JPH04329941A - Treating system using electroacoustic transducer - Google Patents

Abstract

PURPOSE:To enable the matching of a focal point ideal for any object to be treated existing in vivo as well. CONSTITUTION:A support device 20 is provided with a mechanism in order to switch the first layout for an applicator 10 which make sound waves irradiate an object from top to bottom and the second layout for the applicator 10 which makes the sound wave irradiate the object from bottom to top. In addition, with the mechanism, a means is included to display a tomographic image at the first layout and the tomographic image at the second layout.

Description

[Detailed description of the invention]

0001

[Industrial Application Field] The present invention relates to a shock wave treatment device that crushes and treats a stone by irradiating the shock wave generated from an electroacoustic transducer to the stone, and a continuous ultrasonic wave generated from the electroacoustic transducer. The present invention relates to a treatment device such as a continuous wave treatment device that destroys and treats cancerous tissue by irradiating the same with cancer tissue.

0002

2. Description of the Related Art A shock wave therapy device will be described as an example of a conventional therapy device of this type. In other words, the shock wave therapy device includes an applicator, an applicator support, a bed,
Consists of shock wave control equipment, tomographic imaging equipment, water control equipment, etc. A patient is placed on the bed, and the applicator is lightly applied from above the patient by an applicator support. The applicator has a concave shock wave generator including a plurality of electroacoustic transducing elements, and can direct and irradiate shock waves in a predetermined direction and converge on a predetermined position. Therefore, according to the present treatment device, it is possible to irradiate the gall stones and kidney stones existing in the patient's body with convergent shock waves from a predetermined direction to a predetermined position.

[0003] As described above, the conventional shock wave therapy device irradiates shock waves from the applicator located above to the patient located below. This is called the upward approach. On the other hand, irradiating a shock wave from an applicator located below to a patient located above is called a downward approach. The superior approach was chosen because it is easy to align the focal point and is advantageous for fragmenting kidney stones. That is, it can be seen that the upward approach makes it easier to align the focal point, depending on the relationship between the patient's position and the operator's hand and eye positions. Additionally, although kidney stones do not easily move within the body, it is not easy to focus on kidney stones that are located deep in the abdomen, so an upward approach is preferred because it makes it easier to focus, as described above. .

0004

[Problems to be Solved by the Invention] However, with conventional shock wave therapy devices that adopt an upward approach, it is easy to align the focal point and is particularly suitable for treating kidney stones. This is a problem. That is, when treating a gallstone by crushing it using an upward approach, the patient assumes a supine position on a bed. In this position, the gallbladder is located below the ribs, so it is difficult to focus on the gallstone using an upward approach.Moreover, the gallstone moves due to body movements such as breathing, so the positioning described above is difficult. becomes increasingly difficult.

[0005] The above is a description of the problems with shock wave therapy devices, but even continuous wave therapy devices that adopt an upward approach have the same problem that it is difficult to focus on the treatment target depending on the treatment target. be.

SUMMARY OF THE INVENTION Accordingly, an object of the present invention is to provide a treatment apparatus using an electroacoustic transducer element that can preferably focus on any target to be treated within the body.

[0007]

[Means for Solving the Problems] The above object is achieved by the following device. That is, a treatment device using an electroacoustic transducer that includes an applicator that includes a plurality of electroacoustic transducers and generates sound waves for treatment from the plurality of electroacoustic transducers, and a support that supports the applicator. In,

[0008] The supporter has a first arrangement for the applicator that radiates the sound wave from above to the bottom and a second arrangement for the applicator that irradiates the sound wave from the bottom to the top. and means for displaying a tomographic image in the first arrangement and a tomographic image in the second arrangement using the mechanism. A treatment device that uses acoustic conversion elements.

[0009]

[Operation] According to the treatment device having such a configuration, the first arrangement and the second arrangement can be appropriately selected by operating the mechanism, and the arrangement state can be known from a tomographic image. can. Therefore, for example, in the case of crushing treatment for kidney stones, the first arrangement is selected, and in the case of crushing treatment for bile stones, the second arrangement is selected, and each is observed using a tomographic image. Thereby, the focus can be easily aligned and treatment can be performed with high positioning accuracy.

0010

Embodiments Hereinafter, embodiments will be described with reference to the drawings. 1 and 2 are perspective views showing the structure of a shock wave treatment device according to a first embodiment of the present invention. FIG. 1 is a diagram showing a state of upward approach, and FIG. 2 is a diagram showing a state of downward approach.

As shown in FIG. 1, the shock wave treatment device of the first embodiment includes an applicator 10, an applicator support 20, a shock wave control device 30, a tomographic imaging device 40, and a water control device 50. and a bed 60.

As schematically shown in FIG. 3, the applicator 10 includes a concave shock wave generator 1 having a hole in the center.
1, a bellows 12, and a membrane 13 constitute a sealed body 14. The sealing body 14 is attached to a frame 15 having a hole in the center. Furthermore, water 16 is contained within the sealed body 14 as an ultrasonic propagation substance. Furthermore, a rod 17 is inserted into the sealing body 14 through the frame 15 and the hole in the concave shock wave generator 11 . Rod body 17
A tomographic imaging probe 18 is provided at the end of the probe. A probe drive mechanism 19 is provided on the frame 15 . This probe drive mechanism 19 includes a rod 17
is moved forward and backward within the sealed body 14. The concave shock wave generator 11 has a plurality of high-output ultrasonic transducers. These high-power ultrasonic transducers are
It is arranged in the frame 15 in a concave shape and in an annular shape. With this arrangement, the focus of the shock wave can be set at a predetermined distance from the concave shock wave generator 11.

The applicator supporter 20 supports the applicator 10 and moves the applicator 10 horizontally (XY-axis movement) and vertically (large Z-axis movement).
It can be moved up and down in small steps (small Z-axis movement), reversed (inverted movement), and tilted (tilted movement). Details of the applicator supporter 20 will be described later.

The shock wave control device 30 includes a transmitter/receiver 31, a pulser 32, a main controller 33, a fixed console 34, a detachable console 35, a display 36, and a probe position controller 37. The transceiver 31 can selectively provide the concave shock wave generator 11 with a large output pulse or a small output pulse provided from the pulser 32 . The high output pulse is for generating shock waves. The small output pulse is used to obtain waveform information for confirming the coincidence of the shock wave focus and the stone. Statistical data such as the number of times the large output pulse and small output pulse are fired is displayed on the display 36. The probe position controller 37 moves the rod 17 forward and backward within the sealed body 14 according to commands from the main controller 33, and sets the tomographic imaging probe 18 at a desired position within the sealed body 14. The detachable operation console 35 is detachably provided on the frame 15 of the applicator 10 as shown. The main controller 33 controls the entire device of this embodiment.

The tomographic imaging device 40 includes a tomographic imaging probe 18, and a B-mode control device 4.
1 and a display 42, and displays a tomographic image (B-mode image) obtained by electronic sector scanning on the display 42.

The water control device 50 supplies and discharges water 16 within the closed body 14 of the applicator 10. This supply and discharge of water indirectly contributes to setting the position of the tomographic imaging probe 18 within the sealed body 14. The bed 60 has a top plate 60A on which the patient is placed. The top plate 60A has a freely openable/closable part 60B in its center, which is used when approaching downward.
has been established.

With the above configuration, the applicator 10 can be set for an upward approach as shown in FIG. 1, and the applicator 10 can be set for a downward approach as shown in FIG. The configuration can be set to This repositioning is due to the movement of the applicator support 20. Furthermore, when the applicator 10 is set for an upward approach, a normal sector tomographic image 42A is displayed on the display 42 together with a focus marker FM as shown in FIG. When set to placement,
As shown in FIG. 5, the inverted sector tomographic image 42B is displayed on the display 42 together with the focus marker FM. This makes it possible to know the irradiation direction of the shock wave, the focal position, and the calculus position whether in the upper approach or the lower approach. Note that character information CI can be displayed on the display 42. An image of stone CA appears in the tomographic images 42A and 42B.

Next, the applicator support 20 will be explained in detail. As shown in FIG. 6, a base 100 installed on the floor
A support 110 is provided perpendicularly to the base 100. This support 110, as shown in FIGS. 7 and 8,
An XY-axis moving mechanism 120 provided inside the base 100 allows movement in the X-axis direction and the Y-axis direction. XY
The axis moving mechanism 120 has a Y-axis moving mechanism 124 disposed above an X-axis moving mechanism 122. The X-axis moving mechanism 122 and the Y-axis moving mechanism 124 are lead screw mechanisms. In the X-axis moving mechanism 122, a screw 122B is rotatably provided on an X-axis fixing plate 122A. screw 122
B is rotated by a motor 122C provided at its end. Since the screw 122B is provided with the X-axis lead 122D, the X-axis lead 122D can be moved in the X-axis direction by driving the motor 122C. Similarly, in the Y-axis moving mechanism 124, a screw 124B is rotatably provided on a Y-axis fixing plate 124A. The screw 124B is rotated by a motor 124C provided at its end. Since the Y-axis lead 124D is provided on the screw 124B, the Y-axis lead 124 is driven by the motor 124C.
D can be moved in the X-axis direction. The Y-axis fixing plate 124A is fixed to the base 100, and the X-axis fixing plate 122A is fixed to the Y-axis lead 124D. The X-axis lead 122D is the support column 11
Connected to 0. Therefore, the support column 110 can be moved individually in the X-axis direction and the Y-axis direction by the motors 122C and 124C of the XY-axis moving mechanism 120.

The column 110 has a slide body 1 having a C-shaped cross section.
30 is provided so as to be slidable in the Z-axis direction. A sprocket 131 is provided at the end of the column 110,
Similarly, this 131 has a motor 13 at the end of the support column 110.
2 is provided. Sprocket 131 and motor 13
A chain 133 is stretched between the two. It is rotated by Hen. The wire 13 is attached to the sprocket 131.
3 is crossed. One end of the wire 133 is tied to the slide body 130, and a weight 135 is suspended from the other end. Therefore, by rotationally driving the motor 132, the slide body 130 can be set at a desired position in the longitudinal direction of the support column 110. This contributes to moving the applicator 10 largely in the Z-axis direction.

[0020] The slide body 130 is provided with a rotating shaft 140. A sprocket 1 is attached to one end of the rotating shaft 140.
41 are provided. A C-shaped arm 150 is fixed to the other end of the rotating shaft 140. Further, the slide body 130 is provided with an arm rotation mechanism 144. The arm rotation mechanism 144 includes a sprocket 141, a motor 42,
It consists of a chain 143 that is stretched around a sprocket 141 and a motor 142. Therefore, by rotationally driving the motor 142, the C-shaped arm 150 can be rotated as shown in the figure with respect to the slide body 130. With this, the appulicator 10 can be reversed,
An upper approach and a lower approach are realized as desired.

[0021] The C-shaped arm 150 has a C-shaped support 1.
60 are provided. Shafts 161 provided at both ends of the C-shaped support 160 are attached to both ends of the C-shaped arm 150. As a result, C-shaped support 16
0 is rotatable inside the C-shaped arm 150. However, due to the action of an inverted V-shaped stopper 184, which will be described later, the rotation is prevented and the rotation is suppressed to a mere inclination. An applicator support base 170 is provided in the middle of the C-shaped support 160. The applicator support base 170 supports the applicator 10 in a slidable manner. Applicator support base 170 has a screw mechanism 171. The screw mechanism 171 includes a screw 172 and a motor 1 that rotates the screw 172.
73 and a lead 174 provided on the screw 172. One end of the lead 174 is fixed to the applicator 10. Therefore, by rotating the motor 173, the applicator 10 can be moved slightly in the Z-axis direction.

A lead screw mechanism 180 is provided on the arm portion 150A of the C-shaped arm 150. The lead screw mechanism 180 includes a screw 181, a motor 182 that rotates the screw 181, a lead 183 that is moved by the screw 181, and an inverted V-shaped stopper 184. One end of the lead 183 is fixed to the C-shaped support 160. The inverted V-shaped stopper 184 is arranged to sandwich the lead 183. Therefore, by rotating the motor 182 forward and backward, the reed 183 pushes the inverted V-shaped stopper 184, so that the applicator 10 in the horizontal state as shown in FIG.
The applicator 10 can be tilted as shown in FIG.

A grip 190 is provided on the arm portion 150A of the C-shaped arm 150. This grip 190 can be used to manually position the applicator 10 and manually invert the applicator 10.

As described above, according to this embodiment, the upper approach and the lower approach can be selected as appropriate, and the focus position in both cases can be easily determined using the tomographic image. Therefore, as shown in FIG. 12, it is possible to provide an impact treatment device suitable for crushing gallstones of patient P, and as shown in FIG. 13, suitable also for crushing kidney stones. In this case, the openable/closable part 60 of the bed 60
By manipulating B, treatment using a downward approach becomes easier. In this case, the choice between the upper approach and the lower approach is that the applicator support 20 is
This is realized by driving and controlling the arm rotation mechanism 144 in 30. The applicator supporter 20 is connected to the main controller 3
Receive commands by 3. The operator can give commands to the main controller 33 through the fixed console 34 and the removable console 35.

Furthermore, the operator can control the applicator support 20 by giving commands to the main controller 33 using the fixed console 34 and the detachable console 35. Therefore, the movement of the support column 110 in the XY axes can be controlled, and the slide body 130
can be moved largely in the Z-axis direction, the applicator 10 can be moved small in the Z-axis direction, and the applicator 10 can be reversed.
Applicator 10 can be tilted.

Further, the removable operation console 35 can be detached from the applicator 10 and position the applicator 10 using a remote control at a position away from the applicator 10.

Next, a second embodiment of the shock wave treatment device according to the present invention will be described with reference to FIGS. 14 to 16. The second embodiment has a function of automatically inverting the B-mode image displayed on the display 42 between the upward approach state and the downward approach state. That is, FIG.
As shown in FIG. 2, a rotational position detection mechanism 145 is provided within the slide body 130. This rotational position detection mechanism 14
5 is a rod 146 provided on the rotating shaft 140 and this rod 14
It consists of a plurality of sensors 147 that detect the position of 6. As shown in FIG. 15, which is a sectional view taken along the line A-A in FIG. 13, a plurality of sensors 147 (147
A, 147B, 147C, 147D) is the rotating shaft 140
In order to detect the position of the rod 146 that rotates with the rotation of the
The rods 146 are arranged at equal intervals on the rotating circumference. The output of sensor 147 is given to rotational position detector 149, as shown in FIG. The rotational position detector 149 determines whether the applicator 10 is in an upward approach state or a downward approach state based on a detection signal indicating the position of the rod 146 given from a sensor 147. That is, as shown in FIG.
When located at 8A, it is determined that the applicator 10 is in an upward approach state. The rod 146 is the sensor 14
7C and sensor 147D, it is determined that applicator 10 is in the downward approach state.

The approach state judgment signal obtained by the rotational position detector 149 is transmitted to the applicator supporter 20.
The signal is sent to the main controller 33 via the . The main controller 33 is
Based on the approach state judgment signal, a command signal is given to the B-mode controller 41 in order to set the display state of the B-mode image displayed on the display 42.

Note that the B mode controller 41 includes, for example, an automatic mode switch 41A disposed on the operation panel;
It is equipped with a manual switch 41B. When the automatic mode switch 41A is activated, as described above, when the applicator 10 is in the upward approach state, the mode shown in FIG.
The sector B mode image in the normal state is displayed as shown in FIG. 5, and when the applicator 10 is in the downward approach state, the sector B mode image in the inverted state is displayed as shown in FIG. When the manual switch 41B is activated, as described above, when the applicator 10 is in the upward approach state, the indicator 41C
Also, when the applicator 10 is in the downward approach state, this is displayed on the indicator 41C. Therefore, for example, by manually selecting the switch 41D arranged on the operation panel, the operator can set the sector B in the normal state as shown in FIG.
A mode image or a sector B mode image in an inverted state as shown in FIG. 5 can be displayed. Of course, if the manual switch 41B is activated, it goes without saying that there is no need to perform any switch operation to change the display state, whether in the upward approach state or the downward approach state. do not have.

The above is a description of the effects of the shock wave therapy device. By providing a continuous ultrasonic generator in place of the pulser 32 in FIG. 3 or FIG. 16, it is possible to appropriately select the upper approach and the lower approach. It is possible to provide a continuous wave treatment device (hyperthermia device) that can easily position the focal point in both cases using a tomographic image. The present invention is not limited to the above-mentioned embodiments, but can be implemented with various modifications without departing from the gist of the present invention.

[0031]

As described above, the present invention provides an applicator that includes a plurality of electroacoustic transducers and generates sound waves for treatment from the plurality of electroacoustic transducers, and a support that supports this applicator. In a treatment device using an electroacoustic transducer comprising:

[0032] The supporter has a first arrangement for the applicator that irradiates the sound wave from above to the bottom and a second arrangement for the applicator that irradiates the sound wave from the bottom to the top. means for displaying a tomographic image in the first arrangement and a tomographic image in the second arrangement by the mechanism;

[
This is a treatment device using an electroacoustic transducer, characterized by comprising: According to the treatment apparatus having such a configuration, by operating the mechanism, the first arrangement and the second arrangement can be appropriately selected, and the arrangement state can be known from the tomographic image. Therefore, for example, in the case of crushing treatment for kidney stones, the first arrangement is selected, and in the case of crushing treatment for bile stones, the second arrangement is selected, and each is observed using a tomographic image. Thereby, the focus can be easily aligned and treatment can be performed with high positioning accuracy.

Therefore, according to the present invention, it is possible to provide a treatment apparatus using an electroacoustic transducer that can preferably focus on any target to be treated within the body.

[Brief explanation of the drawing]

FIG. 1 is a perspective view showing the configuration of a shock wave treatment device according to a first embodiment of the treatment device using an electroacoustic transducer according to the present invention in an upward approach state.

FIG. 2 is a perspective view showing the configuration of a shock wave treatment device according to a first embodiment of the treatment device using the electroacoustic transducer according to the present invention in a downward approach state.

FIG. 3 is a block diagram showing the configuration of an electric circuit of a shock wave treatment device according to a first embodiment of a treatment device using an electroacoustic transducer according to the present invention.

FIG. 4 is a diagram showing a display example of a tomographic image in an upward approach state of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 5 is a diagram showing a display example of a tomographic image in a downward approach state of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 6 is a view from above of an applicator and an applicator supporter of a shock wave treatment device according to a first embodiment of a treatment device using an electroacoustic transducer according to the present invention.

FIG. 7 is a front view of the applicator and applicator support of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 8 is a side view of the applicator and applicator support of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 9 is a diagram showing a horizontal state due to the tilting mechanism of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 10 is a diagram showing one tilting state by the tilting mechanism of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 11 is a diagram showing another tilting state by the tilting mechanism of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 12 is a diagram showing a treatment situation in an upward approach state of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention. FIG.

FIG. 13 is a diagram showing a treatment situation in a downward approach state of the shock wave treatment device according to the first embodiment of the treatment device using the electroacoustic transducer according to the present invention.

FIG. 14 is a side view of an applicator and an applicator support of a shock wave treatment device according to a second embodiment of a treatment device using an electroacoustic transducer according to the present invention.

15 is a cross-sectional view taken along the AA direction in FIG. 13. FIG.

FIG. 16 is a block diagram of a shock wave treatment device according to a second embodiment of the treatment device using the electroacoustic transducer according to the present invention.

[Explanation of symbols]

10... Applicator, 20... Applicator supporter, 30
... Shock wave control device, 40 ... Tomographic image imaging device, 5
0...Water control device.

Claims (1)

[Claims] 1. An electroacoustic transducer comprising: an applicator that includes a plurality of electroacoustic transducers and generates sound waves for treatment from the plurality of electroacoustic transducers; and a supporter that supports the applicator. In the treatment device used,
The support device is configured to switch between a first arrangement for the applicator that irradiates the sound wave from above toward the bottom and a second arrangement for the applicator that irradiates the sound wave from the bottom to the top. An electroacoustic transducer comprising: a mechanism for displaying a tomographic image in the first arrangement and a tomographic image in the second arrangement using the mechanism; A treatment device that uses