JPH0581146B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Object of the Invention] (Industrial Application Field) The present invention relates to a shock wave treatment device for treating stones, etc. in a living body by crushing them using shock wave energy.

(Prior art) Unexamined patent application published in 1983 as a device for crushing stones, etc. in living organisms.
There is one disclosed in the -049843 publication. FIG. 6 shows this device. The applicator 1 has a hole of a predetermined shape in the center, a spherical vibrator 2 formed with a curvature of 10 cm in diameter, and a backing material uniformly bonded to the back side of the vibrator 2. 3
It consists of The imaging probe 4 is arranged so that its transmitting/receiving surface 4a is the same curved surface as the transmitting/receiving surface of the vibrator 2 or at a position set back from that surface. 5 is a water bag, and shock waves are transmitted into the living body 6 via this water bag 5.

(Problem to be Solved by the Invention) However, in the above configuration, the ultrasonic waves transmitted and received by the imaging probe 4 are scattered and attenuated by the water in the water bag 5, so that the in-vivo stone is crushed. The disadvantage is that it is difficult to obtain a B-mode image that can be used to determine the

Therefore, the inventor of the present application previously proposed a device that obtains B-mode image information with the wave transmitting/receiving surface of an imaging probe (ultrasonic transducer) in contact with a living body (subject). 62−
290158).

However, when moving the applicator to position the shock wave focal area with the imaging probe's transmitting and receiving surface in contact with the living body, the tip of the imaging probe may hit the living body's bones, etc. In such cases, a new drawback arises in that it causes pain to living organisms.

Therefore, the present invention aims to eliminate the above-mentioned drawbacks.
The purpose is to provide a shock wave therapy device that does not cause pain to a living body during shock wave focal region positioning and that can obtain a B-mode image that can accurately determine the state of fragmentation of stones, etc. in the living body. There is a particular thing.

[Structure of the Invention] (Means for Solving the Problems) The present invention for solving the above problems includes a shock wave generating means that generates shock waves that are focused in a living body;
and a shock wave transmitting means disposed on the shock wave transmitting surface side of the means to form a shock wave applicator,
In a shock wave therapy device in which an imaging probe for collecting B-code information of a living body is arranged in the center of the applicator, the transmitting/receiving wave surface of the imaging probe is positioned behind the tip of the shock wave applicator when determining the focus area of the shock wave. and a probe movement control means for moving the imaging probe so that the wave transmitting/receiving surface of the imaging probe is located at the tip of the shock wave applicator after focal region positioning is completed.

Also, a distance detection means for detecting the distance between the tip of the imaging probe and the surface of the living body during focal region positioning of the shock wave, and an alarm generation means for issuing an alarm when the distance detection result becomes less than a predetermined value. and.

(Function) According to the above configuration, the wave transmitting/receiving surface of the imaging probe is located behind the tip of the shock wave applicator during shock wave focal region positioning, so even if the applicator is moved, the tip of the imaging probe The part will not come into contact with the bones of the living body. Furthermore, after the shock wave focal region positioning, the imaging probe is moved under the control of the probe movement control means so that the wave transmitting/receiving surface of the imaging probe is located at the tip of the shock wave applicator. A B-mode image can be obtained that allows accurate determination of .

Further, if the tip of the imaging probe comes too close to the living body during focal region positioning, an alarm is issued, thereby preventing the probe tip from coming into contact with bones, etc. of the living body.

(Example) Hereinafter, the present invention will be specifically explained with reference to Examples.

FIG. 1 shows an embodiment of the invention.

This device consists of a shock wave applicator (hereinafter referred to as an applicator) comprising a shock wave generating means 15 that generates shock waves that are focused in the living body, and a shock wave transmitting means 33 disposed on the shock wave transmitting surface side of this means 15. ) 17. Here, a spherical vibrator is used as the shock wave generating means 15, and a water bag is used as the shock wave transmitting means 33. Reference numeral 16 denotes an imaging probe (hereinafter referred to as probe) for collecting B-mode information, and this probe 16 is arranged at the center of the applicator 17. Further, the device of this embodiment has a pulser 18 that sends a pulse signal to the shock wave generating means 15.
, a transmitter/receiver circuit 19 that sends a pulse signal to the probe 16 and receives an echo signal from the probe 16; and a transmitter/receiver circuit 19 that takes in the output signal of the transmitter/receiver circuit 19, performs amplitude detection on it, and converts it into a video signal. It has a signal processing circuit 20 that sends signals to the system 21. Furthermore, a CPU (central processing unit) 22 that controls the operation of each part of the device and this CPU 22
The transmitting/receiving circuit 19 and the signal processing circuit 2 under the control of
0, a controller 23 that controls the transmission/reception timing, amplitude, frequency, etc. of pulse signals in the pulser 18, the transmission/reception circuit 19, and a signal processing circuit 20;
A signal conversion system 21 (digital scan converter) performs signal conversion processing on the output signal of
and display means 27 for displaying focal range markers 26 and the like.
and a pulse generation switch 2 connected to the CPU 22 to set the generation timing of the pulse signal sent from the pulser 18 to the shock wave generation means 15.
9, and a position control 30 for adjusting the relative positional relationship of the probe 16 with respect to the shock wave generating means 15. Here, the probe 16 is moved in the direction of arrow B by the movement drive section 36.

The position controller 30 also controls the wave transmitting/receiving surface 16a of the probe 16 when positioning the focal region of the shock wave.
is positioned behind the tip 17a of the applicator 17 (see FIG. 2), and after the focal area positioning is completed, the transmitting/receiving surface 16a of the probe 16 is positioned behind the applicator 17.
(See FIG. 3). Therefore, this position controller 30 is an example of probe movement control means in the present invention.

Also, during the focal region positioning of the shock wave, the probe 16
The distance between the tip of the body and the surface of the living body (standoff length) is detected by the CPU 22. This standoff length can be determined based on ultrasonic A-mode information. Therefore, the distance detection means in the present invention is functionally realized by this CPU 22. Furthermore, if the standoff length detection result by the CPU 22 is less than a predetermined value (threshold), a buzzer 31 sounds. Here, this buzzer 31 is an example of an alarm generating means in the present invention.

In the above configuration, focal region positioning of the shock wave is performed as follows.

FIG. 2 shows the state of this focal region positioning.

As shown in the figure, in this positioning state, the wave transmitting/receiving surface 16a of the probe 16 is located behind the tip 17a of the applicator 17, and a predetermined distance is formed between the wave transmitting/receiving surface 16a of the probe 16 and the surface of the living body 32. A standoff S is provided. At such a probe position, even if the applicator 17 is moved significantly, the tip of the probe 16 will not come into contact with the bone 32a or the like of the living body 32. Therefore, the operator can safely move the applicator 17 or adjust the amount of water in the water bag 33 to reach the shock wave focal region 2.
6 positioning can be performed. This positioning is performed by aligning the marker 26a indicating the focal region 26 with the stone 39 or the like to be crushed on the B-mode image 25, as in the conventional apparatus.

In addition, in the above positioning, if the length of the standoff S becomes less than a predetermined value, there is a risk that the tip of the probe 16 will come into contact with the bone 32a of the living body 32, so the buzzer 31 will sound to notify you of this. Inform the operator. In this case, the operator takes measures such as further retracting the probe 16 to ensure a predetermined standoff length to avoid the above-mentioned danger. Here, the above-mentioned alarm (buzzer sound) is generated as follows.

That is, the CPU 22 grasps the length of the standoff S from the ultrasonic A mode information, and sets this standoff length to a predetermined value (threshold value).
An alarm generation signal is sent to the buzzer 31 when the following conditions occur. The buzzer 31 sounds in response to this signal input.

After the above positioning is completed, the probe 16 is lowered so that the wave transmitting/receiving surface 16a of the probe 16 is located at the tip 17a of the applicator 17. The probe is driven by the moving drive section 36, which is controlled by the position controller 30. FIG. 3 shows the state after this probe movement, in which the wave transmitting/receiving surface 16a of the probe 16 and the surface of the living body 32 are in close contact. In addition, it is actually water bag 3.
The thin film forming the wave transmitting/receiving surface 16a and the living body 32
exists between the surface of Although the shock wave is transmitted in this state, the tip of the probe 16 does not prevent the shock wave from being transmitted.

Here, the contact state of the tip of the probe 16 is managed as follows.

As shown in FIG. 4, when the length of the probe 16 in the applicator 17 (probe length) is M _P , the standoff length is S _P , and the correction constant is B, the contact condition CTC is: CTC=M-( _MP + _SP )-B. Here, M is the probe length in the case of zero standoff. The state of CTC = 0 is probe 1
6 is in contact with the surface of the living body. In addition, when rotating the probe 16,
Lower the probe 16 so that CTC > 0, and after rotation, lower the probe 16 so that CTC = 0 again.
lower.

Furthermore, the standoff length is measured using the A mode information as follows.

In FIG. 5, ALENGTH is the length of the A-mode information, and Zud is the A-mode insensitive area.
Note that standoffs smaller than 5mm cannot be measured due to the presence of this Zud.

The actual length Δpix [mm/pixel] per pixel is Δpix=1530×10 ³ /2·1/s=C ₀ /2·s. However, s is the sampling frequency.
The dead pixel length MPud is MPud=Zud/Δpix. Therefore, the standoff length S [mm] is S=MP _sleogth ·Δpix.

Shock waves are generated by turning on the pulse generation switch 29. That is, when this switch 29 is turned on, it is recognized by the CPU 22, and a driving pulse is output from the pulser 18 under the control of the controller 23, and when it is applied to the shock wave generating means 15, this shock wave generating means A shock wave is transmitted from 15 toward the stone 39 within the living body 32. Since this shock wave is focused in the focal region 26, the above positioning allows the stone 39 and the focal region 26 to be focused.
If they match, the stone 39 will be crushed by the energy of the shock wave. In this stone crushing, the wave transmitting/receiving surface 16a of the probe 16 is
2, a good B-mode image 25 is displayed on the display means 27,
From this B-mode image 25, the fracture state of the stone 39 can be accurately determined.

In this manner, in the present embodiment, the wave transmitting/receiving surface 16a of the probe 16 is
is located behind the tip of the applicator 17, so even if the applicator 17 is moved, the tip of the probe will not hit the bone of the living body, and after positioning, the probe 16
The transmitting/receiving surface 16a of the applicator 17 is the tip 1 of the applicator 17.
Since it is moved to position 7a, a B-mode image can be obtained that can accurately determine the state of fragmentation of an in-vivo stone.

Although one embodiment of the present invention has been described above, the present invention is not limited to the above embodiment.
Needless to say, various modifications are possible.

[Effects of the Invention] As described in detail above, according to the present invention, B does not cause pain to a living body during shock wave focal region positioning, and can accurately determine the state of fragmentation of stones, etc. in a living body. A shock wave therapy device capable of obtaining a mode image can be provided.

[Brief explanation of the drawing]

FIG. 1 is a block diagram of an apparatus according to an embodiment of the present invention.
Fig. 2 is an explanatory diagram of the probe position during shock wave focal region positioning, Fig. 3 is an explanatory diagram of the probe position during shock wave transmission, Fig. 4 is an explanatory diagram of the contact state management of the probe tip, and Fig. 5 is an explanatory diagram of the probe position during shock wave transmission. An explanatory diagram of standoff length measurement using A mode information, and FIG. 6 is an explanatory diagram of a conventional device. 15... Shock wave generating means, 16... Imaging probe, 17... Shock wave applicator, 22
... CPU (distance detection means), 30 ... position controller (probe movement control means), 31 ... buzzer (alarm generation means), 33 ... water bag (shock wave transmission means).

Claims (1)

[Scope of Claims] 1. A shock wave applicator is formed by having a shock wave generating means that generates a shock wave that is focused in a living body, and a shock wave transmitting means disposed on the shock wave transmitting surface side of this means, and this applicator In a shock wave therapy device, an imaging probe for collecting B-code information of a living body is disposed in the center of the shock wave therapy device, and when positioning the focal area of the shock wave, the wave transmitting/receiving surface of the imaging probe is positioned behind the tip of the shock wave applicator. 1. A shock wave treatment device, comprising probe movement control means for moving the imaging probe so that the wave transmitting/receiving surface of the imaging probe is located at the tip of the shock wave applicator after focal region positioning is completed. 2 distance detection means for detecting the distance between the tip of the imaging probe and the surface of the living body during focal region positioning of the shock wave; and alarm generation means for issuing an alarm when the distance detection result falls below a predetermined value. The shock wave therapy device according to claim 1, further comprising: