JPH06105851A - Ultrasonic therapeutic apparatus - Google Patents

Abstract

PURPOSE:To detect the position of a therapeutic target in real time and to follow it at the focus position by making a constitution wherein a positional information of an irradiated object is detected by irradiating an ultrasonic wave for searching in a plurality of regions in the neighborhood of the object to be irradiated and the focus position or a plurality of piezoelectric elements is controlled based on this. CONSTITUTION:An applicator 1 consists of n pieces of piezoelectric elements 1a, 1b,... and driving circuits 2a, 2b,... being independent from them are each brought into contact with them. Strengths of the driving circuits 2a, 2b,... are determined by the voltage of an electric source 3 and a voltage pulse is each applied on the piezoelectric elements 1a, 1b,... in accordance with delayed values from delayed circuits 4a, 4b,.... The electric voltage is changable between high voltage and low voltage by means of a control circuit 5. In addition, to detect the position, the moving velocity etc., of a concrement 7, echo signals of a plurality of focus in the neighborhood of the concrement are received and reflective strength of each echo focus position is obtd. by a simultaneous receiving method in parallel.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic therapeutic apparatus for irradiating a shock wave from outside the body using a piezo element to crush stones inside the body.

[0002]

2. Description of the Related Art In recent years, as a method for removing calculi in the body without surgery, a method of crushing calculi by focusing intense ultrasonic waves on the calculus site inside the body from outside the body has been proposed and widely used. . Similarly, a method for treating a tumor inside the body by focusing intense ultrasonic waves from outside the body is also being studied.

As described above, high-intensity ultrasonic waves are widely applied in the medical field, but when the treatment target is in the abdomen, such as in the treatment of lithotripsy, the treatment target is moved by breathing. Generally, the focus of the therapeutic ultrasonic wave is fixed, but even if the therapeutic target moves from the focal point, the therapeutic ultrasonic wave continues to be emitted, which damages normal tissue around the therapeutic target. There was a drawback.

Therefore, by irradiating a weak ultrasonic wave for exploration and analyzing the magnitude of the reflected signal from the treatment target, the coincidence and non-coincidence of the focus of the treatment ultrasonic wave with the treatment target are detected, and There is known a technique of irradiating therapeutic ultrasonic waves only when the treatment target coincides with the treatment target to avoid erroneous irradiation other than the treatment target (Japanese Patent Laid-Open No. 63-5736).

However, in the case of a mismatch, the shock wave is not irradiated, so that the number of shock wave irradiations per unit time is reduced, and the temporal treatment efficiency is deteriorated. Furthermore, if the shock wave focus is deviated from the actual position of the calculus, a large reflected wave will not be returned and the shock wave will not be emitted at all.In such a case, the operator will re-position and the reflected wave It is necessary to search for a large returning position, which further increases the treatment time.

Regarding the detection of the position of the treatment target,
Conventionally, coordinate calculation based on radiation image,
While looking at the ultrasonic image, the treatment target was matched with the focus position. However, the method of searching the position of the treatment target while observing the image as described above has a drawback that it takes time to detect the treatment target.

Further, in order to solve such a problem regarding the detection of the position of the treatment target, there is known a method of detecting the position of the treatment target by mechanically scanning an ultrasonic applicator (Japanese Patent Laid-Open No. Sho 63-63). However, when mechanically operating a wide range, there is a problem that it takes time to detect the position of the treatment target.

Therefore, in the method of using a plurality of piezo elements arranged two-dimensionally, a method of three-dimensionally changing the focal position of the shock wave by controlling the drive timing of each element has been proposed. (US registered patent No. 4,526,168). When this is used, it is not necessary to mechanically move the entire treatment head when focusing on the treatment site, so the operability of the device can be dramatically improved.

However, although such a method improves operability, it is necessary to drive many piezo elements at independent timings. Therefore, even if each drive circuit has the ability to drive two or more piezo elements, it is necessary to prepare independent drive circuits for the number of piezo elements, which causes a problem of enormous circuit scale. there were. Furthermore, when the number of piezo elements is reduced to reduce the circuit scale, the quantization error increases, so there is a problem that the output at the focus decreases when the focus position is changed significantly.

[0010]

As described above, the conventional ultrasonic therapeutic apparatus has the following problems. That is, (1) In the case where the treatment target does not match only the geometrical focus position by the method of determining whether or not it matches, the shock wave is not emitted, so that the damage to the surrounding living tissue can be minimized. Although it is possible, the number of shock wave irradiations per unit time is reduced accordingly, and the temporal treatment efficiency deteriorates. Furthermore, if the shock wave focus is deviated from the actual position of the calculus, a large reflected wave will not be returned and the shock wave will not be emitted at all.In such a case, the operator will re-position and the reflected wave It is necessary to search for a large returning position, which further increases the treatment time. As a result, there is a problem that the throughput of the treatment itself is deteriorated.

(2) As a diagnostic problem associated with the movement of the treatment target, when the treatment target is monitored by an ultrasonic image or the like, when the treatment target moves in the direction perpendicular to the ultrasonic image plane, the ultrasonic wave is generated. There is a problem in that it disappears from the screen, making it difficult to accurately and promptly diagnose a treatment target.

(3) In the method of judging only whether or not the treatment target coincides with the geometric focus position, the position of the treatment target becomes completely unknown when the treatment target moves to a position other than the geometric focus position. Therefore, it cannot be used as a method for detecting the position of a treatment target. In addition, the method of detecting the position of the treatment target by mechanical scanning of the applicator has a problem that it takes time to detect the position of the treatment target as a result of mechanically scanning a wide range.

(4) In the method of changing the focus position by controlling the drive timing using a plurality of two-dimensionally arranged piezo elements, it is necessary to prepare independent drive circuits for the number of piezo elements. However, there is a problem that the circuit scale becomes huge. Furthermore, when the number of piezo elements is reduced to reduce the circuit scale, the quantization error increases, so there is a problem that the output at the focus decreases when the focus position is changed significantly.

Therefore, according to the present invention, the position of the treatment target can be detected using ultrasonic waves, and even if the treatment target moves, the position of the treatment target can be detected in real time and the focus position can be tracked. An object of the present invention is to provide a calculus breaking device. Another object of the present invention is to provide an ultrasonic therapy apparatus that enables electronic control of the focus position with a drive circuit that is smaller than the number of piezo elements configured.

[0015]

In order to solve the above-mentioned conventional problems, the present invention provides an ultrasonic therapeutic apparatus for irradiating an object within a subject with a shock wave generated from a plurality of piezoelectric elements for crush treatment. , Means for irradiating a plurality of regions near the irradiation object in the subject with ultrasonic waves for exploration and receiving the reflected wave, and a reflection intensity distribution based on the plurality of reflected waves received by this means Provided is an ultrasonic therapy apparatus comprising: a unit for calculating the position of the center of gravity and detecting the position information of an irradiation target; and a unit for controlling the focus positions of the plurality of piezo elements based on the position information detected by this unit. To do.

Further, in an ultrasonic therapy apparatus for irradiating an irradiation object in a subject with a shock wave generated from a plurality of piezo elements for crush treatment, X-ray imaging for obtaining a plane projection image of a desired position of the subject. And an ultrasonic image capturing means for determining an ultrasonic tomographic plane based on the plane projection image obtained by the X-ray imaging means and acquiring an ultrasonic tomographic image corresponding to the ultrasonic tomographic plane. Position information calculating means for calculating the position information of the irradiation object based on the ultrasonic tomographic image obtained by the ultrasonic image capturing means, and the respective piezoelectric element application timings based on the position information obtained by this position information calculating means There is provided an ultrasonic therapy device comprising a timing control means for controlling the.

Further, in an ultrasonic therapy apparatus for irradiating an object to be irradiated in a subject with a shock wave generated from a plurality of piezo elements to treat the object to be crushed, the driving voltage applied to the plurality of piezo elements is lowered. A switching means for switching between a high voltage and a high voltage, and a shock wave generated when the driving voltage is set to a low voltage, a piezo reflected wave signal output from each piezo element according to a reflected wave reflected in the subject. Receiving means for delaying reception so that the element group has a focus at the same position as the focus when a shock wave is generated, and controlling the focus position so that the focus position can be scanned within a specified area when the drive voltage is a low voltage. Based on the position information obtained by the position information calculation means for calculating the position information of the irradiation target from the reflected wave intensity distribution at each position of the scan area It said to provide an ultrasonic therapy apparatus comprising a timing control means for controlling each piezoelectric element application timing.

Further, in an ultrasonic therapy apparatus for irradiating an irradiation object in a subject with a shock wave generated from a plurality of piezo elements to treat crushing, the irradiation object in the subject is irradiated with a search ultrasonic wave. Means, ultrasonic wave receiving means for exploration spatially arranged at at least three different points for receiving reflected waves from the object irradiated by this means, and the time from the time when the ultrasonic wave for exploration is applied Means for measuring the time until the reflected wave is received, means for calculating the position information of the irradiated object based on the time measured by this means, and a plurality of the plurality of units based on the position information calculated by this means Provided is an ultrasonic therapy device comprising means for controlling the focus position of a piezo element.

Further, in an ultrasonic treatment apparatus for irradiating an irradiation object in a subject with a shock wave generated from a plurality of piezo elements for crush treatment, a plurality of piezo element pairs arranged in point symmetry and the piezo elements. Provided is an ultrasonic therapy device comprising switching means for electrically coupling a pair and means for controlling a focal position of the piezo element pair and the other piezo element pair electrically coupled by the switching means. .

[0020]

According to the present invention, by focusing on that position and irradiating strong ultrasonic waves, the movement of the subject is tracked, and the subject is always present at the focus. False irradiation can be reduced. Further, unlike the conventional case, the treatment efficiency can be improved without stopping irradiation even when the object moves from the focus.

Further, by using the X-ray image diagnostic apparatus and the ultrasonic diagnostic apparatus together or by using the ultrasonic diagnostic apparatus alone, the calculi are visualized on the ultrasonic B mode. At this time, by detecting the respiratory movement direction of the calculi on the X-ray image, the ultrasonic probe is set at an angle such that the calculi are always drawn on the ultrasonic image, and the scanning direction and the depth direction thereof are set. The ultrasonic reflection intensity of is displayed in real time. At the same time, the position of the calculus is calculated from the center of gravity of the reflected wave intensity in the two directions, the focal point is mechanically or electronically scanned to make the shock wave focus coincide with the calculus, and the shock wave is irradiated. The reflected wave intensities in the two directions may be acquired by an inner ultrasonic probe, or the same piezo element that generates a shock wave is driven by a weak voltage to generate an ultrasonic wave, and the reflected wave from the focal area is the same. It is also possible to perform reception by using a piezo element. In the latter case, a function of two-dimensionally scanning the focus position in the B-mode image plane where the calculus is displayed is required.

Here, since the plane on which the calculus is always drawn is cut regardless of the respiratory movement on the B-mode image, the position of the calculus and the respiratory movement range are set by an indicator such as a trackball. Then, by detecting the maximum point of the reflected wave intensity only within that range, malfunction due to surrounding gas can be prevented, and more safe and effective treatment can be performed. Further, it becomes possible to automatically track calculi, and it can be expected that treatment time will be shortened and throughput will be improved. Next, the operation of the pair of piezo elements arranged point-symmetrically will be described.

Focus movement by controlling the drive timing of a plurality of piezo elements is called a phased array technique. The propagation time is calculated from the distance from each point to each piezo element and the speed of sound, and the timing of each drive is adjusted so that the ultrasonic waves emitted from each piezo element reach that point at the same time. It is known to be the focus. Therefore, piezoelectric elements having the same propagation distance may be driven at the same timing, and if the electric capacity of the driving circuit is sufficient, one driving circuit can drive a plurality of piezoelectric elements having the same propagation distance.

This operation will be described with reference to FIG. Figure 2
As shown in FIG. 4 (a), the spherical shell-shaped applicator 1 is a to x.
When the piezo element is composed of 24 piezo elements, the piezo elements are arranged symmetrically with respect to the axes 241 to 246. When forming the focal point F, if the focal point 2 is on the plane 24 including the central axis 24 and the axis 24 of the applicator, as shown in FIG.
Since 12 sets of piezo elements such as 1 and b and k have the same distance to the focal point, they can be driven at the same timing, and if there is a capacity to drive two piezo elements, one set of piezo elements can be used. They can be electrically coupled and driven by the same drive circuit. Therefore, the number of drive circuits that is half the number of piezoelectric elements is possible. Next, when the focus F is moved three-dimensionally, the set to be electrically coupled may be changed. That is, if a plane 24 passing through the focal point F and the central axis 24 passes through the axis 24, the set of piezo elements is changed to a and b and c and l. With the above operation, the number of drive circuits can be reduced to half that of the conventional one. Here, strictly speaking, it is impossible to set the focus within θ degrees between the axes of symmetry, but it can be put to practical use by reducing θ or enlarging the focus size.

Further, this modification will be described with reference to FIG. In this configuration, a plurality of piezo elements have one symmetry axis 25.
Is symmetric only with respect to. Therefore, the focus can be moved only on the plane including the central axis of the applicator 1 and the axis of symmetry 25. When the rotational movement of the entire applicator 1 (minimum 180 degrees) is added thereto, the focus can be freely set over the entire treatment space.
Therefore, also in this case, the number of drive circuits can be halved as compared with the conventional case as in the above-mentioned invention. The only difference is that the same piezo element is always used as a set, so that means for changing the electrical coupling is unnecessary.

In the first configuration, if the treatment target is extremely small and the focus cannot be increased, or if θ cannot be reduced due to the limit of the number of piezo elements, the focus non-settable region θ may be a problem. Further, as in the case of the modification described above, it may be difficult to rotate as much as 180 degrees because the mechanism becomes large. Therefore, the focus can be set in the entire treatment region by allowing the rotation of the entire applicator by θ while keeping θ large, and the number of drive circuits can be reduced by half.

[0027]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to the drawings. [First invention]

FIG. 1 is a diagram showing the configuration of an ultrasonic therapeutic apparatus according to an embodiment of the present invention. In FIG. 1, an applicator 1 includes n piezoelectric elements 1a, 1 spatially arranged.
., and the piezo elements 1a, 1b ,.
Independent drive circuits 2a, 2b, ... Are connected to each other. The strength of each of the drive circuits 2a, 2b, ... Is determined by the potential of the power supply 3, and a voltage pulse is applied to the piezo elements 1a, 1b, ... In accordance with the delay value from the delay circuits 4a, 4b ,. Here, it is assumed that the power source 3 can change between a high voltage and a low voltage in order to generate a weak ultrasonic wave and a strong ultrasonic wave capable of crushing stones. This change in voltage is controlled by the control circuit 5. The ultrasonic treatment apparatus configured as described above has a coupling material (not shown).
The calculus 7 is brought into contact with the subject 6 through the and the strong ultrasonic wave is applied.

In this embodiment, echo signals at a plurality of focal points near the calculus are received in order to detect the position, the moving speed, etc. of the calculus 7. The plurality of focal points are three-dimensionally arranged in, for example, a cylinder so as to include the predicted calculus movement range around the calculus center position 7a as shown in FIG. Is obtained by the parallel simultaneous reception method. Here, the parallel simultaneous reception method will be described.

Conventionally, as shown in FIG. 3 (a), ultrasonic waves are focused on a geometrical focus for both transmission and reception, and one transmission and reception results in 1
In contrast to the case where only the information of one focal area d0 having a focal point at a position can be obtained, the information of a plurality of focal lines can be obtained by one transmission. Figure 3 (b)
FIG. 4 is a diagram showing a principle diagram of a parallel simultaneous reception method. First,
Any piezo element 1x selected from the piezo element group
To transmit spherical ultrasonic waves. Next, the ultrasonic echo signals reflected at all points in the subject are received by each piezo element group. At this time, the phases of these received waveforms are shifted and added so as to be in phase with respect to a certain position, in other words, if the phases are shifted and added so that the point is focused, The waveforms cancel each other out of the focus, the amplitude increases only at the focus, and the reflection intensity at the focus can be obtained. In this way, by recording each of all the waveform data obtained by each piezo element group by one transmission / reception in the memory, for example, by shifting the phase with respect to a plurality of focal points d1 to d4 and adding,
Information about multiple focal points can be obtained at the same time. Next, a method of using the ultrasonic therapy device according to the present invention will be described. FIG. 4 is a diagram showing a flow of operations of the ultrasonic therapeutic apparatus according to the present invention.

First, a weak spherical ultrasonic wave is transmitted from the piezo element 1a located near the center of the applicator 1 in FIG. 1 (S1). This spherical ultrasonic wave is reflected by the stone 6 due to the difference in acoustic impedance, and the echo signal waveform is received by each piezo element (S2). The received echo signal waveform is converted into an electric signal,
The signals are digitally sampled by the / D converters 8a, 8b, ... (S3) and input to the control circuit 5. First, the control circuit 5 adds delay values to waveforms received by each piezo element for each set focus so that virtual distances between the focus and the elements become equal, that is, in-phase. (S4). This addition may be a weighted addition depending on the conduction distance in order to improve the sensitivity. Now, when the added waveform as shown in FIG. 5 is obtained, only the time ranges T1 and T2 corresponding to the desired focal ranges d1 and d2 are cut out, and the power (integrated value) or peak of the waveform in the range is detected. Then, let this be the reflection intensity in each focal region (S5). Collect data at all focal points with similar steps. The center of gravity of the signal intensity is calculated from the spatial distribution of the reflection intensity obtained in this way, and it is set as the spatial position of the stone.

Here, a method of calculating the center of gravity will be described. In this embodiment, intensity information is added to each of the x, y and z axes for projection (S6). This is because, as shown in FIG. 6A, in the projection onto the x-axis, first the three-dimensional distribution is added in the z-axis direction at each point on the xy plane, and the two-dimensional mapping is performed. The data is y at each point on the x-axis
It is obtained by adding in the axial direction. Then, the center of gravity of each is calculated, and the obtained coordinates are used as the coordinates of the center of gravity (S7). The obtained barycentric coordinate data is stored in the memory 9. Further, the difference between the position coordinates obtained by the previous position detection and the coordinates obtained this time is obtained, so that the movement vector between the previous transmission and the current transmission can be obtained (S8). By dividing it by the time Δt between transmissions, the moving velocity vector of the calculus can be obtained (S9). These are displayed as the calculus information on the CRT 12 by superimposing the images obtained by the ultrasonic diagnostic imaging apparatus 10 by the DSC 11. Based on this information,
Determine the focus position of the next strong ultrasonic wave with a light pen, keyboard, etc., or with a feedback loop (S1
0). Then, the control circuit 5 controls the delay circuits 4a, 4b, ... To that position in the same manner as when receiving, and supplies a high voltage from the power source 3 to each piezo element to irradiate a powerful ultrasonic wave for treatment. (S11).

The time interval between weak ultrasonic waves and strong ultrasonic waves is
Since it is extremely small for the movement of stones, the irradiation position of strong ultrasonic waves is the position of the center of gravity estimated by weak ultrasonic waves, and the central focal position of the focus distribution of the next weak ultrasonic waves is the same as the previous strong ultrasonic irradiation position. A weak ultrasonic wave can be applied to the center. FIG. 7 is a diagram showing an example of a combination of transmission of weak ultrasonic waves and strong ultrasonic waves. In FIG. 7A, the focal position of the strong ultrasonic wave a4 and the central focal position of the focal distribution of the weak ultrasonic wave a5 are made the same. The focus distribution position of the weak ultrasonic waves may be fixed, but in that case, the range of the focus distribution of the weak ultrasonic waves needs to be wide enough to include the movable range of the calculi.

It is also possible to predict the transmission position of such weak and strong ultrasonic waves on the control circuit. This prediction is considered to move at a constant speed from the measured position in the direction of the measured velocity vector until the irradiation of the next strong ultrasonic wave, and the next irradiation position is estimated as shown in FIG. 7B. This operation is repeatedly performed as shown in FIG. 7B, and the set focus distribution for position and speed detection is set centered on the previously predicted stone position each time. In this embodiment, the position of b4 is estimated from the positions of b1 and b3, and the position of b5 is the same as that of b4. Further, as shown in FIG. 7C, the focal points of the strong ultrasonic waves and the weak ultrasonic waves may be predicted to constantly move the focal points. In this case, for example, the positions of c4 and c5 are estimated from the positions of c1 and c3.

The progress of the treatment is observed in real time by the ultrasonic image diagnostic apparatus 9, and the apparatus can be freely stopped as soon as the operator completes the treatment. Here, it is expected that the focus will be out of the image plane of the ultrasonic image diagnostic apparatus 9 due to the above-described automatic tracking, but since the focus position coordinates are known, the image plane is simultaneously received in parallel with weak ultrasonic waves. If the stone is rotated so as to always include the three-dimensional position of the stone, the treatment can be continued without losing the stone on the image. Alternatively, if an ultrasonic diagnostic apparatus of the type that collects three-dimensional image information is used, it will never be lost.

In order to prevent erroneous irradiation when stones deviate from the set range of the distribution of multiple focal points, irradiation is performed only when the intensity of the center of gravity exceeds a preset threshold value, and if not, treatment is performed. Then, the calculus is searched for again in the ultrasonic image obtained by the ultrasonic probe 9, and the focus setting position is changed. With the above configuration, it is possible to always recognize the position of the calculus, automatically track the position, and perform treatment on the position. It should be noted that the present invention is not limited to the above-described embodiment, but can be appropriately modified as in (a) to (e).

(A) In this embodiment, a spherical applicator was used, but a planar applicator array can be used as well. Further, although the electronic focus movement applicator array is used, a mechanical focus movement may be used. In that case, a phase delay circuit is not required, but a movement control circuit for the applicator is required instead.

(B) In the present embodiment, the information of a plurality of focal points is obtained by the simultaneous simultaneous reception by the simultaneous irradiation. However, even when only the intensity data of one focal point is obtained by a single transmission as in the conventional example, A similar effect can be obtained by scanning this at each set focal point very quickly. It is also possible to divide the plural focal points into several parts, obtain echo signals for each of them by parallel simultaneous reception, and combine the results.

(C) In the present embodiment, the position and speed detection by weak ultrasonic waves and the treatment by strong ultrasonic waves are performed once, respectively, but the position and speed detection and strong ultrasonic wave irradiation are collectively performed a plurality of times. You can go.

(D) In the present embodiment, when the intense ultrasonic wave is emitted, the phase is controlled through the delay circuit. However, the phase is calculated on the control circuit in the same manner as at the time of reception, and the timing is directly output from the control circuit. The triggers may be output in parallel to the drive circuit with. (E) In the present embodiment, the irradiation position prediction method is not limited to the one described above, and a linear prediction model or the like may be constructed from the position data of some past points, and is not limited to this. Although the calculus crushing device has been described above, other treatment targets may be used as long as the treatment target is an acoustically strong reflector. [Second invention]

FIG. 8 is a diagram showing the configuration of the ultrasonic therapeutic apparatus according to the present invention. In FIG. 8, the applicator 1 is
A plurality of ring-shaped piezoelectric elements 1a, 1b, ..., Which are shock wave sources, are arranged concentrically and are in contact with the subject 6 by a coupling material.

A drive circuit is connected to each of the piezoelectric element groups. The drive circuit 2 is connected to a power source 3 whose voltage can be arbitrarily switched, and is controlled so that the focal pressure becomes constant even if the focal point is electronically scanned, for example. A drive phase delay circuit 4 is connected to the drive circuit 2. The drive phase delay circuit 4 is configured by using, for example, a shift register or a delay line capable of delaying a pulse of a logic level, the control circuit 5 controls the delay amount, and each drive circuit 2 has a predetermined timing. The trigger pulse is supplied with to control the application timing of the drive voltage to the piezo element.

The delay amount of the drive phase delay circuit 4 is determined by the auxiliary input device 13 when the piezo element group generates a shock wave.
(For example, light pen, keyboard, trackball,
Even if the user sets so that the focus is substantially at the position specified by the mouse, etc., the drive phase of each transducer is calculated from the image and the focus position (depth) is automatically calculated as described later. May be controlled so as to change

At the center of the applicator 1, an ultrasonic probe 14 and an X-ray tube 15 are held in a watertight manner so that they can be mechanically moved and replaced by a pulse motor 16. The movement of the ultrasonic probe 14 and the X-ray tube 15 in the axial direction of the applicator, the horizontal movement for exchanging the two, and the rotation / movement of the ultrasonic probe 14 are performed by the pulse motor controller 17 according to a command from the control circuit 57. Controls each pulse motor.

The ultrasonic image diagnostic apparatus 10 is for obtaining a signal transmitted and received by the ultrasonic probe 14 as an ultrasonic B-mode image, and the X-ray image diagnostic apparatus 18 is also provided.
Is for obtaining the signals acquired by the X-ray tube 15 and the X-ray imaging tube 19 as a plane X-ray image. These images are displayed simultaneously or individually on the CRT 12 via the DSC 11. Next, the operation of the ultrasonic therapy apparatus according to this embodiment will be described.

First, as shown in FIG. 9A, the pulse motor controller 17 is controlled so that the X-ray tube 15 comes to the center of the applicator 1 in the initial state, and an X-ray fluoroscopic image of the patient is taken. FIG. 9B is a diagram showing an X-ray image displayed on the CRT 12. By observing the real-time X-ray image, the position of the calculus and the moving direction of the calculus due to respiration can be known.
Give location information by. If stones (that is, lumps with a small amount of X-ray transmission other than bone) can be recognized on the X-ray image,
It is possible to extract a two-dimensional velocity (direction of change in X-ray transmission amount) on a real-time X-ray image. That is,
By obtaining the difference image of the previous screen from the temporally later screen of two screens with slightly different times, as a vector from the center of gravity of the low luminance signal portion to the center of gravity of the high luminance signal portion as shown in FIG. The respiratory movement direction of can be easily obtained. As a result, the position and the moving direction of the calculus can be known, so that it is possible to obtain a cross section capable of always depicting the calculus. Therefore, by mechanically moving the entire applicator, the respiratory movement path of the stone can be set so as to pass through the center on the X-ray image (FIG. 9C). Next, the X-ray tube 15 is horizontally displaced from the central axis of the applicator 1, and the pulse motor controller 17 controls the pulse motor 16 so that the ultrasonic probe 14 is brought into close contact with the body surface of the subject 6. Further, the probe is rotationally controlled so that the plane of the ultrasonic B-mode image matches the respiratory movement direction of the stone obtained from the X-ray image, so that the stone is always depicted on the ultrasonic B-mode image. Set (FIG. 9 (d)).

At this time, an ultrasonic image as shown in FIG. 11 is displayed on the CRT 11, and the ultrasonic reflection intensity 111 in the ultrasonic scanning direction and the ultrasonic reflection intensity 1 in the depth direction 1 are displayed.
12 are displayed at the lower end and the left end, respectively. next,
The flow of stone position detection from this B-mode image will be described with reference to FIG.

In the B mode image, the ultrasonic A mode is fan-shaped scanned, the position from the probe tip is calculated from the angle of reflection and the propagation time, and the reflected wave intensity corresponding to that position is 8b.
It is displayed on the image as image data of it. This image data is stored in an image memory (VRAM) inside the ultrasonic diagnostic apparatus together with position information. A coordinate having the maximum luminance signal on this memory is calculated by the luminance signal comparison circuit 121, and the one-dimensional distribution of the reflected wave signal intensity in the scanning direction and the depth direction passing through the coordinate is respectively depth-direction / horizontal-direction A mode. Data is acquired by the data acquisition circuits 122 and 123, and DSC1
Display as 111, 112 on the CRT 12 via 1. At this time, it is possible to control the electronic scanning / applicator mechanically to move the focal point to the position having the maximum luminance signal so as to irradiate the shock wave, but the calculus itself has a certain matrix. Therefore, it is possible to detect the calculus position more accurately by obtaining the barycentric position of the intensity in each direction from the reflected wave signal intensity distribution displayed on 111 and 112. Therefore, this method allows the shock wave focus to automatically follow the calculus.

Since the annular array type transducer can move only one-dimensional focus in the depth direction, it is necessary to mechanically move in the horizontal direction. However, even if the mechanical movement in the horizontal direction is not performed, the movement on the central axis is possible. It is also possible to control so that the shock wave is emitted only when a calculus comes.

At this time, in order to prevent misidentification due to intestinal gas or the like, the user instructs the respiratory movement range 113 of the stone with the auxiliary input device 13 as shown in FIG. That is, it is also possible to obtain the distribution of the intensity of the reflected wave in a predetermined coordinate area in the VRAM,
This allows more accurate stone position determination.

In the above-mentioned embodiment, the intensity of the biaxial reflected wave passing through the high-brightness portion on the screen is displayed, but it is also possible to display the integrated value of the band-shaped portion having a certain width as the reflected wave intensity. . Further, it is also possible to display the values obtained by integrating the reflected wave intensity data in the respiratory movement range 113 of the stone instructed by the user in the scanning direction and the depth direction.

Although the annular array type oscillator is used in the above-mentioned embodiment, the use of the two-dimensional array type oscillator allows the focus to be scanned three-dimensionally. Eliminates the need to move.

In the above-described embodiment, a normal two-dimensional B-mode diagnostic apparatus is used as the ultrasonic diagnostic apparatus, but three-dimensional stone extraction can be performed by using the ultrasonic diagnostic apparatus capable of three-dimensional scanning or volume scanning. Since it is possible, three-dimensional focus tracking becomes possible. Next, an ultrasonic therapeutic apparatus according to the second embodiment of the present invention will be described.

FIG. 13 is a view showing the arrangement of an ultrasonic therapeutic apparatus according to another embodiment of the present invention. Ultrasonic probe 14
The movement / rotation operation of the X-ray tube 15 and the image data acquisition and display by the ultrasonic image diagnostic apparatus 10, the X-ray image diagnostic apparatus 18, etc. are the same as those of the annular array type. Realized by receiving reflected waves when the piezoelectric element groups 1a, 1b for shock wave generation are driven with a weak voltage without using the inner ultrasonic probe 14 and by the same piezoelectric element groups 1a, 1b ,. To do. Here, the piezoelectric element groups 1a, 1b, ... Are two-dimensional array type vibrators, and the focus can be three-dimensionally scanned by controlling the drive phase. This operation will be briefly described. After setting so that stones are always drawn on the ultrasonic B-mode image by the same method as in the first embodiment, first, the changeover switch 131 is changed over to the low voltage power source 3b side. . When the operator operates the treatment start switch (not shown), the drive circuit 2 is activated by the trigger pulse from the drive phase delay circuit 4. As a result, the piezo element groups 1a, 1b, ... Are driven in a pulsed manner at a low voltage and emit ultrasonic pulses with a weak pressure that does not cause a shock wave. This ultrasonic pulse is irradiated into the body of the subject 6 via the propagation medium in the coupling material, and is focused on the focal region set by the delay time of the drive phase delay circuit 4. Here, the delay amount of the delay circuit 4 is controlled by the control circuit 5 so that the focus position of the search ultrasonic wave is horizontally scanned within the drawn screen. The delay amount is determined according to the delay information stored in advance in the memory 9 in order to enable a faster focus movement.

The ultrasonic pulse applied to the inside of the body is reflected by the portions having different acoustic impedances. This reflected wave is received by the piezo element group 1, and in the obtained reflected wave signal, the focus region set by the reception delay circuit 4, that is,
A signal from the same area as the focus area set by the drive phase delay circuit 4 is supplied to the adding circuit 132. This is because the control circuit 5 causes the receiving delay circuit 4'to have a sampling gate after the ultrasonic wave reciprocating time between the piezo element groups 1a, 1b, ... And the focus at the timing when the drive circuit 2 generates a low voltage pulse. This can be achieved by supplying a gate signal that applies a signal. The reflected wave signal from the focal region, which is detected by the reception delay circuit 4 ′ with the same phase, is directly sent to the control circuit 5.

At this time, the focus moving range in the horizontal direction is previously set to X.
Since it is determined by a line image or the like, for example, a range in which a calculus exists in the depth direction is set as a preset value, and the range determined by the preset value is scanned, or the operator specifies it with the auxiliary input device 13. Depth (ie
The horizontal distribution of the reflected wave intensity is measured by scanning only the depth where the calculus exists), and CRT1
It is displayed at the lower end of the ultrasonic image above 2. Further, the weak ultrasonic focus is scanned in a direction passing through the maximum position or the center of gravity of the reflected wave intensity display 111 displayed at the lower end, and a similar reflected wave intensity distribution 112 is obtained in the depth direction, and the CRT is also used.
12 Display on top.

The signal from the drive phase delay circuit 4 is controlled so that the focal point coincides with the position determined by each barycentric position thus obtained, and the changeover switch 131 is switched to the high voltage power source 3a side to generate a shock wave. Irradiate.

In the above examples, the position of the calculus is determined by the barycentric position of the reflected wave intensity distribution in two directions. However, the position of the reflected wave maximum intensity in the scanned range is not limited to this, and the position of the calculus is determined. It is also possible to In addition, assuming that there is a stone in the place where the reflected wave above a certain threshold is returned, measure and display the two-dimensional distribution of the stone,
It is also possible to perform shock wave irradiation / treatment while scanning the area. FIG. 14 is a diagram showing the configuration of the delay time compensation circuit.

The delay time compensating circuit can accurately match the driving phases of all the transducers at the position requested by the user because the transmission time varies in the driving circuit 2 and in the driving pulse transmission system. Due to the difficulty, the peak pressure required at the focus position may not be obtained. It is extremely difficult to adjust such variations in transmission time to be constant in all drive circuits, and it is considered impossible in practice. Therefore, in order to solve such a problem, it is considered necessary to provide a circuit for compensating the delay time with respect to the set time.

In FIG. 14, first, the changeover switch 13
With 1 being on the side of the low voltage power supply 3b, the delay data is sent from the control circuit 5 toward the drive phase delay circuit 4 of each channel so as to focus on the designated position. next,
The control circuit 5 generates an initial drive pulse A. The initial drive pulse A is input to the drive phase delay circuit 4 and triggers the counter 141. From that point, the counter 141 starts counting the time (number of times) of the clock 142. The drive phase delay circuit 4 gives the set delay to the input pulse and causes the drive circuit 2 to trigger B.
To drive the piezo element group 1, the output voltage C of the drive circuit 2 is sent to the comparison circuit 143, and the voltage threshold T
Compared to H. Then, when the output voltage C becomes larger than TH for the first time, the pulse D is sent to the counter 141 to close the counter gate. Then, the actual delay value is measured depending on how many clock pulses are input between the counter gates, and the delay value comparison circuit 144 is provided with the delay value.
The delay value comparison circuit 144 compares the set delay value on the memory 9 with the actual delay value, and the control circuit 5 resets the drive phase delay circuit 6 again so that the actual delay time and the set time match. cure. This enables the phases of all the vibrators to be accurately matched at the position requested by the user. At this time, the difference between the actual delay time and the set time is stored in the memory 9, and in the subsequent treatment, the delay amount is set with a value that compensates for the difference with respect to the calculated set time.

In the above embodiment, the compensation of the delay value has been described. For example, when the actual delay value is within the set value ± ΔT, it is assumed that the drive phase delay circuit 4 is operating normally and the delay value is compensated. However, if it exceeds the above range, it is considered as a failure of the drive phase delay circuit 4 and a message to that effect is displayed on the CRT (not shown), or the user is notified by a sound or the treatment is impossible. It is also possible to control so that the operation of the device is stopped in order to make [Third invention]

FIG. 15 is a diagram showing an ultrasonic therapeutic apparatus according to an embodiment of the present invention. In the figure, the ultrasonic applicator 1 is composed of a plurality of piezoelectric elements arranged in a spherical shape, and an ultrasonic probe 15 for imaging is provided at the center of the applicator 1. The applicator 1 is brought into contact with the subject 6 through a propagation medium of acoustic energy (for example, water or ultrasonic jelly) in order to crush and treat the calculi 7 in the subject 6.

The piezoelectric elements 1a, 1b, ... Can be driven independently of each other, and are connected to the drive circuits 2a, 2b ,. Has been done. Drive circuits 2a, 2
b, ... Are connected to the delay circuit 4, and the control circuit 5 generates a delay value for obtaining a desired focus position.
A dimensional array focus moving device is constructed.

First, the operation when searching for a treatment target will be described. One piezo element arbitrarily selected from the piezo elements 1a, 1b, ... Is connected to the exploration drive voltage source 21 and used as a piezo element for exploration, and any three piezo elements are reception signals. The receiving piezo element connected to the buffer 22 can be appropriately selected by the switching device 20 controlled by the control device 10. That is, when a good reception signal cannot be obtained due to an obstacle such as a bone, the control device 10 controls so that a good reception signal is obtained by changing the search piezo element and the reception piezo element. The reception signal buffer 22 is connected to the control circuit 5, and the control circuit 5 calculates the distance from the time taken from transmission to reception of the probe ultrasonic signal to the treatment target.

FIG. 16 is a diagram for explaining the principle of position detection of the treatment target. Now, the piezo elements 1a, 1b, ...
Ultrasonic waves are radiated from the exploration piezo element 161 selected from among the above, reflected by the calculus 7, and received by the piezo element 162.
~ 164 received. At this time, assuming that the distances b, c, and d are different, the timings of the transmission ultrasonic wave and the reception ultrasonic wave are as shown in FIG. At this time, the delay time indicated by the arrow in the figure is a value obtained by dividing the distances a + b, a + c, and a + d by the sound velocity. Therefore, the distances a + b, a + c, and a + d can be calculated by measuring the delay time. In other words, the treatment target exists on the ellipsoidal surface having the exploration piezo element 161 and the receiving ultrasonic piezo elements 162 to 164 as the focal points. In the above case, there are three ellipsoids. Since these three ellipsoids intersect at one point,
The position of the treatment target is calculated three-dimensionally by solving the simultaneous equations for the three ellipsoids. If the ultrasonic waves for exploration are applied during the irradiation of the therapeutic ultrasonic waves, the position of the therapeutic target can be calculated in almost real time.

By the way, in FIG. 15, the ultrasonic probe 14 is connected to the ultrasonic probe moving mechanism 23. As described above, since the position of the treatment target can be calculated in real time, when the treatment target deviates from the slice plane of the ultrasonic image, the ultrasonic probe moving mechanism 23 mechanically moves the ultrasonic probe 3 (for example, Rotation) so that the treatment target is always visualized on the ultrasound image.
Next, a method of tracking a treatment target will be described in detail by taking calculus breaking as an example.

Each piezo element radiates a shock wave for calculus breaking. When the movement of the treatment target is detected, as described above, one arbitrary piezo element is driven by the drive pulse for calculus search and the other piezo elements are not driven. Now, it is assumed that the focal position and the calculus are matched with each other by using an ultrasonic image, a radiation image, and other means. An ultrasonic pulse is emitted from the piezo element for exploration, and at least 3 reflection signals reflected by the calculus are emitted.
Received by one or more transducers. At this time, since the calculus is first matched with the focal position, a reflection signal from the bone or other ultrasonic reflector and a reflection signal from the calculus can be distinguished by providing a time gate for reception. . When a stone moves due to breathing, etc., the reception timing of each piezo element is limited within the range in which the stone moves within the measurement interval in order to distinguish it from the reflected signal from the bone or other ultrasonic reflectors. To do. Under such conditions, ultrasonic waves for exploration are emitted, the time until the reflection signal from the treatment target is received is measured, and the position of the treatment target is calculated by the above-described method. At that time, the position of the treatment target is stored in a memory (not shown) in the control circuit 5 together with the measurement time. By repeating this operation a predetermined number of times, a series of calculus positions at arbitrary times can be created. Therefore, since the control circuit 5 can calculate the moving amount, moving direction, and moving speed of the calculus per unit time from the position of the calculus at a certain time and the position of the calculus at the next time, the position of the calculus at any time. Information, moving direction and moving speed can be monitored in real time. Therefore, from these data, when the calculus displayed on the ultrasonic tomographic image disappears from the screen due to the movement, the ultrasonic probe 15 is moved by the ultrasonic probe moving mechanism 23, and the ultrasonic screen is displayed. By aligning the direction of the stone with the moving direction of the stone, it becomes possible to always visualize the stone on the ultrasonic tomographic image.

As described above, after detecting the calculus position, the moving direction and the moving speed, the control circuit 5 calculates the delay value to be set in the delay circuit 4 based on these data,
A two-dimensional array is used to electronically move the focal position to irradiate a shock wave. By repeating the above operation, it becomes possible to always draw the treatment target on the ultrasonic tomographic image. Further, the measured data and the therapeutic ultrasonic focus position are displayed in real time on the operator's monitor, and the numerical data can be used to immediately determine whether the calculus position and the focus position are the same or not. If they do not match, the shock wave is not emitted. Another embodiment of the present invention will be described below.

FIG. 18 is a diagram showing an embodiment of the ultrasonic therapeutic apparatus according to the present invention. In the second embodiment, three ultrasonic wave generation sources for exploration (not necessarily piezoelectric elements) 181-
The generated ultrasonic frequencies of 183 are different from each other, and the structure is the same as that of the first embodiment except that the ultrasonic wave generating sources 181 to 183 for exploration are also used for reception. These search ultrasonic wave generation sources 181 to 183 are connected to a search drive voltage generation source 23 and a reception signal buffer 22 that generate three or more types of frequencies. Received signal buffer 2
2 includes a resonance circuit whose resonance frequency is variable or fixed,
Any frequency signal can be selected. Here, the principle of detecting the position of the treatment target (calculus) will be described with reference to FIG. In FIG. 19, the ultrasonic wave sources 181 to 183 for exploration are
These are ultrasonic wave generation sources having different generation frequencies, and also receive a reflected signal. Now, it is assumed that the ultrasonic wave generated from each transducer is received by the same transducer as the generation source as shown in FIG. When the time until reception is measured based on the time when the ultrasonic wave is emitted from each vibrator, it is equal to the value obtained by doubling the distance from each vibrator to the calculus and dividing by the speed of sound. The calculus position is a position where each oscillator draws a spherical surface having a radius of the above-mentioned delay time and intersects them. Therefore, if there are three transducers, the stone position can be specified three-dimensionally. Furthermore, even if the number of calculi is plural, if the position is not the same as other calculi, the time chart of ultrasonic wave emission and reception becomes as shown in FIG. 20 when there are two calculi, for example. The position of each calculus can be specified by solving the simultaneous equations that satisfy these delay times and boundary conditions (inside the spherical shell of the piezo element group). Further, another advantage of using such a multi-frequency probe ultrasonic wave is that if the frequency of the therapeutic shock wave and the probe ultrasonic frequency are made different, the emission of the probe ultrasonic wave during irradiation of the therapeutic ultrasonic wave and Receiving is always possible, and thus more accurate real-time monitoring of calculus position is possible. Here, the calculation result is shown as an example.

When the three ultrasonic transducers for exploration are arranged as shown in FIG. 21 (in the figure, the origin is the geometrical focus position and the unit is millimeters), for example, a calculus is present at the position (3, 2, −5). If it exists, the speed of sound in water and in the living body is 1
Table 1 shows the delay time until the ultrasonic wave transducers are received at 500 m / s. Further, a time chart at that time is shown in FIG.

[0071]

[Table 1]

Therefore, the calculus position calculated from the delay times shown in Table 1 is (3.0, 2.0, -5.0).
Here, if the treatment target is, for example, a calculus, the size of the calculus is usually several millimeters to ten and several millimeters, so the accuracy of the position search is sufficient to be 0.5 mm. Therefore, the speed of sound is 15
Considering that it is 00m / s, the delay time is 0.1μ
It is sufficient to measure up to the s digit. Since the speed of sound changes with temperature, it is advisable to calculate the speed of sound by measuring the water temperature in the applicator and the body temperature of the subject, or to directly measure the speed of sound.

In addition to the method of identifying a plurality of calculus positions by the three frequencies described above, a time period in which a reflected signal can be received using a single frequency and three ultrasonic wave generators and three receiving ultrasonic vibrators. If ultrasonic waves for exploration are emitted from each transducer at the above intervals, it is possible to specify a plurality of calculus positions by the same method as the above-described calculation of position by three frequencies. However, in that case, the time resolution of the stone position monitoring decreases. Although the calculus crushing device has been described as an example, the present invention can be applied to ultrasonic treatment devices other than the calculus crushing device as long as the treatment target is a high-reflector of ultrasonic waves. [Fourth Invention]

FIG. 23 is a diagram showing an ultrasonic therapeutic apparatus according to an embodiment of the present invention. As shown in FIG. 24, the applicator 1 has 36 piezo elements arranged in a spherical shell rotational symmetry, and has a shape divided in the radial direction and the circumferential direction. Therefore, it has nine symmetry axes and the angle θ between the axes is 20 degrees. Also, in the center of the applicator 1,
An ultrasonic probe 14 for observing the condition of the treatment target during treatment is provided, and can be displayed as an ultrasonic tomographic image by the ultrasonic image diagnostic apparatus 10. Further, the ultrasonic probe 15 can change the relative position with respect to the applicator 1 by the movement of the probe moving mechanism 23 such as back and forth and rotation. It should be noted that the rotation operation in this case is not continuous but can be set discretely only at the position that coincides with the target axis. The surface of the applicator 1 is sealed with a flexible film (not shown) that sufficiently transmits ultrasonic waves, and is filled with a liquid (not shown) for coupling with a subject. Further, the applicator 1 is held by the applicator moving mechanism 24 and its position is three-dimensionally controlled.
The piezo elements 1a, 1b, ... Are each connected to a changeover switch 21, and this changeover device 20 electrically connects any two piezo elements based on a signal from the control circuit 5, and further drives the drive circuit. 2a, 2b, ... The changeover switch 21 is specifically composed of a set of mechanical relays and solid-state switching elements. And
The drive circuits 2a, 2b, ... Include delay circuits 4a, 4 respectively.
The high voltage pulse is transmitted at the timing of the trigger signal sent from the control circuit 5 via b, .... Next, an operation procedure of the ultrasonic therapy apparatus according to the present embodiment will be described.

The operator operates the auxiliary input device 13 including a keyboard and a joystick to bring the applicator 1 into contact with the subject surface by using a coupling jelly (not shown). Then, while changing the position of the applicator 1, the ultrasonic diagnostic imaging apparatus 1
The stone to be treated is imaged on the CRT 12 by 0. Next, when the operator instructs a stone on the CRT 12 with a pointing device such as a light pen, the control circuit 5 causes the ultrasonic probe moving mechanism 23 to move the ultrasonic probe 1 to the calculus.
The ultrasonic probe 14 reads the direction in which 4 is facing.
The switching device 20 is controlled so as to electrically couple the piezo elements located symmetrically with respect to the axis of symmetry that coincides with the angle. Then, the delay value of each piezo element pair required to match the focus F with the coordinates designated by the light pen is calculated and sent to the delay circuit 4. Then, the drive circuits 2 are respectively driven according to the delay value of the delay circuit 4 to drive the piezo elements via the switching device 20. As a result, ultrasonic waves having different phases are emitted from each piezoelectric element pair to form the focal point F.

Since the axis of symmetry is discrete and the rotational direction can be set only for each θ angle, the focus F cannot be set if there is a calculus in between, but the angle of the ultrasonic probe is aligned with the axis of symmetry. With a slight mechanical vibration of the applicator, it is possible to match the treatment target on the ultrasonic tomographic image, that is, on the focusable surface. Alternatively, if the applicator moving mechanism 24 enables the rotational movement of the minimum θ angle about the central axis of the applicator 1, even if the rotational angle of the ultrasonic probe 15 is continuously variable, as described above. In addition, the focus F can be matched to all points. That is, as described above, when the calculus is drawn on the CRT 12 while changing the position of the applicator 1 and the calculus on the CRT is instructed by the light pen, the control circuit 5 causes the probe moving mechanism 23 to face the ultrasonic probe 14. Read the direction. Here, the control circuit 5 selects the axis of symmetry of the applicator 1 that is closest to the angle of the ultrasonic probe 14, rotates the applicator 1 via the applicator moving mechanism 24, and the axis of symmetry and the ultrasonic probe 14 are selected. Match the angles of. Then, similarly, a delay value is set and ultrasonic waves are emitted. Next, another embodiment of the present invention will be described.

In the present invention, there is no switching device in which the piezo element and the drive circuit 4 are connected in the first embodiment, and each drive circuit 4 is placed at a symmetrical position with respect to a predetermined axis of symmetry. It is fixedly connected to a set of piezo elements. The operator operates the auxiliary input device 13 including a keyboard and a joystick as in the first embodiment, and uses the coupling jelly (not shown) to apply the applicator 1
To the subject surface. Then, while changing the position of the applicator 1, the stone to be treated is drawn on the CRT of the ultrasonic diagnostic imaging apparatus 10. Next, when the operator instructs a stone on the CRT with a pointing device such as a light pen, the control circuit 5 controls the probe moving mechanism 23 and the applicator moving mechanism 11, and the angle of the probe 14 remains unchanged, and the applicator 1 The whole is rotated around the central axis AA ′, and the rotation axis of the probe 14 is made to coincide with the unique axis of symmetry. Then, the delay value of each piezo element set required to match the focus F with the coordinates designated by the light pen is calculated and sent to the delay circuit 4. Then, according to the delay value of the delay circuit 4, the drive circuit 2 drives each driven piezo element set.

Although the above embodiment describes the calculus breaking device, the present invention is not limited to this and can be applied to a treatment device having a plurality of acoustic output elements such as a hyperthermia device by continuous wave or burst drive.

In the above embodiment, the ultrasonic diagnostic apparatus was used to confirm the position of the treatment site, but other than this, X-CT and M
Any means can be used as long as it can determine the treatment site three-dimensionally like RI.

In the above embodiment, only the function of emitting a therapeutic ultrasonic wave was used, but as described in Japanese Patent Laid-Open No. 63-5736, it is confirmed that the object to be treated and the focal point of the therapeutic ultrasonic wave coincide. In order to do so, it is possible to additionally have a means for transmitting and receiving a weak ultrasonic wave immediately before the strong ultrasonic wave is emitted.

[0081]

According to the present invention, the position of the treatment target can be detected using ultrasonic waves, and even if the treatment target moves, the position of the treatment target can be detected in real time to follow the focal position. Like Further, according to the present invention, it becomes possible to electronically control the focus position with a small number of drive circuits with respect to the number of configured piezoelectric elements.

[Brief description of drawings]

FIG. 1 is a diagram showing a configuration of an ultrasonic therapeutic apparatus according to an embodiment of the present invention.

FIG. 2 is a diagram showing an example of an arrangement of a plurality of focal points when receiving weak ultrasonic waves in FIG.

FIG. 3 is a diagram for explaining a parallel simultaneous reception method.

FIG. 4 is a diagram showing a flow of operations of the ultrasonic therapeutic apparatus according to the present invention.

FIG. 5 is a diagram for explaining how to divide an added waveform.

FIG. 6 is a diagram showing an example of a method of projecting from the three-dimensional distribution of the reflection intensity of each focus on each axis.

FIG. 7 is a diagram for explaining a prediction example of a focus position.

FIG. 8 is a diagram showing a configuration of an ultrasonic therapeutic apparatus according to an embodiment of the present invention.

FIG. 9 is a diagram for explaining the operation of the ultrasonic therapeutic apparatus according to the present embodiment.

10 is a diagram showing an operation example regarding movement / rotation control of the ultrasonic probe and the X-ray tube in FIG.

FIG. 11 is a diagram showing an example of a method for detecting a calculus movement direction in FIG.

12 is a diagram showing a display example on the CRT display in FIG.

FIG. 13 is a diagram showing a configuration of an ultrasonic therapeutic apparatus according to another embodiment of the present invention.

FIG. 14 is a diagram showing a configuration of a delay time compensation circuit.

FIG. 15 is a diagram showing a configuration of an ultrasonic therapeutic apparatus according to an embodiment of the present invention.

FIG. 16 is a diagram for explaining the principle of position detection of a treatment target according to the present invention.

FIG. 17 is a diagram showing a time chart of a transmission ultrasonic wave and a reception ultrasonic wave.

FIG. 18 is a diagram showing an ultrasonic therapeutic apparatus according to another embodiment of the present invention.

FIG. 19 is a diagram for explaining the principle of position detection of a treatment target according to the present invention.

FIG. 20 is a diagram showing a time chart of a transmission ultrasonic wave and a reception ultrasonic wave.

FIG. 21 is a diagram for explaining an example of the calculation result of the present invention.

22 is a diagram showing a time chart of transmission ultrasonic waves and reception ultrasonic waves in FIG. 21. FIG.

FIG. 23 is a diagram showing the configuration of an ultrasonic therapeutic apparatus according to an embodiment of the present invention.

FIG. 24 is a view for explaining the operation principle of the ultrasonic therapeutic apparatus according to one embodiment of the present invention.

FIG. 25 is a view for explaining the operation principle of the ultrasonic therapeutic apparatus according to another embodiment of the present invention.

FIG. 26 is a diagram showing a configuration of an ultrasonic therapeutic apparatus according to an embodiment of the present invention.

[Explanation of symbols]

 1 Applicator 1a, 1b, ... Piezo element 2a, 2b, ... Drive circuit 3 Power supply 4 Delay circuit 5 Control circuit 6 Subject 7 Stone 7a, 8b, ... A / D converter 9 Memory 10 Ultrasound image diagnostic device 11 DSC 12 CRT 13 Auxiliary input device 14 Ultrasonic probe 15 X-ray tube 16 Pulse motor 17 Pulse motor controller 18 X-ray image diagnostic device 19 X-ray image pickup tube 20 Switching device 21 Search drive voltage source 22 Received signal buffer 23 Ultrasonic probe moving mechanism 24 Applicator movement mechanism

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Mariko Shibata No. 1, Komukai Toshiba-cho, Sachi-ku, Kawasaki-shi, Kanagawa Inside the Toshiba Research Institute Co., Ltd. No. 1 Incorporated company Toshiba Research Institute

Claims (5)

[Claims] 1. An ultrasonic therapy apparatus for irradiating an irradiation object in a subject with a shock wave generated from a plurality of piezoelectric elements for fragmentation treatment, comprising: Means for irradiating ultrasonic waves and receiving the reflected waves, and means for calculating the barycentric position of the reflection intensity distribution based on the plurality of reflected waves received by the means, and detecting position information of the irradiated object. An ultrasonic treatment apparatus comprising: a means for controlling the focus positions of the plurality of piezoelectric elements based on the position information detected by the means. 2. An ultrasonic therapy apparatus for irradiating an irradiation object in a subject with a shock wave generated from a plurality of piezo elements to treat crushing, wherein a plane projection image of a desired position of the subject is acquired.
Line image pickup means, an ultrasonic image pickup means for determining an ultrasonic tomographic plane based on the plane projection image obtained by the X-ray image pickup means, and acquiring an ultrasonic tomographic image corresponding to the ultrasonic tomographic plane, Position information calculating means for calculating the position information of the irradiation object based on the ultrasonic tomographic image obtained by the ultrasonic image capturing means, and each of the piezo elements based on the position information obtained by the position information calculating means. An ultrasonic therapy apparatus comprising: a timing control unit that controls an application timing. 3. An ultrasonic therapy apparatus for irradiating an irradiation target in a subject with a shock wave generated from a plurality of piezoelectric elements to treat the irradiation target by fragmentation, wherein a driving voltage applied to the plurality of piezoelectric elements is low. A switching means for switching between a high voltage and a high voltage, and a shock wave generated when the driving voltage is set to a low voltage, a piezo reflected wave signal output from each piezo element in accordance with a reflected wave reflected in the subject. Receiving means for delaying reception so that the element group has a focus at the same position as the focus when a shock wave is generated, and controlling the focus position so that the focus position can be scanned within a specified region when the drive voltage is a low voltage. Controlling means, position information calculating means for calculating the position information of the irradiated object from the reflected wave intensity distribution at each position of the scan area, and based on the position information obtained by this position information calculating means It is comprised of a timing control means for controlling the respective piezoelectric elements application timing ultrasonic therapeutic apparatus according to claim. 4. An ultrasonic therapy apparatus for irradiating an irradiation object in a subject with a shock wave generated from a plurality of piezo elements for crush treatment, wherein the irradiation object in the subject is irradiated with a search ultrasonic wave. Means, ultrasonic wave receiving means for exploration spatially arranged at at least three different points for receiving the reflected waves from the irradiation object irradiated by this means, and from the time when the ultrasonic wave for exploration is irradiated, Means for measuring the time until the reflected wave is received, means for calculating the position information of the object to be irradiated based on the time measured by this means, and a plurality of means for calculating the position information of the irradiation object based on the position information calculated by this means. An ultrasonic therapy device comprising: a means for controlling the focus position of a piezo element. 5. An ultrasonic treatment apparatus for irradiating an irradiation object in a subject with a shock wave generated from a plurality of piezo elements for fragmentation treatment, and a plurality of piezo element pairs arranged in point symmetry, and the piezo elements. An ultrasonic wave characterized by comprising switching means for electrically coupling the pair, and means for controlling the focal position of the piezo element pair and the other piezo element pair electrically coupled by the switching means. Treatment device.