JP2852076B2 - Hyperthermia probe - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a probe for hyperthermia treatment for locally heating and treating a lesion generated in a living body.

[Prior Art] A thermotherapy probe for locally heating and treating a lesion in a living body is disclosed in, for example, US Pat. No. 4,700,716. In this method, a microwave irradiation antenna unit having an external electrode and an internal electrode is provided at the tip of a probe, and the microwave is irradiated from the antenna unit toward a lesion in a living body. The external electrodes constituting the antenna for microwave irradiation in this probe are as follows:
It is formed of a metal material.

Ultrasound tomography was often useful in diagnosing lesions to be treated with heating using this probe.

On the other hand, a method of applying a high-frequency current between an in-vivo electrode and an extracorporeal electrode to heat a lesion located between the electrodes is also known as a heating means (see Japanese Patent Publication No. 62-48505).
In this case, the in-vivo electrode is provided on a probe for the in-vivo electrode inserted into the body lumen organ. The internal electrode is formed of a tubular braid, a bellows or a spiral formed of a metal wire such as a stainless wire or a tin-plated wire.

Also, when the internal electrode probe is introduced into the body and a high-frequency current is applied to a lesion to perform thermal treatment, a diagnostic apparatus based on an ultrasonic tomographic image is used for diagnosing a lesion to be subjected to heating treatment. .

[Problems to be Solved by the Invention] By the way, in each of the above probes, the electrode of the microwave irradiation antenna portion or the internal electrode for high frequency is made of a metal material. When diagnosing with an ultrasonic tomographic image using an ultrasonic diagnostic probe, blind spots are likely to occur due to the obstruction of the electrodes.
In addition, since the hyperthermia probe and the ultrasonic diagnostic probe are separate bodies, it is difficult to accurately match the part to be treated by the hyperthermia probe and the part to be diagnosed by the ultrasonic diagnostic apparatus. For this reason, it has been difficult to make an accurate diagnosis of the treatment site during or before and after treatment.

Further, with the conventional probe for thermal treatment, it was difficult to accurately confirm the position of the affected part in the living body and to guide the probe to an optimal position for treating the affected part.

The present invention has been made in view of the above-mentioned problem, and an object thereof is to easily guide a heating probe to a position most suitable for heating and treating a lesioned part generated in a living body. It is another object of the present invention to provide a probe for hyperthermia treatment capable of clearly diagnosing the state of a diseased part during or before and after the hyperthermia treatment and the surrounding living tissue site by ultrasonic waves.

[Means and Actions for Solving the Problems] In order to solve the above problems, the present invention provides a heating electrode on an in-vivo probe to be introduced into a body cavity, and generates a probe in a living body using the heating electrode. In a thermotherapy probe for locally treating and treating a lesion, the in-vivo probe includes:
An ultrasonic element for ultrasonic diagnosis was incorporated near the heating electrode, and at least a portion of the heating electrode located on the side of the visual field observed by the ultrasonic element was formed of an ultrasonically permeable material.

With such a configuration, an ultrasonic diagnostic image of the living tissue around the electrode can be obtained over the heating electrode provided on the in-vivo probe. Therefore, reliable and clear ultrasonic diagnosis can be performed with one probe simultaneously with the hyperthermia treatment.

Embodiment FIG. 1 and FIG. 2 show a first embodiment of the present invention. FIG. 1 shows the in-vivo probe 1 for thermal treatment. The probe body 2 of the in-vivo probe 1 is constituted by using a flexible two-hole tube formed of silicone rubber. A coaxial cable 5 composed of an inner conductor 3 and an outer conductor 4 is inserted through a center hole formed in the probe main body 2. The outer conductor 4 is divided into a plurality of parts on the outer periphery of the distal end portion of the probe main body 2, for example, on a plane perpendicular to the longitudinal axis direction of the in-vivo probe 1. Is covered with an insulating coating 6.

The inner conductor 3 pulled out from the coaxial cable 4 to the distal end side is concentrically arranged inside the outer electrode a to form an inner electrode b, thereby forming an antenna portion c as a heating electrode. doing.

Further, the plurality of divided external conductors 4 constituting the external electrode b are formed of a conductive material having a small attenuation of ultrasonic waves, such as conductive silicon rubber. Further, the insulating film 6 in the antenna section c is formed of a material such as Teflon having a low dielectric constant due to microwaves. At the same time, the insulating coating 6 is formed of a material having a small attenuation of ultrasonic waves.

On the other hand, an ultrasonic probe 8 is inserted into an insertion hole 7 formed by the other hole of the probe main body 2. The ultrasonic probe 8 is provided with an ultrasonic diagnostic ultrasonic element (ultrasonic vibration element unit) 9 at the distal end thereof, and oscillates ultrasonic waves outward (downward in FIG. 1). The reflected wave is received.

A connector 11 is attached to the end of the coaxial cable 4 in the in-vivo probe 1 configured as described above.
Another connector 12 is provided at the end of the ultrasonic probe 8. Then, as shown in FIG. 2, the connector 11 of the in-vivo probe 1 is connected to the microwave generator 13,
The connector 12 of the ultrasonic probe 8 is a probe driving device 14,
And the ultrasonic generator 15. Further, an observation monitor 16 is connected to the ultrasonic generator 15.

Next, an example in which the thus configured and connected in-vivo probe 1 is used for thermotherapy will be described with reference to FIG. FIG. 2 shows that the in-vivo probe 1 is inserted into the living body lumen 20 and the antenna section c is located near the tumor 22 formed in the living tissue 21.
Is shown to perform a thermal treatment.

That is, the in-vivo probe 1 is orally or percutaneously inserted into the body lumen 20, for example, a bile duct or the like.
At this time, the ultrasonic element 9 portion of the ultrasonic probe 8 inserted into the in-vivo probe 1 is positioned inside in response to the antenna section c. Then, while the ultrasonic probe 8 is driven to rotate about the longitudinal axis of the ultrasonic probe 8 by the probe driving device 14, the ultrasonic diagnostic ultrasonic element 9 performs the oscillating operation and the receiving operation. The received signal is subjected to image signal processing and observed on the monitor 16.

In this case, since the external electrode b is formed of a material having a small ultrasonic attenuation, the external electrode b does not hinder the ultrasonic diagnosis. That is, an ultrasonic image of the tissue around the antenna section c can be observed through the external electrode b.

In this way, while observing, the in-vivo probe 1 is introduced so that the antenna section c of the in-vivo probe 1 is disposed immediately below the tumor 22. Then, as shown in FIG. 2, the microwave is transmitted from the microwave generator 13 by the coaxial cable 5 in a state where the antenna portion c is in contact with the wall surface of the living body lumen 20 immediately below the tumor 22, and Microwaves are radiated from the part c to perform the hyperthermia treatment of the tumor 22. At the same time, the ultrasonic probe 8 is linearly driven in the axial direction of the probe 1 by the probe driving device 14 by the axial length of the antenna section c, and the tumor 2 is heated by scanning.
2. Observe an ultrasonic image of the living tissue 21 and the vicinity thereof.

The tomographic image of the living tissue 21 on the outer periphery of the antenna section c can be observed by the ultrasonic probe 8 from the inside of the hyperthermia probe 1 by the operation and action as described above. In-vivo probe 1 easily finds tumor 22 even at the site to be heated
Can be led. Further, even during the heating treatment, changes in the normal tissue in the tumor 22 and its surroundings can be observed without blind spots by ultrasonic tomographic images, so that safer treatment can be performed.

FIG. 3 shows an in-vivo probe 41 for hyperthermia in a second embodiment of the present invention. The in-body probe 41 is formed of a flexible silicon tube as a probe body 42, and a coaxial cable 43 is inserted into the probe body 42. Inner conductor 44 pulled out from this coaxial cable 43
Constitute the internal electrode a. Also, the probe body
The external electrode b is formed, for example, on a spiral provided on the outer periphery of the tip of 42. Note that the outer conductor 45 may not be spiral and may be divided into a plurality of parts before and after. The antenna c is constituted by the internal electrode a and the external electrode b.

In the tip of the probe body 42, a plurality of ultrasonic elements 47a,
47b is fixedly set. For example, one ultrasonic element 47a is located relatively forward and installed downward. The other ultrasonic element 47b is located relatively rearward and installed upward.

Cables 48a and 48b for transmitting ultrasonic waves are separately connected to these ultrasonic elements 47a and 47b.

Further, the external conductor 45 forming the external electrode b is formed by the first conductor
As in the case of the first embodiment, it is made of a material having an extremely small attenuation of ultrasonic waves. Further, the outer periphery of the antenna portion c including the outer conductor 45 is covered with an insulating film 49.

The in-vivo probe 41 configured in this manner includes a connector 50 attached to the end of the coaxial cable 43 and connectors 51a and 51b attached to the ends of the ultrasonic transmission cables 48a and 48b, respectively, as in the first embodiment. The connector 50 is connected to the microwave oscillator, and the connectors 51a and 51b are connected to the probe driver and the ultrasonic generator.

The thus-configured and connected in-vivo probe 41 for thermal treatment is inserted into a living body lumen and heats and treats an affected part by microwaves, as in the case of the first embodiment.

During the heating treatment, the affected parts around the electrodes in each direction are observed by the ultrasonic elements 47a and 47b. With the in-vivo probe 41 of the second embodiment, the same operation and effect as in the first embodiment can be obtained.

FIG. 4 and FIG. 5 show a fourth embodiment of the present invention. In this embodiment, hyperthermia is performed using high frequency. FIG. 1 shows the probe 50 in the body. In vivo probe
Reference numeral 50 denotes a flexible four-hole silicon tube as the probe body 51, and a tubular internal electrode 52 is fixedly provided on the outer periphery of the distal end of the probe body 51. The in-body electrode 52 is made of conductive silicon rubber or the like that has a very small attenuation of ultrasonic waves. The inside where the in-body electrode 52 is provided is hollow inside except for the front and rear end portions thereof, and a closed space 53 is formed.
Is formed.

A cable 54 is connected to the body electrode 52, and this cable
54 is inserted through one hole 55 in the probe main body 51. A diagnostic ultrasonic probe 57 is inserted through the other hole 56. This diagnostic ultrasonic probe 57 is composed of a flexible shaft 58 and an ultrasonic vibration element unit provided at the tip thereof.
The ultrasonic vibration element unit 59 is disposed in a closed space 53 surrounded by the tubular internal electrode 52. The inside of the closed space 53 is filled with an ultrasonic transmission liquid 61 such as liquid paraffin.

Further, a balloon 62 for capturing the body electrode 52 so as to be captured inside is attached to the outer periphery of the distal end portion of the probe main body 51. The balloon 62 is formed of a soft thin film such as latex. And balloon 62
Is connected to a water supply pipe 63 and a drain pipe (64) formed by using the remaining two holes of the probe body 51. A water supply tube 65 and a drainage tube 66 are connected to the water supply line 63 and the drainage line (64).

The in-vivo probe 50 includes a first connector 67 attached to the end of the cable 54, and a diagnostic ultrasonic probe.
There are provided a second connector 68 attached to the end of the flexible shaft 58 of 57, and third and fourth connectors 71 and 72 attached to the respective ends of the water supply tube 65 and the drainage tube 66, respectively. As shown in FIG. 5, the first connector 67 includes a high-frequency generator 73 and a second connector 68.
Is connected to the ultrasonic probe driving device 74, and the third and fourth connectors 71 and 72 are connected to the coolant circulating device 75, respectively.

An unillustrated ultrasonic signal transmission cable connected to the ultrasonic vibration element unit 59 of the diagnostic ultrasonic probe 57 is connected to an external ultrasonic generating / observing device 76 through the flexible shaft 58.

Further, as shown in FIG. 5, an extracorporeal electrode 78 having a bolus 77 is provided, and the extracorporeal electrode 78 is connected to the high-frequency generator 73 through a cable 79. Extracorporeal electrode
Although the liquid is supplied to and discharged from the bolus 77 of 78, the cooling liquid may be circulated by a cooling liquid circulating device through a water supply tube or a drain tube similar to the above.

Next, an example of use of this embodiment will be described. As shown in FIG. 5, the in-vivo probe 50 is inserted into a living body lumen 81 such as a dining room. At this time, the cooling liquid is not supplied to the balloon 62 so as to be easily inserted, and the balloon 62 is completely contracted.

Further, at the time of this insertion, the diagnostic ultrasonic probe 57 inserted into the probe main body 51 is rotated around its axial center by the driving device 74, and further, the ultrasonic generating / observing device 76
Drive. Accordingly, the ultrasonic vibration element unit 59 emits ultrasonic waves while rotating, and receives the reflected waves.
Based on this received signal, the ultrasonic image is observed by the ultrasonic generating / observing device 76. By the way, the above ultrasonic vibration element unit
Since the in-vivo electrode 52 located around the 59 does not attenuate the ultrasonic waves as described above, the living tissue 82 passes through the in-vivo electrode 52.
Can be observed.

Thus, while observing the ultrasonic image of the living tissue around the distal end of the in-vivo probe 50 having the in-vivo electrode 52, the distal end of the in-vivo probe 50 is positioned immediately below the lesion (tumor) 83.

Next, the cooling liquid is supplied into the balloon 62 by the cooling liquid circulation device 75, and the balloon 62 is inflated. Thereby, the balloon 62 is brought into close contact with the inner wall surface of the living body lumen 81. Also,
The circulation flow rate of the cooling liquid is adjusted so as to maintain this close contact state. Note that it is desirable to use deaerated water or the like having a small attenuation of ultrasonic waves as the cooling liquid.

On the other hand, an extracorporeal electrode 78 is provided on the extracorporeal surface facing the tip of the intracorporeal probe 50 having the in vivo electrode 52. The lesion 83 is located between the internal electrode 52 and the external electrode 78.

Therefore, a high frequency is applied between the in-vivo electrode 52 and the extracorporeal electrode 78 by the high-frequency generator 73, and the lesion 83 between them is heated and treated. During this treatment, the internal electrode 82 and the external electrode
Since normal tissue near 78 is likely to be warmed, balloon 62
And circulating a cooling fluid in the bolus 77 to prevent heating of normal tissue.

Further, within the in-vivo probe 50, if the ultrasonic vibration element unit 59 is moved by linearly driving the diagnostic ultrasonic probe 57 in the axial direction, the lesion 83 between the in-vivo electrode 52 and the extracorporeal electrode 78 can be moved. An ultrasonic tomographic image can be observed.

The in-vivo probe 50 has a built-in diagnostic ultrasonic probe 57 therein, and has an ultrasonic vibrating element unit.
Since the in-body electrode 52 surrounding the body 59 does not attenuate the ultrasonic waves, an ultrasonic tomographic image of the living tissue 82 or the lesion 83 can be observed through the in-body electrode 52. Therefore, the in-vivo probe 50 can be easily and accurately introduced into a desired position of the living body lumen 81 (a position suitable for treating the lesion 83). Further, since the ultrasonic tomographic image of the heating section can be observed even during the treatment, safe and accurate thermal treatment can be performed.

6 to 8 show a fourth embodiment of the present invention. FIG. 6 shows an in-vivo probe 90 for performing hyperthermia using a high frequency similarly to the third embodiment. The in-vivo probe 90 comprises a flexible three-hole silicone tube as the probe body 91, and a tubular in-vivo electrode 92 is fixedly provided on the outer periphery of the distal end of the probe body 91. The internal electrodes 92 are formed of a material such as conductive silicon rubber which has a very small attenuation of ultrasonic waves. Also, internal electrodes
92 is covered with an electrically insulating thin film 93. Further, the member of the probe body 91 on the inner side where the in-body electrode 52 is provided is cut away except for both front and rear ends thereof to form a window 94.

One thickest hole of the probe body 91 is an insertion hole 95.
Which penetrates to the tip of the probe body 91. However, the diameter of the foremost hole portion 96 is particularly small. The foremost hole part 96 is inserted through the tapered part 97
Is connected to the tip side portion of

The cable 98 connected to the internal electrode 92 is guided to the proximal end through another hole 99 of the probe body 91, and is connected to the high-frequency generator as in the above embodiment.

The other hole 101 of the probe main body 91 is connected to the window 94.
It communicates with the space 102 inside. Then, the ultrasonic transmission fluid 103 such as liquid paraffin is injected.

On the other hand, the guide wire 104 and the ultrasonic diagnostic probe 105 can be selectively inserted into the insertion hole 95 as shown in FIG. Guide wire 104 is the most advanced hole 9
It can be inserted from 6 until it penetrates to the tip side. The guide wire 104 is guided by the tapered portion 97 and is densely inserted into the hole portion 96 at the foremost end. At this time, the hole portion 96 is closed.

Further, the ultrasonic diagnostic probe 105 is inserted to a position immediately before the tapered portion 97, and is stopped at a position where it does not enter the hole portion 96 at the foremost end, whereby the final insertion position is determined. And the ultrasonic diagnostic probe 10
In 5, the ultrasonic vibration element unit 106 is incorporated in a portion corresponding to the window 94 where the internal electrode 92 is provided. An ultrasonic signal transmission cable (not shown) is connected to the ultrasonic vibration element unit 106. The ultrasonic signal transmission cable is connected to an external ultrasonic generating / observing device (not shown) through the flexible shaft 106 of the ultrasonic diagnostic probe 105 as in the above embodiment.

Next, the operation in the case of using this embodiment will be described.

First, the in-vivo probe 90 is introduced into the living body lumen in the same manner as in the third embodiment. In this case, the guide wire 104 is previously introduced into the living body lumen using an endoscope or the like. Next, as shown in FIG. 6, the guide wire 104 is inserted into the insertion hole 95 of the probe main body 91 from the hole 96 on the distal end side. Then, the in-vivo probe 90 is guided into a thin living body lumen such as a bile duct using the guide wire 104 as a guide.

Next, only the guide wire 104 is pulled out from the hand side, and instead of this, the ultrasonic diagnostic probe 105 is inserted into the insertion hole 95 to the final position as shown in FIG. At this time, the tip of the ultrasonic diagnostic probe 105 comes into close contact with the inner wall of the tapered portion 97 and closes the hole portion 96 at the most distal end. Further, the ultrasonic vibration element unit 106 is located at a position corresponding to the window 94 where the internal electrode 92 is provided. In this state, an ultrasonic transmission fluid 103 such as liquid paraffin is injected into the space 102 inside the window 94 through the hole 101.

Therefore, similarly to the third embodiment, the ultrasonic vibration element unit 106 is driven, and the diagnostic ultrasonic probe 105 is rotated around its axis by a driving device (not shown) while the ultrasonic generating / observing device is rotated. Observed by That is, the ultrasonic vibration element unit 106 emits ultrasonic waves while rotating, and receives the reflected waves. Based on the received signal, an ultrasonic image is observed by the ultrasonic generation / observation device. By the way, since the in-vivo electrode 92 located around the ultrasonic vibration element unit 106 does not attenuate the ultrasonic wave as described above, the site of the living tissue can be clearly observed through the in-vivo electrode 92.

In this way, while observing the ultrasonic image of the living tissue around the tip of the in-body probe 90 having the in-body electrode 92, the insertion position is set so that the tip of the in-body probe 90 is located immediately below the lesion (tumor). To correct.

Then, similarly to the third embodiment, high frequency is applied between the in-body electrode 92 and the extracorporeal electrode (not shown) by the high-frequency generator, and the lesion located therebetween is heated and treated.

Further, in the in-body probe 90, if the ultrasonic vibration element unit 106 is moved by linearly driving the diagnostic ultrasonic probe 105 in the axial direction, the ultrasonic wave at the lesion between the in-body electrode 92 and the extracorporeal electrode can be obtained. A tomographic image can be observed.

According to the in-vivo probe 90, the same operation and effect as those of the third embodiment can be obtained. Further, the in-vivo probe 90 can be inserted into the body lumen using the guide wire 104. Therefore, it can be easily inserted and can be easily inserted even in a thin living body lumen.

The present invention is not limited to one or two ultrasonic elements installed inside the thermotherapy probe,
More ultrasonic elements may be incorporated. Also,
The configuration of the heating electrode such as the antenna unit is not limited to the above embodiment.

[Effect of the Invention] As described above, the probe for thermotherapy of the present invention
Since the heating electrode formed at the tip of the probe is made of a material with extremely low attenuation of ultrasonic waves, the ultrasonic element for ultrasonic diagnostics placed inside the ultrasonic An image can be observed, and therefore, the heating electrode can be easily and accurately guided to a position most suitable for heating treatment corresponding to a tumor or the like in a living tissue. further,
Since the ultrasonic tomographic image of the affected part or the like can be observed during the heating treatment, safe and accurate thermal treatment can be performed.

[Brief description of the drawings]

FIG. 1 is a cross-sectional view showing the structure of a probe for thermal treatment according to a first embodiment of the present invention, FIG. 2 is an explanatory view showing a state in which the probe for thermal treatment of the first embodiment is used, and FIG. FIG. 4 is a sectional view showing the configuration of a probe for thermal treatment according to a second embodiment of the present invention, FIG. 4 is a sectional view showing the configuration of a probe for thermal treatment according to a third embodiment of the present invention, and FIG. Also the third
FIG. 6 is an explanatory view showing a state in which the probe for thermal treatment of the embodiment is used, FIG. 6 is a sectional view showing the configuration of the probe for thermal treatment of the fourth embodiment of the present invention, and FIG. FIG. 8 is a cross-sectional view taken along the line A, and FIG. 8 is a cross-sectional view showing the configuration of the thermal treatment probe of the fourth embodiment. 1. Probe for thermal treatment, 2. Probe body, 3.
... inner conductor, 5 ... outer conductor, 8 ... ultrasonic probe,
9 ... ultrasonic element, a ... internal electrode, b ... external electrode,
c: antenna, 41: internal probe, 47a, 47b: ultrasonic element, 50: internal probe, 52: internal electrode, 59:
… Ultrasonic vibration element unit, 90 …… In-body probe, 92…
... body electrode, 106 ... ultrasonic vibration element unit.

──────────────────────────────────────────────────続 き Continuation of the front page (56) References JP-A-2-277469 (JP, A) JP-A-2-271876 (JP, A) JP-A-62-284658 (JP, A) JP-A-63-284 105773 (JP, A) JP-A-2-121660 (JP, A) JP-A 63-114623 (JP, U) (58) Fields investigated (Int. Cl. ⁶ , DB name) A61N 5/02 A61N 1 / 40 A61F 7/12

Claims (1)

(57) [Claims] An in-vivo probe to be introduced into a body cavity is provided with a heating electrode, and the heated electrode is used to locally heat and treat a lesion generated in a living body using the heating electrode. Incorporating an ultrasonic element for ultrasonic diagnosis close to the heating electrode in the in-vivo probe, the heating electrode has at least a portion positioned on the observation side to be observed by the ultrasonic element, having an ultrasonic transmission property. A probe for thermotherapy characterized by being formed of a material.