JPH07194611A - Ultrasonic wave treatment device - Google Patents

Abstract

PURPOSE:To provide a ultrasonic wave treatment device with which the position of the subject to be treated can be decided and the effects of treatment can be easily judged by X rays during the treatment as the focus of ultrasonic waves is always monitored by X rays, so that treatment can be carried out efficiently and safely. CONSTITUTION:The applicator 3 is not doughnut-shaped, but is cut in half and the cut part 3a is formed. The X ray tube ball for deciding X ray position and the image intensifier 1 are installed on the cut part 3a so that X ray pass can go through 3a. The applicator 3 is supported by C arm and the C arm is retained at the retaining part. The applicator 3 is rotatable together with C arm. With such a constitution, X ray pass can always monitor the focus of ultrasonic waves without being hindered by the applicator 3.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus capable of constantly monitoring an X-ray image or an ultrasonic image when treating a treatment object such as a stone with ultrasonic energy.

[0002]

2. Description of the Related Art In recent years, ultrasonic medical treatment devices have been attracting attention as medical diagnostic devices have been developed. The ultrasonic treatment device includes a shock wave treatment device that non-invasively crushes stones by irradiating the stones formed in the subject with strong ultrasonic waves from the outside, and locally heats the tumor site to kill it. There is a hyperthermia treatment device that can be used for both purposes.

Such an ultrasonic therapeutic apparatus has been conventionally used, for example, in the R. Wolf; USP 5,060,634 (199
1-10-29) is known.
This will be described below with reference to FIG. The figure shows a state in which a treatment target 71 existing in the body of the patient 21 is irradiated with ultrasonic waves for treatment, and an applicator 74 for emitting ultrasonic waves is arranged below the patient 21. .

The applicator 74 has a plurality of piezoelectric vibrators 73 arranged in a donut shape, and when the ultrasonic focus Q is set, a strong ultrasonic wave is applied thereto. Water 72 is filled between the piezoelectric vibrator 73 and the patient 21 to prevent reflection of ultrasonic waves at the boundary with the patient 21.

Here, when the treatment is actually performed, it is necessary to surely match the treatment object 71 and the ultrasonic focus Q, and therefore, the X-ray fluoroscope and the ultrasonic imaging apparatus are provided. . That is, as an X-ray fluoroscope, an X-ray tube 2 that irradiates X-rays and an image intensifier 1 that collects and images X-rays that have passed through a patient 21 are arranged to face each other with a subject 21 interposed therebetween. Therefore, an X-ray image in the vicinity of the ultrasonic focus Q can be obtained. The water 72 is not required during the X-ray photography, so the water in the air path 2a is drained.

Further, an ultrasonic probe 51 is provided as an ultrasonic imaging apparatus, and when ultrasonic waves are radiated from this tip, an ultrasonic path 75 is obtained and an ultrasonic image in the vicinity of the ultrasonic focus Q is obtained. Then, using at least one of the X-ray image and the ultrasonic image, adjustment is performed so that the treatment target portion 71 and the ultrasonic focus Q of the applicator 74 coincide with each other.

However, in such a conventional method,
Since the air path 2a is required to secure the X-ray passage (X-ray path 41), the water in the air path 2a is drained when performing X-ray photography, and ultrasound images or supersonic images are taken. The operation is troublesome because it is necessary to fill it with water when performing the ultrasonic treatment. In addition, the X-ray tube 2 and the ultrasonic probe 5
Since 1 is incorporated into the applicator 74, the entire applicator 74 becomes large, and the entire applicator 74 is also inconvenient to move. Therefore, it is difficult to approach the applicator 74 from the upper side or the lateral direction other than the lower side.

Therefore, in order to solve this problem, FIG.
It is known that the applicator 74 and the X-ray imaging apparatus are separated as shown in FIG. That is, as shown in FIG.
The above problem is solved by making the X-ray tube 2 and the image intensifier 1 independent from the applicator 74. However, with this method, X
Since the line path 41 interferes with the applicator 74, the shadow of the applicator 74 exists in the X-ray image, which makes positioning difficult.

[0009] Further, as related to this, Japanese Unexamined Patent Publication No. Hei 2
-2688752. FIG. 8 is a diagram for briefly explaining this conventional example, and in this example, the applicator 91 is provided with a cutout portion 91a. Along with this, a cutout is also formed in the ultrasonic transducer 92, and the ultrasonic probe 51 is formed in the center of the applicator 91.
Are arranged. The applicator 91 is supported by the C arm 5. And the ultrasonic probe 5
When taking an ultrasonic image of the inside of the patient in 1
The presence of 1a prevents interference with the applicator 91.

[0010]

However, in the conventional example shown in FIG. 8, the ultrasonic imaging apparatus is used for positioning the treatment target, and the one using the X-ray fluoroscope is mentioned. Not not. Therefore, when positioning is performed using the X-ray fluoroscope, the X-ray path 41 and the applicator 74 interfere with each other as in the conventional example shown in FIG.
There is a drawback that the shadow of the applicator 74 is reflected in the X-ray fluoroscopic image.

The present invention has been made in order to solve such a conventional problem, and its purpose is to
An object of the present invention is to provide an ultrasonic treatment device capable of preventing interference between a line path and an applicator.

[0012]

In order to achieve the above object, the present invention has a plurality of ultrasonic transducers, and a drive voltage is applied to each of the ultrasonic transducers to apply ultrasonic waves to a treatment object of a subject. An ultrasonic treatment apparatus comprising: an applicator that irradiates and treats; and an X-ray fluoroscope that irradiates an image of the subject with X-rays to form an image, and positions the focus of the applicator. A notch is provided in the applicator in order to prevent interference between the applicator and.

[0013]

In the present invention constructed as described above, the applicator is not in the shape of a donut, but a part of the applicator is cut out to form a notch. Then, an X-ray tube for X-ray positioning and an image intensifier are arranged so that the X-ray path passes through the notch.

Therefore, with such a structure, the X-ray passage and the applicator do not interfere with each other. As a result, the ultrasonic focus can be monitored at any time by the X-ray image, and it is not necessary to forcibly create the air path or the water path, and the treatment effect can be easily determined by the X-ray during positioning and treatment of the treatment target. Therefore, the treatment can be efficiently and safely proceeded.

[0015]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT A preferred embodiment of the present invention will be described below with reference to the drawings. FIG. 1 is a plan view showing a configuration of an applicator of an ultrasonic therapeutic apparatus according to an embodiment of the present invention. As shown in the figure, a spherical vibrator 6 is arranged on the upper surface of the applicator 3. The applicator 3 is not in the shape of a donut and is cut in half to provide a cutout 3a. At the center of the cutout 3a,
An X-ray tube 2 for X-ray positioning and an image intensifier 1 are arranged. The applicator 3 is supported by the C arm 5, and the C arm 5 is held by the holding portion 4. The applicator 3 can rotate in the direction of arrow L together with the C arm 5.

With such a structure, the ultrasonic focus can be constantly monitored without the X-ray path being disturbed by the applicator 3. Here, the X-ray tube 2 for X-ray positioning and the image intensifier 1 can be separated from the applicator 3. In addition, in the present embodiment, the case where the shape of the applicator 3 is a spherical surface is shown. However, a plurality of transducers 6 are arranged, and these transducers 6 delay by which the delay time calculated from the focal length is set. The ultrasonic waves from the transducers 6 may be set to reach the same focal point at the same time by being connected to a circuit.

FIG. 2 is a block diagram showing an ultrasonic therapeutic apparatus using the applicator of FIG. In the figure, the same symbols as those shown in FIG. 1 are the same elements, and their explanations are omitted. The applicator 3 rotates together with the C-arm 5 in the direction of arrow M (direction along the C-arm), in the direction of arrow N (vertical direction), in the direction of arrow P (front-rear, left-right direction) and in the direction of arrow L (rotation). It is possible to move. The patient 21 is the couchtop 2
It is put on 2.

Further, a pulser 23a is provided to apply a voltage to the vibrator 6, and the pulser control section 23b controls the pulse output timing of the pulser 23a.
The drive voltage is controlled by the drive voltage controller 23c.

The X-ray tube 2 is connected to an X-ray generation circuit 23d for controlling the amount of X-ray exposure, and the X-ray generation circuit 23d outputs X-rays in response to a command from the X-ray trigger circuit 23e. Take control.

The output of the image intensifier 1 is connected to an image acquisition device 23i, and this output is supplied to an image processing circuit 23j which produces an X-ray fluoroscopic image. The image acquisition device 23i operates according to a command from the X-ray trigger circuit 23e described above.

The image storage device 23k includes an image processing circuit 23.
The image generated by the image display device 23
output to n. The X-ray trigger circuit 23e and the image storage device 23k operate under the control of the X-ray positioning device 23f for determining the X-ray imaging position of the patient 21. And
The pulsar control unit 23b and the X-ray positioning device 23 described above.
f is controlled by a system controller 23g which is the control center of the ultrasonic treatment apparatus, and this system controller 23g controls a position controller 23m for controlling the positions of the C arm 5 and the holding unit 4. Further, the operator's input is made on the console 23h.

Next, the operation of this embodiment will be described.
When the patient 21 is placed on the top plate 22, the position controller 23m operates to move the C-arm 5 and the support base 4 in each direction (directions of arrows L, M, N, P), and the treatment target is moved to X. It is made to come to the line shooting position. Then, according to a command from the X-ray trigger circuit 23e, X-rays are emitted from the X-ray tube 2 and an X-ray fluoroscopic image in the vicinity of the treatment object is captured. Then, this X-ray fluoroscopic image is displayed on the image display device 23n.

Then, the operator finely adjusts the C-arm 5 and the support portion 4 while observing the displayed image so that the ultrasonic focus of the treatment object and the ultrasonic focus of the applicator 3 coincide with each other. After that, under the control of the pulsar control unit 23b, ultrasonic waves are emitted from the transducer 6 toward the treatment target, and the treatment is performed.

At this time, as described with reference to FIG. 1, since the applicator 3 is provided with the cutout portion 3a, the image display device 23n is treated without the shadow of the applicator appearing in the X-ray fluoroscopic image. An image near the object is clearly displayed.

In order to irradiate an object to be treated such as a calculus with a shock wave and perform crushing treatment, usually 3,000 to 5,000 shock waves are applied. At this time, if a shock wave having a high peak pressure is applied from the beginning, the patient will be distressed. Therefore, in the pulsar control unit 23b, when the system controller 23g receives the instruction signal for starting the treatment, the peak pressure is raised stepwise to an appropriate height. After that, pulsar 23a should be used so that crushing treatment can be performed at the optimum peak pressure.
The output voltage of is controlled.

Further, by changing the pulsar 23a to a device for generating ultrasonic waves for thermotherapy, the shock wave therapy device can function as a thermotherapy device. In this case, the pulsar control unit in the ultrasonic therapy device functions as a peak temperature control unit that variably adjusts the peak temperature rise during thermotherapy.

FIG. 3 is a side view of the applicator shown in FIG. 1, showing a state in which the angles of the X-ray tube 2 and the image intensifier 1 are changed. That is, even if the X-ray imaging system is rotated with respect to the applicator 3, it is possible to image the vicinity of the focus Q without interfering with the X-ray paths 41 and 41 'due to the notch. It can be understood.

FIG. 4 is a block diagram showing another embodiment of the applicator. In this embodiment, an ultrasonic probe 51 for positioning and an X-ray tube 2 for positioning are combined. Here, in the figure, the applicator 53 is notched and provided with the notch 53a, and the ultrasonic probe 51 and the X-ray tube 2 are arranged in a portion where the transducer 52 is not present. The ultrasonic probe 51 and the X-ray tube 2 are rotated in the direction of the arrow R in a state where they are still arranged in the center of the applicator 53 or in a state where they are once separated from the center of the applicator 53, The positions can be exchanged with each other or the applicator 53 can be removed.

Similar to the case of FIG. 1, in the embodiment shown in FIG. 4, the applicator 53 has a spherical shape, but a plurality of vibrators 52 are arranged and the vibrators 52 are arranged.
However, the ultrasonic wave from each transducer 52 may be set to reach the same focus at the same time by being connected to a delay circuit that sets a delay time calculated from the focal length. With such a structure, the ultrasonic focus can be constantly monitored without the X-ray path being disturbed by the applicator 53.

FIG. 5 is a front sectional view of FIG. As shown in the figure, the ultrasonic wave emitted from the transducer 52 causes an ultrasonic wave path 61 and an ultrasonic wave focus Q. The ultrasonic probe 51 is slidable in the direction of arrow U and rotatable in the direction of arrow S, which allows the treatment target to be more accurately confirmed. Further, by moving the X-ray tube 2 in the direction of the arrow R, the X-ray path 41 can be rotated in the direction of the arrow T around the ultrasonic focal point Q, whereby the object to be treated can be more accurately measured. I can confirm. Furthermore, the entire applicator is slidable in the direction of arrow V.
With such a structure, the ultrasonic focus can be constantly monitored without the X-ray path being disturbed by the applicator 53.

[0031]

As described above, according to the present invention,
The applicator is not in the shape of a donut, but is cut in half to provide a notch, and an X-ray tube for X-ray positioning and an image intensifier are arranged so that the X-ray path passes through the notch. With this configuration, the X-ray passage and the applicator do not interfere with each other.

As a result, the ultrasonic focus can be monitored by X-rays at any time, and it is not necessary to forcibly create an air path or a water path, and the treatment effect can be easily obtained with X-rays during positioning and treatment of the treatment object. The effect of being able to make a decision and being able to proceed with treatment efficiently and safely is obtained.

[Brief description of drawings]

FIG. 1 is a plan view showing a configuration of an ultrasonic applicator according to an embodiment of the present invention.

FIG. 2 is a block diagram showing a configuration of an ultrasonic therapeutic apparatus according to an embodiment of the present invention.

FIG. 3 is an explanatory diagram showing a state in which an X-ray tube and an image intensifier are rotated.

FIG. 4 is a plan view showing the configuration of an ultrasonic applicator according to another embodiment of the present invention.

FIG. 5 is a side view of an applicator according to another embodiment.

FIG. 6 is a configuration diagram showing a first conventional example of an ultrasonic applicator.

FIG. 7 is a configuration diagram showing a second conventional example of an ultrasonic applicator.

FIG. 8 is a configuration diagram showing a third conventional example of an ultrasonic applicator.

[Explanation of symbols]

 1 Image Intensifier 2 X-ray tube 3 (53, 74, 91) Applicator 3a (53a, 91a) Notch 6 (52, 73, 92) Transducer 21 Patient 23a Pulser 23b Pulser controller 23c Driving voltage control Part 23d X-ray generation circuit 23e X-ray trigger circuit 23f X-ray positioning device 23g System controller 23h Operator console 23i Image acquisition device 23j Image processing circuit 23k Image storage device 23m Position controller 23n Image display device 41 (41 ') X-ray path Q Ultrasonic focus 71 Treatment target

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Yuji Yanagida 1385-1 Shimoishigami, Otawara-shi, Tochigi Stock company Toshiba Nasu factory (72) Inventor Hideki Kosaku 1385-1, Shimoishigami, Otawara-shi, Tochigi Company Toshiba Nasu Factory

Claims (2)

[Claims] 1. An applicator having a plurality of ultrasonic transducers, applying a driving voltage to each of the transducers to irradiate the subject to be treated with ultrasonic waves for treatment, and an X-ray to the subject. In an ultrasonic treatment apparatus including an X-ray fluoroscopic device that irradiates an image to image and positions the focus of the applicator, the cutout portion is provided to prevent interference between the X-ray passage and the applicator. An ultrasonic treatment device characterized by being provided in an applicator. 2. The applicator and fluoroscope are
The ultrasonic therapy device according to claim 1, wherein the ultrasonic therapy device is movable integrally or individually.