JP4943969B2 - Ultrasonic diagnostic equipment - Google Patents

Description

  The present invention relates to an ultrasonic diagnostic apparatus, and more particularly to an ultrasonic diagnostic apparatus including a biopsy needle.

  In recent years, an ultrasonic endoscope is inserted into a living body, a lesion in the body is found from an optical image, and then an ultrasound is irradiated, and a diagnosis is performed using an ultrasonic tomogram of the lesion from a reflected wave. Is widely spread. In addition, a method of performing a definitive diagnosis with aspirated cells by performing puncture while visually recognizing a biopsy needle and aspirating cells under the guidance of an optical image and an ultrasonic tomographic image has also been implemented.

  When this definitive diagnosis is performed, it is necessary to accurately extract the tissue. As a method of collecting, the lesion is surely collected by inserting a needle into the lesion under the B mode guide of the ultrasonic image. There are methods. When performing this definitive diagnosis, radial scanning capable of scanning the entire lumen is suitable for diagnosing a lesion in the lumen such as the body. Therefore, first, the surgeon diagnoses the lesion by using the intracavity ultrasonic endoscope for radial scanning. After confirming the location of the lesion, in order to make a definitive diagnosis, it is necessary to search the lesion again with an intracorporeal ultrasound endoscope for convex scanning, and to collect the tissue of the lesion with a biopsy needle. The scanning intracavity ultrasound endoscope is reinserted into the patient. Therefore, it is necessary for the patient to drink the intracorporeal ultrasound endoscope twice, which causes pain to the patient.

  Japanese Patent Application Laid-Open No. 2004-135893 discloses a biplane ultrasonic diagnostic apparatus in which a probe for radial scanning and a transducer for convex scanning are arranged so that their scanning directions intersect each other. Has been. According to this ultrasonic diagnostic apparatus, an easy definitive diagnosis under an ultrasonic guide can be performed while switching between a radial scanning transducer and a convex scanning transducer using a single probe.

Japanese Unexamined Patent Application Publication No. 2005-168766 discloses an ultrasonic probe that can switch the scanning direction of one transducer array to a different direction. It is disclosed that a biopsy needle can be displayed as a dimensional image that can be easily grasped by an operator by using this ultrasonic probe.
JP 2004-135893 A JP 2005-168766 A

  By using the biplane ultrasonic diagnostic apparatus or the ultrasonic probe disclosed in Japanese Patent Application Laid-Open No. 2005-168766, the biopsy needle can be punctured while confirming two orthogonal ultrasonic scanning planes using one probe. Is possible.

  However, the hardness of living tissue varies depending on the tissue structure and the like. For this reason, the biopsy needle may be bent during the puncture. In particular, in the thin biopsy needle, the influence of the difference in hardness depending on the tissue was remarkable. If the surgeon continues to puncture without bending the biopsy needle, that is, the needle is not noticed, cells will be collected from a tissue different from the target tissue, or the biological needle will pierce the blood vessel There was also a risk of bleeding.

  Since the biopsy needle is punctured within the convex scanning plane, the convex image is an image that allows the operator to easily confirm the puncture of the biopsy needle. For this reason, convex image display is widely used for puncturing. However, when the biopsy needle is bent in a direction orthogonal to the convex scanning plane, the bending of the needle cannot be confirmed in the convex image. That is, the amount of biopsy needle image on the convex scan image only appears slightly smaller than the actual amount of biopsy needle penetration. That is, the surgeon cannot accurately grasp the position of the biopsy needle by puncturing while viewing only the convex image. Therefore, it is necessary for the surgeon to perform puncturing while simultaneously displaying both the convex image and the radial image or switching the display of both images.

  An object of this invention is to provide the ultrasonic diagnostic apparatus which can puncture a biopsy needle reliably.

  In order to achieve the above object, an ultrasonic diagnostic apparatus of the present invention includes a radial scanning transducer that scans in a circle in a plane perpendicular to a probe axis, and a convex that scans in a plane orthogonal to the radial scanning transducer. An ultrasonic diagnostic apparatus comprising a scanning transducer and a biopsy needle that is parallel to the probe axis and protrudes within the scanning plane of the convex scanning transducer, wherein the radial image is scanned by the radial scanning transducer A biopsy needle image detecting means for detecting an ultrasonic image of the biopsy needle in the image, an allowable range setting means for setting an allowable range of the ultrasonic image of the biopsy needle in the radial image, and the biopsy needle image detecting means A determination unit that determines whether the position of the ultrasonic image of the biopsy needle detected in step S is within an allowable range set by the allowable range setting unit; and a warning generation that issues a warning based on the determination by the determination unit Means and Provided.

  The present invention provides an ultrasonic diagnostic apparatus that can reliably puncture a biopsy needle.

  Embodiments of the present invention will be described below with reference to the drawings.

<First Embodiment>
FIG. 1 is a configuration diagram of an ultrasonic diagnostic apparatus 1 according to the first embodiment of the present invention. The ultrasonic diagnostic apparatus 1 according to the present embodiment includes an ultrasonic endoscope 20, a control device 40, an input unit 60 that is connected to the control device 40 and operates the control device 40, and is also connected to and controlled by the control device 40. The display means 70 which displays the image information obtained with the apparatus 40, and the warning means 80 are provided.

  The ultrasonic endoscope 20 is inserted into a body cavity or the like and transmits an ultrasonic beam toward the observation target part, and receives a reflected wave reflected from the boundary of the acoustic impedance of the observation target part. To obtain an echo signal. The control device 40 is connected to the ultrasonic endoscope 20 with cables 21 a and 22 b and controls transmission / reception of the ultrasonic endoscope 20.

  The ultrasonic endoscope 20 includes an elongated probe to be inserted into a body cavity and the like, and a plurality of transducers 30 provided at the distal end of the probe for transmitting and receiving an ultrasonic beam, that is, two A vibrator, a convex scanning vibrator 31 and a radial scanning vibrator 32 are provided. The convex scanning vibrator is the same as the CLA (Curved Linear Array) vibrator, and the vibrator that electronically performs radial scanning in the radial scanning vibrator is the ELR (Electronic Radial) vibrator. In the case of mechanical radial scanning in which mechanical radial scanning is performed, there may be a single transducer. In this embodiment, the transducer is not only a transducer group including a plurality of transducers but also a mechanical group. It also includes a single transducer for radial scanning.

  The control device 40 selects and switches either the transducer 31 or 32, a transmission / reception processing unit 42 that scans the transducer selected by the switching unit A41, detects an echo signal, and the like, and transmission / reception processing An image generation unit 43 that generates display image data from the data obtained by the unit 42, and an image signal of each transducer 31 or 32 is converted into a convex image memory 46 or a radial image memory 47 as a respective image memory. A switching unit B45 for storing data, a puncture guide setting means 49 for setting a puncture guide, a puncture guide image memory 50 for displaying a puncture guide, and biopsy needle image detection for detecting a biopsy needle image in a radial image Means 48, determination means 52 for determining the positional relationship between the puncture guide and the biopsy needle image, warning generation means 53 for generating a warning based on the determination means 52, It includes an image synthesizing unit 51 for synthesizing the image, and a control unit 44 for controlling also performed in the ultrasonic diagnostic apparatus in general. The switching unit A41 may use a multiplexer (MUX).

  The convex image stored in the convex image memory 46, the radial image stored in the radial image memory 47, the puncture guide image stored in the puncture guide image memory 50, and the warning image created by the warning generation means are: The image is synthesized by the image synthesizing means 51 and displayed on the display screen 71 of the display means 70.

  The signal of the warning generating means 53 is not only displayed on the display means 70 via the image synthesizing means 51 but also sent to the warning means 80 to warn the surgeon by a method such as a warning sound.

  FIG. 2 is a perspective view of the tip 20a of the probe according to the present embodiment. The convex scanning transducer 31 scans in a fan shape in a plane parallel to the probe axis, as indicated by a convex scanning plane 31A. On the other hand, the radial scanning vibrator 32 scans in a circle in a plane perpendicular to the probe axis, as indicated by a radial scanning vibrator scanning surface 32A. The biopsy needle 22 projects into the lumen via the forceps channel 21. When the biopsy needle 22 protrudes straight, the biopsy needle 22 advances in the convex scanning surface 31A.

  3A is a front view and FIG. 3B is a side view in the probe insertion direction of the tip portion 20a of the probe according to the present embodiment. As shown in FIG. 3, the convex scanning surface 31A and the radial scanning transducer scanning surface 32A scan in the plane orthogonal to each other.

  FIG. 4 is a perspective view of the distal end portion 20a of the probe according to the present embodiment. 5A is a front view and FIG. 5B is a side view in the probe insertion direction of the tip portion 20a of the probe according to the present embodiment. 4 and 5 show a state in which the biopsy needle 22 is bent in a direction perpendicular to the convex scanning surface 31A.

As shown in FIGS. 3 and 5, the convex scanning surface 31A and the radial scanning transducer scanning surface 32A have a depth corresponding to the width w1 and w2 of each transducer. For this reason, even if the biopsy needle 22 is bent in the direction orthogonal to the convex scanning surface 31A, no change is seen in the convex image in a region where the bending range is equal to or smaller than the width w1 of the convex scanning surface. Further, when the range of bending of the biopsy needle 22 exceeds the width w1 of the convex scanning surface, the biopsy needle 22 is outside the convex scanning range, so that the tip of the biopsy needle 22 does not appear in the convex image. For this reason, even if the biopsy needle protrudes excessively, it cannot be identified from the convex image.
Further, from FIG. 5B, it can be seen that the biopsy needle displayed on the radial image is only the portion passing through the region of the width w2 of the radial scanning transducer.

  Hereinafter, the operation of the ultrasonic diagnostic apparatus 1 according to the present embodiment will be described with reference to FIGS. 6-11 is a figure which shows the display screen 71 for demonstrating operation | movement of the ultrasound diagnosing device 1 of this Embodiment.

  As shown in FIG. 6, a convex image 31E and a radial image 32E are displayed side by side on the display screen 71 of the present embodiment. The positional relationship between the convex image 31E and the radial image 32E shown in FIG. 6 corresponds to the positional relationship between the convex scanning surface 31A and the radial scanning transducer scanning surface 32A shown in FIG.

First, as shown in FIG. 7, the allowable range of the position of the ultrasound image 22E2 of the biopsy needle is set in the radial image 32E by the puncture guide setting means 49 which is an allowable range setting means. That is, the puncture guide setting unit 49 sets the puncture guide 75 in accordance with an instruction from the input unit 60.
The two puncture guide lines 75a and 75b indicating the permissible range of the puncture guide 75 are stored in the puncture guide image memory, synthesized with a radial image or the like by the image synthesis means 51 at the time of radial scanning, and displayed on the display screen 71. The

  The display screen 71 shown in FIG. 8 displays the ultrasound image 22E1 of the biopsy needle 22 on the convex image 31E and the biopsy needle on the radial image 32E in a state where the biopsy needle 22 shown in FIGS. 22 ultrasonic images 22E2 are displayed.

  As shown in FIG. 8, when the biopsy needle 22 advances straight, the biopsy needle 22 advances in parallel within the convex scanning surface 31A, so that the ultrasonic image 22E2 of the biopsy needle 22 is radial scanned on the radial image. It becomes a straight line perpendicular to the sound line of the vibrator. For this reason, as shown in FIG. 7, the allowable range of the position of the ultrasonic image of the biopsy needle on the radial image set by the puncture guide setting means 49 as the allowable range setting means is two puncture guide lines 75a and It can be specified by 75b. That is, the allowable range of the position of the ultrasound image of the biopsy needle can be set only by the interval d1 between the two puncture guide lines 75a and 75b. Note that the interval d1 that is an allowable range is set by the operator using the input unit 60 according to the contents of the diagnosis scheduled to be performed.

  Next, the display screen 71 shown in FIG. 9 displays ultrasonic images 22E1 and 22E2 of the biopsy needle 22 in a state where the biopsy needle 22 is bent and punctured. The biopsy needle image 22E1 on the convex image 31E in FIG. 9 is almost the same as the biopsy needle image 22E1 on the convex image 31E in FIG. On the other hand, on the radial image 32E, the ultrasonic image 22E2 of the biopsy needle 22 is not a straight line perpendicular to the sound line of the radial scanning transducer but a line oblique to the sound line.

  FIG. 10 shows the ultrasound images 22E1 and 22E2 of the biopsy needle 22 in the state shown in FIGS. 4 and 5 as the puncture progresses further in the state where the biopsy needle 22 is bent from the state of FIG. In the state shown in FIG. 10, a part of the ultrasonic image 22E2 of the biopsy needle 22 in the radial image 32E is outside the allowable range set by the two puncture guide lines 75a and 75b. In this case, in the ultrasonic diagnostic apparatus 1 according to the present embodiment, the determination unit 52 determines that the position of the ultrasonic image 22E2 of the biopsy needle 22 is outside the allowable range.

  FIG. 11 shows a display screen 71 when the determination unit 52 determines that the ultrasonic image 22E2 of the biopsy needle 22 is out of the allowable range. The warning text 81 using characters generated by the warning generation means 53 is combined with the convex image 31E by the image combining means 51 and displayed on the forefront of the display screen 71.

  As described above, the warning generating means 53 can not only display the warning text 81 on the display screen 71 but also notify the surgeon by the warning means 80. As the warning means 80, various known warning methods such as sound, light or vibration are used alone or in combination. Alternatively, the biopsy needle 22 can be locked, i.e., restricted in movement, so that no further protrusion is possible.

  The surgeon can reliably know that the biopsy needle 22 is bent and punctured by the warning.

FIG. 12 is a flowchart for explaining an example of the processing flow of the ultrasonic diagnostic apparatus 1 of the present embodiment.
First, puncture guide setting processing is performed (S11). As described above, the puncture guide can be set by the distance d1 between the two puncture guide lines 75a and 75b. Next, radial scanning (S12) and radial image generation (S13) are performed. Based on the image in the radial image memory 47, the biopsy needle image detection means 48 detects the biopsy needle image 22E2 from the radial image (S14). In addition, from the detected biopsy needle image, not only information on the location of the biopsy needle image 22E2 in the radial image but also information on the shape, ie, length and angle of the biopsy needle image 22E2.

  The biopsy needle 22 is preferably subjected to high echo processing that easily reflects ultrasonic waves. High-echo processing means processing the surface of the biopsy needle 22 with fine irregularities, creating the biopsy needle 22 using a material that easily reflects ultrasound, or using a material that easily reflects ultrasound. It is to coat the surface of the meter reading 22.

  The high-echo processed biopsy needle ultrasound image 22E2 is displayed more clearly on the radial image 32E than the unprocessed biopsy needle. For this reason, by using the biopsy needle 22 subjected to high echo processing, detection of the biopsy needle image is facilitated, and at the same time, more accurate ultrasonic image information of the biopsy needle can be obtained.

  The relationship between the position of the ultrasound image 22E of the biopsy needle detected by the biopsy needle image detection means 48 and the allowable range set by the puncture guide setting means by the determination means 52, that is, a part of the ultrasound image 22E is obtained. Whether it is outside the allowable range is determined (S15). If it is determined that a part of the ultrasonic image 22E is outside the allowable range, a warning is generated by the warning generation means 53 (S16). After the warning is generated or when it is determined that the ultrasonic image 22E is not outside the allowable range, the radial scan (S12) is newly performed again until an end instruction (S17) is received from the operator. Is called.

  Although not shown in the figure, the switching unit 41 performs convex scanning alternately with radial scanning, and the display screen 71 simultaneously displays the convex image 31E and the radial image 32E.

  It is not necessary to display a radial image on the display means 70 only for warning display. Puncturing can also be performed while displaying only the convex image on the display means 70. Since the convex image in which the biopsy needle can be easily grasped can be displayed on a limited display screen, the operator's operability is further improved. In this case, the radial image 32E and the puncture guide 75 are not displayed on the display unit 70, but the above-described processing is operating in the background, and a warning by the warning unit 80 other than the display unit 70, if necessary. And the operator is informed of the bending of the biopsy needle 22.

  Since the ultrasonic diagnostic apparatus 1 of the present embodiment warns the surgeon of bending of the biopsy needle 22, it can puncture the biopsy needle safely.

<Second Embodiment>
FIG. 13 is a configuration diagram of the ultrasonic diagnostic apparatus 2 according to the second embodiment of the present invention. As shown in FIG. 13, the ultrasonic diagnostic apparatus 2 has the same main components as the ultrasonic diagnostic apparatus 1 of the first embodiment, but includes a biopsy needle progress estimation unit 54. The biopsy needle progress estimating means 54 estimates the traveling direction of the biopsy needle 22 based on the information of the biopsy needle image 22E2 detected by the biopsy needle image detecting means 48.

14 to 16 are display screens 71 for explaining the operation of the ultrasonic diagnostic apparatus 2.
FIG. 14 shows a biopsy needle image 22E2 in a state where the biopsy needle 22 starts to bend. The position of the biopsy needle image 22E2 is still within the allowable range set by the puncture guide 75. However, in the ultrasonic diagnostic apparatus 2 of the present embodiment, the biopsy needle progress estimating means 54 estimates the state in which the puncture of the biopsy needle 22 has further progressed as it is.

  That is, as shown in FIG. 15, the biopsy needle progress estimation means 54 extrapolates the biopsy needle image 22E2 based on the detected information of the biopsy needle image 22E2, and advances the extrapolation line of the biopsy needle image 22E2. 22E3 is created. Then, the determination means 52 determines the relationship between the position of the extrapolation line 22E3 of the biopsy needle 22 and the allowable range set by the puncture guide 75, and a part of the extrapolation line of the biopsy needle 22 is within the allowable range. If it is determined that it is outside, a warning is generated by the warning generation means 53 and a warning text 82 is displayed on the display screen 71 as shown in FIG.

  In order to create the extrapolation line of the biopsy needle 22, a method of linearly approximating the biopsy needle image 22 </ b> E from the shape of the biopsy needle image 22 </ b> E, that is, the length and angle, and extrapolating is simple. Known approximation methods such as polynomial approximation and multidimensional approximation other than linear approximation may be used. Alternatively, the progression extrapolation line of the biopsy needle 22 is created by storing a correspondence database between the display of the biopsy needle image 22E and the actual progress state of the biopsy needle 22 in the biopsy needle progression estimation means 54. You may create based on.

  Note that the warning generated by the extrapolation of the biopsy needle 22 by the biopsy needle progress estimating means 54 may be different from the warning generated when the biopsy needle image 22E is actually determined to be outside the allowable range. Good.

  The ultrasonic diagnostic apparatus 2 of the present embodiment can warn the surgeon of the bending of the biopsy needle 22 at an earlier stage by estimating the advancing direction of the biopsy needle. , And safer to puncture.

<Third Embodiment>
FIG. 17 shows a display screen 71 of the ultrasonic diagnostic apparatus 3 according to the third embodiment of the present invention. In the ultrasonic diagnostic apparatus 3, a three-dimensional ultrasonic image 22E4 of the biopsy needle 22 is formed by the image synthesizing unit 51 from the convex image 31E and the radial image 32E. As shown in FIG. 17, the three-dimensional ultrasonic image may be displayed so as to be superimposed on the schematic image 20a1 of the probe tip 20a.

Further, the progress extrapolation line 22E5 of the biopsy needle 22 may be displayed superimposed on the three-dimensional ultrasonic image 22E4 of the biopsy needle 22, or may be displayed superimposed on the warning text from the warning generating means 53. Good.
Of course, not only the three-dimensional ultrasonic image 22E4 of the biopsy needle 22 but also an ultrasonic image of a lesion in the lumen may be displayed together, or a three-dimensional Doppler image may be displayed together.
The display means for performing the three-dimensional display may be a normal monitor, but a known three-dimensional display device such as a hologram display device is preferable.

  Since the ultrasonic diagnostic apparatus 3 of the present embodiment illustrates the traveling direction of the biopsy needle 22 three-dimensionally, the surgeon can easily know the traveling direction of the biopsy needle 22, and the biopsy needle can be more reliably And it can puncture more safely.

  The present invention is not limited to the above-described embodiments, and various changes and modifications can be made without departing from the scope of the present invention.

1 is a configuration diagram of an ultrasonic diagnostic apparatus according to a first embodiment of the present invention. It is a perspective view of the front-end | tip part of the probe concerning the 1st Embodiment of this invention. It is the (A) front view and (B) side view in the probe insertion direction of the front-end | tip part of the probe concerning the 1st Embodiment of this invention. It is a perspective view of the front-end | tip part of the probe concerning the 1st Embodiment of this invention. It is the (A) front view and (B) side view in the probe insertion direction of the front-end | tip part 20a of the probe concerning the 1st Embodiment of this invention. It is a figure which shows the display screen for demonstrating operation | movement of the ultrasonic diagnosing device concerning the 1st Embodiment of this invention. It is a figure which shows the display screen for demonstrating operation | movement of the ultrasonic diagnosing device concerning the 1st Embodiment of this invention. It is a figure which shows the display screen for demonstrating operation | movement of the ultrasonic diagnosing device concerning the 1st Embodiment of this invention. It is a figure which shows the display screen for demonstrating operation | movement of the ultrasonic diagnosing device concerning the 1st Embodiment of this invention. It is a figure which shows the display screen for demonstrating operation | movement of the ultrasonic diagnosing device concerning the 1st Embodiment of this invention. It is a figure which shows the display screen for demonstrating operation | movement of the ultrasonic diagnosing device concerning the 1st Embodiment of this invention. It is a flowchart of operation | movement of the ultrasonic diagnosing device concerning the 1st Embodiment of this invention. It is a block diagram of the ultrasonic diagnosing device concerning the 2nd Embodiment of this invention. It is a display screen for demonstrating operation | movement of the ultrasonic diagnosing device of the 2nd Embodiment of this invention. It is a display screen for demonstrating operation | movement of the ultrasonic diagnosing device of the 2nd Embodiment of this invention. It is a display screen for demonstrating operation | movement of the ultrasonic diagnosing device of the 2nd Embodiment of this invention. It is a display screen of the ultrasonic diagnosing device concerning the 3rd Embodiment of this invention.

Explanation of symbols

1, 2, 3 ... Ultrasound diagnostic device, 2 ... Ultrasound diagnostic device, 20a ... Probe tip, 22 ... Biopsy needle, 22E ... Biopsy needle image, 31 ... Convex scanning transducer, 31E ... Convex image, 32 ... Radial Scanning vibrator, 32E ... radial image, 43 ... image generation unit, 48 ... biopsy needle image detection means, 49 ... puncture guide setting means, 50 ... puncture guide image memory, 51 ... image composition means, 52 ... determination means, 53 ... Warning generating means, 54 ... biopsy needle progress estimating means, 60 ... input means, 70 ... display means, 75 ... puncture guide, 80 ... warning means

Claims (5)

A radial scanning vibrator that scans in a circle in a plane perpendicular to the probe axis;
A convex scanning vibrator that scans in a plane orthogonal to the radial scanning vibrator;
An ultrasonic diagnostic apparatus comprising a biopsy needle that is parallel to the probe axis and protrudes within the scanning plane of the convex scanning transducer;
Biopsy needle image detection means for detecting an ultrasonic image of the biopsy needle in a radial image scanned by the radial scanning transducer;
An allowable range setting means for setting an allowable range of the position of the ultrasonic image of the biopsy needle in the radial image;
Determining means for determining whether the position of the ultrasonic image of the biopsy needle detected by the biopsy needle image detecting means is within an allowable range set by the allowable range setting means;
An ultrasonic diagnostic apparatus comprising: warning generation means for issuing a warning based on the determination by the determination means. From the ultrasound image of the biopsy needle, comprising biopsy needle progress estimation means for creating a progress extrapolation line of the biopsy needle,
Determining means for determining whether the biopsy needle advancement extrapolation line is within an allowable range set by the allowable range setting means;
An ultrasonic diagnostic apparatus comprising: warning generation means for issuing a warning based on the determination by the determination means.   The ultrasonic diagnostic apparatus according to claim 1, further comprising an image composition unit configured to compose a three-dimensional image from the radial image and the convex image scanned by the convex scanning transducer.   The ultrasonic diagnostic apparatus according to claim 1, wherein the allowable range setting unit sets the allowable range by setting an allowable range width.   The ultrasonic diagnostic apparatus according to any one of claims 1 to 4, wherein the biopsy needle is a high-echo processed biopsy needle.

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