the distal end 12 a of the puncture needle 12 moves along the scanning surface 6.

  FIG. 8 is a perspective view showing a state in which ultrasonic waves are irradiated toward the prostate 28 and the puncture needle 12 is punctured into the prostate 28. In this figure, the configuration other than the transrectal probe 10 is the same as that shown in FIG.

  As shown in FIG. 8, the ultrasonic transducer array 2 emits ultrasonic waves, whereby a fan-shaped scanning surface 6 is formed. The reflected wave from the subject crossing the scanning surface 6 is received by the receiving unit provided at the tip 1a. The prostate 28 as the subject in this case intersects with the scanning plane 6, and the two puncture needles 12 protruding from the side surface of the distal end 1 a of the insertion portion 1 move along the scanning plane 6.

[Ultrasonic diagnostic equipment]
The received echo information is processed by, for example, the ultrasonic diagnostic apparatus 50 shown in FIG. 4, so that a cross-sectional image of the prostate 28 and an image of the puncture needle 12 moving on the scanning plane 6 are displayed on the display unit 54. Is displayed as a B-mode image. Since the displayed image of the puncture needle 12 is an image in the advancing direction of the puncture needle 12, that is, an image in the longitudinal direction, it is possible to easily grasp the position of the tip 12a of the puncture needle 12 and the direction in which the puncture needle 12 advances. it can.

  In the puncture with the puncture needle 12, first, the insertion portion 1 of the transrectal probe 10 is inserted into the rectum 27, and the distal end 1a is opposed to the prostate 28 through the intestinal wall 27a. Next, ultrasonic waves are irradiated from the ultrasonic transducer array 2 toward the prostate 28 and received by the receiving unit provided at the distal end 1 a from the intersection surface 6 a between the prostate 28 and the scanning surface 6. The received reflected wave is processed as described above to display a B-mode image on the display unit 54. Based on the displayed B-mode image, a desired puncture surface in the prostate 28 is determined by searching the intersection surface 6a. Next, the puncture tool 11 is operated to cause the puncture needle 12 to protrude from the distal end 1a of the insertion portion 1, and puncture of the prostate 28 is started.

  FIG. 9 shows an example in which a cross-sectional image of the prostate 28 and an image of the puncture needle 12 are displayed on the display unit 54 as a B-mode image. Here, the hatched portion shown in the figure is for showing the crossing surface 6a and does not show a cross section. Further, a portion surrounded by a broken line shown in the figure is a cross-sectional image 14 of the prostate 28 taken by MRI. This cross-sectional image 14 shows a prostate image 14a and a urethral image 14b.

  As shown in FIG. 9, the display unit 54 displays a B-mode image generated by processing echo information that is a reflected wave from the scanning surface 6 in the same manner as described above. . On the intersecting plane 6a where the scanning plane 6 displayed on the display unit 54 and the prostate 28 as the subject intersect, the prostate image 13 which is a cross-sectional image cut out on the scanning plane 6 is displayed. In addition, a prostate image 14 a and a urethral image 14 b that are cross-sectional images 14 taken by MRI are shown at positions corresponding to the prostate image 13.

  When the puncture is performed on the cross section along the line D-D of the prostate 28 as shown in FIG. 7, the tip 12 a of the puncture needle 12 moves along the scanning plane 6, so that it is displayed on the display unit 54. An image in the traveling direction of the puncture needle 12 is displayed in the scanning surface 6. Thereby, the positional relationship between the prostate 28 and the tip 12a of the puncture needle 12 can be grasped.

  Furthermore, as shown in the cross-sectional image of the prostate 28 taken by MRI, the urethra 29 as shown in FIG. For example, there is a case where it is desired to puncture the prostate 28 at positions that are line-symmetric with respect to the urethra 29 as the central axis. In this case, first, the position of the prostate image 13 and the position of the prostate image 14a are made to correspond to each other, and the position of the urethra 29 on the scanning plane 6 is determined from the position of the urethral image 13a. Next, the puncture position on the scanning plane 6 is determined from the determined position of the urethra 29, and puncture is performed on this position.

  As described above, the positional relationship between the distal end 1a of the insertion unit 1 and the distal end 12a of the puncture needle 12 is grasped by referring to the cross-sectional image of the prostate 28 and the image of the puncture needle 12 displayed on the display unit 54. The puncture device 11 can be operated. Furthermore, the prostate image 14a, which is a cross-sectional image of the prostate 28 taken by MRI, and the prostate image 13, which is a cross-sectional image of the prostate 28 displayed in the B-mode image, are associated with each other, and By grasping the position in the cross section, biopsy can be performed at a desired position in the prostate 28.

  Thus, according to the transrectal probe 10, a cross-sectional image of the prostate 28 can be acquired. Thus, a so-called fusion display can be performed in which a cross-sectional image acquired by the transrectal probe 10 and a cross-sectional image acquired by different modalities such as MRI are superimposed and displayed with corresponding coordinate positions. It becomes possible. Based on this fusion display, the prostate 28 can be punctured.

  As a method for performing fusion display, a conventionally known method can be appropriately selected. Specifically, the fusion display can be performed as follows. First, position detecting means is provided in the transrectal probe 10 to perform alignment between images obtained by other modalities. As the position detecting means, for example, a magnetic sensor is used, and a magnetic transmitter is provided in the vicinity of the magnetic sensor. From the magnetic transmitter, the magnetic fields in the x, y, and z directions are switched and emitted in time series, and the magnetic sensor synchronizes with this to detect the position in the x, y, and z directions and the rotation about each axis. can do.

  The registration of images between different modalities is performed by first converting a cross-sectional image of the prostate 28 (hereinafter referred to as an ultrasound image) displayed by the transrectal probe 10 into a cross-sectional image of the prostate 28 (hereinafter referred to as other images) of other modalities. The transrectal probe 10 is operated so as to be substantially parallel to the above-mentioned modality image.

  Next, a part having a characteristic that becomes a mark on the ultrasonic image is searched, and the part is marked as a mark position. Next, a part having the same feature in another modality image is searched with reference to the image. When a tomographic image that seems to be the same part is obtained in another modality image, a part that seems to correspond to the mark position is marked on the image.

  Through the above operations, parameters necessary for corresponding alignment between the ultrasonic image and other modality images are obtained. Thereafter, coordinate conversion for matching both images in the apparatus is automatically performed, and a tomographic image of another modality corresponding to the real-time image obtained by the transrectal probe 10 is displayed. . The rest of the operation of the transrectal probe of this embodiment is the same as that of the transrectal probe 10 of the first embodiment.

[Action and effect of transrectal probe]
The transrectal probe 10 of this embodiment includes a puncture device 11 provided so as to cover at least a part of the insertion portion 1 of the transrectal probe having the same configuration as that of the first embodiment. The puncture device 11 is provided along the curved shape of the insertion portion 1, and two puncture needles 12 protrude from the front surface portion 11 b in the bending direction 5 from both sides of the head portion 1 b of the insertion portion 1. It is provided as possible. These have the same advantages as those of the first embodiment, and the puncture needle 12 can be moved along the scanning surface 6. For example, the display unit 54 scans with the cross-sectional image of the prostate 28. An image of the puncture needle 12 moving on the surface 6 can be displayed as a B-mode image.

  In the puncture guide by the conventional ultrasonic diagnostic apparatus, since the advancing direction of the puncture needle and the irradiation surface of the ultrasonic wave are orthogonal, only the cross section of the puncture needle 12 is depicted, and an accurate guide of the puncture needle There was a case that could not be.

  As a probe capable of guiding the puncture needle, there is a biplane type probe in which an endfire type and an axial type are mounted on one probe. This probe can be punctured while depicting the sagittal plane of the prostate with an ultrasonic diagnostic apparatus. On the other hand, when performing puncturing while performing image comparison with other modalities, there is a demand for puncturing with a cross-section that is often used in other modalities. However, the biplane type probe has a problem that it cannot be punctured in a cross section.

  On the other hand, since the image of the puncture needle 12 displayed in this embodiment is an image in the advancing direction of the puncture needle 12, that is, an image in the longitudinal direction, the position of the tip 12a of the puncture needle 12 and the puncture needle 12 The direction of travel can be easily grasped.

  Further, the transrectal probe 10 of this embodiment has a curved portion 1 c in the insertion portion 1. Therefore, when the transrectal probe 10 is inserted into the rectum 27 through the anus 26, the transrectal probe 10 can be set to be in a direction along the transverse section of the prostate 28. As a result, a cross section of the prostate 28 can be obtained, and puncture can be performed while the cross section of the prostate is depicted by the ultrasonic diagnostic apparatus.

  In addition, since the cross-sectional image of the prostate 28 can be relatively easily acquired by the transrectal probe 10, the cross-sectional image acquired by the transrectal probe 10 and the cross-section acquired by different modalities such as MRI. It is possible to perform a so-called fusion display in which the surface image is displayed so as to overlap with the coordinate position. Based on this fusion display, the prostate 28 can be punctured. Thereby, the speed | rate, precision, etc. in the case of puncturing the prostate 28 can be improved compared with the past.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope and gist of the invention, and are also included in the invention described in the claims and the equivalents thereof.

DESCRIPTION OF SYMBOLS 1 Insertion part 1a Tip 1b Head part 1c Bending part 1d Shaft part 1d1 Upper surface part 1f Both sides 2 Ultrasonic transducer array 2a Ultrasonic transducer 3 Grasping part 3a Upper surface part 3b Offset part 3c Inclination part 3d Flat part 3e Wing part 3f Side surface 4 Insertion direction 5 Curvature direction 6 Scanning surface 6a Crossing surface 10 Transrectal probe 10a Main body portion 11 Puncture tool 11a Back surface portion 11b Front surface portion 11c Side surface portion 11d Puncture needle guide 11d1 Insertion port 11d2 Runway 11d3 Projection port 11f Upper surface portion 11e Lower surface portion 11g Stopper 12 Puncture needle 12a Front end 12b Rear end portion 12c Buffer material

Claims (9)

An insertion part that can be inserted into the body cavity of the subject,
The insertion portion includes a plurality of ultrasonic transducers at a distal end, and has a first curved portion where the distal end is curved toward a predetermined direction with respect to the insertion direction,
The plurality of ultrasonic transducers are arranged so that a scanning plane formed by the emitted ultrasonic waves is orthogonal to a plane including the insertion direction and the predetermined direction.
Body cavity probe. A puncture device provided on the surface of the insertion portion;
The puncture device is provided so that a puncture needle can protrude from the position of the distal end of the insertion portion toward the predetermined direction,
The tip of the puncture needle is configured to move along the scanning plane,
The body cavity probe according to claim 1. The puncture device comprises a puncture needle guide for guiding the puncture needle along the first curved portion on a side surface of the insertion portion,
The puncture needle guide has a second curved portion that curves along the first curved portion, and the puncture needle travels in the puncture needle guide along the second curved portion,
The intra-body-cavity probe according to claim 2, wherein: The puncture device includes a pair of puncture needle guides on both side surfaces sandwiching the insertion portion,
Each puncture needle protrudes from a position facing through the plurality of ultrasonic transducers,
The body cavity probe according to claim 3. The puncture device is provided to be detachable from the insertion portion.
The intra-body-cavity probe according to any one of claims 2 to 4, wherein The complementary angle of the angle formed by the insertion direction and the predetermined direction is 10 ° or more and 70 ° or less,
The intra-body-cavity probe according to any one of claims 1 to 5, wherein: Comprising at least one intracavity probe;
The body cavity probe is
An insertion part that can be inserted into the body cavity of the subject,
The insertion portion includes a plurality of ultrasonic transducers at a distal end, and has a first curved portion where the distal end is curved toward a predetermined direction with respect to the insertion direction,
The plurality of ultrasonic transducers are arranged so that a scanning plane formed by the emitted ultrasonic waves is orthogonal to a plane including the insertion direction and the predetermined direction.
Ultrasonic diagnostic equipment. A puncture device provided on the surface of the insertion portion;
The puncture device is provided so that the puncture needle can protrude from the position of the distal end of the insertion portion toward the predetermined direction,
The tip of the puncture needle is configured to move along the scanning plane,
The ultrasonic diagnostic apparatus according to claim 7. With a display,
The display unit displays an image based on image data generated by processing a reflected wave from the scanning plane,
In the scanning plane, a cross-sectional image of the subject that is an intersection surface of the scanning plane and the subject, and an image in the advancing direction of the puncture needle are displayed.
The ultrasonic diagnostic apparatus according to claim 8.

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