JPH0747078A - Ultrasonic therapeutic system - Google Patents

Abstract

PURPOSE:To reduce noises included in an ultrasonic image for diagnosis from the therapeutic ultrasonic waves and generate a high picture quality by furnishing a means to reduce the therapeutic ultrasonic wave component to be included in an ultrasonic imaging system only in the period when irradiation is made with the therapeutic ultrasonic waves. CONSTITUTION:The focus F of an ultrasonic vibrator 1 is located in a lesion 11 inside of a patient 10, and the vibrator 1 is driven by a therapeutic ultrasonic wave driving device 6. An ultrasonic probe 2 observes a CT image of the inside of the patient body using an ultrasonic imaging device 5, and a system control device 7 makes synthesized control of a position control device 4 and the devices 5, 6. When the emitted ultrasonic waves are reflected in the inside of vital organism and generated signals are received by the probe 2, they disturb the image as noises. As the countermeasure thereto, for example, the ultrasonic imaging device 5 is equipped with a means which increases the transmitting power of the imaging device only at the time of irradiation with the therapeutic ultrasonic waves so as to compensate the S/N ratio of the image signal.

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 performing intensive irradiation of intense ultrasonic waves from outside a subject for treatment.

[0002]

2. Description of the Related Art In recent years, in the world of medical treatment, MI aims to achieve a sufficient therapeutic effect while minimizing the injuries and burdens on patients.
T (Minimally Invasive Trea)
Tent: Minimally invasive treatment) is emphasized, and it is expected to become a trend for future medical devices.

As a representative of this MIT, Japanese Patent Publication No. 4-48
Extracorpore treatment for crushing and treating stones by irradiating shock waves from outside the body as disclosed in Japanese Patent No. 457.
alShock Wave Lithotripsy
(ESWL). This treatment method is now the first treatment of choice for urinary tract stones, and at present, gallstones are also used for insurance treatment.

Among them, the method of using a piezoelectric element for a powerful ultrasonic source is a focus position by controlling the phase of a driving waveform applied to a plurality of piezoelectric elements, which has a small focal point, no consumables, can control the strength of a powerful ultrasonic wave arbitrarily. It has excellent advantages such as control of the temperature (see JP-A-60-145131, USP-4526168). Further, the shape of the focus can be changed by controlling the phase of the drive waveform (see Japanese Patent Laid-Open No. 62-42773).

Further, in the treatment using such strong acoustic energy, as shown in Japanese Patent Laid-Open No. 61-13956, the temperature of the affected area is kept at 43 ° C. by continuous strong ultrasonic irradiation. Hyperthermia, which treats cancer by elevating it to a certain degree, has been receiving attention. It was confirmed that the survival rate of cancer cells was significantly decreased at 42.5 ° C as a boundary and the survival rate of normal cells was not significantly changed, and that it was normal in neoplastic cells such as cancer cells. This is because cancer cells have the property of being more easily heated than normal cells because they have less blood flow than cells and have a smaller cooling effect due to blood flow. A method of locally heating the tumor site is particularly effective.

[0006] Further, the above-mentioned hyperthermia treatment method is advanced, and the method described in the document “G. Vallancien et al., Pro.
press in Urology, 1 (1991)
as shown in pp.
It has been reported that the tumor tissue is denatured by heating it to a temperature of not lower than 0 ° C, and as shown in JP-A-61-1955 and Japanese Patent Application No. 3-306106, a strong treatment is performed outside the body. An apparatus has been developed in which ultrasonic waves are focused on a treatment site in a body and heat is generated by absorption of ultrasonic energy of a tissue to heat-treat cancer.

[0007] Further, a therapeutic method of irradiating a cancer with a powerful pulsed ultrasonic wave for crushing stones rather than heat generation by ultrasonic waves and necrosis of cells by its mechanical force has also been studied. (Hoshi, S. et al .:
J. Urology, Vol. 146: 439, 19
91. ) When performing lithotripsy treatment and tumor treatment using high-intensity ultrasound, these dedicated devices must be prepared separately, and there is a drawback that the installation space of the device and the cost burden increase. To solve this problem, Japanese Patent Application No. 3-30
As described in Japanese Patent No. 6106, there is known an ultrasonic treatment device in which a calculus crushing device and a heating / heating treatment device are integrated, and a treatment mode is clearly displayed on an image so that the usage is not mistaken. ing.

By the way, the heat treatment ultrasonic waves have a frequency of about 1 MHz and are irradiated in bursts of several seconds or less.
A single ablation area is several mm in the vicinity of the focus, and the focus position is moved to treat the entire affected area, and irradiation is repeated.
At the time of treatment, it is necessary to align the focus with the affected area and observe the treated area. As a means for that, ultrasonic images are advantageous in terms of real-time properties, and it is possible to reliably monitor the progress of treatment while preventing erroneous irradiation of the peripheral portion.

Further, the most important technique in an ultrasonic treatment apparatus for focusing ultrasonic waves from outside the body is a positioning technique for correctly aligning the focal point of therapeutic ultrasonic waves with the affected area. Conventionally, as disclosed in Japanese Patent Publication No. 4-48457, an ultrasonic probe for image capturing is attached to the center of an applicator that emits therapeutic ultrasonic waves, and the position of the affected area is determined from the ultrasonic tomographic image obtained thereby. It is judged and the mechanical position of the applicator is controlled to control the focus position. Here, the position control of the applicator is mechanical position control, although it depends on the size of the applicator. Theoretically, the positions can be uniquely matched by controlling the three axes of X, Y, and Z, but in reality, the rotation of two axes is given and the axes are controlled by five axes.

[0010]

As described above, in the ultrasonic treatment apparatus for destroying a malignant tumor such as cancer by irradiating the living body with strong ultrasonic waves locally and maintaining it at a high temperature for several seconds, A therapeutic ultrasonic wave generating element and means for observing the treated area are required. As a means for that, ultrasonic images are advantageous in terms of real-time properties, and it is possible to reliably monitor the progress of treatment while preventing erroneous irradiation of the peripheral portion. However, there is a problem in that the ultrasonic wave image is affected by the therapeutic ultrasonic wave during the irradiation of the therapeutic ultrasonic wave, and the progress of the medical treatment cannot be monitored because of noise in the ultrasonic image. In order to solve this, there has been a conventional method of intermittently irradiating therapeutic ultrasonic waves and using the time during which the ultrasonic waves are not irradiated as the transmission / reception time of diagnostic ultrasonic waves, but the real-time property is impaired. Therefore, it was not possible to accurately irradiate the treated area with strong ultrasonic waves due to body movements and respiratory movements.

Therefore, the present invention realizes an ultrasonic treatment apparatus capable of reducing the noise mixed in the diagnostic ultrasonic image due to the influence of the therapeutic ultrasonic wave and obtaining a real-time high-quality ultrasonic image during the progress of the treatment. With the goal.

[0012] In the above-mentioned treatment apparatus, before the treatment, the operator manually makes full use of a small ultrasonic probe to obtain a good ultrasonic tomographic image and prepare a treatment plan. However, when the treatment is started, the sensation when the affected area is visualized by the control of the applicator by machine operation is very different from the sensation of the ultrasonic diagnostic apparatus. It was a problem.

Further, in particular, when ultrasonic treatment of cancer or the like is performed by laparotomy or craniotomy (intraoperative irradiation), a small applicator must be submerged in the abdominal cavity to perform delicate position adjustment. Poor operability at the time was a problem. Furthermore, in the case of intraoperative irradiation as described above, sterilization of the applicator part is important because infection to patients or infection between patients becomes a big problem, but long cables such as electricity and water supply and drainage are attached, and the material is Therefore, it is very complicated to sterilize the entire applicator every time. If the treatment area is extremely shallow from the body surface,
Since the distance between the focal point of the therapeutic ultrasonic waves and the coupling film on the front surface of the applicator becomes very close, the ultrasonic energy may damage the film and the coupling liquid inside the applicator may leak out. It was For this reason, it was necessary to constantly sterilize the coupling liquid and the entire water supply / drainage system, but it was practically difficult.

When the inside of a living body is heated by high-intensity ultrasonic waves, if there is a substance such as air bubbles that is clearly different in acoustic characteristics from the living body in the coupling portion between the applicator and the living body surface, that portion becomes abnormal. It may generate heat and damage the surface of the living body. Further, it is expected that similar heat generation will occur due to the difference in acoustic characteristics between the stratum corneum existing on the surface of the living body and the inside of the living body.

Therefore, in the present invention, in order to prevent damage to the surface of the living body due to this abnormal heat generation, the temperature change on the surface of the living body is always observed, and when abnormal heat generation is observed, irradiation with strong ultrasonic waves is performed. We propose an ultrasonic therapy device characterized by weakening and stopping.

For the usual measurement of the temperature change on the surface of a substance, use of a contact type thermometer such as a platinum resistance thermometer, a thermocouple thermometer, a thermistor thermometer and a non-contact type radiation thermometer is required. It is conceivable that it is difficult to contact metallic temperature sensitive parts with different acoustic characteristics on the surface of the living body in the measurement during heating temperature using strong ultrasonic waves, and it is preferable to use a non-contact type thermometer. .

As a therapeutic device applying strong ultrasonic waves, an ultrasonic therapeutic device in which an extracorporeal shock wave calculus crushing device and a heating / heating treatment device are integrated has been proposed. Since the fundamental frequencies of ultrasonic waves for hot / heat treatment are greatly different, not only is it uneconomical to use the same ultrasonic transducer to perform the above-mentioned two types of treatments, it is also uneconomical. There was a problem that the unit etc. became large.

Further, since the frequencies of the ultrasonic waves for heating / heat treatment and the ultrasonic waves for diagnosis are close to each other, the in-vivo imaging image by the ultrasonic waves for diagnosis is covered with noise during the heating / heat treatment. However, there is a problem that in-vivo information during treatment cannot be obtained in real time.

[0019]

In order to solve the above-mentioned problems, in the first invention of the present application, a minute region in the vicinity of the focal point in the subject is heated in a short time by irradiating the subject with ultrasonic waves. , Including a therapeutic ultrasonic wave generator for cauterizing a lesion area such as a tumor, and an ultrasonic imaging apparatus used for at least aligning a therapeutic ultrasonic focus with a tissue such as a tumor and monitoring a therapeutic state, and during treatment. In an ultrasonic therapy apparatus that constantly monitors an affected area by the ultrasonic imaging apparatus, a means for reducing the therapeutic ultrasonic component mixed in the ultrasonic imaging apparatus is provided only during the time when the therapeutic ultrasonic waves are being irradiated. There are the following three specific means.
The first of the means is means for increasing the transmission power of the ultrasonic imaging apparatus. The second is a means for imaging with a signal after performing a filtering process for attenuating the main component of the occupied frequency band of therapeutic ultrasonic waves which are burst-driven with respect to the received signal of the ultrasonic imaging apparatus. Thirdly, the received signal of the ultrasonic imaging apparatus is received by the ultrasonic imaging apparatus set to the receiving state at the time of irradiation of the therapeutic ultrasonic wave in advance, and after the recorded signal component of the therapeutic ultrasonic wave is canceled. It is a means of imaging with a signal.

In the second invention of the present application, both of the therapeutic ultrasonic wave generating means and the diagnostic ultrasonic wave generating means are piezoelectric bodies, and at least one of them has a basic resonance of thickness longitudinal vibration, and
It is characterized in that it is provided with a means for generating a second harmonic.
Specifically, the piezoelectric body has a laminated structure. More specifically, it is preferable to have a two-layer structure by the method described below. There are two methods. First, as shown in FIGS. 7 and 8, the first method is to bond a plate having substantially the same acoustic impedance to one surface of a piezoelectric body on which electrodes are formed on both sides, and drive voltage is applied to the electrodes. It is applied to the piezoelectric body sandwiched by. The plates to be joined are preferably the same piezoelectric material. The joining method may be adhesion (FIG. 7) or integral firing (FIG. 8), and the method is not particularly limited, but the influence of acoustic impedance mismatch at the joint should be minimized. In the second method, the two layers have different thicknesses and are laminated so that the electric field direction and the polarization direction are opposite. Specifically, a method in which the polarization directions are reversed by acoustically and electrically in series configuration (FIG. 9) and a method in which the polarization directions are the same acoustically in series and electrically parallel to each other are the same. There is a method (No. 10). In order to be electrically connected in series, electrodes are formed on both end faces of the two-layer piezoelectric body as shown in FIG. Further, in order to make them electrically parallel, a pair of electrodes formed on both end faces are connected on the side faces as shown in FIG. 10, and leads are pulled out from the internal electrodes sandwiched between the two piezoelectric bodies to form a pair of electrodes. Use as an electric terminal.

As one of the preferred frequency settings of the present invention, at least the diagnostic ultrasonic wave is made to generate the fundamental resonance and the second harmonic, and the therapeutic ultrasonic frequency is set to the fundamental resonance and the second harmonic of the diagnostic ultrasonic wave. So that it is almost in the middle.

Further, the ultrasonic treatment apparatus also has the following two features. One is an ultrasonic treatment apparatus for treating an affected part in the body using high-intensity ultrasonic waves, an applicator including an ultrasonic transducer that emits high-intensity therapeutic ultrasonic waves and an ultrasonic probe that obtains an image of the inside of the body. And a holding portion projecting with respect to the applicator, and a holding portion for substantially offsetting the weights of the applicator and the holding portion in the vertical direction.

Further, the grip portion is characterized by being rotatable with respect to the applicator and being fixed at a variable angle with respect to the therapeutic ultrasonic irradiation axis. Further, a cable or hose for supplying and draining electric energy to and from the applicator is configured to be detachable at the applicator portion.

Further, in the present invention, a coupling body having a double structure which covers at least the ultrasonic wave irradiation portion of the applicator and which holds a degassed / sterilized liquid or gel is provided to the applicator. It is characterized by being detachably attached.

[0025] The other is an ultrasonic treatment apparatus for focusing a powerful ultrasonic wave for treatment, and a means for detecting a temperature change on the surface of the object to be treated, and the strong ultrasonic wave based on the detected temperature change data. It is characterized by having a means for controlling the irradiation conditions of sound waves, and means for detecting a temperature change on the surface detects coloration due to a thermosensitive or pressure-sensitive color reaction of a chemical substance applied to the surface of a living body. It is a means to do.

Alternatively, the means for detecting the change in the surface temperature of the treatment target is to use a radiation thermometer. Furthermore, an ultrasonic wave generation source that locally irradiates ultrasonic waves to the treatment target inside the patient's body generates a piezoelectric element group that generates a shock wave for calculus crushing and a heating and heating ultrasonic wave of a frequency different from those. When the calculus crushing piezoelectric element group is driven at a low voltage, it is composed of a piezoelectric element group, and driving means for driving the calculus breaking piezoelectric element group at high voltage and low voltage The ultrasonic wave generated in the piezoelectric element group is reflected by the treatment target, and the reflected wave processing circuit that processes the reflected ultrasonic wave as a reflected signal via the piezoelectric element, and the ultrasonic wave is generated by the data from the reflected wave processing circuit. A control device for controlling the generation of sound waves, a driving means for driving the piezoelectric element group for heating and heating ultrasonic waves, a means for switching between a calculus breaking mode and a heating and heating mode, and an in-vivo image imaging super-device. And wave probe, and a-vivo image reconstructor.

[0027]

The operation of the first invention of the present application will be described below. Since the occupied frequency bandwidth of the ultrasonic waves for imaging generated from the ultrasonic imaging apparatus is about 100% with respect to the center frequency, the reception sensitivity on the low frequency side is up to 1/2 the frequency of the center frequency. It has little sensitivity to frequency. Since the therapeutic ultrasonic generator is driven in burst, its main frequency band is narrow and its occupied frequency width is narrow. Therefore, if the frequency of the therapeutic ultrasonic wave is set to 1/2 or less of the center frequency of the ultrasonic wave for imaging, it is possible to prevent the main frequency component of the therapeutic ultrasonic wave from being mixed in the reception signal of the ultrasonic imaging apparatus. The wider the frequency difference between the two, the more effective it is. However, the frequency difference of about 2 to 3 times is often used. Since therapeutic ultrasonic waves are burst driven, the main frequency band is a narrow band, but a low level sub-band exists over a wide frequency band. Since therapeutic ultrasonic waves are driven at a high power of several hundred W, these low-level components may become noise in the image of the ultrasonic imaging apparatus and become a problem. In such a case, it is necessary to reduce noise only during the irradiation of therapeutic ultrasonic waves. Increasing the transmission power of the ultrasonic imaging apparatus compensates for the increment of noise during treatment by increasing the image signal component, and the influence of noise can be reduced. It is also effective to perform high-pass filter processing on components in the low frequency region that do not significantly affect the image of the ultrasonic imaging apparatus. It is more effective to perform the FFT conversion of the image signal containing noise and then perform digital processing to make the signal in the noise frequency range zero, and in some cases perform interpolation processing of the cut component and then perform inverse FFT conversion to perform image processing. Furthermore, it is still more effective if the mixed noise component due to the therapeutic ultrasonic wave is measured and recorded in advance and the cancellation processing is performed on the received signal of the imaging device.

According to the second invention of the present application, FIGS.
With such a configuration, it is possible to generate the second harmonic in addition to the fundamental resonance. Noise on the ultrasonic image is likely to occur when the frequency of the therapeutic ultrasonic wave and the frequency of the diagnostic ultrasonic wave are close to each other. In the present invention, at least one of the therapeutic ultrasonic wave generation means and the diagnostic ultrasonic wave probe can generate the second harmonic in addition to the fundamental resonance. Therefore, it is possible to confirm the presence of noise before the treatment and select the combination of frequencies with the least noise. In the conventional method, there is one combination of the therapeutic frequency and the diagnostic frequency, but in the present invention, there are four combinations at maximum. Further, since the frequency can be selected according to the depth of the treated region from the body surface, safe and efficient treatment can be performed. Specifically, considering the ultrasonic attenuation of the living body, it is possible to set a low frequency at a deep place and a high frequency at a shallow place. Further, as will be described later, the ultrasonic frequency is determined by the total thickness of the two layers, and the relative value of the electromechanical conversion efficiency of the fundamental resonance and the second harmonic can be controlled by changing the ratio of the thickness of each layer. Can be reflected in the design of.

The principle of generation of the second harmonic will be described below, but since the idea is the same, only one case will be described.
As for the structure, it is assumed that two-layer piezoelectric bodies having different thicknesses shown in FIG. 9 are laminated so as to have opposite polarization directions and are electrically connected in series. When a voltage is applied to the electrodes on both end faces, a compressional wave propagates in the piezoelectric body. If a rough wave is radiated from the interface A of the one piezoelectric body 31 to the outside, the dense wave (1) propagates inside the piezoelectric body 31 by a reaction. Two piezoelectric bodies 31,
At the interface B of 33, since the relationship between the electric field direction and the polarization direction of each layer is opposite, when one piezoelectric body expands, the other contracts, and a compression wave is generated. That is, the dense wave (2) propagates to the piezoelectric body 31, and the coarse wave (3) propagates to the piezoelectric body 32. On the other hand, on the surface C of the piezoelectric body 32 on the side opposite to the interface B, since the relationship between the electric field direction and the polarization direction is opposite to that of the piezoelectric body 31, the rough wave (4) propagates inside the piezoelectric body 32. Therefore, from interface A (1) to (4)
The wave is emitted until it decays. When the wave reaches the interface C, the polarity is inverted due to the size of the acoustic impedance with the outside. Considering that this is different from the thickness of the two layers, the time interval between the rough wave and the dense wave emitted from the interface A is not constant. That is, this means that the radiated wave is represented by a Fourier series whose fundamental frequency is the frequency of the half-wavelength of the entire thickness of the two-layer piezoelectric body, and there are even harmonics. Therefore, it becomes possible to excite the second harmonic in addition to the fundamental frequency.

By the way, when it is made possible to generate the fundamental resonance and the second harmonic in the diagnostic ultrasonic wave, as shown in FIG. 14, the transfer function (frequency spectrum of the impulse response) of the fundamental resonance and the second harmonic is obtained. A steep valley is formed between them. Therefore, when the therapeutic ultrasonic frequency is set in the valley, noise inclusion in the ultrasonic image is reduced.

One of the two additional features is that the weights of the applicators are approximately offset, allowing the operator to manually control the position of the applicator without resorting to mechanical force. . Further, at this time, the operator grips the gripping part attached to the applicator to ensure the position control.

With this structure, the operator can handle the applicator as if it were an ultrasonic probe, so the affected area can be visualized with the same image quality as when the affected area was confirmed with the ultrasonic probe before surgery. It is possible to accurately match the ultrasonic focus to the target.

Further, since the patient does not feel the weight of the applicator as it is, the discomfort is reduced. Further, in the present invention, since the angle of the grip portion is variable, for example, when treating a tumor in the upper part of the liver, by tilting the grip portion largely from the irradiation axis of therapeutic ultrasonic waves, even in a narrow abdominal cavity where the abdomen is opened. It is possible to insert the applicator from under the costal arch and attach it to the affected area. Further, since the grip portion can rotate, the slice plane angle of the ultrasonic probe inside the applicator can be changed independently of the angle of the grip portion.

Furthermore, since cables and hoses for power supply and water supply / drainage can be attached and detached at the applicator portion, it is not necessary to sterilize long cables and hoses when sterilizing the outside of the applicator, and the work is simplified.

Further, in the present invention, since the coupling body is detachable, it is easy to exchange the coupling body for each patient, and it is necessary to sterilize the applicator which is difficult to sterilize every time. Disappear. Also, since the coupling body has a structure in which sterile water is put inside,
Even if microscopic holes are formed in the film near the focal point by the energy of the therapeutic ultrasonic waves, there is no risk of infection of the patient. Therefore, it is not necessary to sterilize the coupling liquid inside the applicator. Moreover, since the patient's blood does not reach the applicator side directly, it is not necessary to sterilize the applicator.

The other is a means for detecting a temperature change on the body surface of the patient when the treatment is performed by focusing a strong ultrasonic wave, and the irradiation of the strong ultrasonic wave is based on the detected temperature change data. By the means for controlling the conditions, it is possible to prevent abnormal fever on the body surface of the patient, and to perform safe treatment without damaging the skin of the patient.

Further, since the piezoelectric element group for generating a shock wave for calculus crushing and the piezoelectric element group for generating ultrasonic waves for heating / heating having different frequencies are housed in the same applicator, whichever treatment is used. It also enables treatment with high energy efficiency. Further, by combining both piezoelectric element groups, it becomes possible to change the focus property. Furthermore, if the piezoelectric element group for calculus breaking is used as an ultrasonic generation source for in-vivo exploration, information near the focus can be obtained in real time even during heating / heating treatment in which diagnostic ultrasonic waves cannot be used.

[0038]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 1 is a schematic view of the configuration of an ultrasonic therapeutic apparatus according to the first invention of the present application. An ultrasonic transducer 1 including a concave piezoelectric element that generates a focused ultrasonic wave has its focus F on the patient 1 side.
It is aligned with the lesion area 11 inside 0 and driven by the therapeutic ultrasonic drive device 6. A few mm of focus F in about 1 second
The region is heated to 70 to 90 ° C to necrot the diseased tissue.
The ultrasonic probe 2 is used for observing a tomographic image inside the human body with the ultrasonic imaging device 5, and is used for aligning the focal point F with a lesion and for observing a treatment situation. Manipulator 3
The position controller 4 aligns the focal point F of the ultrasonic transducer 1 with the lesion area of the image. This is for gradually moving the focal point F within the lesioned part 11 and necrosis of the entire lesioned part. The system controller 7 is the position controller 4,
The ultrasonic imaging apparatus 5 and the therapeutic ultrasonic drive apparatus 6 are controlled in a centralized manner. The water bag 8 holds an ultrasonic wave propagation medium 9.

The ultrasonic probe 2 is for transmitting ultrasonic pulses, receiving reflected waves from internal tissues of a living body, and displaying a tomographic image. When the ultrasonic transducer 1 is driven and the emitted ultrasonic waves are reflected inside the living body and received by the ultrasonic probe 2, the signal disturbs the image as noise. When it is difficult to see, only the therapeutic signal is displayed and the tomographic image is not displayed at all. FIG. 2 shows an example of frequency characteristics of the ultrasonic probe 2. The ratio between the occupied frequency bandwidth Δf and its center frequency f0 is about 100 to 150%, although it varies depending on the configuration of the transceiver. Assuming 100%, the frequency with sensitivity is 0.5 × f
It is about 0 to 1.5 × f0. If the frequency component of the reflected wave from the living tissue caused by the irradiation of therapeutic ultrasonic waves can be set so as not to be included in the frequency band of the imaging apparatus, it is possible to prevent noise from being mixed into the ultrasonic image. The therapeutic ultrasonic waves are burst-driven and driven at a frequency of about 1 MHz for about 1 second, so that the frequency characteristic example has a narrow band as shown in FIG. Therefore, if the therapeutic ultrasonic frequency is set to ½ or less of the center frequency of the imaging device, the main frequency component of the therapeutic ultrasonic wave is outside the sensitivity band of the imaging device, and an image without noise influence can be obtained. However, it does not mean that there is no sensitivity at frequencies other than the sensitivity band of the above-described imaging apparatus, and therapeutic ultrasonic waves also have a wide range of frequencies due to burst driving, although at a low level. Therapeutic ultrasound is driven with high power of hundreds of watts, and even low level components, which are usually negligible, may affect the image of the imaging device. Therefore, the larger the respective frequency ratios, the more desirable.

The center frequency of the ultrasonic imaging apparatus of the practical ultrasonic treatment apparatus is 3 to 5 MHz, and the treatment frequency is considered to be about 1 to 2 MHz. When the ratio of the treatment frequency to the imaging frequency is 2 to 3 times, the power of the treatment ultrasonic waves is large as described above, and thus noise may not be mixed in the image in some cases. As a countermeasure against this, noise is mixed only during the irradiation of therapeutic ultrasonic waves, so that it is sufficient to provide the imaging apparatus with means for reducing noise only during this period.

The first means of noise reduction is to keep the S / N ratio of the image of the ultrasonic imaging apparatus constant. Provided in the ultrasonic imaging device 5 is a means for increasing the transmission power of the ultrasonic imaging device and compensating for the S / N ratio of the image signal only when the therapeutic ultrasonic wave is irradiated in accordance with the increase in noise due to the irradiation of the therapeutic ultrasonic wave. Just go. At that time, needless to say, the power of ultrasonic waves for ultrasonic imaging is limited to a range that does not adversely affect normal human tissues.

The second means of noise reduction is to perform a high-pass filter process in which the cutoff frequency is set to such an extent that there is little influence on the image before the received signal of the ultrasonic imaging apparatus is imaged. For example, when the power of the therapeutic ultrasonic wave is too large and a frequency component lower than the frequency band of the ultrasonic probe shown in FIG. 2 is mixed as noise and affects the image, the frequency band of the transducer is cut off. By performing the high-pass filter processing, it is possible to remove the mixing of noise. Further, even when the noise component slightly includes a low frequency region within the frequency band of the transmitter / receiver, a high pass filter is used to cut a frequency equal to or lower than about 0.7 times the center frequency f0 of the ultrasonic probe as shown in FIG. Even if processed, the influence on the image is small, and the treatment situation can be observed. If the influence of the image is small, filter processing means may be permanently provided in the ultrasonic imaging device 5, but when the image deterioration is large, the reception signal of the ultrasonic imaging device is received only during the time when the therapeutic ultrasonic wave is being irradiated. Means for filtering may be provided.

As a filter processing method, there is also a method of performing FFT conversion of an image signal containing noise, then performing digital processing to make a signal in the noise frequency range zero, and again performing inverse FFT conversion. It can be removed sharper than an analog filter, and the removed image signal component can be interpolated. It is assumed that the frequency component obtained by FFT-transforming the image signal containing noise is as shown in FIG. This is cut by digital processing below the frequency of f1 as shown in FIG. 5 (b). If this is subjected to inverse FFT conversion to form an image signal, an image from which noise has been removed can be obtained. When the cut image signal component is large, it is more effective to reduce the disturbance of the image signal by performing a process of interpolating the cut diagonal line component with a certain function by digital processing as shown in FIG. 5C. Is. If such a filtering means is permanently installed in the ultrasonic imaging apparatus, it is not necessary to control the ultrasonic therapy apparatus in synchronization with the drive of the ultrasonic therapy apparatus, and the synchronization control means is not necessary, and the system can be simplified.

The third means of noise reduction is to record the frequency component of only noise in advance and remove the noise component from the received signal in which the noise is mixed by subtraction processing. This is effective when the noise frequency component occupies a wide area within the frequency band of the ultrasonic probe.
Only the therapeutic ultrasonic wave component received by the ultrasonic probe when the therapeutic ultrasonic wave is radiated is recorded instantaneously, and the noise frequency component recorded from the received signal for imaging is recorded only when the therapeutic ultrasonic wave is radiated. When the ultrasonic imaging apparatus 5 is provided with a means for performing a removal process and imaging, an image from which noise is removed can be obtained.

An embodiment of the second invention of the present application will be described. It was constructed so that the second harmonic could be excited for both therapeutic and diagnostic purposes. As an example, the therapeutic frequencies are 1MHz and 2MHz,
The diagnostic frequencies were 2.5 MHz and 5 MHz. The piezoelectric bodies used were both zircon / lead titanate (PZT) -based piezoelectric ceramics, and the piezoelectric bodies were composed of piezoelectric bodies of the same thickness for treatment as shown in FIGS. For use, piezoelectric materials having different thicknesses and opposite polarization directions were laminated to form electrodes on both end surfaces. The basic configuration of the present invention is shown in FIG. The ultrasonic transducer 1 is, for example, a spherical shell having a diameter of 15 cm and a curvature of 15 cm, and the electronic sector probe 2 is installed at the center thereof. The ultrasonic vibrator 1 is formed by bonding a piezoelectric ceramic of the same type and the same thickness with an epoxy adhesive to the convex portion of a PZT piezoelectric ceramic having a thickness of 1 mm which is processed into a concave surface to form an electrode. Layered. On the other hand, in the production of the piezoelectric ceramic of the ultrasonic probe 2, platinum paste was screen-printed on the green sheet as an internal electrode, the green sheet was laminated on the green paste, degreased, and integrally fired. After firing, the thickness of the piezoelectric layer was adjusted to 400 μm and 200 μm. Silver paste was printed and baked on this to form external electrodes. After that, polarization treatment was performed so that the directions were reversed, and the two-layer piezoelectric body shown in FIG. 9 was manufactured. 400μ thick for probe fabrication
Matching layer so that the m side becomes the ultrasonic wave emitting surface,
Backing material etc. were formed.

The applicator 12 is connected to the system control device 7 via the drive circuit group 15 and the ultrasonic probe 2 via the transmission circuit 13, and an appropriate frequency is set. The diagnostic ultrasonic wave transmitted by the ultrasonic probe 2 is reflected in the body and received by the ultrasonic probe 2. After this reflected signal is amplified and detected by the receiving circuit 14, it is converted into a digital signal by the A / D converter 16 and taken into the image memory 17.
The image memory 17 is not described in detail because it is a known technique.
Then, after processing the data for display, a tomographic image is displayed on the CRT 19 through the D / A converter 18. All of these controls are controlled by the system controller 7. In the present embodiment, considering the ultrasonic attenuation of the living body, the treatment frequency is preferably 1 MHz and the diagnosis frequency is 2.5 MHz at a depth of 10 cm or more, and 2 MHz and 5 MHz are preferable at a depth of less than 10 cm. However, there is no need to be concerned with this, and it can be appropriately selected depending on the situation. Further, regarding the focusing of the therapeutic ultrasonic waves to the treated region, the position of the applicator 12 is mechanically changed to match. At this time, when adjusting in the depth direction, the applicator 1
The amount of water in 2 will be adjusted to ensure contact with the patient 10. Further, the vibrator of the applicator 12 uses a concentric circle type as shown in FIG. 12 or a two-dimensional array type as shown in FIG. 13, and the driving signals of different phases are given to the divided vibrators to change the focus position. It can be controlled electronically. The positional relationship between the applicator 12 and the ultrasonic probe 2 is also shown in FIG.
It is not necessary to install the ultrasonic probe 2 at the center of the applicator 12 as described above, but the ultrasonic probe 2 may be installed beside the applicator 12 as shown in FIG. Further, the magnitude relationship between the therapeutic ultrasonic frequency and the diagnostic ultrasonic frequency is not the same as that of the present embodiment, and the former may be larger than the latter. Also, the therapeutic frequency is 2.5 which is the diagnostic frequency.
When the frequency is set to 3.75 MHz, which is an intermediate between 5 MHz and 5 MHz, noise mixing in the ultrasonic image is reduced as described above.

The third embodiment of the present invention will be described below with reference to the drawings. FIG. 15 shows the configuration of the first embodiment of the present invention. As disclosed in Japanese Patent Publication No. 4-48457, the applicator 12 has an ultrasonic transducer for generating therapeutic ultrasonic waves inside and an ultrasonic probe for forming an ultrasonic tomographic image in the body in a watertight state. It is configured. Here, an ultrasonic image device for reconstructing and displaying a tomographic image by connecting with a drive circuit for driving the therapeutic ultrasonic transducer and an ultrasonic probe, and a cable and a hose for connecting them are not shown. The applicator 12 is suspended by two cables 41 and held by an arm 42. The arm 42 is swingably and rotatably attached to a stand 44, and a counterbalance 43, which is approximately in weight balance with the applicator 12 and is slightly heavy, is attached to the end opposite to the applicator 12. Here, the joint portion 45 connecting the arm 42 and the stand 44 is not only swingable and rotatable, but also has a suitable resistance feeling, and the weight balance of the components attached as in the present embodiment can be almost balanced. In the situation where the external force is applied, it moves only when the external force is applied, and the applicator 12 is maintained in a slightly raised position when the external force is removed. The base of the stand 44 has a structure that can be moved in the horizontal direction. Therefore, when the operator tries to change the position by holding the grip portion 46 attached to the applicator 12, three kinds of force, that is, the inertial force of the applicator 12 and the resistance of the joint portion 45 and the resistance when the stand 44 is moved horizontally are used. The position can be adjusted to an arbitrary position simply by countering, and the position can be held with an extremely small force after the movement. Further, since the counter balance 43 is slightly heavy, the applicator 12 is retracted from the patient unless the operator intentionally wears it on the patient. Therefore, it is in a fail-safe situation and is very safe.

FIG. 16 shows the detailed structure of the applicator 12 of this embodiment. FIG. 16A shows a state in which the grip portion 47 attached to the applicator 12 is perpendicular to the applicator 12. Two left and right suspension cables 41 are fixed to a shaft 48 for changing the angle of the grip portion 47.

A cable 49 for supplying electric energy for radiating therapeutic ultrasonic waves through the inside of the grip portion 47 and a hose 50 for supplying / draining water for coupling are attached. And applicator 1
On the upper surface of 2, there are formed four protrusions 51 for attaching a coupling body, which will be described later. A switch 52 for controlling the irradiation of therapeutic ultrasonic waves is attached to the grip portion 47. 16B shows a state in which the gripping portion 47 is fixed to the applicator 12 at an angle. The structure of the joint portion of the gripping portion 47 is a technique known to those skilled in the art, and a description thereof will be omitted. However, the mechanism is such that it is lightly fixed at a predetermined angle around the shaft 48 to give a click feeling.

Next, FIG. 17A shows a coupling body 53 of the present invention. For example, four mounting portions 54 having elasticity and having mounting holes are formed on the upper portion.
FIG. 17B shows the cross section, and the main body 55 is a thin film through which therapeutic ultrasonic waves are sufficiently transmitted. Moreover, it has a double structure and deaerated sterilized water 56 is enclosed inside. The coupling body is the applicator 1
FIG. 17C shows a cross section of the state of being attached to No. 2. The contact surface between the membrane of the applicator 12 and the inner side of the coupling body should be protected from air due to degassed water (which does not necessarily have to be sterile water in this case) or ultrasonic jelly poured at the time of mounting. Has become. Then, the attachment portion 54 is hooked on the protrusion 51 in a state where the attachment portion 54 is sufficiently pulled and extended. Therefore, the replacement of the coupling body 53 is very easy. Recently, the number of infectious diseases using body fluid, blood, etc. as a medium has been increasing, and normally such a coupling body 53 is disposable for each patient. Therefore, it is possible to use it as if it is a disposable surgical glove by making a packaged sterilized whole of the coupling body 53.

FIG. 18 shows another embodiment of the applicator. The applicator 57 includes a cable for supplying electric energy for irradiating therapeutic ultrasonic waves, a hose for supplying / draining internal water, and a cable for exchanging signals with the internal ultrasonic probe. Since the connector group 58 for connecting the cables is constructed, it is not necessary to remove each cable and hose when sterilizing the applicator and when exchanging the applicator.

The present invention can be variously modified without departing from the scope of the invention. For example, in the above embodiment, the applicator 1
Although the counter balance method using the suspension cable in the mechanism portion supporting 2 is used, other than this, an articulated arm method in which a spring is balanced or an electric method combining a sensor and a motor system is also possible. The same applies to other specific design methods.

An embodiment of the fourth invention of the present application will be described below with reference to the drawings. FIG. 19 shows a block diagram of this embodiment.
First, the ultrasonic treatment section will be described. Applicator 12 is
It comprises an ultrasonic transducer 1 for irradiating therapeutic strong ultrasonic waves, an ultrasonic wave propagation medium 9 for guiding the strong ultrasonic waves to the patient 10, and a water bag 8 for sealing the ultrasonic wave propagation medium 9. Applicator 1
As shown in FIG. 20, the reference numeral 2 has a shape obtained by dividing the circular flat plate ultrasonic transducer 1 in the radial and circumferential directions. At the time of treatment, the applicator 12 is placed on the body surface, and the water bag 8 is brought into contact with the skin of the patient 10 via the ultrasonic jelly 59 or the like. Focus F
After matching with the lesioned part 11, the ultrasonic transducer 1 is driven by the drive circuit group 15 to irradiate a strong ultrasonic wave, and the treatment site corresponding to the focus F is maintained at a high temperature for treatment.

In this example, a phased array was used as a strong ultrasonic wave generation source. Therefore, by controlling the drive timing of the drive circuit group 15 by the phase control circuit group 60, the focus position, the sound field, and the heating / heating area can be operated without moving the applicator 12. The drive circuit group 15 is divided into the same number of channels as the divided ultrasonic transducers 1, and is driven by an independent timing signal delayed by the phase control circuit group 60 by a signal from the system controller 7. As a result, the ultrasonic focus F,
F'can be set three-dimensionally at any place. The operation of moving the focus position by this delay time control is performed in USP 4,52
This is described in detail in Japanese Patent No. 6,168.

Next, the positioning and MRI image pickup section will be described. First, the patient 10 is set on the treatment table 61, and the system controller 7 controls the imaging gantry (not shown) in which the RF coil 62, the static magnetic field coil 63, and the gradient magnetic field coil 64 are built. , And is sent by the table moving device 69.

Next, the system controller 7 operates the gradient magnetic field power source 6
5. The transmission / reception circuit 66 is activated by a predetermined sequence (for example, T2 weighted imaging method) instructed by the input means 67, and the three-dimensional image information of the inside of the patient 10 is stored in a memory (not shown).

Here, it is possible to make a treatment plan in advance based on the MRI image inside the patient 10. The method of displaying the MRI image on the CRT and the method of treatment planning are described in Japanese Patent Application No. 4-43603.

When the MRI image is obtained, the system controller 7 controls the manipulator 3 and the applicator 12 is attached to the patient 10. At this time, the position of the focal point F of the strong ultrasonic wave in the body was measured in advance with a signal from the position control device 4 including a potentiometer (not shown) attached to each part of the manipulator 3. The system control device 7 calculates from the information on the attachment position of the MRI device and the manipulator 3 and stores it.
The focus position F is displayed on the MRI image of the CRT 19. Further, not only the focus F but also the incident path 68 of the ultrasonic wave can be displayed together on the MRI image of the CRT 19.

The coincidence between the position of the focus F and the position of the lesion 11 stored in the system controller 7 is checked, and the system controller 7 starts the ultrasonic wave irradiation to drive circuit group 15
, And treatment is started.

Here, the detection of the abnormal heat generating portion 70 in the coupling portion between the applicator 12 and the body surface of the patient 10 will be described. First, by using crystalline gel particles of a chemical substance exhibiting reversible thermochromism between the water bag 8 of the applicator 12 and the body surface of the patient 10, an ultrasonic jelly 59 is used by using a gel medium having an acoustic impedance close to that of a living body. Apply as. Reversible thermochromic substances are spiropyrans, biantrons,
Condensed aromatic ring-substituted ethylene derivatives such as dixanthylene are conceivable. Among them, a substance that exhibits a color reaction at a temperature of 50 to 60 ° C. before damage to a living body is used.

During heating, an abnormal heat-generating portion 70 is generated on the surface of the patient's body, and, for example, when the thermochromic particles in that portion develop red color when the temperature reaches 60 ° C., the central portion of the vibrator 12 is affected. An optical camera 71 that is attached and constantly monitors the contact surface between the water bag 8 and the body surface detects the color development.

Here, the real-time image captured by the optical camera 71 is always sent to the CRT 19, and the system controller 7 determines whether the real-time image on the CRT 19 has a red pixel (not shown). In addition, judging the brightness of red light, if there is a pixel showing red,
A signal is sent to the drive circuit group 15 to control the energy such as reducing the intensity of the intense ultrasonic waves according to the brightness, or to stop the irradiation. In this example, an ethylene derivative having a reversible thermochromic property was used, which is a lacquer / vinyl varnish as a color-developing agent in a reversible thermochromic paint, and a mercury that shows a discoloration due to a crystal transition in a pigment. Halides such as, and complex salts and double salts thereof may be used. In addition, it is a pigment of irreversible temperature-inhibiting paint, which changes color due to dehydration reaction, CoCl ₂ .2 (CH ₂ ) ₆ N ₄ .10H ₂ O, N
C such as iBr ₂ · 2 (CH ₂ ) ₆ N ₄ · 10H ₂ O
o, Ni complex salts, double salts, as used in thermal paper,
A colorless color reaction of leuco crystal violet and bisphenols or a thermal destruction color reaction of colored fine particles in the maskrocapsules may be used.

Further, instead of being mixed with a gel medium and used, the thermochromic substance itself may be used in a film form if possible. Further, instead of using the thermochromic substance, a temperature-sensitive liquid crystal film may be used.

The irradiation of ultrasonic waves is stopped at the time when it is considered to be in the middle or at the end of the initial treatment plan, and the progress of treatment is observed. This is performed in the same manner as the above operation, and the lesion part 11
MRI images of the surroundings are taken to examine changes in the living body. During this time, the applicator 12 is still attached to the patient 10. By subtracting the T2 weighted image data stored on the memory before the treatment and the present data, the heat-denatured region can be clearly confirmed, and whether the treatment was sufficiently performed or insufficient treatment required retreatment. Can determine if it is necessary. It is also possible to incorporate this into the treatment plan from the beginning and automatically take an image at every predetermined treatment time.

When it is judged by the MRI treatment effect that the treatment is completed, the operator finishes the treatment. At this time, the system control circuit 7 can retrieve the history of treatment conditions from the memory and output the treatment record from the CRT 19.

Here, a coil in the body cavity may be used as the RF coil for transmission and reception. Further, although the phased array is used for the ultrasonic transducer 1, this may be an annular array or the focus may be moved by mechanically moving the applicator.

Further, as shown in the second embodiment of FIG. 21, the ultrasonic transducer 1 is attached with an ultrasonic probe 2 connected to an ultrasonic imaging apparatus 5 at the center, and an ultrasonic image inside the body is real-time. You may be able to observe.
The ultrasonic probe 2 is configured to be able to slide and rotate in the front-rear direction. By providing a means for obtaining the relative position between the ultrasonic probe 2 for obtaining the ultrasonic tomographic image and the focal point F of the therapeutic ultrasonic wave, the focal position F can be displayed on the ultrasonic image and further obtained by MRI. The position of the ultrasonic tomographic image that is being displayed at that time is displayed on the three-dimensional or three-dimensional in-vivo image, and the ultrasonic tomographic image can be used in accordance with the previously established treatment plan.

These methods are described in Japanese Patent Application No. 4-242886.
The issue is detailed. Further, the applicator 12 can be used not only in the upper approach as in the present embodiment but also in the lower approach by moving the manipulator 3.

In this embodiment, the abnormal heat generating portion 70 on the body surface of the patient 10 is detected by the radiation thermometer 72 attached to the center of the vibrator 2. When the radiation thermometer 72 shows, for example, a temperature increase of 20 ° C. relative to the normal body temperature (for example, 40 ° C.), this information is transmitted to the system controller 7, and the system controller 7 drives the drive circuit group 15. Control, weaken the irradiation energy of strong ultrasonic waves, or stop the irradiation.

In the above embodiments, the treatment of tumor by ultrasonic heating was described, but the same applies to the treatment of stones by high intensity ultrasonic waves. However, in this case, it is more important to form a high-pressure portion on the body surface of the patient 10 than to generate heat, and therefore the pressure-sensitive color reaction is detected by the optical camera 72.

An embodiment of the fifth invention of the present application will be described below with reference to the drawings. FIG. 22 shows an embodiment of the ultrasonic therapeutic apparatus according to the present invention. In the figure,
The ultrasonic applicator 12 is flexible with the ultrasonic transducers 1A and 1B in which a plurality of piezoelectric elements are arranged on a spherical shell, and the ultrasonic probe 2 for imaging inserted and arranged in the center of the ultrasonic transducer. It is composed of a water bag 8. As shown in the figure, the applicator 12 treats the lesioned part 11 in the body of the patient 10 via the acoustic energy propagation medium 9 (for example, water) made of a substance having an acoustic impedance close to that of the living body. Abutted against.

The ultrasonic transducers 1A and 1B are composed of piezoelectric elements having different resonance frequencies, and can be driven independently. For example, ultrasonic transducer 1A
Has a resonance frequency of 250 kHz and is used for calculus breaking. Also, the ultrasonic transducer 1B has a resonance frequency of 1.5 MHz.
z is used for heating and heating. In this embodiment, the ultrasonic transducer 1A is arranged inside the class shell, and the ultrasonic transducer 1B is provided.
Is placed outside, but if you place it like this,
The focal size of the intense ultrasonic waves for heating is smaller than that located inside, and a higher pressure (high temperature) region can be created in a more limited range.

The ultrasonic transducers 1A and 1B are driven by the drive circuit groups 15A and 15B adjusted to the respective resonance frequencies. The drive circuit group 15A has a switching means 73.
Via a high voltage source 74A or a low voltage source 75. The high voltage source 74A is a power source for generating a therapeutic strong ultrasonic wave, and the low voltage source 75 generates a weak ultrasonic pulse for searching the lesion 11 as described in JP-A-63-5376. Is a power source for. Drive circuit group 15
B is connected to a high voltage source 74B and outputs therapeutic ultrasonic waves. The drive circuit group 15A includes a phase control circuit group 60A.
The phase control circuit group 60B is connected to the drive circuit group 15B and outputs a square wave of a certain length for the treatment mode. The phase control circuit groups 60A, 60B,
The low voltage source 75 and the high voltage sources 74A and 74B are connected to the system controller 7 and their operating states are controlled.

A reflected wave processing circuit 77 is provided in the ultrasonic transducer 1A.
Are connected. As described in Japanese Patent Laid-Open No. 63-5736, an ultrasonic transducer 1A irradiates a weak ultrasonic pulse toward a lesion portion 11, and the lesion portion 11 is an ultrasonic high reflector such as a stone. If so, the exploration wave is efficiently reflected only when the focal point and the lesioned part 11 match, and the signal is received by the ultrasonic transducer 1A. The reflected signal acquired by the ultrasonic transducer 1A is processed by the reflected wave processing circuit 77,
The result is sent to the system controller 7 and the digital scan converter 78 (hereinafter referred to as DSC). DSC7
In 8, in addition to the above-described reflection signal, information such as the in-vivo ultrasonic image from the ultrasonic image imaging device 5 and the treatment status is processed, and the result is displayed on the CRT 19.

The ultrasonic probe 2 inserted and arranged in the applicator 12 is connected to the ultrasonic imaging apparatus 5, and the in-vivo image is reconstructed in the ultrasonic imaging apparatus 5.

In addition to the treatment mode selection, the system controller 7 confirms the mode, issues a warning, controls the DSC 78, and inputs means 67.
It processes the commands instructed by Here, the input unit 67 is an input device such as a keyboard, a mouse, or a light pen.

Next, the operation of the present invention will be described with reference to FIG. First, the case where the lesioned part 11 is a kidney stone or a gallstone will be described. The operator uses the input means 67 (for example, a mouse or a light pen) on the screen shown in FIG. 23 to select the treatment mode. The information on the treatment mode is sent to the system control device 7, the treatment mode is displayed via the DSC 78, and the operator is notified by voice from the speaker 80 via the voice processing circuit 79. Next, the operator inputs the irradiation mode and the irradiation energy, and the treatment preparation is completed.
In the calculus breaking mode, normally only the ultrasonic transducer 1A operates, but when it is desired to increase the focal pressure, the ultrasonic transducer 1A is operated.
B also operates at the same time. An intense ultrasonic wave having a fundamental frequency of 1.5 MHz is output from the ultrasonic oscillator 1B, and is focused toward a focus together with the intense ultrasonic wave of 250 kHz from the ultrasonic oscillator 1A. At that time, a shock wave is formed in the vicinity of the focus, but the peak pressure and the focus size can be changed by the ratio of the ultrasonic waves from the ultrasonic transducers 1A and 1B. The operator inputs desired focus peak pressure and focus size by the input means 67, and the system controller 7 refers to the memory 76 to adjust the output and output timing of the high voltage sources 74A and 74B.

Next, the heating / heating mode will be described. The operator inputs the treatment mode via the input means 67. Here, it is assumed that the heating / heating mode is selected as shown in FIG. This information is displayed by the system controller 7 on the CRT 19 via the DSC 78, and at the same time, the operator is notified by voice from the speaker 80 via the voice processing circuit 79. Next, the operator inputs the irradiation energy, burst length and repetition frequency, and the preparation for treatment is completed.

The treatment is mainly performed by using the ultrasonic transducer 1B. However, also in this case, similarly to the calculus destruction, the ultrasonic transducer 1A can be controlled at the same time to set the focal peak pressure and the focal size arbitrarily. The setting method is the same as in the case of lithotripsy treatment. Further, the length of the burst wave can be changed by controlling the time gate width of the phase control circuit groups 60A and 60B.

Now, when only the ultrasonic transducer 1B is used as a strong ultrasonic source for treatment, the ultrasonic transducer 1A can be used as an ultrasonic source for exploration. The frequency of the ultrasonic waves for heating / heating is usually several MHz (1.5 MHz in this embodiment), which is close to the ultrasonic frequency for imaging (3.75 MHz). Therefore, during heating / heat treatment, the in-vivo image by the ultrasonic waves for imaging is buried in noise, and real-time monitoring is difficult. Therefore, a part of the in-vivo information is acquired by using the search ultrasonic waves having the ultrasonic frequency of 250 kHz. An example will be described below.

As the heat treatment progresses and the thermal denaturation of the tissue near the focus progresses, the acoustic impedance at that site changes greatly. Therefore, if ultrasonic waves for exploration are directed toward the focal point during heating / heating treatment, the change in acoustic impedance due to thermal denaturation of tissue can be known in real time by analyzing the magnitude of the reflected wave. It can be used for heating and heating treatment ultrasonic wave irradiation control.

It is also possible to know information on cavitation generated near the focal point. It is known that when strong ultrasonic waves propagate in water, cavitation occurs in the water. The inside of the cavitation is filled with a low-pressure gas, and the ultrasonic waves are absorbed, scattered and reflected by the cavitation. When intense ultrasonic waves for heating and heating are focused on the focal point, cavitation occurs from before the focal point to the focal point. For this reason, the energy of the ultrasonic waves is affected by cavitation before focusing, and is also largely heat-denatured before focusing. In order to avoid this, cavitation generation grows in front of the focus when the ultrasonic wave for ultrasonic probe 1A is applied in pulses during heating / heating treatment and the time to receive the reflected wave due to cavitation becomes early. If so, the ultrasonic wave for heating / heating is stopped.

It is also possible to obtain information on changes in the body surface. Temperature rise on the body surface becomes a problem in heating and heating treatment. When intense ultrasonic waves are directed toward the inside of a living body, if the transmitted energy density on the body surface is large, the temperature of the body surface rises, and sometimes heat denaturation occurs.
In order to avoid this, the search ultrasonic waves emitted from the ultrasonic transducer 1A are used. The distance between the ultrasonic transducer and the body surface is measured in advance, and the reflection intensity of the exploration wave on the body surface is measured in advance. When the body surface begins to change due to heating, the reflection intensity of the exploration wave on the body surface increases, so the change in the body surface can be known. More specifically, if the reception gate time of the reflected wave processing circuit 77 is adjusted so that the signal on the body surface can be received, the reflected wave on the body surface can be selected and acquired. When the size of the wave exceeds a certain threshold, the irradiation of heating / heating ultrasonic waves is stopped and a warning is displayed. The above operation can also be performed by ultrasonic waves for imaging when the irradiation of therapeutic ultrasonic waves is stopped, and even if the echo becomes high on the body surface, a warning is issued and even if the therapeutic ultrasonic waves are not emitted. Good.

In addition, a method of positively utilizing cavitation can be considered. The ultrasonic transducers 1A and 1B are connected to high voltage sources 74A and 74B, respectively. As shown in FIG. 25, a pulse high voltage is applied to the ultrasonic transducer 1A to focus the shock wave on the focal point. If the ultrasonic oscillator 1B is driven with an appropriate delay relative to the ultrasonic oscillator 1A, when the shock wave reaches the focal point and cavitation is generated near the focal point, the powerful ultrasonic wave for treatment from the ultrasonic oscillator 1B is focused on the focal point. To reach. At that time, the document “K. Hynynen., Ultr.
a. Med. Biol. 17 (1991) p
p. 157-169 ", the energy of therapeutic ultrasound is absorbed in the cavitation, where the living body is heated to a higher temperature than it would be without cavitation. By irradiating the therapeutic high-intensity ultrasonic waves in the irradiation sequence as described above, the treatment efficiency can be improved.

[0085]

As described above, in the first invention of the present application, the treatment ultrasonic waves are irradiated to prevent the mixing of the main frequency component of the ultrasonic waves for treatment into the reception signal of the ultrasonic imaging apparatus. It is more effective to provide the ultrasonic imaging apparatus with means for reducing the signal component of the therapeutic ultrasonic wave only for the time. Specifically, according to the increase in noise during treatment,
A means for increasing the transmission power of the ultrasonic imaging apparatus to compensate for the S / N of the image signal, a filter processing means for cutting low frequency components that do not significantly affect the image of the ultrasonic imaging apparatus, and a prerecorded noise component By providing means for canceling the received signal, a high-resolution tomographic image can be obtained even during treatment.

As described above, according to the second invention of the present application, by forming the piezoelectric body used for ultrasonic transmission / reception in a laminated structure, it becomes possible to excite the second harmonic in addition to the fundamental frequency. Therefore, it is possible to change the combination of the frequency of the therapeutic ultrasonic wave and the frequency of the diagnostic ultrasonic wave, and it is possible to set the combination that is less affected by noise in the diagnostic ultrasonic image.

[Brief description of drawings]

FIG. 1 is a structural conceptual diagram of an ultrasonic treatment apparatus of the first invention of the present application.

FIG. 2 is a sensitivity band of a transmitter / receiver for an ultrasonic imaging apparatus.

FIG. 3 is a frequency band of therapeutic ultrasonic waves to be irradiated.

FIG. 4 is a diagram showing a sensitivity band after the high-pass filter processing of the first invention of the present application.

FIG. 5 is an explanatory diagram of a digital filter process of the first invention of the present application.

FIG. 6 is a block diagram showing an ultrasonic therapeutic apparatus according to the second invention of the present application.

FIG. 7 is a diagram showing a configuration of a piezoelectric body capable of exciting a second harmonic.

FIG. 8 is a diagram showing a configuration of a piezoelectric body capable of exciting a second harmonic.

FIG. 9 is a diagram showing a configuration of a piezoelectric body capable of exciting a second harmonic.

FIG. 10 is a diagram showing a configuration of a piezoelectric body capable of exciting a second harmonic.

FIG. 11 is another layout diagram of the applicator and the ultrasonic probe of the second invention of the present application.

FIG. 12 is an electrode division structure of an applicator showing another embodiment of the second invention of the present application.

FIG. 13 is an electrode division structure for an applicator showing another embodiment of the second invention of the present application.

FIG. 14 is a frequency spectrum of an impulse response of the ultrasonic probe according to the second invention of the present application.

FIG. 15 is a configuration diagram according to an embodiment of the third invention of the present application.

FIG. 16 is a schematic view showing an applicator according to an embodiment of the third invention of the present application.

FIG. 17 is a schematic view showing a coupling body according to an embodiment of the invention of FIG. 3 of the present application.

FIG. 18 is a schematic view showing an applicator in a second embodiment of the invention of FIG. 3 of the present application.

FIG. 19 is a configuration diagram of a first embodiment of the fourth invention of the present application.

FIG. 20 is a schematic diagram of an ultrasonic applicator of an example.

FIG. 21 is a configuration diagram of a second embodiment of the fourth invention of the present application.

FIG. 22 is a block diagram showing an embodiment of the fifth invention of the present application.

FIG. 23 is a CRT display example in the calculus breaking mode.

FIG. 24 shows a CRT display example in heating / heating treatment.

FIG. 25 is a time chart for driving the piezoelectric element group.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic vibrator, 2 ... Ultrasonic probe, 3 ... Manipulator, 4 ... Position control device, 5 ... Ultrasonic imaging device, 6 ... Treatment ultrasonic drive device, 7 ... System control device, 8 ... Water bag, 9 ... Ultrasonic propagation medium, 10
... Patient, 11 ... Lesion, F ... Focus, Δf ... Occupied bandwidth of ultrasonic transducer for imaging, f0 ... Center frequency of ultrasonic transducer for imaging, 12 ... Applicator, 13 ... Transmission circuit, 14 ... Receiving circuit, 15 ... Driving circuit group, 16 ... A / D converter, 17 ... Image memory, 18 ... D / A converter, 19 ... CRT, 20 ... Adhesive layer, 21, 23, 26, 28, 30 , 32, 34,
36, 38 ... Electrodes, 22, 27, 29, 31, 33,
37, 39 ... Piezoelectric body, 35, 40 ... Polarization direction, 25
… Rear joining plate, 41… Cable, 42… Arm, 4
3 ... Counter balance, 44 ... Stand, 45 ...
Joint parts, 46, 47 ... Gripping part, 48 ... Shaft, 49 ... Cable, 50 ... Hose, 51 ... Projection part, 52 ... Switch, 53 ... Coupling body, 54 ... Mounting part,
55 ... Main body part, 56 ... Sterilized water, 57 ... Applicator, 58 ... Connector group, 59 ... Ultrasonic jelly, 6
0 ... Phase control circuit group, 61 ... Treatment table, 62 ... RF coil, 63 ... Static magnetic field coil, 64 ... Gradient magnetic field coil, 65 ... Gradient magnetic field power supply, 66 ... Transceiver circuit, 67
... Input means, 68 ... Ultrasonic wave incident path, 69 ... Table moving device, 70 ... Abnormal heating section, 71 ... Optical camera, 72 ... Radiation thermometer, 1A, 1B ... Piezoelectric element group,
15A, 15B ... Drive circuit, 73 ... Switching means for low voltage source and high voltage source, 74A, 74B ... High voltage source, 75
... low voltage source, 60A ... Phase control circuit group, 60B ... Phase control circuit group, 76 ... Memory, 77 ... Reflected wave processing circuit, 78 ... Digital scan converter (DSC),
79 ... Voice processing circuit, 80 ... Speaker.

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Mariko Shibata No. 1 Komukai Toshiba-cho, Sachi-ku, Kawasaki-shi, Kanagawa Within the Corporate Research and Development Center, Toshiba Corporation (72) Takuji Suzuki Komukai-Toshiba, Kouki-ku, Kawasaki, Kanagawa Town No. 1 Incorporated company Toshiba Research and Development Center (72) Inventor Shiro Saito Komukai Toshiba Town No. 1, Komukai-ku, Kawasaki City, Kanagawa Prefecture Incorporated Toshiba Research and Development Center (72) Inventor Mori Izumi Kawasaki, Kanagawa Prefecture Komukai-Toshiba-cho 1-ku, Toshiba Research & Development Center

Claims (4)

[Claims] 1. A therapeutic ultrasonic wave generator for irradiating a therapeutic region of a subject with a therapeutic ultrasonic wave, and an ultrasonic wave for imaging for collecting image information in the vicinity of the treated region of the subject. Occasionally, in an ultrasonic treatment apparatus comprising an ultrasonic imaging apparatus for irradiating the therapeutic ultrasonic waves from the therapeutic ultrasonic generator and generating an image of the vicinity of the treatment site, the ultrasonic imaging apparatus collects Image information is collected in advance when the therapeutic ultrasonic wave is irradiated from the therapeutic ultrasonic wave generating device, and the ultrasonic wave is obtained based on the signal component information of the therapeutic ultrasonic wave obtained from the image information. An ultrasonic therapy apparatus comprising: an information processing unit that processes image information obtained by irradiating an ultrasonic wave for imaging from the imaging apparatus. 2. The ultrasonic therapeutic apparatus according to claim 1, wherein the information processing means filters the signal component information of the therapeutic ultrasonic wave from the collected image information. 3. An ultrasonic imaging apparatus collects image information when the therapeutic ultrasonic wave is irradiated from the therapeutic ultrasonic wave generator in advance, and obtains the therapeutic ultrasonic wave signal obtained from the image information. The ultrasonic treatment apparatus according to claim 1, further comprising a storage unit that stores the component information. 4. A therapeutic ultrasonic wave generation means for irradiating a therapeutic region of a subject with a therapeutic ultrasonic wave, and an imaging ultrasonic wave irradiating for collecting image information in the vicinity of the treated region of the subject. In an ultrasonic treatment apparatus including an ultrasonic wave generation means, the therapeutic ultrasonic wave generation means and the imaging ultrasonic wave generation means are made of a piezoelectric material, and the therapeutic ultrasonic wave generation means and the imaging ultrasonic wave are used. At least one of the generating means is provided with a second harmonic generating means for generating a second harmonic in addition to the fundamental resonance of the longitudinal vibration with respect to the thickness of the piezoelectric body.