JP5771806B1 - Ultrasonic probe, ultrasonic image display device, puncture guide attachment - Google Patents

Abstract

It is an object of the present invention to provide an ultrasonic probe that can easily and reliably puncture a subject with a puncture needle. In the probe main body 12 of the ultrasonic probe 3, a positioning recess 30 is provided on the extension line L 0 of the ultrasonic transducer array 25 and on the edge 20 a of the transducer installation surface 20. The side surface 22 is provided with a plurality of probe side engaging portions 28 to which the puncture guide attachment 14 can be fixed. The puncture needle guide portion 34 of the attachment 14 is provided with a guide groove 33 formed with an opening 41 for introducing the puncture needle and a bottom portion 42 for contacting the puncture needle. The sandwiching and fixing portion 36 of the attachment 14 is provided with a plurality of arm portions 35 in which a plurality of attachment side engagement portions 37 are formed. The insertion angle of the puncture needle is adjusted in multiple stages by changing the position of the bottom portion 42 by changing the engagement position of the attachment side engagement portion 37.

Description

  The present invention relates to an ultrasonic probe that performs puncturing of a puncture needle while confirming the position of the puncture needle using an ultrasonic image, an ultrasonic image display device, and an attachment for a puncture guide.

  In medical practice, puncture of living tissue (subject) such as general injection, nerve block injection, blood sampling, and catheter insertion is widely performed. When performing treatments such as nerve block injection and catheter insertion, biological tissue may be damaged unless the target site is punctured accurately. In such a background, in recent years, an ultrasonic guide technique has been used in which puncture is performed while observing the state of a target region with an ultrasonic image.

  Conventionally, in an apparatus using an ultrasonic guide, one tomographic image is displayed and puncture is performed. With this apparatus, only one of a short-axis image (transverse section) and a long-axis image (longitudinal section) can be confirmed. Therefore, even when a blood vessel is pierced by a puncture needle or a tissue such as a nerve is damaged, there is a problem that it is not noticed.

  In order to solve this problem, two orthogonal cross sections (cross section and longitudinal section) are scanned simultaneously to display ultrasonic images (short axis image and long axis image) of each section, and puncture while observing these images An angiography apparatus has been proposed (see, for example, Patent Document 1).

Japanese Patent No. 5292581

  However, even when puncturing is performed using the angiography apparatus of Patent Document 1, the insertion angle of the puncture needle is adjusted while confirming two tomographic images (transverse and vertical cross-sectional images), and the target site In order to perform puncture surely, a certain amount of skill is required. For this reason, an improvement in the structure for guiding the puncture needle has been desired so that an operator with little work experience using the angiographic apparatus can puncture easily and reliably without damaging the living tissue. . The improvement of the structure for guiding the puncture needle is not limited to the ultrasonic probe that performs puncturing while confirming two tomographic images as in Patent Document 1. That is, it is desired to improve the structure for guiding the puncture needle even in an ultrasonic probe that performs puncture while confirming one tomographic image.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide an ultrasonic probe, an ultrasonic image display device, and a puncture guide attachment that can easily and reliably puncture a subject with a puncture needle. It is to provide.

  In order to solve the above-mentioned problem, the invention according to claim 1 is used in an ultrasonic image display device capable of displaying a tomographic image of a subject, in order to linearly scan ultrasonic waves to obtain the tomographic image. A plurality of ultrasonic transducers arranged linearly, a transducer installation surface that contacts the subject and transmits and receives the ultrasound, a rear surface on the opposite side of the transducer installation surface, and the transducer installation A probe body having a plurality of side surfaces between an outer surface and an outer surface; and a predetermined puncture needle that is detachably fixed to the outer surface of the probe body and has a puncture needle set along a cross section indicated by the tomographic image An ultrasonic probe comprising a puncture guide attachment for guiding the puncture needle to be inserted into the subject at an angle of the probe body, on the extension line of the ultrasonic transducer array and in the probe body A positioning recess for determining the insertion position of the puncture needle with respect to the subject is provided at the edge of the child installation surface to contact the distal end side of the puncture needle, and the attachment for the puncture guide can be fixed to the outer surface A plurality of probe side engaging portions, and the puncture guide attachment protrudes at a position spaced apart from the transducer installation surface to the rear surface side, and the supervising view is projected from the transducer installation surface side. A puncture needle guide portion having a guide groove formed so as to extend along an extension line of the acoustic wave transducer array and a plurality of arm portions sandwiching and fixing the probe main body extend to the opposite side of the puncture needle guide portion. A plurality of attachment side engagement portions that are selectively engaged with the plurality of probe side engagement portions are formed on the plurality of arm portions that are in contact with the outer surface. The guide groove is provided with an opening for introducing the puncture needle and a bottom portion for contacting the introduced puncture needle, and the combination of the bottom portion and the positioning concave portion When the insertion angle of the puncture needle is determined, and the position of the bottom portion is changed by changing the engagement position of the plurality of attachment side engagement portions with respect to the plurality of probe side engagement portions, the insertion angle of the puncture needle is increased. The gist of the ultrasonic probe is that it can be adjusted step by step.

  Therefore, according to the first aspect of the present invention, the positioning recess of the probe main body is provided on the extension line of the ultrasonic transducer array and on the edge portion of the transducer installation surface, and the guide groove of the puncture guide attachment is It is formed along the extended line of the ultrasonic transducer array. For this reason, the puncture needle can be reliably guided along the cross section indicated by the tomographic image by introducing the puncture needle into the guide groove and bringing its tip into contact with the positioning recess. Further, the insertion angle of the puncture needle is determined by bringing the puncture needle into contact with the bottom of the guide groove in the puncture needle guide portion while the tip of the puncture needle is in contact with the positioning recess of the probe body. Here, since the puncture needle guide portion is provided at a position spaced from the transducer installation surface to the rear side, a sufficient distance between the positioning recess and the bottom portion can be secured, and the insertion angle of the puncture needle can be accurately set. Can be determined. In addition, a plurality of probe side engaging portions are provided on the outer surface of the probe main body, and a plurality of attachment side engaging portions formed on the arm portion of the puncture guide attachment are selectively selected as the probe side engaging portions. Engage with. As a result, the puncture guide attachment is detachably fixed to the outer surface of the probe body. Furthermore, when the engagement position of the plurality of attachment side engagement portions with respect to the plurality of probe side engagement portions is changed, the position of the bottom portion of the guide groove is changed with respect to the positioning recess of the probe body. Therefore, the insertion angle of the puncture needle can be adjusted in multiple steps by changing the position of the bottom by changing the engagement position of the attachment side engagement portion. Further, since the guide groove is formed along the extension line of the ultrasonic transducer array, the puncture needle can be reliably inserted along the cross section indicated by the tomographic image without deviating from the cross section. Furthermore, when the puncture needle is inserted into the blood vessel using the ultrasonic probe of the present invention, for example, when the inserted puncture needle reaches the blood vessel wall, the needle tip does not penetrate the blood vessel wall and the blood vessel wall is tent-shaped. Recessed (tenting). In this state, if the puncture needle is moved to the opening side along the guide groove and the angle of the puncture needle is changed from large to small, the needle tip can be safely and reliably penetrated into the blood vessel wall. Thereafter, while maintaining the puncture state of the puncture needle (while leaving the puncture route), the probe main body is moved along the guide groove, and an ultrasonic probe (attachment for puncture guide and probe main body) is passed through the guide groove opening. It can be easily removed from the puncture needle. Furthermore, in the ultrasonic probe of the present invention, the puncture guide attachment can be detached from the probe body. For this reason, the attachment for puncture guide can be made into a disposable type (disposable) attachment. Further, even when the puncture guide attachment is reused, the attachment can be easily sterilized by removing the puncture guide attachment from the probe body. Therefore, when the ultrasonic probe of the present invention is used, hygiene can be performed hygienically while maintaining cleanliness.

  According to a second aspect of the present invention, in the first aspect, the ultrasonic image display device includes a first tomographic image showing a transverse section of the subject and a second tomographic image showing a longitudinal section orthogonal to the transverse section. In the probe main body, the plurality of ultrasonic transducers are linearly arranged along a short axis direction corresponding to the transverse section and a long axis direction corresponding to the longitudinal section, respectively. The puncture needle guide portion in the puncture guide attachment is provided to guide the puncture needle along the longitudinal section indicated by the second tomographic image, and the guide groove in the puncture needle guide portion is The gist of the invention is that it is formed so as to extend along an extension line of the ultrasonic transducer array arranged linearly along the major axis direction in a projection view from the transducer installation surface side. To do.

  Therefore, according to the second aspect of the present invention, in the probe body, a plurality of ultrasonic transducers arranged in the minor axis direction are used, and the ultrasonic wave is scanned in the minor axis direction, whereby the cross section of the subject is obtained. Image data of the first tomographic image shown is acquired, and the first tomographic image is displayed on the display device. In addition, by using a plurality of ultrasonic transducers arranged in the long axis direction in the probe body and scanning the ultrasonic waves in the long axis direction, image data of a second tomographic image showing a longitudinal section of the subject is acquired. Then, the second tomographic image is displayed on the display device. The puncture needle is guided along the longitudinal section by the puncture needle guide portion of the puncture guide attachment. Here, it is also possible to display the first tomographic image so that the puncture needle is located at the center of the cross section. In this way, the position of the puncture needle can be easily confirmed from the first tomographic image and the second tomographic image, and the puncture needle can be reliably punctured without damaging nerves or arteries around the treatment portion in the subject. can do.

  According to a third aspect of the present invention, in the second aspect, a plurality of the probe side engaging portions are arranged at equal intervals along the major axis direction on the side surface of the probe main body parallel to the major axis direction. And the attachment-side engagement portion has the same interval as the arrangement interval of the probe-side engagement portion on the inner surface of the plurality of arm portions in the puncture guide attachment, and The gist thereof is a plurality of engaging convex portions or engaging concave portions disposed along the long axis direction.

  Therefore, according to the third aspect of the present invention, the position of the bottom portion of the guide groove is moved in the major axis direction by changing the engagement position of the attachment side engagement portion with respect to the probe side engagement portion of the probe body. Can do. Therefore, the insertion angle of the puncture needle can be reliably changed without the puncture needle being detached from the longitudinal section indicated by the second tomographic image in the long axis direction. Further, in the probe main body, the side surface parallel to the long axis direction has a sufficient length, so that more probe side engaging portions can be provided along the long axis direction. In this case, a sufficient amount of slide required for angle adjustment can be ensured.

  According to a fourth aspect of the present invention, in any one of the first to third aspects, the puncture guide attachment is slid in the long axis direction to adjust the amount of pinching by the plurality of arm portions, and The gist is to change the engagement position of the attachment-side engagement portion with respect to the probe-side engagement portion.

  Therefore, according to the fourth aspect of the present invention, the guide groove is adjusted by changing the engagement positions of the plurality of attachment-side engagement portions with respect to the plurality of probe-side engagement portions by adjusting the amount of pinching by the plurality of arm portions. The position of the bottom is moved in the long axis direction. In this way, the insertion angle of the puncture needle can be changed more reliably without the puncture needle being detached from the longitudinal section indicated by the second tomographic image in the long axis direction.

  The gist of a fifth aspect of the present invention is that, in any one of the first to fourth aspects, the probe-side engagement portion and the attachment-side engagement portion are rectangular.

  Therefore, according to the fifth aspect of the present invention, since the probe-side engagement portion and the attachment-side engagement portion are square, it is possible to reliably prevent linear movement and rotational movement of the puncture guide attachment. The puncture guide attachment can be securely fixed to the main body.

  According to a sixth aspect of the present invention, the ultrasonic probe according to any one of the second to fifth aspects is mounted, a first tomographic image showing a transverse section of the subject, and a longitudinal section orthogonal to the transverse section. An ultrasonic image display device including an image display unit capable of simultaneously displaying a second tomographic image showing a surface, and displaying a guideline indicating a direction in which the puncture needle advances on the first tomographic image; A guideline display means for displaying a guideline indicating a course at an insertion angle of the puncture needle according to a current engagement position of the attachment side engagement portion on the second tomographic image is provided. The gist of the sound image display device is as follows.

  Therefore, according to the sixth aspect of the present invention, the guideline indicating the direction in which the puncture needle advances is displayed on the first tomographic image showing the cross section of the subject, and the second tomographic image showing the longitudinal section of the subject. Above, the guideline at the insertion angle of the puncture needle corresponding to the current engagement position of the attachment side engagement portion is displayed. In this case, according to each guideline, the puncture needle can be reliably punctured on the treatment portion (a tissue such as a vein or a nerve) of the subject while confirming the course of the puncture needle and the insertion angle of the puncture needle.

  In addition to the guideline which shows the course at the insertion angle of the puncture needle according to the present engagement position of the attachment side engagement part, the guideline display means in the invention according to claim 7, The gist is to display on the second tomographic image an angle adjustment guideline indicating a course at another insertion angle.

  Therefore, according to the seventh aspect of the invention, on the second tomographic image, in addition to the guideline indicating the course at the insertion angle of the puncture needle, the guideline for angle adjustment indicating the course at the other insertion angle is displayed. Therefore, the insertion angle suitable for the treatment part of the subject can be visually confirmed. When the insertion angle needs to be changed, the insertion angle suitable for the treatment section can be easily obtained by moving the puncture guide attachment relative to the probe body and changing the engagement position of the attachment side engagement portion. Can be adjusted.

  The invention according to claim 8 further comprises position information input means for inputting position information according to the engagement position of the attachment side engaging part with respect to the plurality of probe side engaging parts in claim 6 or 7. The guideline display means determines the insertion angle of the puncture needle according to the engagement position based on the position information input by the position information input means, and indicates the course at the insertion angle. Is displayed on the second tomographic image.

  Therefore, according to the eighth aspect of the present invention, the position information input means inputs position information corresponding to the current engagement position of the attachment-side engagement portion, so that the puncture needle corresponding to the engagement position is input. A guideline indicating a course at the insertion angle is displayed on the second tomographic image. As a result, the puncture needle can be reliably inserted into the subject at the insertion angle indicated by the guideline on the second tomographic image.

  A ninth aspect of the present invention provides the method according to any one of the sixth to eighth aspects, wherein in the first tomographic image and the second tomographic image, a portion having a temporal change is compared with a portion having no temporal change. The gist of the invention is to further include identification display means for performing identification display by changing the color or luminance.

  Therefore, according to the ninth aspect of the present invention, in the ultrasonic image display device, the ultrasonic scanning using the ultrasonic probe is repeatedly performed, and the first tomographic image and the second tomographic image are updated for each scanning. The At this time, in the first tomographic image and the second tomographic image, a portion having a temporal change is identified and displayed by changing a color or luminance with respect to a portion having no temporal change. In this case, the portion of the blood vessel wall with pulsation, the moving portion of the needle tip of the puncture needle, the deformed portion of the blood vessel wall due to tenting of the puncture needle, etc. are displayed with a color or brightness different from the peripheral portion without deformation. Therefore, the puncture needle can be reliably inserted while avoiding the artery. Furthermore, since the tenting operation can be performed appropriately, the needle tip of the puncture needle can be penetrated safely and reliably into the blood vessel wall.

  In a tenth aspect of the present invention, a plurality of ultrasonic transducers are linearly arranged, and are detachably fixed to the outer surface of the probe main body of an ultrasonic probe that scans ultrasonic waves to obtain a tomographic image of the subject. A puncture guide attachment for guiding the puncture needle so that the puncture needle is inserted into the subject at a predetermined angle along the tomographic image, and the plurality of ultrasonic vibrations in the probe body Provided in a state of projecting from the transducer installation surface on which the child is disposed to the rear surface side of the probe body, and on the extension line of the ultrasonic transducer array in a projected view from the transducer installation surface side A puncture needle guide portion having a guide groove formed so as to extend along and a plurality of arms for sandwiching and fixing the probe main body are provided so as to extend to the opposite side of the puncture needle guide portion. A plurality of arm portions that are in contact with an outer surface, and a pinching and fixing portion in which a plurality of attachment-side engaging portions that are selectively engaged with a plurality of probe-side engaging portions provided in the probe body are formed. The guide groove is provided with an opening for introducing the puncture needle and a bottom portion for contacting the introduced puncture needle, and the bottom portion and a positioning recess provided in the probe body. The insertion angle of the puncture needle is determined by the combination, and the position of the bottom portion is changed by changing the engagement position of the plurality of attachment side engagement portions with respect to the plurality of probe side engagement portions. The gist of the puncture guide attachment is characterized in that the angle can be adjusted in multiple stages.

  Therefore, according to the invention described in claim 10, the puncture needle is brought into contact with the bottom portion of the guide groove in the puncture needle guide portion while the needle tip of the puncture needle is brought into contact with the positioning recess of the probe body. The insertion angle of the needle is determined. The puncture needle guide part is provided at a position spaced from the transducer installation surface, which is the front surface, to the rear side, so that a sufficient distance between the positioning recess and the bottom part can be secured, and the insertion angle of the puncture needle can be accurately set. Can be determined. In addition, a plurality of probe side engagement portions are provided on the outer surface of the probe main body, and a plurality of attachment side engagements formed on the arm portions of the clamping and fixing portions of the puncture guide attachment are attached to the probe side engagement portions. The parts are selectively engaged. As a result, the puncture guide attachment is detachably fixed to the outer surface of the probe body. Furthermore, when the engagement position of the plurality of attachment side engagement portions with respect to the plurality of probe side engagement portions is changed, the position of the bottom portion of the guide groove is changed with respect to the positioning recess of the probe body. Therefore, the insertion angle of the puncture needle can be adjusted in multiple steps by changing the position of the bottom by changing the engagement position of the attachment side engagement portion. Further, since the guide groove is formed along the extension line of the ultrasonic transducer array, the puncture needle can be reliably inserted along the cross section indicated by the tomographic image without deviating from the cross section. Furthermore, the angle of the puncture needle can be changed from large to small by moving the puncture needle toward the opening along the guide groove. For this reason, after the tenting operation of the puncture needle, the needle tip can penetrate the blood vessel wall safely and reliably by changing the angle so that the puncture needle follows the direction of the blood vessel. Further, when the puncture guide attachment of the present invention is used, the puncture guide attachment (ultrasonic probe) can be removed from the puncture needle while maintaining the puncture state of the puncture needle (while leaving the puncture route). Furthermore, since the puncture guide attachment of the present invention can be removed from the probe body, the puncture guide attachment can be a disposable type (disposable) attachment. In addition, even when the puncture guide attachment is reused, the attachment can be sterilized easily. Therefore, when the puncture guide attachment of the present invention is used, hygiene can be performed hygienically while maintaining cleanliness.

  The invention according to an eleventh aspect is the invention according to the tenth aspect, wherein the probe main body is brought into contact with two side surfaces parallel to the arrangement direction of the ultrasonic transducer array in the probe main body. The gist is that a pair of arm portions sandwiched and fixed are provided as the plurality of arm portions.

  Therefore, according to the invention described in claim 11, in the probe main body, the two side surfaces parallel to the arrangement direction of the ultrasonic transducer array have a sufficient length in the arrangement direction. For this reason, it is possible to secure a sufficient contact area with the side surface by sandwiching each side surface of the probe main body by the pair of arm portions of the clamping and fixing portion, and it is possible to reliably fix the puncture guide attachment to the probe main body. .

  The gist of the invention described in claim 12 is that, in claim 11, the plurality of attachment side engaging portions are engaging convex portions projecting on the inner surfaces facing each other in the pair of arm portions. .

  Therefore, according to the twelfth aspect of the present invention, since the plurality of attachment-side engaging portions formed on the inner surfaces of the pair of arm portions are engaging convex portions, each compared with the case where the engaging concave portions are formed. It can be set as the structure which is easy to maintain the intensity | strength of an arm part.

  The gist of the invention described in claim 13 is that, in claim 12, the pair of arm portions includes a plurality of engaging protrusions arranged at equal intervals along the direction in which the pair of arm portions extend. And

  Therefore, according to the invention of claim 13, the pair of arm portions includes a plurality of engaging convex portions arranged at equal intervals along the direction in which the arm portions extend, and the engaging convex portions are the probe. It is engaged with a plurality of engaging recesses arranged on the side surface of the main body. In this case, the puncture guide attachment can be reliably fixed in a state where the arm portion has a width in the extending direction.

  As described above in detail, according to the first to thirteenth aspects of the present invention, it is possible to puncture the subject simply and reliably.

1 is a front view showing an angiography apparatus according to an embodiment. 1 is a block diagram showing an electrical configuration of an angiography apparatus according to an embodiment. Explanatory drawing which shows the short-axis image and long-axis image of one Embodiment. 1 is an exploded perspective view showing an ultrasonic probe according to an embodiment. The perspective view which shows the probe main body seen from the bottom face side. The top view which shows the attachment for puncture guides. The side view of the ultrasonic probe which shows the insertion angle of a puncture needle. The side view of the ultrasonic probe which shows the insertion angle of a puncture needle. Explanatory drawing which shows a short-axis image and a long-axis image. The top view which shows the attachment for puncture guides of another embodiment. The side view which shows the ultrasonic probe of another embodiment. The side view which shows the ultrasonic probe of another embodiment. The disassembled perspective view which shows the ultrasonic probe of another embodiment.

  Hereinafter, an embodiment in which the present invention is embodied in an angiography apparatus as an ultrasonic image display apparatus will be described in detail with reference to the drawings. FIG. 1 is a front view showing an angiographic apparatus 1 according to the present embodiment, and FIG. 2 is a block diagram showing an electrical configuration of the angiographic apparatus 1.

  As shown in FIGS. 1 and 2, the angiography apparatus 1 includes an apparatus main body 2 and an ultrasonic probe 3 connected to the apparatus main body 2. An angiography apparatus 1 according to the present embodiment is an apparatus used when, for example, a puncture needle 6 such as a catheter is inserted into a vein 5 in a living tissue 4 (subject). One tomographic image 8 (short axis image) and a second tomographic image 9 (long axis image) showing a longitudinal section of the vein 5 are simultaneously displayed (see FIG. 3).

  The ultrasonic probe 3 includes a signal cable 11, a probe main body 12 connected to the distal end of the signal cable 11, a puncture guide attachment 14 that is detachably fixed to the probe main body 12, and a base end of the signal cable 11. And a probe-side connector 15 provided on the device. A connector 16 is provided in the apparatus main body 2, and a probe-side connector 15 of the ultrasonic probe 3 is connected to the connector 16.

  The ultrasonic probe 3 is a linear probe for performing linear electronic scanning, and, for example, linearly scans ultrasonic waves of 5 MHz. As shown in FIGS. 4 and 5, the probe main body 12 of the ultrasonic probe 3 is in contact with the biological tissue 4 to transmit / receive ultrasonic waves, and the rear surface on the opposite side of the transducer installation surface 20. 21 and a plurality of side surfaces 22 between the vibrator installation surface 20 and the rear surface 21 as outer surfaces. A plurality of ultrasonic transducers 24 are arranged on the transducer installation surface 20 of the probe main body 12 so that the arrangement directions are orthogonal to each other and are substantially T-shaped. More specifically, in the probe main body 12, a plurality of ultrasonic transducers 24 are linearly arranged along the short-axis direction Y corresponding to the transverse section and the long-axis direction X corresponding to the longitudinal section. The ultrasonic transducer array 25 in the major axis direction X is disposed along the center line L0 of the probe main body 12 on the transducer installation surface 20. That is, in the present embodiment, the extension line L0 of the ultrasonic transducer array 25 in the major axis direction X and the center line L0 of the probe main body 12 coincide with each other on the transducer installation surface 20. Furthermore, the ultrasonic transducer array 25 in the major axis direction X is arranged so that the start end of the ultrasound transducer array 25 is positioned at the approximate center of the ultrasound transducer array 26 in the minor axis direction Y.

  In the ultrasonic probe 3 of the present embodiment, the scanning of the ultrasonic waves in the substantially T-shaped ultrasonic transducer arrays 25 and 26 is, for example, one end of the ultrasonic transducer array 26 in the short axis direction Y (for example, FIG. 2). Starting from the ultrasonic transducer 24 at the start end). Then, the elements are sequentially performed one by one toward the ultrasonic transducer 24 at the other end of the ultrasonic transducer array 26 in the short axis direction Y (for example, the terminal end at the left end in FIG. 2). Thereafter, the other end from the ultrasonic transducer 24 at one end of the ultrasonic transducer row 25 in the major axis direction X located at the approximate center of the ultrasonic transducer row 26 in the minor axis direction Y (the lower end in FIG. 2). Ultrasonic scanning is performed in order for each element toward the ultrasonic transducer 24 at the upper end (the upper end in FIG. 2).

  In the ultrasonic probe 3 of the present embodiment, the transducer installation surface 20 located on the bottom surface of the probe main body 12 is a contact surface with the biological tissue 4 and serves as a transmission / reception surface for transmitting and receiving ultrasonic waves. In the transducer installation surface 20, a substantially T-shaped acoustic lens 27 is disposed through a not-shown acoustic matching layer at a portion where the ultrasonic transducer arrays 25 and 26 are disposed in a substantially T-shape. Yes.

  In the probe main body 12, a plurality (ten in the present embodiment) of probe-side engagement portions 28 to which the puncture guide attachment 14 can be fixed are provided on a pair of side surfaces 22 parallel to the long axis direction X. . A plurality of probe-side engagement portions 28 are arranged at equal intervals along the long-axis direction X at positions on the rear surface 21 side that are spaced rearward from the transducer installation surface 20 on each side surface 22 of the probe main body 12. Yes. The probe-side engagement portion 28 is an engagement recess having a rectangular shape, and is formed to have a short side in the major axis direction X.

  In the probe main body 12, on the extension line of the ultrasonic transducer array 25 in the major axis direction X (center line L0 of the probe main body 12 in the transducer installation surface 20) and the edge 20a of the transducer installation surface 20 (FIG. 4 and FIG. A positioning recess 30 is provided in the left edge portion in FIG. The positioning recess 30 is a recess for determining the insertion position of the puncture needle 6 with respect to the living tissue 4 when the distal end side of the puncture needle 6 abuts. Further, on the transducer installation surface 20 of the probe main body 12 with which the living tissue 4 comes into contact, at both ends in the minor axis direction Y, the protruding strips 31 for avoiding compression of the observation site of the living tissue 4 are arranged in the major axis direction. It is provided along X. By providing the pair of ridges 31 apart from each other on the transducer installation surface 20 of the probe body 12, the region between the pair of ridges 31 on the transducer installation surface 20 side is not pressed too strongly. Therefore, the vein 5 at the observation site is prevented from being crushed, and the vein 5 can be punctured with certainty.

  As shown in FIGS. 4 and 6, the puncture guide attachment 14 is fixed by sandwiching the puncture needle guide portion 34 formed with the guide groove 33 for guiding the puncture needle 6 and the side surface 22 of the probe main body 12. And a clamping / fixing portion 36 provided with a pair of arm portions 35. The puncture guide attachment 14 has the puncture needle 6 positioned at the center of the transverse section indicated by the first tomographic image 8 and the puncture needle 6 at a predetermined angle along the longitudinal section indicated by the second tomographic image 9. The puncture needle 6 is guided to be inserted into 4. The puncture guide attachment 14 of this embodiment is a resin molded part formed using a flexible resin material, and is used as a disposable attachment.

  Each arm portion 35 of the holding and fixing portion 36 is provided so as to extend to the opposite side of the puncture needle guide portion 34. The arm portion 35 includes a plurality of attachment-side engagement portions 37 that are arranged at equal intervals along the direction in which the arm portion 35 extends (the long axis direction X of the probe main body 12). Specifically, in each arm portion 35, the inner surfaces 38 that face each other serve as contact surfaces that contact the side surface 22 of the probe main body 12. A plurality of attachment-side engagement portions 37 that are selectively engaged with the plurality of probe-side engagement portions 28 are disposed on the inner surfaces 38 of the arm portions 35. The attachment-side engagement portion 37 is an engagement convex portion having a rectangular shape in plan view, and has a short side in the arrangement direction of the ultrasonic transducer array 25 in the long axis direction X. Further, the attachment side engaging portions 37 are arranged on the inner surface 38 of each arm portion 35 along the long axis direction X with the same interval as the arrangement interval of the probe side engaging portions 28. Each arm portion 35 of the sandwiching and fixing portion 36 is formed in a relatively thin plate shape, and a force for sandwiching the side surface 22 of the probe main body 12 works by its elastic force.

  The puncture needle guide part 34 protrudes at a position spaced from the transducer installation surface 20 to the rear surface 21 side. The guide groove 33 of the puncture needle guide 34 is formed so as to extend along the extension line L0 of the ultrasonic transducer array 25 in a projection view from the transducer installation surface 20. The puncture needle guide portion 34 is composed of two rod-like members 40 that extend in a direction parallel to the arrangement direction of the ultrasonic transducer rows 25 in the major axis direction X and whose base end portions are connected to each other. The shape seen is substantially U-shaped. A gap provided between the two rod-shaped members 40 in the puncture needle guide portion 34 becomes the guide groove 33. In the puncture guide attachment 14, the puncture needle guide portion 34 is provided at a position higher than the clamping and fixing portion 36 (see FIG. 7 and the like).

  In a state where the puncture guide attachment 14 is attached to the probe body 12, the guide groove 33 is disposed on the center line L 0 of the probe body 12. The guide groove 33 is provided with an opening 41 for introducing the puncture needle 6 and a bottom portion 42 for contacting the introduced puncture needle 6. Further, the guide groove 33 of the puncture needle guide portion 34 is provided with a puncture needle introduction portion 43 formed so that the groove width gradually increases toward the opening 41 side.

  Then, as shown in FIG. 7, the insertion angle of the puncture needle 6 is determined by the combination of the bottom 42 of the guide groove 33 and the positioning recess 30 of the probe main body 12. That is, the needle tip of the puncture needle 6 is brought into contact with the positioning recess 30 of the probe main body 12 and the side surface of the puncture needle 6 is brought into contact with the bottom 42 of the guide groove 33, thereby inserting the puncture needle 6 into the living tissue 4. The angle is determined. Further, in the present embodiment, as shown in FIG. 8, the puncture guide attachment 14 is slid in the long axis direction X of the probe main body 12 to adjust the amount of pinching in the pair of arm portions 35, and a plurality of probe sides The engagement positions of the plurality of attachment side engagement portions 37 with respect to the engagement portion 28 are changed. The insertion angle of the puncture needle 6 determined by the bottom 42 and the positioning recess 30 is changed in multiple stages by changing the position of the bottom 42 of the guide groove 33 based on the change of the engagement position of the attachment side engagement portion 37. It has come to be adjusted. In the present embodiment, a plurality of attachment side engagement portions 37 are engaged with half or more (5 or more out of 10) of the plurality of probe side engagement portions 28. The puncture needle 6 is punctured. In this way, the puncture guide attachment 14 can be securely attached to the probe body 12. As a result, even if an external force is applied from the puncture needle 6 during puncturing, the bottom portion 42 of the guide groove 33 is fixed at a predetermined position without the puncture guide attachment 14 moving in any direction. It is possible to reliably puncture the puncture needle 6 at an insertion angle corresponding to the above.

  Next, the electrical configuration of the angiography apparatus 1 will be described in detail.

  As shown in FIG. 2, the apparatus main body 2 of the angiography apparatus 1 includes a controller 50, a pulse generation circuit 51, a transmission circuit 52, a reception circuit 53, a signal processing circuit 54, an image processing circuit 55, a memory 56, and a storage device 57. , An input device 58, a display device 59 (image display unit), and the like. The controller 50 is configured to include a known central processing unit (CPU), and executes a control program using the memory 56 to control the entire apparatus centrally.

  The pulse generation circuit 51 operates in response to a control signal from the controller 50, and generates and outputs a pulse signal having a predetermined period. The transmission circuit 52 includes a plurality of delay circuits (not shown) corresponding to the number of elements of the ultrasonic transducer 24 in the ultrasonic probe 3, and each ultrasonic vibration based on the pulse signal output from the pulse generation circuit 51. A drive pulse delayed according to the child 24 is output. The delay time of each drive pulse is set so that the ultrasonic wave output from the ultrasonic probe 3 is focused at a predetermined irradiation point.

  The reception circuit 53 includes a signal amplification circuit, a delay circuit, and a phasing addition circuit (not shown). In this receiving circuit 53, each reflected wave signal (echo signal) received by each ultrasonic transducer 24 in the ultrasonic probe 3 is amplified, and a delay time considering reception directivity is added to each reflected wave signal. After that, phasing addition is performed. By this addition, the phase difference between the reception signals of the ultrasonic transducers 24 is adjusted.

  The signal processing circuit 54 includes a logarithmic conversion circuit, an envelope detection circuit, an A / D conversion circuit, and the like (not shown). The logarithmic conversion circuit in the signal processing circuit 54 logarithmically converts the reflected wave signal, and the envelope detection circuit detects the envelope of the output signal of the logarithmic conversion circuit. The A / D conversion circuit converts the analog signal output from the envelope detection circuit into a digital signal.

  The image processing circuit 55 performs image processing based on the reflected wave signal output from the signal processing circuit 54 and generates image data of a B-mode ultrasound image (tomographic image). Specifically, the image processing circuit 55 generates image data with luminance corresponding to the amplitude (signal intensity) of the reflected wave signal. Image data generated by the image processing circuit 55 is sequentially stored in the memory 56. Here, image data of the first tomographic image 8 showing the transverse section of the living tissue 4 and the second tomographic image 9 showing the longitudinal section of the living tissue 4 are generated and stored in the memory 56. Based on the image data for one frame stored in the memory 56, the first tomographic image 8 and the second tomographic image 9 of the living tissue 4 are displayed on the display device 59 in black and white. Further, in the present embodiment, in the first tomographic image 8 and the second tomographic image 9, the part having temporal change is changed in color to the part having no temporal change (black and white display part), for example, red. The identification is displayed.

  The input device 58 includes a keyboard 61, a trackball 62, and the like, and is used for inputting requests and instructions from the user. The display device 59 is, for example, a display such as an LCD or a CRT, and is used to display a first tomographic image 8 and a second tomographic image 9 (see FIG. 3) of the living tissue 4 and an input screen for various settings. .

  As shown in FIG. 3, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the display screen of the display device 59 of the present embodiment. In addition, a guideline 65 indicating the advancing direction of the puncture needle 6 is displayed on the first tomographic image 8, and a guideline 66 indicating the course at the insertion angle of the puncture needle 6 is displayed on the second tomographic image 9. The The guide lines 65 and 66 on the first tomographic image 8 and the second tomographic image 9 are displayed with the same line type (specifically, broken line) and line color (specifically, yellow). Further, on the second tomographic image 9, in addition to the guideline 66 indicating the course at the insertion angle of the puncture needle 6, an angle adjustment guideline 67 indicating the path at another insertion angle is displayed. The angle adjustment guideline 67 is displayed lighter than the guideline 66.

  The storage device 57 is a magnetic disk device, an optical disk device or the like, and the storage device 57 stores a control program and various data. The controller 50 transfers programs and data from the storage device 57 to the memory 56 in accordance with instructions from the input device 58, and sequentially executes them. The program executed by the controller 50 may be a program stored in a storage medium such as a memory card, a flexible disk, or an optical disk, or a program downloaded via a communication medium, and is installed in the storage device 57 at the time of execution. Use.

  Next, an operation example when inserting the puncture needle 6 of the catheter into the vein 5 of the living tissue 4 using the angiography apparatus 1 of the present embodiment will be described below.

  Here, an operator such as a doctor first determines the insertion angle of the puncture needle 6 suitable for the treatment section of the patient. Then, the operator engages the plurality of attachment-side engaging portions 37 with the plurality of probe-side engaging portions 28 in the probe main body 12 so as to obtain the insertion angle, and attaches the probe main body 12 to the puncture guide attachment 14. Wear. Thereafter, the operator operates the keyboard 61 of the input device 58 as position information input means, and inputs position information corresponding to the engagement positions of the attachment side engagement portions 37 with respect to the plurality of probe side engagement portions 28. At this time, the controller 50 temporarily stores the position information in the memory 56.

  Further, the operator applies an acoustic medium (sterile gel or sterilized gel) to the surface of the biological tissue 4 serving as the treatment section, and then contacts the transducer installation surface 20 of the probe main body 12 through the acoustic medium. Thereafter, the operator operates a scan start button (not shown) provided on the input device 58. Then, the controller 50 determines the button operation, and starts processing for displaying the tomographic images 8 and 9 of the living tissue 4.

  In this process, the controller 50 operates the pulse generation circuit 51 to start transmission / reception of ultrasonic waves by the ultrasonic probe 3. Specifically, the pulse generation circuit 51 operates in response to a control signal output from the controller 50, and a pulse signal having a predetermined cycle is supplied to the transmission circuit 52. In the transmission circuit 52, a drive pulse having a delay time corresponding to each ultrasonic transducer 24 is generated based on the pulse signal and supplied to the ultrasonic probe 3. Thereby, each ultrasonic transducer | vibrator 24 of the ultrasonic probe 3 vibrates, and an ultrasonic wave is irradiated toward the biological tissue 4. FIG. A part of the ultrasonic wave propagating in the living tissue 4 is reflected by a tissue boundary surface (for example, blood vessel wall) in the living tissue 4 and received by the ultrasonic probe 3. At this time, the reflected wave is converted into an electric signal (reflected wave signal) by each ultrasonic transducer 24 of the ultrasonic probe 3. The reflected wave signal is amplified by the receiving circuit 53 and then input to the signal processing circuit 54.

  The signal processing circuit 54 performs signal processing such as logarithmic conversion, envelope detection, and A / D conversion, and a reflected wave signal converted into a digital signal is supplied to the image processing circuit 55. The image processing circuit 55 performs image processing for generating image data of the tomographic images 8 and 9 based on the reflected wave signal. Then, the controller 50 temporarily stores each image data generated by the image processing circuit 55 in the memory 56.

  The controller 50 reads out each image data stored in the memory 56 and generates data for one frame of the first tomographic image 8 and the second tomographic image 9. Further, the controller 50 as the guideline display means reads the position information stored in the memory 56, determines the insertion angle of the puncture needle 6 based on the position information, and guidelines 65, 66 and 66 corresponding to the insertion angle. Display data of the angle adjustment guideline 67 is generated. Thereafter, the controller 50 outputs the generated data of the tomographic images 8 and 9 and the display data of the guidelines 65 to 67 to the display device 59. As a result, as shown in FIG. 9, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the display screen of the display device 59 at the same time, and the guide lines 65 to 65 are displayed on the tomographic images 8 and 9. 67 are superimposed and displayed. In the present embodiment, ultrasonic scanning is repeatedly performed every predetermined time, and image data of the first tomographic image 8 and the second tomographic image 9 is generated and the data in the memory 56 is updated each time. . At this time, the controller 50 as the identification display means determines a portion having a temporal change based on the image data before update and the image data after update. Then, in the data of the first tomographic image 8 and the second tomographic image 9, the controller 50 obtains image data obtained by changing the color of a portion having a temporal change with respect to a portion having no temporal change (a monochrome display portion). Generate and output to the display device 59. As a result, in the first tomographic image 8 and the second tomographic image 9, a portion having a temporal change due to pulsation such as a blood vessel wall 70 of an artery is identified and displayed in red.

  The operator confirms the first tomographic image 8 and the second tomographic image 9 displayed on the display device 59 and adjusts the position of the ultrasonic probe 3. Specifically, as shown in FIG. 9, the operator captures a cross section of the vein 5 on the first tomographic image 8 (short axis image) and the guideline 65 on the first tomographic image 8 is a vein. The ultrasonic probe 3 is moved so as to be located at the center of 5. Furthermore, the ultrasonic probe 3 is moved so that the longitudinal section of the vein 5 is photographed along the second tomographic image 9 (long-axis image), and the direction in which the vein 5 extends (axial direction) and the probe main body 12. The major axis direction X is made to coincide.

  Thereafter, the operator determines whether or not the insertion angle of the puncture needle 6 indicated by the guideline 66 on the second tomographic image 9 is an angle suitable for puncturing the vein 5. Here, when there is a problem with the insertion angle of the puncture needle 6, after confirming the position of the angle adjustment guideline 67, the puncture guide attachment 14 is slid by the probe body 12 so that an appropriate insertion angle is obtained. The engagement positions of the plurality of attachment side engagement portions 37 with respect to the plurality of probe side engagement portions 28 are changed. Here, if there is a portion (red blood vessel wall 70 of the artery) displayed in red on the guide lines 65 and 66 indicating the course at the insertion angle of the puncture needle 6, the operator should avoid the artery. The position of the ultrasonic probe 3 is moved.

  Thereafter, the operator introduces the puncture needle 6 of the catheter through the opening 41 of the guide groove 33 in the puncture needle guide portion 34 of the puncture guide attachment 14. Then, the operator brings the needle tip of the puncture needle 6 into contact with the position of the positioning recess 30 of the probe main body 12, and after bringing the side surface of the puncture needle 6 into contact with the bottom 42 of the guide groove 33, Then, the puncture needle 6 is inserted. Then, as shown in FIG. 3, the puncture needle 6 is displayed in the first tomographic image 8 and the second tomographic image 9, and the needle tip 71 of the puncture needle 6 has a temporal change in the second tomographic image 9. As a part, it is identified and displayed in red. Further, the operator inserts the puncture needle 6 while confirming the insertion position of the puncture needle 6 based on the needle tip 71 of the puncture needle 6 displayed in red.

  When the needle tip 71 of the puncture needle 6 reaches the blood vessel wall of the vein 5, the needle tip 71 does not penetrate the blood vessel wall and the blood vessel wall is recessed in a tent shape (tenting). At this time, in addition to the needle tip 71 of the puncture needle 6, a recessed portion in the blood vessel wall is identified and displayed in red as a portion having a temporal change. When the operator determines that the tenting has sufficiently progressed based on the red display portion corresponding to the dent of the blood vessel wall, the operator moves the rear end side of the puncture needle 6 along the guide groove 33 to the side of the opening 41. Move to. As a result, the insertion angle of the puncture needle 6 is changed so that the puncture needle 6 follows the direction of the vein 5, so that the needle tip 71 easily penetrates the blood vessel wall of the vein 5, and the needle tip 71 becomes a blood vessel. Inserted inside. Based on the second tomographic image 9, the operator confirms that the needle tip 71 of the puncture needle 6 has reached the vein 5 and stops the puncture operation of the puncture needle 6. Thereafter, the operator operates a scan end button (not shown) provided on the input device 58. The controller 50 determines the button operation, and ends the process for displaying the tomographic images 8 and 9 of the living tissue 4.

  Further, the operator moves the probe main body 12 along the guide groove 33 while maintaining the puncture state of the puncture needle 6 (while leaving the puncture route). Then, the operator removes the ultrasonic probe 3 (the puncture guide attachment 14 and the probe main body 12) from the puncture needle 6 through the opening 41 of the guide groove 33. Thereafter, the operator performs a catheter operation, inserts the catheter into the vein 5 and performs a predetermined treatment.

  Therefore, according to the present embodiment, the following effects can be obtained.

  (1) In the ultrasonic probe 3 of the present embodiment, the positioning recess 30 of the probe main body 12 is provided on the extension line L0 of the ultrasonic transducer array 25 and on the edge 20a of the transducer installation surface 20, The guide groove 33 of the puncture guide attachment 14 is formed along the extension line L 0 of the ultrasonic transducer array 25. Therefore, by introducing the puncture needle 6 into the guide groove 33 and bringing its tip into contact with the positioning recess 30, the puncture needle 6 can be reliably guided along the longitudinal section indicated by the tomographic image 9. Further, the insertion of the puncture needle 6 is performed by bringing the puncture needle 6 into contact with the bottom 42 of the guide groove 33 in the puncture needle guide portion 34 with the distal end of the puncture needle 6 in contact with the positioning recess 30 of the probe body 12. The angle is determined. Here, since the puncture needle guide portion 34 is provided at a position separated from the transducer installation surface 20 toward the rear surface 21, the distance between the positioning concave portion 30 and the bottom portion 42 can be sufficiently secured. The insertion angle of the needle 6 can be accurately determined. Further, in the ultrasonic probe 3 of the present embodiment, a plurality of probe side engaging portions 28 are provided on the side surface 22 of the probe main body 12, and the probe side engaging portions 28 are attached to the puncture guide attachment 14. The plurality of attachment side engagement portions 37 formed are selectively engaged. As a result, the puncture guide attachment 14 is detachably fixed to the side surface 22 of the probe body 12. Furthermore, when the engagement positions of the plurality of attachment-side engagement portions 37 with respect to the plurality of probe-side engagement portions 28 are changed, the position of the bottom portion 42 of the guide groove 33 changes with respect to the positioning recess 30 of the probe main body 12. Therefore, the insertion angle of the puncture needle 6 can be adjusted in multiple steps by changing the position of the bottom portion 42 by changing the engagement position of the attachment side engagement portion 37. In addition, since the guide groove 33 is formed along the extension line L0 of the ultrasonic transducer array 25, the puncture needle 6 can be securely inserted along the cross section indicated by the second tomographic image 9 without departing from the cross section. Can be inserted.

  (2) In the ultrasonic probe 3 of the present embodiment, the angle of the puncture needle 6 can be changed by moving the puncture needle 6 toward the opening 41 along the guide groove 33. For this reason, after the tenting operation of the puncture needle 6, the needle tip 71 can be penetrated safely and reliably into the blood vessel wall by changing the angle so that the puncture needle 6 is aligned with the method of the vein 5. . Further, when the puncture guide attachment 14 of the present embodiment is used, the puncture guide attachment 14 (ultrasound probe 3) is attached to the puncture needle 6 while maintaining the puncture state of the puncture needle 6 (while leaving the puncture route). Can be removed from. Therefore, the treatment using the catheter can be performed easily and quickly without the ultrasonic probe 3 getting in the way. Furthermore, since the puncture guide attachment 14 of the present invention can be detached from the probe body 12, the puncture guide attachment 14 can be a disposable attachment. Even when the puncture guide attachment 14 is reused, the attachment 14 can be sterilized easily. Therefore, when the puncture guide attachment 14 of the present embodiment is used, hygiene can be performed in a hygienic manner while maintaining cleanliness.

  (3) In the ultrasonic probe 3 of the present embodiment, the probe main body 12 uses a plurality of ultrasonic transducers 24 arranged in the short axis direction Y, and scans the ultrasonic waves in the short axis direction Y, thereby causing veins. 5 is obtained, and the first tomographic image 8 is displayed on the display device 59. The probe main body 12 uses a plurality of ultrasonic transducers 24 arranged in the long axis direction X, and scans the ultrasonic waves in the long axis direction X, whereby a second tomographic image 9 showing a longitudinal section of the vein 5 is obtained. And the second tomographic image 9 is displayed on the display device 59. The puncture needle 6 is guided along the longitudinal section by the puncture needle guide portion 34 of the puncture guide attachment 14. In this way, the position of the puncture needle 6 in the living tissue 4 can be easily confirmed by the first tomographic image 8 and the second tomographic image 9, and the puncture needle can be obtained without damaging nerves or arteries around the treatment portion. 6 can be reliably punctured.

  (4) In the ultrasonic probe 3 of the present embodiment, the amount of pinching in the plurality of arm portions 35 is adjusted by sliding the puncture guide attachment 14 in the major axis direction X with respect to the probe body 12. Thereby, the engagement positions of the plurality of attachment side engagement portions 37 with respect to the plurality of probe side engagement portions 28 are changed, and the position of the bottom portion 42 of the guide groove 33 can be moved in the long axis direction X. For this reason, the insertion angle of the puncture needle 6 can be reliably changed without the puncture needle 6 being detached from the longitudinal section indicated by the second tomographic image 9 in the major axis direction X.

  (5) In the ultrasonic probe 3 of the present embodiment, the probe-side engaging portion 28 and the attachment-side engaging portion 37 have a rectangular shape having a short side in the long axis direction X that is the sliding direction of the attachment 14. In this case, since it is possible to provide more probe-side engagement portions 28 in the probe body 12, the puncture guide attachment 14 can be reliably fixed to the probe body 12. Moreover, since each engaging part 28 and 37 is rectangular shape, the linear movement and rotation movement of the attachment 14 for puncture guides can be prevented reliably.

  (6) In the angiography apparatus 1 of the present embodiment, a guideline 65 indicating the direction in which the puncture needle 6 advances is displayed on the first tomographic image 8 showing the transverse section of the vein 5 and the longitudinal section of the vein 5 is displayed. On the second tomographic image 9 shown, a guideline 66 at the insertion angle of the puncture needle 6 corresponding to the current engagement position of the attachment side engagement portion 37 is displayed. Therefore, the puncture needle 6 can be reliably punctured into the vein 5 while confirming the path of the puncture needle 6 in the living tissue 4 and the insertion angle of the puncture needle 6 according to the guidelines 65 and 66.

  (7) In the angiography apparatus 1 of the present embodiment, on the second tomographic image 9, in addition to the guideline 66 showing the course at the insertion angle of the puncture needle 6, angle adjustment showing the course at another insertion angle Since the guideline 67 for use is displayed, the insertion angle suitable for the vein 5 can be confirmed. If the insertion angle needs to be changed, the puncture guide attachment 14 is moved with respect to the probe main body 12 to change the engagement position of the attachment-side engagement portion 37, thereby making the insertion suitable for the vein 5. Can be easily adjusted to the angle.

  (8) In the angiography apparatus 1 of the present embodiment, in the first tomographic image 8 and the second tomographic image 9, the portion of the vascular wall 70 with pulsation, the moving portion of the needle tip 71 of the puncture needle 6, the puncture needle The deformed portion of the blood vessel wall due to the tenting of No. 6 is displayed in a color different from that of the peripheral portion without deformation. In this way, the puncture needle 6 can be reliably inserted avoiding the artery. In particular, since the puncture needle 6 is very thin, it is difficult to confirm the movement of the puncture needle 6 in the second tomographic image 9, but the needle tip 71 which is the most important part at the time of puncture is highlighted and displayed in a different color. Therefore, the movement of the needle tip 71 can be accurately grasped. Accordingly, the tenting operation can be performed appropriately, and the needle tip 71 of the puncture needle 6 can be penetrated safely and reliably into the blood vessel wall. In addition, a color Doppler method has been put into practical use as a method for displaying a blood flow on a black and white tomographic image by color-coding a portion having blood flow such as a blood vessel. When this color Doppler method is adopted, complicated processing such as fast Fourier transform is required, and the processing load increases, so that the frame rate of the image by ultrasonic scanning becomes slow. In contrast, in the present embodiment, since the blood vessel wall 70 and the needle tip 71 can be identified and displayed by a simple process such as comparing image data before and after update, the first tomographic image 8 and the second tomographic image are displayed. The frame rate of 9 can be increased. Accordingly, the tomographic images 8 and 9 can be displayed in real time, and the movement of the needle tip 71 can be confirmed accurately.

  (9) In the puncture guide attachment 14 of the present embodiment, the pinching and fixing portion 36 is brought into contact with the two side surfaces 22 parallel to the arrangement direction of the ultrasonic transducer array 25 in the probe main body 12, thereby A pair of arm portions 35 are provided to sandwich and fix them. In the probe main body 12, the two side surfaces 22 parallel to the arrangement direction of the ultrasonic transducer arrays 25 have a sufficient length in the arrangement direction. For this reason, the contact area with the side surface 22 can be sufficiently secured by sandwiching the side surfaces 22 of the probe main body 12 by the pair of arm portions 35, and the puncture guide attachment 14 is securely fixed to the probe main body 12. Can do.

  (10) In the puncture guide attachment 14 according to the present embodiment, the plurality of attachment-side engaging portions 37 are engaging convex portions projecting from the inner surfaces 38 facing each other in the pair of arm portions 35. Compared with the case where the concave portion is formed, the strength of each arm portion 35 can be easily maintained.

  (11) In the puncture guide attachment 14 of the present embodiment, the pair of arm portions 35 are provided with a plurality of engaging convex portions 37 arranged at equal intervals along the direction in which the arms 35 extend. Then, these engaging convex portions 37 are engaged with a plurality of engaging concave portions 28 disposed on the side surface 22 of the probe main body 12. In this case, since the puncture guide attachment 14 can be reliably fixed in a state where the arm portion 35 extends in the extending direction, the movement of the puncture guide attachment 14 relative to the probe body 12 can be reliably prevented. .

  (12) In the puncture guide attachment 14 of the present embodiment, since the groove width of the puncture needle introducing portion 43 provided on the opening 41 side in the guide groove 33 is wide, the guide groove extends from the puncture needle introducing portion 43. The puncture needle 6 can be easily introduced into 33.

  (13) In the puncture guide attachment 14 of the present embodiment, since the puncture needle guide portion 34 is constituted by the two rod-like members 40, the puncture guide attachment 14 can be formed in a compact manner. Therefore, when the puncture guide attachment 14 of the present embodiment is used, the ultrasonic probe 3 becomes easy to handle and the workability is improved. Specifically, since the surface area of the puncture needle guide portion 34 is reduced, the problem that the positioning recess 30 of the probe main body 12 is hidden by the puncture needle guide portion 34 and is difficult to confirm can be avoided.

  (14) In the ultrasonic probe 3 of the present embodiment, a pair of ridges 31 are provided along the major axis direction X at both ends in the minor axis direction Y on the transducer installation surface 20 of the probe body 12. ing. By providing the ridges 31 in this manner, even when the transducer mounting surface 20 of the probe main body 12 is pressed against the surface of the living tissue 4, it is possible to avoid compression of the observation site. Therefore, the vein 5 is not crushed and the puncture needle 6 can be punctured reliably.

  (15) In the angiography apparatus 1 of the present embodiment, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the display screen of the display device 59. In the first tomographic image 8 and the second tomographic image 9, the guide lines 65 and 66 are displayed with the same line type and line color. In this way, the position of the vein 5 and the position of the puncture needle 6 can be easily confirmed, so that the puncture needle 6 can be punctured quickly.

  In addition, you may change embodiment of this invention as follows.

  In the puncture guide attachment 14 of the above-described embodiment, the puncture needle guide portion 34 is formed by the two rod-like members 40 having the same length, but is not limited thereto. Like the puncture guide attachment 14A shown in FIG. 10, the two rod-shaped members 40A, 40B constituting the puncture needle guide portion 34A have different lengths, and the distal end portion of the relatively longer rod-shaped member 40A is You may form so that it may protrude from the front-end | tip part of the relatively short rod-shaped member 40B. When the puncture needle guide portion 34A is formed in this way, the puncture needle 6 can be easily guided into the guide groove 33 by applying the puncture needle 6 to the tip of the protruding rod-like member 40A. That is, the distal end portion of the relatively long rod-like member 40A can function as the puncture needle introduction portion 43A.

  In the ultrasonic probe 3 of the above embodiment, the probe side engaging portion 28 is an engaging concave portion and the attachment side engaging portion 37 is an engaging convex portion. The joining portion may be an engaging convex portion, and the attachment side engaging portion may be an engaging concave portion. Further, when the probe-side engagement portion 28A that is an engagement convex portion is formed on the side surface 22 of the probe body 12 as in the ultrasonic probe 3A shown in FIG. 11, a through-hole is formed as the attachment-side engagement portion 37A. Then, the attachment 14B for puncture guide may be fixed to the probe body 12 by fitting the attachment side engagement portion 37A of the through hole into the probe side engagement portion 28A.

  In the ultrasonic probe 3 of the above embodiment, the probe side engaging portions 28 and 28A and the attachment side engaging portions 37 and 37A are rectangular, but the present invention is not limited to this. For example, as in the ultrasonic probe 3B shown in FIG. 12, a cross-shaped probe side engagement portion 28B (engagement recess) is formed in the probe main body 12B, and the cross-shaped attachment side engagement is performed on the puncture guide attachment 14C. The portion 37B (engagement convex portion) may be formed. Further, a T-shaped or L-shaped probe side engaging portion and attachment side engaging portion may be formed, or a circular or elliptical probe side engaging portion and attachment side engaging portion may be formed. Also good.

  In the ultrasonic probe 3, 3A, 3B of the above embodiment, the puncture guide attachment 14 is slid in the long axis direction X with respect to the probe main body 12, 12A, 12B, and the engagement position of the attachment side engagement portion 37 However, the present invention is not limited to this. Specifically, in the case where a thick probe body 12C is used as in the ultrasonic probe 3C shown in FIG. 13, in the side surface 22A of the probe body 12C, there are a plurality in the height direction Z in addition to the major axis direction X. The probe side engaging portion 28 is formed. Then, the puncture guide attachment 14 is slid in the height direction Z of the probe main body 12C, and the engagement position of the attachment side engagement portion 37 is changed. Even in this case, since the position of the bottom 42 of the guide groove 33 is changed, the insertion angle of the puncture needle 6 can be adjusted in multiple steps.

  In the puncture guide attachments 14, 14 </ b> A to 14 </ b> C of the above embodiment, the puncture needle guide portions 34, 34 </ b> A are configured by the two rod-shaped members 40, 40 </ b> A, 40 </ b> B, but are not limited thereto. Instead, the puncture needle guide portion may be configured by a flat plate-like member. In the flat puncture needle guide portion, a guide groove is formed so that the opposite side of the clamping and fixing portion 36 opens. In this case, since the surface area of the flat puncture needle guide portion is increased, the puncture needle guide portion is formed using a transparent resin material. In this way, since the positioning concave portion 30 of the probe main body 12 can be easily confirmed through the flat puncture needle guide portion, the puncture needle 6 can be quickly inserted into the living tissue 4.

  In the ultrasonic probe 3 of the above-described embodiment, the clamping / fixing portion 36 in the puncture guide attachment 14 sandwiches and fixes the side surface 22 of the probe body 12 with the two arm portions 35. It is not limited. There may be provided a plurality of arm portions of three or more as the clamping and fixing portions, and the arm portions are fixed to the probe main body 12 by each arm portion. In addition, each arm portion 35 sandwiches the side surface 22 of the probe main body 12, but in addition to this, each arm portion is configured so as to sandwich and fix the outer surface such as the transducer installation surface 20 and the rear surface 21. May be. However, when fixing using the transducer installation surface 20, each arm portion is configured to sandwich the outer edge side avoiding the portion where the ultrasonic transducer 24 is disposed.

  In the angiography apparatus 1 of the above embodiment, the guideline 66 indicating the course at the insertion angle of the puncture needle 6 is displayed based on the position information input by operating the keyboard 61. However, the present invention is not limited to this. Is not to be done. Specifically, for example, the probe main body 12 is provided with position detection means (sensor or switch) for detecting the engagement position of the attachment side engagement portion 37 in the plurality of probe side engagement portions 28. Then, the controller 50 determines the insertion angle of the puncture needle 6 according to the engagement position detected by the position detection means, and displays the guideline 66 indicating the course at the insertion angle on the second tomographic image 9. It may be configured. In this way, since the insertion angle of the puncture needle 6 according to the engagement position of the attachment side engagement portion 37 can be automatically determined, the puncture needle 6 can be punctured quickly.

  In the angiography apparatus 1 of the above embodiment, the tomographic images 8 and 9 of the vein 5 are displayed and the treatment using the catheter is performed, but the angiography apparatus is used when performing other treatment such as blood sampling. 1 may be used. Further, the present invention is not limited to the angiography apparatus 1, and the present invention may be embodied in an ultrasonic image display apparatus that displays a tomographic image of a nerve other than a blood vessel and performs other treatment such as nerve block injection. .

  In the above embodiment, the probe main bodies 12 and 12A to 12C are embodied as the ultrasonic probes 3, 3A, and 3B in which a plurality of ultrasonic transducers 14 are arranged so as to be substantially T-shaped. However, the present invention is not limited to this. Is not to be done. The present invention may be embodied in a general linear scanning ultrasonic probe having a plurality of ultrasonic transducers linearly arranged in the probe body.

  In the above embodiment, the dedicated probe bodies 12 and 12A to 12C in which the probe-side engaging portions 28 having a predetermined shape are formed in advance are used. However, the present invention is not limited to this. For example, the probe body is on the outer surface of a general-purpose probe body. Existing recesses or the like may be used as a plurality of probe-side engaging portions.

Next, in addition to the technical ideas described in the claims, the technical ideas grasped by the embodiments described above are listed below.
(1) The ultrasonic probe according to claim 2, wherein a plurality of ultrasonic transducers are arranged in the probe main body so that the arrangement directions thereof are orthogonal to each other and are substantially T-shaped.

  (2) The ultrasonic probe according to claim 2, wherein the puncture guide attachment guides the puncture needle so that the puncture needle is positioned at a central portion of a transverse section indicated by the first tomographic image. .

  (3) In Claim 2, on the transducer installation surface of the probe main body, at both end portions in the short axis direction, protruding strips for avoiding compression of the observation site of the subject are in the long axis direction. An ultrasonic probe provided along the line.

  (4) The ultrasonic probe according to claim 5, wherein the probe-side engaging portion and the attachment-side engaging portion have a rectangular shape having a short side in the arrangement direction of the ultrasonic transducer array.

  (5) In any one of claims 1 to 5, the plurality of attachment-side engagement portions engage with more than half of the plurality of probe-side engagement portions. Ultrasonic probe.

  (6) The ultrasonic probe according to any one of claims 1 to 5, wherein the puncture guide attachment is a resin molded part.

  (7) The ultrasonic probe according to any one of claims 1 to 5, wherein the ultrasonic transducer array and the positioning recess are provided on a center line of the probe main body.

  (8) The guideline according to claim 6 or 7, further comprising position detection means provided on the probe main body for detecting an engagement position of the attachment side engagement portion with respect to the plurality of probe side engagement portions, The display means determines an insertion angle of the puncture needle according to the engagement position detected by the position detection means, and displays the guideline indicating a course at the insertion angle on the second tomographic image. An ultrasonic image display device.

  (9) The ultrasonic image display according to any one of claims 6 to 9, wherein the guide line is displayed in the same line type and line color in the first tomographic image and the second tomographic image. apparatus.

  (10) The ultrasonic image display device according to any one of claims 6 to 9, wherein the image display unit displays the first tomographic image and the second tomographic image side by side.

  (11) In any one of claims 10 to 13, the guide groove is provided with a puncture needle introduction portion formed so that the groove width gradually increases toward the opening. Features a puncture guide attachment.

  (12) The puncture needle guide portion according to any one of claims 10 to 13, wherein the puncture needle guide portion extends in a direction parallel to the arrangement direction of the ultrasonic transducer arrays and the base end portions are connected to each other. An attachment for puncture guide, wherein the guide groove is a gap provided between the two rod-shaped members.

  (13) In the technical idea (12), the two rod-shaped members constituting the puncture needle guide portion have different lengths, and the distal end portion of the longer rod-shaped member has the shorter length A puncture guide attachment, wherein the puncture guide attachment functions as the puncture needle introduction section while projecting from a distal end portion of the rod-shaped member.

  (14) The puncture guide attachment according to any one of claims 10 to 13, wherein the clamping and fixing portion is formed using a flexible material.

  (15) In any one of claims 10 to 13, the puncture needle guide portion is a flat guide portion, and the guide groove is formed in the puncture needle guide portion so that the opposite side of the clamping and fixing portion is open. An attachment for a puncture guide, characterized by being formed.

  (16) The attachment for puncture guide according to the technical idea (15), wherein the puncture needle guide portion is formed using a transparent resin material.

DESCRIPTION OF SYMBOLS 1 ... Angiography apparatus as an ultrasonic image display apparatus 3,3A-3C ... Ultrasonic probe 4 ... Biological tissue as a subject 5 ... Venus in a subject 6 ... Puncture needle 8 ... First tomographic image 9 ... Second Tomographic images 12, 12A to 12C ... Probe main body 14, 14A to 14C ... Attachment for puncture guide 20 ... Vibrator installation surface 20a ... End edge 21 ... Rear surface 22, 22A ... Side surface 24 ... Ultrasonic transducer 25 ... Long axis direction Ultrasonic transducer array 26 ... Ultrasonic transducer array 28, 28A, 28B ... Probe-side engaging portion 30 ... Positioning recess 33 ... Guide groove 34, 34A ... Puncture needle guide portion 35 ... Arm portion 36 ... Nipping and fixing portion 37, 37A, 37B ... Attachment side engaging portion 38 ... Inner surface of arm portion 41 ... Opening 42 ... Bottom portion 50 ... Controller 58 as guideline display means and identification display means 58 Position information extension line of the display device 65, 66 ... guidelines 67 ... angle adjustment guidelines L0 ... ultrasonic transducer as the input device 59 ... image display unit as an input unit X ... major axis direction Y ... minor axis direction

Claims (13)

It is used in an ultrasonic image display device that can display a tomographic image of a subject,
A plurality of ultrasonic transducers linearly arranged to linearly scan ultrasonic waves so as to acquire the tomographic image, and a transducer installation surface that transmits and receives the ultrasonic waves in contact with the subject; A probe body having a rear surface opposite to the transducer installation surface and a plurality of side surfaces between the transducer installation surface and the rear surface as outer surfaces;
A puncture guide attachment that is detachably fixed to the outer surface of the probe main body and guides the puncture needle so that the puncture needle is inserted into the subject at a predetermined angle along a cross section indicated by the tomographic image. An ultrasonic probe comprising:
In the probe body, a positioning recess that determines the insertion position of the puncture needle with respect to the subject by contacting the distal end side of the puncture needle on the extension line of the ultrasonic transducer array and on the edge portion of the transducer installation surface. A plurality of probe-side engagement portions capable of fixing the puncture guide attachment are provided on the outer surface;
The puncture guide attachment is:
A guide groove that protrudes at a position spaced from the transducer installation surface to the rear surface side and extends along an extension line of the ultrasonic transducer array in a projection view from the transducer installation surface side; A puncture needle guide part having
A plurality of arm portions for sandwiching and fixing the probe main body are provided so as to extend to the opposite side of the puncture needle guide portion, and the plurality of arm portions that contact the outer surface are connected to the plurality of probe side engaging portions. A plurality of attachment-side engaging portions that are selectively engaged with each other,
The guide groove is provided with an opening for introducing the puncture needle and a bottom portion for contacting the introduced puncture needle,
The insertion angle of the puncture needle is determined by the combination of the bottom and the positioning recess,
The insertion angle of the puncture needle can be adjusted in multiple steps by changing the position of the bottom by changing the engagement position of the plurality of attachment side engagement parts with respect to the plurality of probe side engagement parts. A characteristic ultrasonic probe. The ultrasonic image display device can simultaneously display a first tomographic image showing a transverse section of the subject and a second tomographic image showing a longitudinal section orthogonal to the transverse section,
In the probe body, the plurality of ultrasonic transducers are linearly arranged along a short axis direction corresponding to the transverse section and a long axis direction corresponding to the longitudinal section,
The puncture needle guide portion in the puncture guide attachment is provided for guiding the puncture needle along the longitudinal section indicated by the second tomographic image, and the guide groove in the puncture needle guide portion is provided with the vibration. The projection is formed so as to extend along an extension line of the ultrasonic transducer array arranged linearly along the long axis direction in a projection view from a child installation surface side. 2. The ultrasonic probe according to 1. The probe-side engagement portion is an engagement recess or an engagement protrusion that is disposed at equal intervals along the major axis direction on the side surface of the probe body that is parallel to the major axis direction.
A plurality of the attachment-side engagement portions are disposed along the major axis direction at the same interval as the probe-side engagement portion on the inner surface of the plurality of arm portions of the puncture guide attachment. The ultrasonic probe according to claim 2, wherein the ultrasonic probe is a mating convex portion or an engaging concave portion.   The puncture guide attachment is slid in the long axis direction to adjust the amount of pinching by the plurality of arm portions, and the engagement position of the attachment side engagement portion with respect to the plurality of probe side engagement portions is changed. The ultrasonic probe according to any one of claims 1 to 3, characterized in that:   The ultrasonic probe according to any one of claims 1 to 4, wherein the probe-side engagement portion and the attachment-side engagement portion have a quadrangular shape. A first tomographic image showing a transverse section of the subject, and a second tomographic image showing a longitudinal section orthogonal to the transverse section, the ultrasonic probe according to any one of claims 2 to 5 being mounted. An ultrasonic image display device including an image display unit capable of displaying simultaneously,
A guideline indicating a direction in which the puncture needle advances is displayed on the first tomographic image, and insertion of the puncture needle according to a current engagement position of the attachment-side engagement portion is displayed on the second tomographic image. An ultrasonic image display device comprising guideline display means for displaying a guideline indicating a course in an angle.   The guideline display means includes an angle adjustment guideline indicating a course at another insertion angle in addition to a guideline indicating a course at the insertion angle of the puncture needle according to a current engagement position of the attachment-side engagement portion. The ultrasonic image display device according to claim 6, wherein the ultrasonic image display device displays the image on the second tomographic image. A position information input means for inputting position information according to the engagement position of the attachment side engagement portion with respect to the plurality of probe side engagement portions;
The guideline display means determines an insertion angle of the puncture needle according to the engagement position based on the position information input by the position information input means, and displays the guideline indicating a course at the insertion angle. The ultrasonic image display device according to claim 6, wherein the ultrasonic image display device displays the image on the second tomographic image.   The first tomographic image and the second tomographic image further include identification display means for identifying and displaying a portion having a temporal change by changing a color or luminance with respect to a portion having no temporal change. Item 9. The ultrasonic image display device according to any one of Items 6 to 8. A plurality of ultrasonic transducers are linearly arranged, and are detachably fixed to the outer surface of the probe body of an ultrasonic probe that scans ultrasonic waves to obtain a tomographic image of the subject, and punctures along the tomographic image A puncture guide attachment for guiding the puncture needle to insert a needle into the subject at a predetermined angle set in advance,
The probe main body is provided in a state of protruding from a transducer installation surface on which the plurality of ultrasonic transducers are installed to a rear surface side of the probe main body, and is projected from the transducer installation surface side. A puncture needle guide portion having a guide groove formed so as to extend along an extension line of the ultrasonic transducer array;
A plurality of arm portions sandwiching and fixing the probe body are provided so as to extend on the opposite side of the puncture needle guide portion, and a plurality of probes provided on the probe body are provided on the plurality of arm portions contacting the outer surface. A plurality of attachment side engaging portions that selectively engage with the side engaging portions,
The guide groove is provided with an opening for introducing the puncture needle and a bottom portion for contacting the introduced puncture needle,
The insertion angle of the puncture needle is determined by a combination of the bottom and a positioning recess provided in the probe body,
The insertion angle of the puncture needle can be adjusted in multiple steps by changing the position of the bottom by changing the engagement position of the plurality of attachment side engagement parts with respect to the plurality of probe side engagement parts. Features a puncture guide attachment.   The sandwiching and fixing portion includes a pair of arm portions that sandwich and fix the probe main body by contacting two side surfaces parallel to the arrangement direction of the ultrasonic transducer array in the probe main body. The puncture guide attachment according to claim 10, wherein the puncture guide attachment is provided as a part.   The puncture guide attachment according to claim 11, wherein the plurality of attachment-side engaging portions are engaging convex portions protruding from inner surfaces facing each other in the pair of arm portions.   The puncture guide attachment according to claim 12, wherein the pair of arm portions includes a plurality of the engaging convex portions arranged at equal intervals along a direction in which the pair of arm portions extend.

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