JPH0479946A - Sound wave therapeutic apparatus - Google Patents

Abstract

PURPOSE:To focus a shock wave to a subject to be treated so as to sufficiently crush the subject to be treated and also eliminate the necessity of pressing an applicator against a body surface too much by displaying on the body surface contact portion of the applicator an area corresponding to the depth from the body surface to the subject to be treated and necessary for contact with the body surface, for identifying the area. CONSTITUTION:An area H corresponding to the depth D from a body surface 7 to a subject to be treated and necessary for contact with the body surface is indicated for identification on the body surface contact portion of an applicator 1; i.e. the concentric circles C1 to C4 of the necessary area H (60 to 90mm) corresponding to the depth D (30 to 130mm) are indicated on the subject contact portion 23 of the applicator 1 using a magic marker and the like, whereby a plurality of cross lines L1 to L4 are obtained in such a manner as being noticeable also from each side. Until the subject 8 to be treated comes into sight at roughly the center portion of a TV monitor screen, an operator shifts the applicator 1 while watching a B-mode image and finds data on the depth D from the body surface 7 to the subject to be treated. The operator therefore presses the applicator 1 against the body surface until the cross lines each entered as the numerical value of the depth D corresponding to the data all make contact with the body surface of a subject.

Description

[Detailed Description of the Invention] [Objective of the Invention] (Industrial Application Field) The present invention relates to a shock wave lithotripter that destroys objects to be treated such as cancer tissues and stones using shock waves as sound waves, and The present invention relates to a sonic therapy device such as a continuous wave thermal therapy device that destroys cancerous tissue etc. by the thermal effect of the convergent energy of sound waves.

(Prior Art) In a sound wave therapy device, for example, in a first-generation shock wave lithotripter, a subject and a shock wave source are submerged in water as an ultrasound propagation substance, and a second sound wave generated from the shock wave source is submerged in water. The shock waves were guided through the water to the stone inside the subject.

However, with this method, the subject's entire body is immersed in water, which poses problems such as increased stress and an increased amount of maintenance such as cleaning the water tank.

Therefore, shock waves are currently placed in ice bags based on the idea that the acoustic propagation path only needs to be secured in the area through which the shock waves actually pass. By pressing an ice bag against the subject's body surface, it has become possible to treat stones without getting the subject wet.

Such devices are commonly referred to as second generation shock wave lithotripters. FIG. 7 is a diagram showing an example of the applicator of the second generation extracorporeal shock wave lithotripter. This applicator has a lid shape on the top and has a built-in destructive vibrator for generating shock waves and an ultrasonic probe for transmitting ultrasonic waves as the first sound waves toward the subject. A body 21 , a hemispherical subject contacting part 23 at the bottom for contacting the subject's body surface (not shown), and a telescopic bellows 22 between the applicator body 21 and the subject contacting part 23 . and is provided. Further, the inside of the subject contacting section 23 is filled with water as an acoustic propagation medium.

Then, as shown in FIG. 8, when a powerful shock wave is converged toward the object to be treated 8 from the destructive vibrator 2, which includes a plurality of vibrators, the object to be treated 8 is destroyed by the energy of this shock wave. At this time, the shock wave passes through a propagation path as shown by the dotted line. Further, the shock wave passage range on the body surface changes depending on the calculus depth D from the body surface 7 of the subject to the object 8 to be treated. Further, the body surface contact portion 23 of the applicator is brought into contact with the subject so as to cover the shock wave passage range.

(Problem to be solved by the invention) However, in the second generation shock wave lithotripter, the acoustic coupling between the subject and the applicator is weaker than in the first generation, so a sufficient shock wave propagation path is secured. In some cases, it may not be done. For example, as shown in Figure 9, if the applicator's body surface contact area is narrower than the shock wave passage range (necessary contact range) and there is a space such as the shaded area PQ, most of the shock waves will be transmitted to the water/air interface. Since the shock wave is reflected by the shock wave and the transmitted portion is also strongly attenuated assuming air transmission, the shock wave does not advance into the interior of the object. In other words, if the intensity of the shock wave that enters the body decreases, a sufficient stone crushing effect cannot be obtained. Furthermore, there is currently no index for determining how much area of the applicator needs to be brought into contact with the body surface. For this reason, the operator tends to press the applicator against the subject more than necessary, and the subject is subjected to considerable pressure.

Therefore, an object of the present invention is to present the necessary contact range of the applicator to the subject, set the sound wave passage range to an appropriate range, sufficiently crush the object to be treated, and reduce the pressure burden on the subject. The purpose of the present invention is to provide a sound wave therapy device.

[Structure of the Invention] (Means for Solving the Problems) In order to solve the above problems and achieve the objects, the present invention takes the following measures. The present invention involves bringing an applicator having a probe that transmits a first sound wave and a sonic transducer that emits a second sound wave into contact with the body surface of a subject, and transmitting the sonic transducer to an object to be treated of the subject. In a sonic therapy device that emit a second sound wave toward the object to be treated, the range necessary for body surface contact corresponding to the depth from the body surface to the object to be treated is set to the body surface of the applicator. It is characterized by an identification mark on the contact part.

Further, the range corresponding to the depth is identified and displayed on the body surface contact portion using concentric circles.

(Effects) By taking such measures, the following effects are achieved. The range required for body surface contact, which corresponds to the depth from the body surface to the object to be treated, is identified and displayed on the body surface contact part of the applicator, so the operator can move between the identified range or the body surface of the subject. Just press the applicator until it touches the entire surface. As a result, the shock wave can be converged on the object to be treated through the above range with a simple operation, so the object to be treated can be sufficiently crushed, and there is no need to press the applicator excessively against the object, so there is no burden on the object. can be reduced.

(Example) Fig. 1 is a block diagram showing the configuration of a shock wave lithotripter as an embodiment of the sonic therapy device according to the present invention, and Fig. 2 is for explaining the necessary range of the contact portion of the applicator with the subject. and FIG. 3 are diagrams in which the contact portion of the applicator with the subject is represented by a circle, and FIG. 3(a) is a side view and FIG. 3(b) is a top view. .

In this embodiment, as shown in FIG. 2, the range H required for body surface contact, which corresponds to the depth D from the body surface 7 to the object to be treated, is identified and displayed on the body surface contact portion of the applicator. It is characterized by: That is, the operator determines the depth D, the diameter r of the shock wave vibrator 2, and the distance from the shock wave vibrator 2 to the object 8.
The range H necessary for the applicator 1 to contact the subject is determined by calculating the following using the length R of the applicator 1 and the length R of the subject.

Equation (1) is used here because the required contact range H and the diameter r of the shock wave vibrator correspond to each other as shown in FIG. This is because the lengths R up to 8 correspond to each other, and a similar relationship holds between them.

That is, the operator may determine each required contact range corresponding to each depth D, and may create a comparison table as shown below, and the manufacturer may attach it to the device.

Furthermore, using this comparison table, as shown in FIG. 3(b), the depth D (
30mm, 60mm, 90mm.

120mm) corresponding to each required range H(60mm
, 70mm, 80mm, 90mm) using a magic marker etc. to create concentric circles (CI for φ60mm).

C2 for φ70mm, 03 for φ80mm, φ
Mark C4) for 90mm.

If concentric circles 01 to C4 are displayed in this way, Figure 3 (a
) As can be seen from the side, the concentric circles 01
A plurality of horizontal lines L1 to L4 corresponding to C4 are obtained.

Further, as shown in FIG. 3(a), the numerical value of the depth D is set at 30°60.90,12 on the plurality of horizontal lines L1 to L14.
Enter 0.

Next, a case will be described in which the applicator 1 with the mark displayed in this manner is brought into contact with the subject.

First, the depth D is determined by, for example, an ultrasonic diagnostic apparatus as shown in FIG. This will be explained below.

In FIG. 1, the shock wave lithotripter uses an applicator 1. Transmitter 11. Receiver 12. Signal processing section 13.
DSC 14, arithmetic circuit 15, memory 16, and a controller 17 that controls all of these. A TV monitor 18 is provided.

The applicator 1 includes a shock wave transducer 2 equipped with a plurality of transducers for emitting a shock wave as a second sound wave to a treatment object 8 of a subject, and a shock wave transducer 2 for emitting an ultrasonic wave as a first sound wave. It has a probe 3 that waves.

Furthermore, by bringing the applicator 1 into contact with the body surface 7 of the subject, shock waves can be emitted from the shock wave oscillator 2 toward the object to be treated 8 of the subject.

The arithmetic circuit 15 determines the depth D from the body surface 7 to the object 8 by transmitting and receiving the ultrasonic waves.

The probe 3 is equipped with a plurality of ultrasonic transducers, and in order to perform sector scanning, the excitation timing of each transducer is changed according to a desired direction so that the transmission direction of the ultrasonic beam is sequentially changed in a fan shape. I'll let you do it.

The transmitter 11 gives a delay time to the ultrasonic rate pulse so that the ultrasonic wave is transmitted in a predetermined direction for each transducer, and drives the probe 3 with the delayed rate pulse. Then, the ultrasound from the probe 3 is transmitted to the subject, and the reflected ultrasound from the subject, for example, the ultrasound reflected from the body surface 7 or the ultrasound reflected from the object to be treated 8, is transmitted to the receiver 12.
will be received.

The receiver 12 amplifies the received signal to a predetermined level,
For the received signal from each vibrator, the transmitter 11
A delay time is applied to return the delayed time to the original value, and these received signals are added and combined.

The signal processing unit 13 detects the envelope of the received signal output from the receiver 12 to obtain B-mode image data (tomographic image data), and supplies this to the DSC 14 .

The B-mode image data is written into an internal frame memory by the DSC 14, read out from this, and then
A B-mode image including the object to be treated 8 of the subject is displayed on the V monitor 18 .

While viewing the B-mode image, the operator confirms that the object to be treated 8 is on the TV.
Hold applicator 1 until it appears approximately in the center of the monitor screen.
move.

On the other hand, when the reflected ultrasound from the body surface 7 and the reflected ultrasound from the object to be treated 8 are input to the arithmetic circuit 15, the arithmetic circuit 15 calculates time difference data between the two reflected ultrasound waves. Furthermore, data on the depth D from the body surface 7 to the object to be treated 8 is determined based on this time difference data and ultrasound velocity data.

Therefore, based on the obtained data on the depth D, the operator presses the applicator 1 until the horizontal line marked with the numerical value of the depth D corresponding to this data completely contacts the body surface of the subject. For example, the obtained depth D data is 30
If it is mm, then when the applicator 1 is pressed until the horizontal line C1 marked with 30 touches the entire body surface of the subject,
The range required for the body surface is φ60 mm.

In this way, the operator can set the contact range H of the body surface 7 of the applicator 1 with an eye to securing the shock wave passage range, so that insufficient contact between the subject and the applicator 1 can be avoided. As a result, the shock wave can be sufficiently focused on the object to be treated 8 through the range H with a simple operation, so that the object to be treated 8 can be sufficiently crushed.

Furthermore, when the calculus is shallow, the necessary contact range is narrow, so there is no need to press the applicator 1 excessively against the subject, and the burden on the subject can be reduced.

Next, a first modification of the applicator 1 will be explained with reference to FIG. 4. Applicator 1a as a first modification
As shown in FIG. 4(b), the subject contacting part 23a of
Concentric circles C representing each range H corresponding to each depth D
The regions R1 to R4 between 1 and 04 are displayed in different colors (for example, red, pink, orange, and yellow) for identification. If the identification is displayed in this way, a different color (for example, red, pink, orange, yellow) is displayed between each of the horizontal lines L1 to L4 on the side surface, as shown in FIG. 4(a). It is only necessary to press the applicator 1 until the color corresponding to the depth D completely contacts the subject's body surface.

With such color display on the object contacting part 23, the operator can sufficiently converge the shock wave onto the object to be treated 8 through the range H with a simple operation, so that the object to be treated 8 can be sufficiently crushed. can. Furthermore, when the calculus is shallow, the necessary contact range is narrow, so there is no need to press the applicator 1 excessively against the subject, and the burden on the subject can be reduced.

Next, a second modification of the above embodiment will be explained with reference to FIG. In the second modification, the horizontal lines L1 to L14 indicating each range H are displayed as marks, but the numerical value of the depth D is not displayed. That is, the subject contacting part 23b of the applicator 1b as the second modification example tells the operator that if the first horizontal line L1 is determined to be, for example, 30 mm in depth, the second and subsequent horizontal lines L2
゜L3. L4 suggests that the depth of the first horizontal line increases by 30 mm in order from the depth of 30 mm.

Even with such an applicator 1b, the same effects as in the above embodiment can be obtained.

Next, a third modification of the above embodiment will be explained with reference to FIG. The third modification differs from the previous embodiment in that the arithmetic circuit 15 is removed. In the embodiment described above, the stone depth D from the body surface 7 is automatically determined, but the arithmetic circuit 15
Alternatively, the operator may read the calculus depth D from the B-mode image silently.

Note that the present invention is not limited to the embodiments described above. In the above-mentioned embodiment, a shock wave lithotripter was described as an example of a sonic therapy device, but it is also applicable to a continuous wave thermotherapy device that crushes cancerous tissue etc. by the thermal effect of the convergent energy of continuous waves of ultrasonic waves. The present invention is also applicable. In this case, treatment is performed by continuously transmitting ultrasonic waves to the object to be treated from a probe equipped with a plurality of transducers. It goes without saying that various other modifications can be made without departing from the gist of the present invention.

[Effects of the Invention] According to the present invention, the range required for body surface contact corresponding to the depth from the body surface to the object to be treated is identified and displayed on the body surface contact portion of the applicator, so that the operator can It is only necessary to press the applicator until the identified area is completely in contact with the body surface of the subject. As a result, the shock wave can be converged on the object to be treated through the above range with a simple operation, so the object to be treated can be sufficiently crushed, and there is no need to press the applicator excessively against the object, so there is no burden on the object. It is possible to provide a sound wave therapy device that can reduce the

[Brief explanation of drawings]

FIG. 1 is a diagram showing the configuration of an embodiment of the sonic therapy device according to the present invention, FIG. 2 is a diagram for explaining the necessary range of the contact portion of the applicator with respect to the subject, and FIG. FIG. 4 is a diagram showing a first modification of the above embodiment, FIG. 5 is a diagram showing a second modification of the above embodiment, and FIG. FIG. 7 is a diagram showing an example of the applicator; FIG. 8 is a diagram showing an example of the case where the applicator is in contact with the subject and within the required contact range; FIG. 9 is a diagram showing an example of a case where the applicator is brought into contact with the subject but the contact is not within the required contact range. 1... Applicator, 2... Shock wave vibrator, 3...
・Probe, 7... Body surface, 8... Treated object, 11.
... Transmitter, 12... Receiver, 12... B-mode image processing unit, 14... DSC, 15... Arithmetic circuit, 17
...Controller, 18...TV monitor, 21...
・Applicator body, 22... Bellows, 2B, 23
a, 23b...Subject contact part, 24...Water, 01~
C4...Concentric circles, L1-L4...Horizontal lines.

Claims (2)

[Claims] (1) An applicator having a probe that transmits a first sound wave and a sonic transducer that emits a second sound wave is brought into contact with the body surface of the subject, and the sonic transducer is directed toward the object to be treated of the subject. In a sonic therapy device that emit a second sound wave to crush an object to be treated, the body surface contact range of the applicator corresponds to the depth from the body surface to the object to be treated. 1. A sound wave therapy device characterized by having an identification mark on the part. (2) The sonic wave therapy device according to claim 1, wherein the range corresponding to the depth is identified and displayed in concentric circles on the body surface contact portion.