JPH0642885B2 - Shock wave therapy device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION Object of the Invention (Industrial field of application) The present invention relates to a shock wave treatment device for crushing and treating crushed objects such as cancer cells and stones in a subject with focused energy of shock waves. Regarding

(Prior Art) As a conventional shock wave treatment device, there is an ultrasonic treatment device using ultrasonic waves as shock waves. This ultrasonic therapy device
Usually, an ultrasonic transducer that forms a focal point of ultrasonic waves for crushing an object to be crushed in a subject and an ultrasonic transducer that collects tomographic image data of the subject are usually provided. When performing treatment, first, an ultrasonic transducer that collects tomographic image data is used to display the state of the affected area (object to be crushed) on the display unit, and then, while observing the displayed image, the object to be crushed, for example, a stone. Is treated by sending ultrasonic waves for crushing. Specifically, a marga indicating the focusing point of ultrasonic waves for crushing is displayed together with a tomographic image on the display unit, and ultrasonic waves for crushing are transmitted in a state where this marker is aligned with the object to be crushed, and a calculus I try to crush such things. Further, in such a conventional device, the number of shots of ultrasonic waves for crushing is counted, and when the count value reaches a preset number of shots, the transmission of ultrasonic waves is stopped, and thereafter, for example, The tomographic image of the crushed object is again displayed on the display unit by an X-ray diagnostic apparatus or the like to confirm the crushed result.

(Problems to be Solved by the Invention) However, in the above-described conventional apparatus, since the ultrasonic waves for crushing are stopped and restarted based on the number of shots of ultrasonic waves for crushing that are transmitted, the actual object to be crushed is It was difficult to know whether or not the material was crushed during the transmission of ultrasonic waves for crushing.
This means that there is a risk of continuing to send powerful ultrasonic waves for crushing even after the crushing of the crushed object is complete, and also for the crushing of the crushed object when it has not been crushed yet. There is a problem that the transmission of ultrasonic waves is stopped. In the former case, an unnecessary shock wave is transmitted, which is a problem that should be solved immediately from the viewpoint of safety, and in the latter case, there is a problem that a time required for treatment is unnecessarily required.

Therefore, the present invention has been made in consideration of the above circumstances, and an object of the present invention is to provide a shock wave treatment apparatus capable of confirming the crushed state of a crushed object even during transmission of a crushing shock wave.

[Structure of the Invention] (Means for Solving the Problems) The structure of the present invention for achieving the above-mentioned object is to obtain tomographic image data of the crushed object before the transmission of the crushing shock wave in the above-described shock wave treatment apparatus. First collecting means for collecting, second collecting means for collecting tomographic image data of the crushable object during transmission of the shock wave for crushing, and crushable object obtained by the first and second collecting means Display control means for obtaining a subtraction image of the tomographic object data and displaying and controlling the crushed state of the crushed object based on the subtraction image.

(Operation) The operation of the present invention having the above configuration will be described.

First, after transmitting the tomographic image data of the crushed object before the crushing shock wave is transmitted from the first collecting means, the ultrasonic wave transmission is started. Then, the second collecting means collects tomographic image data of the crushed object during transmission of the crushing shock wave. A subtraction image is obtained from the tomographic image data of the crushed object thus obtained, and the crushed state of the crushed object is displayed and controlled based on the obtained subtraction image.

(Example) Hereinafter, the present invention will be described with reference to the drawings.

FIG. 1 is a configuration block diagram of a shock wave treatment device as one embodiment. In this example, an example in which ultrasonic waves are used as shock waves will be described.

In the figure, the shock wave treatment device includes a shock wave transducer 1 that forms a focal point of ultrasonic waves for crushing an object to be crushed and a sound field region that includes a focal point of ultrasonic waves formed by the shock transducer 1. A shock wave applicator 3 including an ultrasonic wave transducer 2 for transmitting and receiving sound waves, a pulser 4 for sending a pulse signal to the shock wave transducer 1, and a pulse signal for the ultrasonic wave transducer 2 via a controller 5. A transmitter / receiver circuit 6 which is sent out and excited to perform a sector scan or the like, and which receives an echo signal from the ultrasonic transducer 2 based on each sector scan, and an output signal of the transmitter / receiver circuit 6 are inputted and amplitude detection is performed. The signal processing circuit 7 which applies the signal to the signal conversion system 8 as a video signal, and A system controller 9 mainly composed of a CPU for controlling each part of the device, and a transmission / reception timing, an amplitude, a frequency, etc. of a pulse signal in the transmission / reception circuit 6, the signal processing circuit 7 and the pulsar 4 which are controlled by the system controller 9. Controller 5 to control
And a signal conversion system 8 which is controlled by the system controller 9 and performs signal conversion processing on the output signals of the transmission / reception circuit 6 and the signal processing circuit 7, and an image storing the tomographic image data output from the signal conversion system 8. An image having a subtraction / gray conversion processing section 20b which forms a subtraction image from the tomographic image data stored in the image memory 20a by a control signal from the memory 20a and the system controller 9 and which performs a gray conversion process on the subtraction image. Based on the control signals from the processing unit 20 and the system controller 9, a tomographic image output from the image processing unit 20 and a subtraction image showing the crushed state of the crushed object before and during the transmission of the ultrasonic waves for crushing. Etc. with the ultrasonic transducer 2, the sector-shaped sound field region, the focusing point indicating the focusing point of the ultrasonic wave for fracture A display unit 10 including a TV monitor for displaying markers and the like, and a switch connected to the system controller 9 for setting the generation timing of the pulse signal sent from the pulsar 4 to the shock wave transducer 1 and instructing the start of pulse transmission. A treatment start switch 11 (not shown), a position controller 12 for adjusting the relative positional relationship of the ultrasonic transducer 2 to the shock wave transducer 1, and the like are configured.

In the present embodiment, the ultrasonic transducer 2 is a first collecting means for collecting tomographic image data of the crushed ultrasonic wave before the ultrasonic wave for crushing is transmitted, and a fault of the crushed object during transmission of the ultrasonic wave for crushing. It has a function as a second collecting means for collecting image data. The functions as the first and second collecting means are executed by the operator operating a photographing button (not shown).

Further, in this embodiment, the system controller 9
And the image processing section 20 obtains a subtraction image of the tomographic image data of the crushed object obtained by the first and second collecting means,
The display control means 21 is configured to display and control the crushed state of the crushed object based on the subtraction image.

Next, the shock wave applicator 3 will be described in detail with reference to FIG.

In the figure, the shock wave applicator 3 and the shock wave transducer 1 form a focusing point 15 of ultrasonic waves (for example, ultrasonic pulse of strong energy) for crushing the object to be crushed, for example, a kidney stone 18 in the subject 14. A water tank 16 provided on the ultrasonic wave transmitting surface 1a side of the shock wave transducer 1 and an ultrasonic wave transmitting region 17 extending from the ultrasonic wave transmitting surface 1a of the shock wave transducer 1 to a focusing point 15 The ultrasonic transducer 2 for forming a sound field region 27 including the focusing point 15 in a state where the ultrasonic wave transmitting / receiving surface 2a is in contact with the surface 14S and collecting the tomographic image data of the subject 14. Has been done. still,
The ultrasonic transducer 2 is arbitrarily moved in the direction of arrow A based on the control signal from the position controller 12 described above.
It can be stopped, and this movement is 13 in the figure.
The detection signal of the position sensor indicated by is used as a reference.

Regarding the action and effect of the shock wave treatment apparatus configured as described above, it is assumed that the renal stones 18 in the kidney shown by 19 in FIG. 2 are crushed and treated while also referring to the timing chart shown in FIG. And explain. In FIG. 6, 27 is a treatment start switch, 28 is an image storage / display before crushing, 2
Reference numeral 9 indicates the timing of the crushing image storage / display, 30 indicates the subtraction image storage / display, and 31 indicates the timing of the shock wave generation pulse trigger. However, the tomographic image is, for example, 30 frames /
It is displayed on the display unit 10 while the power of the device is turned on in seconds.

First, the water tank 16 provided in the shock wave applicator 3 is placed on the surface 14S of the subject 14, and in this state, the transmission / reception circuit 6, the signal processing circuit 7, and the signal conversion system 8 are controlled to drive the ultrasonic transducer 2. Then, the display unit 10 displays a tomographic image of the subject 14.

In this case, the focus point markers corresponding to the ultrasonic waves of the shock wave transducer 1 are displayed on the display unit 10 based on the signals transmitted and received from the system controller 9 to the signal conversion system 8 at fixed positions, respectively, and in real time. In the tomographic image of the subject 14 displayed at, the display portion changes as the shock wave applicator 3 moves.

Then, when the renal stone image 18 is drawn in the tomographic image, the shock wave applicator 3 is further finely adjusted so that the focal point marker (not shown) is aligned with the renal stone image 18, and this state is set. The shock wave applicator 3 is fixed with.

In this state, that is, in the state where ultrasonic waves for crushing are not transmitted, the operator presses the treatment start switch 11 to start the treatment. The tomographic image data of the kidney stone image 18 is stored in the image memory 20a. As tomographic image data in this case, tomographic images corresponding to all tomographic images of the plurality of tomographic images P _{1 to} P _n in one breath of the subject shown in FIG. 3A are stored.

The operator monitors the tomographic image displayed on the display unit 10. A control signal is transmitted to the pulsar 4 via the system controller 9 and the controller 5 so that a shock wave pulse is generated at the next one breath.

As a result, a pulse signal is transmitted from the pulsar 4 to the shock wave transducer 1, and the shock wave transducer 1 outputs an ultrasonic pulse of strong energy (ultrasonic waves for crushing the object to be crushed) at the position corresponding to the display position of the focus marker. The wave is transmitted to the stone 18. This ultrasonic pulse becomes a shock wave at the position of the focal point and crushes the kidney stones 18. And
By repeating the generation of such ultrasonic pulses as many times as necessary, the entire kidney stone 18 is crushed and treated.

Tomographic image data corresponding to all one tomographic images of a plurality of tomographic images Q _{1 to} Q _n obtained during continuous respiration as shown in FIG. Memory 2
It is stored in 0a.

Further, the image processing unit 20 creates subtraction images R _{1 to} R _n as shown in FIG. 3 (c) from the two tomographic image data by one frame with a control signal from the system controller 9, and further, Gray conversion processing is performed according to the gradation value of the subtraction image data.

That is, the pixel concentration of the renal stone 18 before the ultrasonic wave for crushing is transmitted is shown by 22 in FIG. 4 (a), while the pixel concentration of the renal stone 18 during the ultrasonic wave for crushing is shown in FIG. (B)
Shown at 22 '. Therefore, when these pixel density subtractions are performed, as shown by 23 in FIG.
Some pixel density values are negative. Utilizing this, for example, when the area 23a having a negative value is displayed in blue and the area having a positive value is displayed in red, the kidney stone 18 of the kidney stone 18 can be displayed only by observing the display unit. Crushed state can be clearly determined. It should be noted that FIG. 7D shows a state before crushing the kidney stone 18 in a profile, and FIG. 8E shows a state before crushing, corresponding to FIGS. There is.

Then, as shown in FIG. 5, the subtraction image 26 is displayed together with the tomographic image 24 before transmission of the ultrasonic waves for fracture and the tomographic image 25 during transmission of the ultrasonic waves for fracture stored in the image memory 20a. It is displayed on the part 10.

Since the operator can easily understand the crushed state of the kidney stone 18 by looking at this display, when it is judged that the crushing is almost completed, the operator gives an instruction to stop the ultrasonic wave for crushing and the crushing is completed. If it is determined that there is no ultrasonic wave, the ultrasonic wave for crushing is transmitted.

According to the present embodiment described above, the crushed state of the crushed object can be confirmed by a simple operation and easily even while the ultrasonic waves for crushing are being transmitted. Therefore, even after the crushing of the crushed object is completed, it is possible to avoid the risk of continuing to send a powerful ultrasonic wave for crushing, and the ultrasonic wave for crushing is used when the crushed object is not completely crushed. It does not cause the problem of stopping the transmission. That is, the safety of the subject can be secured and the treatment time can be shortened.

The present invention is not limited to the above-described embodiments, and various modifications can be made within the scope of the invention.

In the above-mentioned embodiment, the operator observes the subtraction image displayed on the display unit and gives an instruction to transmit or stop the ultrasonic waves, but the present invention is not limited to this, and the following configuration may be adopted.

In advance, the value of the negative region (area) of the subtraction image in which the object to be crushed is crushed from the phantom or clinical experience so far is stored as a reference value in the image processing unit,
The ultrasonic wave transmission may be automatically stopped when the negative region of the obtained subtraction image exceeds the reference value. With such a configuration, it is possible to reduce the burden on the operator in addition to the effects described above.

By the way, in the above-mentioned embodiment, the case of crushing kidney stones has been described, but the invention is not limited to this and can be applied to crushing gallstones and the like.

[Effects of the Invention] According to the present invention as described above in detail, it is possible to provide a shock wave treatment device capable of confirming the crushed state of a crushed object even during transmission of a crushing shock wave.

[Brief description of drawings]

FIG. 1 is a block diagram showing the configuration of a shock wave treatment device as an embodiment of the present invention, FIG. 2 is an explanatory view showing a cross section of the ultrasonic applicator shown in FIG. 1 and its usage state, and FIG. 3 (a). 4 (a) to 4 (c) are explanatory views showing a tomographic image of a shock wave before and during the transmission of a shock wave obtained in one breath, and FIGS. 4 (a) to 4 (c) are before shock wave transmission. , Fig. 5 is an explanatory view showing changes in pixel density value of the subtraction image during transmission, and Figs. 5 (d) and 5 (e) are explanatory views of a crushed object before and during transmission of a shock wave, Fig. 5 Is an explanatory view showing a tomographic image and a subtraction image displayed on the display unit, and FIG. 6 is a timing chart of the shock wave treatment apparatus shown in FIG. 2 ... 1st, 2nd collection means (shock wave transducer), 10 ... display part, 14 ... test object, 18 ... crushed object, 21 ... display control means.

Claims (1)

[Claims] 1. A crushing shock wave is transmitted to a subject,
In a shock wave treatment apparatus for crushing and treating a crushed object in a subject, a first collecting means for collecting tomographic image data of the crushed object before the crushing shock wave is transmitted, and a crushing shock wave being transmitted. Second collection means for collecting tomographic image data of the crushed object and a subtraction image of the tomographic image data of the crushed object obtained by the first and second collecting means, and the crushed object based on the subtraction image A shock wave treatment device, comprising: a display control means for displaying and controlling a crushed state of an object.