JPH0779990A - Ultrasonic treatment equipment - Google Patents

Abstract

PURPOSE:To provide an ultrasonic treatment equipment, even if it is equipped with an X-ray positioning means outside the container, possible to prevent to cast the shadow of the container on the X-ray image of the X-ray positioning means. CONSTITUTION:In an ultrasonic treatment equipment equipped with an ultrasonic applicator 104 comprising an ultrasonic source 103 to generate an ultrasonic wave to focus on a designated focal point Z, an ultrasonic imaging device 106 to collect ultrasonic tomography images in neighborhood of the focal point Z and an ultrasonic transmission media W to transmit an ultrasonic wave for collection of the focussing ultrasonic wave and the ultrasonic tomography images, the ultrasonic source 103 is placed in a position asymmetric with respect to the center axis of the ultrasonic imaging device.

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 such as a shock wave treatment apparatus for crushing and treating stones and cancer tissues with shock wave energy and a hyperthermia treatment apparatus for performing hyperthermic treatment with focused energy of ultrasonic waves.

[0002]

2. Description of the Related Art Conventionally, a shock wave treatment device for crushing and treating urinary tract stones in the human body, stones such as gallstones, cancer tissue, and the like to be treated by shock wave energy of ultrasonic pulses, and focused energy of strong ultrasonic waves. Ultrasonic treatment devices such as hyperthermia treatment devices that perform destructive treatment are used.

FIG. Wolf; USP 5,060,634 (199
FIG. 1 is a diagram showing a shock wave generator of a conventional shock wave treatment apparatus as an example of such an ultrasonic treatment apparatus disclosed in No. 1.10.29). In the figure, 11 is a bed, 12 is an opening provided in the bed 11, and 13 is a shock wave generator provided so as to contact a part of the opening 12. The shock wave generator 13 is a piezoelectric effect type vibrator 1 formed in a spherical shell shape.
4 and an applicator 15 which is a container containing water W which is an ultrasonic wave propagation medium. The center axis of the oscillator 14 is the alternate long and short dash line 14a, and the range in which the generated shock wave is transmitted is the range surrounded by the alternate long and two short dashes line 14b and converges on the focal point Z. An ultrasonic imaging probe 16 for obtaining a B-mode ultrasonic image and an X-ray tube 17 for irradiating X-rays are provided on a part of the vibrator 14. The image center axis of the ultrasonic imaging probe 16 is the one-dot chain line 16a, and the range of the ultrasonic tomographic image is the range surrounded by the two-dot chain line 16b. The X-ray tube 17 irradiates X-rays around the irradiation axis indicated by the one-dot chain line 17a, and the irradiation range is the two-dot chain line 17a.
The range is surrounded by b. The focal point Z of the oscillator 14 is the irradiation axis 17a of the X-ray tube 17 and the ultrasonic imaging probe 1
6 coincides with the intersection of the central axes 16a. The applicator 15 can discharge and inject water W. An X-ray tube 17 is provided on the side opposite to the X-ray tube 17 with a patient P described later interposed therebetween.
An image intensifier (hereinafter, referred to as II) 18 for converting the X-rays from X to X into an electric signal is arranged, and constitutes an X-ray positioning device together with the X-ray tube 17. Note that P indicates a patient in close contact with the opening 12, Q indicates an internal organ, and S indicates an object to be treated such as a stone.

Further, the shock wave generator 13 as a whole is driven by a drive device (not shown) so that the operator matches the focal point Z with the object S to be treated. The shock wave generator 13 is controlled by a controller (not shown).

The crushing of the calculus S inside the patient P by the conventional shock wave treatment apparatus thus constructed has been performed as follows. The operator operates the X-ray tube 17 and the I.D. I. The stone S inside the patient P is searched while looking at the X-ray image by 18 and rough positioning is performed. At this time, the water W is discharged from the inside of the applicator 15 and air is injected instead. This is because an air path is required for X-ray irradiation. Next, after injecting water W into the applicator 15, the ultrasonic imaging probe 16
While watching the B-mode ultrasonic image by, the marker indicating the focal point Z of the transducer 14 displayed therein is aligned with the stone S. Then, the vibrator 1 is driven by a vibrator excitation device (not shown).
4 was excited to crush the stone S.

FIG. 5 is a sectional view showing another conventional example of a shock wave treatment device. The difference between what is shown in this figure and what is shown in FIG. 4 is that the X-ray tube, which is an X-ray positioning device, is outside the applicator. That is, 21
Is a shock wave generator, 23 is a shock wave generator, 24 is a vibrator, 25 is an applicator, 26 is an ultrasonic imaging probe, 27 is an X-ray tube, 28 is an I.D. I. Is shown. The central axis of the oscillator 24 is the one-dot chain line 24a, and the range in which the generated shock wave is transmitted is the range surrounded by the two-dot chain line 24b, which converges on the focal point Z. The central axis of the ultrasonic imaging probe 26 is the one-dot chain line 26a, and the range of the ultrasonic tomographic image is the range surrounded by the two-dot chain line 26b. X
The irradiation axis of the linear tube 27 is the one-dot chain line 27a, and the irradiation range is the range surrounded by the two-dot chain line 27b. Also in this case,
The focal point Z of the oscillator 24 coincides with the intersection of the irradiation axis 27a of the X-ray tube 27 and the central axis 26a of the ultrasonic imaging probe 26. In addition, the X-ray tube 27 is the applicator 25.
It is attached to a different drive device (not shown).

[0007]

The conventional shock wave treatment device as described above has the following problems. That is, in the structure shown in FIG.
Since the X-ray tube 17 is provided, it is necessary to prepare an air path in the applicator 15 when performing X-ray positioning, and the air must be injected after the water W is discharged. On the other hand, when collecting ultrasonic images or during shock wave treatment, it is necessary to replace the air path with a water path, so it is necessary to replace the water W with the air each time crushing treatment is performed, and the treatment takes time. was there. Further, since the X-ray tube 17 is incorporated in the shock wave generator 13, the shock wave generator 13 as a whole becomes large and the weight also increases. For this reason, there is a drawback in that a complicated and powerful drive device or the like is required to make the shock wave generator 13 approach the patient from above or lateral direction other than below.

On the other hand, the one shown in FIG.
Is outside the shock wave generator 23, it is not necessary to replace the water W with the air. However, the X-ray tube 27 and the I.D. I. In the X-ray image of the positioning means by 28, the treatment object S might be behind the applicator 25. Also, in order to avoid the shadow of the applicator 25, X
When the tube 27 is placed at a position away from the applicator 25, the lumbar bone of the patient P and the central ureteral stone S, which is the object to be treated, may overlap depending on the physique of the patient P and the location of the stone, and the X-ray There are problems that positioning is difficult and it is difficult to determine the therapeutic effect by an X-ray image. Therefore, it is an object of the present invention to provide an ultrasonic therapy device that facilitates X-ray positioning.

[0009]

In order to solve the above problems and achieve the object, the present invention provides an ultrasonic wave generating source for generating an ultrasonic wave focused on a predetermined focus and an ultrasonic tomographic image near the focus. An ultrasonic treatment apparatus including an ultrasonic applicator including an ultrasonic imaging device for collecting, an ultrasonic wave propagating medium for propagating the focused ultrasonic wave and the ultrasonic wave for collecting the ultrasonic tomographic image, and an X-ray positioning device. In, the ultrasonic wave generation source is arranged asymmetrically with respect to the central axis of the ultrasonic imaging apparatus.

[0010]

As a result of taking the above-mentioned means, the following effects occur. That is, the ultrasonic wave generation source was arranged asymmetrically with respect to the central axis of the ultrasonic imaging apparatus. Therefore, it is not necessary to discharge and inject the ultrasonic propagation medium in the container each time the treatment is performed, and the treatment effect can be determined by the X-ray positioning means during the ultrasonic treatment, so that efficient treatment can be performed. Of course, the degree of freedom in arranging the X-ray positioning means and the ultrasonic wave generation source is increased, and it is possible to prevent the shadow of the container from being transferred to the X-ray image of the X-ray positioning means.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIGS. 1A, 1B and 2 show a first embodiment of the present invention.
It is a figure which shows the shock wave treatment apparatus which concerns on an Example. The shock wave treatment device is roughly divided into a shock wave generator 100 and a controller 20.
It is composed of 0 and 0. FIG. 1A shows a cross section of the shock wave generator 100, and the shock wave generator 100 is provided with a shock wave generator 102 so that a part of an applicator 104, which will be described later, is in contact with the shock wave generator 100. The shock wave generator 102 includes a vibrator 103 and an applicator 104 containing water W therein. The range in which the shock wave generated by the oscillator 103 is transmitted is the range surrounded by the chain double-dashed line 103a, and the focal point Z is located off the central axis of the applicator 104. The vibrator 103 is composed of a plurality of piezoelectric effect type vibrating elements 105 arranged as described later. A part of the oscillator 103 is cut out,
Ultrasonic imaging probe 1 for obtaining ultrasonic images
06 is then inserted into the applicator 104. Ultrasonic imaging probe 10 of the vibrating element 105
The sectional shape taken along a line passing through the center of 6 is a spherical shell, a spheroid, or a paraboloid of revolution.

The vibrating element 105 is shown in plan view in FIG. 1 (b).
The vibration elements 105 are excited by a delay circuit (not shown) of the control unit 200 having a delay time calculated from the difference in distance to each focus.
It is set so that the shock wave from each vibrating element 105 can reach the focal point Z at the same time. Further, the drive voltage for pulse-driving each vibrating element 105 is also variable so that an appropriate shock wave sound field can be formed.

On the other hand, adjacent to the shock wave generator 102, X
A line tube 107 is provided. The central axis of the ultrasonic imaging probe 106 is the alternate long and short dash line 106a and passes through the focal point Z. The range of the ultrasonic tomographic image is the range surrounded by the chain double-dashed line 106b. The irradiation axis of the X-ray tube 107 is 107a, and the irradiation range is 107b. On the opposite side of the patient of the X-ray tube 107, I.X. I. 108 is located, X
The radiation from the ray tube 107 is converted into an electric signal, and the electric signal is displayed to enable positioning by an X-ray image.

As shown in FIG. 2, the control unit 200 is a system controller 2 which performs cooperative control of each control unit described later.
01, an X-ray positioning unit 210, an ultrasonic positioning unit 220, a generation unit 230, a positioning unit 240, and a console 202 connected to the system controller 201 to input an instruction from an operator.

The X-ray positioning unit 210 is constructed as follows. The X-ray positioning control unit 211 connected to the system controller 201 uses the X-ray trigger circuit 21.
2 to the X-ray generation circuit 213. In addition, the X-ray positioning control unit 211 uses the image storage device 214.
And I.V. through the image processing circuit 215. I. 10
8 is connected to an image acquisition circuit 216 which acquires the image acquired in step S8. The image acquisition circuit 216 is the X-ray trigger circuit 21.
Connected to 2. The image storage device 214 is connected to the image display device 217.

The ultrasonic positioning unit 220 is constructed as follows. The ultrasonic positioning control unit 221 connected to the system controller 201 is connected to the display unit 222 and the image processing unit 223 that display the ultrasonic tomographic image of the patient P and the marker indicating the focal point position of the shock wave on the monitor. . The image processing unit 223 is connected to the display device 222. The ultrasonic positioning controller 221 also includes a memory 224, a first pulser 225, a transmission circuit 226,
It is connected to the signal processing circuit 227, the receiving circuit 228, and the multiplexer 229. The first pulser 225 is connected to the transmission circuit 226, and the transmission circuit 226 is connected to the multiplexer 229. The image processing unit 223 is connected to the memory 224. The memory 224 includes a plane memory 224a and an image memory 224b, and is connected to the signal processing circuit 227. The signal processing circuit 227 receives the signal from the multiplexer 2 via the receiving circuit 228.
It is connected to 29. The multiplexer 229 is connected to the ultrasonic imaging probe 106.

The source unit 230 is constructed as follows. The source control unit 231 connected to the system controller 201 includes a multiplexer 232 and a transmission circuit 2.
33, a second pulser 234 that applies a pulse voltage to each piezoelectric element of the vibration element 105, a reception circuit 235, and a signal analysis circuit 236. The second pulser 234 is connected to the multiplexer 232 via the transmission circuit 233, and the signal analysis circuit 236 is connected to the multiplexer 232 via the reception circuit 235. Multiplexer 2
Reference numeral 32 is connected to each vibrating element 105. Transmission circuit 2
Reference numeral 33 denotes a delay controller that operates based on a command signal sent from the system controller 201, a delay circuit that receives the control signal sent from the delay controller and adjusts the drive timing of the vibration element 105, and a system controller. The peak pressure control unit controls the pulse voltage of the vibration element 105 based on the control data sent from the control unit 201.

The positioning unit 240 is composed of a position controller 241 connected to the system controller 201 and a drive device 242 for driving the shock wave generator 100. In addition, B has shown the treatment couch on which the patient P is laid down.

In the shock wave treatment apparatus having the above-mentioned structure, the fracture treatment is performed as follows. The operator lays the patient P on the bed B and uses the X-ray image to determine the stone S.
Search for and position at a rough position. Here, since the focus Z is not on the normal line of the surface where the applicator 104 and the patient P are in contact with each other, the applicator 104 does not appear in the X-ray image. Then, the applicator 104 automatically moves,
The shock wave focus Z of the oscillator 103 is moved to the vicinity of the treatment target S. The fine adjustment is performed by the ultrasonic imaging probe 106.
And a B-mode tomographic image around the treatment object S,
The focus marker M of the shock wave generated from the oscillator 103 is displayed on the monitor. Then, the position controller 241 causes the applicator 10 to move the treatment target S to the marker M on the display screen of the display device 222.
Move 4 to match. Then, the oscillator 103 is excited to crush the calculus S. At this time, positioning of X-rays and ultrasonic waves and image confirmation by X-rays or ultrasonic waves before and after treatment become easy.

In order to irradiate a treatment object such as a stone with a shock wave and perform crush treatment, it is usually 3000 to 5000.
It is emitting a shock wave. Irradiating a shock wave with a high peak pressure from the beginning causes pain to the patient.
Therefore, in the peak pressure control unit, when the treatment start command signal is received from the CPU, the peak pressure is increased stepwise to an appropriate strength, and thereafter, the second pulsar 234 is provided so that the crush treatment can be performed at the optimum peak pressure. The output voltage of is controlled.

As described above, in this embodiment, since the applicator 104 does not shade the X-ray image, it becomes easy to position the X-ray and the ultrasonic wave and confirm the image by the X-ray or the ultrasonic wave before and after the treatment.

FIGS. 3 (a) and 3 (b) are views showing the shock wave generator of the shock wave treatment apparatus according to the second embodiment of the present invention.
FIG. 3A shows a shock wave generator 300, and a shock wave generator 302 is provided so that a part of the shock wave generator 300 is in contact with the shock wave generator 300. Shock wave generator 30
2 includes a vibrator 303 and an applicator 304 that contains water W and is formed into a substantially rectangular parallelepiped.
A plurality of piezoelectric effect type plate-like vibrating elements 305 arranged in a plan view as shown in FIG. 3B are arranged on the vibrator 303. The vibrator 303 changes the excitation timing of each vibrating element 305 so that the two-dot chain line 30 in FIG.
The position of the focal point Z can be freely changed within the range indicated by 3a, and the range of transmission of the shock wave is the chain double-dashed line 30.
3b and 303c. Range is 303
In the case of b, the focus Z of the vibrator 303 is the applicator 10
The position is off the central axis of No. 4. The control for changing the excitation timing of each of these vibrating elements 305 is performed as described later. The range 303c can be used when X-ray positioning is not performed.

Further, the transducer 303 is provided with an ultrasonic imaging probe 306 for obtaining an ultrasonic image. The ultrasonic imaging probe 306 is configured such that the center axis thereof is one-dot chain lines 306a and 306c, and the ultrasonic imaging probe 306 can be electronically moved so that a range for collecting an ultrasonic image is a range surrounded by two-dot chain lines 306b and 306d. There is.
The drive voltage for pulse-driving each vibrating element 305 is also variable so that an appropriate shock wave sound field can be formed. On the opposite side of the X-ray tube 307 across the patient, I.D. I. 308 is arranged, which converts the radiation from the X-ray tube 307 into an electric signal and constitutes an X-ray positioning device.

In the shock wave treatment apparatus having the above-mentioned structure, the fracture treatment is performed as follows. The operator lays the patient P on the bed B, and the X-ray tube 307 and the I.D.
I. The stone S is searched for by 308 and positioned at a rough position. The applicator 304 does not appear in the X-ray image. At this time, the X-ray may be a single plane or a biplane. Next, at the point A, the focal point Z of the vibrator 303
Is moved, and the ultrasonic image of the ultrasonic imaging probe 306 is also moved on the ultrasonic scanning plane so that the point A becomes the center. The ultrasonic imaging probe 306 performs fine adjustment positioning.

When the focal point Z of the oscillator 303 and the object S to be treated coincide with each other, the operator starts the treatment by pressing the treatment start switch on the console. When the focal point Z of the shock wave is moved according to the position of the treatment object S, a delay program corresponding thereto is taken into the CPU in the generation source unit from the storage system, and a command signal is sent from this CPU to the delay control unit. . When the delay control unit receives this command signal,
A control signal is sent to each delay circuit, and each delay circuit delays the timing of the pulse voltage output from the corresponding pulsar to perform fracture treatment by shock waves.

As described above, this embodiment has the same effect as that of the first embodiment, and the focal point can be electronically moved within a predetermined range. There is an advantage that the shape and the configuration and arrangement of the shock wave treatment device main body are relatively free.

The present invention is not limited to the above embodiments. That is, in the above embodiment, each vibration element has a spherical shell shape, but may be a flat plate. Also, by changing the pulsar of the generation source unit to a device that generates strong ultrasonic waves of continuous wave or burst wave, the shock wave treatment device can function as a thermotherapy device. In this case, the peak pressure control unit of the shock wave treatment device functions as a peak temperature control unit that variably adjusts the peak temperature rise during the thermal treatment. Of course, various modifications can be made without departing from the scope of the present invention.

[0028]

According to the present invention, since the ultrasonic wave generation source is arranged asymmetrically with respect to the central axis of the ultrasonic imaging apparatus, it is necessary to discharge / inject the ultrasonic wave propagation medium in the container each time a treatment is performed. In addition, since the treatment effect can be determined by the X-ray positioning means during the ultrasonic treatment, efficient treatment can be performed, and the degree of freedom in arranging the X-ray positioning means and the ultrasonic wave generation source is increased. It is possible to avoid the shadow of the container from being transferred to the X-ray image of the X-ray positioning means.

[Brief description of drawings]

FIG. 1 is a diagram showing an outline of a shock wave generator incorporated in a shock wave treatment device according to a first embodiment of the present invention,
FIG. 6A is a sectional view of a main part, and FIG.

FIG. 2 is a block diagram showing the configuration of the device.

3A and 3B are schematic views of a shock wave generator of a shock wave treatment apparatus according to a second embodiment of the present invention, in which FIG. 3A is a sectional view of a main part and FIG. 3B is a plan view of a vibrator.

FIG. 4 is a sectional view showing an outline of a shock wave generator of a conventional shock wave treatment device.

FIG. 5 is a cross-sectional view showing an outline of a shock wave generator of another conventional shock wave treatment device.

[Explanation of symbols]

100, 300 ... Shock wave generator 102, 302 ...
Shock wave generator 103, 303 ... Transducer 104, 304 ...
Applicator 105, 305 ... Vibration element 106, 306 ... Ultrasonic imaging probe 107, 307 ... X-ray tube 108, 308 ...
I. I. 200 ... Control part 201 ... System controller 202 ... Operation table 210 ... X-ray positioning unit 217 ... Image display device 220 ... Ultrasonic positioning unit 222 ... Display device 230 ... Generation source unit 231 ... Generation source control part 240 ... Positioning unit 241 ... Position controller 242 ... Drive device P ... Patient S ... Treatment target B ... Treatment bed Z ... Focus

Claims (2)

[Claims] 1. An ultrasonic generator for generating an ultrasonic wave focused on a predetermined focus, an ultrasonic imaging apparatus for collecting an ultrasonic tomographic image near the focus, and a focused ultrasonic wave and the ultrasonic tomographic image acquisition. An ultrasonic wave applicator including an ultrasonic wave propagating medium that propagates ultrasonic waves, and an X-ray positioning device, wherein the ultrasonic wave generation source is asymmetric with respect to the central axis of the ultrasonic imaging device. An ultrasonic treatment device, characterized in that 2. An ultrasonic wave generation source for generating an ultrasonic wave focused on a predetermined focus, an ultrasonic imaging apparatus for collecting an ultrasonic tomographic image near the focus, and a focused ultrasonic wave and the ultrasonic tomographic image acquisition. An ultrasonic wave applicator including an ultrasonic wave propagating medium that propagates the ultrasonic wave, and an X-ray positioning device, wherein the ultrasonic wave generation source is a focused supersonic wave outside the central axis of the ultrasonic wave applicator. An ultrasonic therapy device, which forms a focus of a sound wave.