JPH08173440A - Lithodialysis apparatus - Google Patents

Abstract

PURPOSE: To decrease the burden given on the living body and to improve diagnosability by providing the above apparatus with a crushing section for crushing the stone of a patient by the convergent energy of the powerful ultrasonic waves from the outside of the body, an X-ray tube for exposing X-rays toward the patient and an X-ray detector for detecting the X-rays transmitted through the patient arranged to face the X-ray tube. CONSTITUTION: A transmission quantity detecting section 8 detects the transmission quantity of the x-rays and detects only the X-ray transmission quantity within an assigned region by previously assigning the region of the stone part 2 of a display screen by a keyboard 11. The X-ray transmission quantity before the treatment is previously stored in a memory section 12. Whether a difference from the transmission quantity during the treatment attains a specified value or above or not is compared in a comparator circuit 13. This comparator circuit 13 transmits a crushing end signal to a controller 10 when the difference in the transmission quantity attains the specified value or above. Driving of a power source 4 for discharge is stopped to end the treatment upon receiving of the crushing end signal. The specified value set in the comparator circuit 13 is determined by empirically measuring a relation between the transmission quantity and the size of the crushed stones.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a calculus crushing device for crushing a patient's calculi with focused energy such as shock waves and ultrasonic waves.

[0002]

2. Description of the Related Art In recent years, a device for crushing stones in a subject by utilizing shock wave energy has been put into practical use.

This device has a predetermined size, and
Put an object with a calculus in a container filled with water of appropriate temperature inside it and make the position of the calculus coincide with one focus position of the spheroid, and at the other focus position by explosive or discharge phenomenon of explosive A shock wave is generated, and the shock wave is focused on the calculus portion by a spheroidal acoustic mirror arranged around the shock wave, so that the calculus is crushed by the shock wave energy.

Confirmation of the calculus position of these patients is performed by displaying the calculus portion by an X-ray fluoroscope. Further, in order to eliminate X-ray exposure, it is also considered to confirm the position with an ultrasonic tomography device.

FIG. 4 is a block diagram showing a conventional example. Living body 1
Rotating ellipsoidal mirror 3 so that the focus is on the position of stone 2 inside
Is arranged. At the time of crushing treatment, the electric charge stored in the discharge power source 4 is discharged through the discharge gap 5 located at the first focal point, and the shock wave energy generated there is reflected by the spheroidal reflecting mirror 3 and the calculus 2 at the second focal point. It is released to the position.

The calculus 2 in the living body 1 and the second focal point of the spheroidal reflecting mirror 3 are positioned by the X-ray detector 6 on the display unit 7.
Is displayed on the screen. The X-ray tube 9 and the X-ray detector 6 are arranged so as to face each other across the living body. The living body 1 is moved while looking at the display device 7, and the calculus 2 is positioned at the center of the screen of the display device 7. Then, the living body 1 is fixed.

The central portion of the screen of the display device 7 is somewhat eccentrically located at the focal point of the spheroidal reflecting mirror 3. In this state, positioning is completed and treatment is started.

During the treatment, the doctor takes a method of generating a shock wave while observing the above-mentioned X-ray fluoroscopic screen and ending the treatment when the calculi are shattered to some extent.

[0009]

In such a conventional apparatus, since the position of the shock wave focus (second focus) is inevitably determined, the positions of the calculus and the second focus are largely deviated. Not only in the case, but also when the positional displacement between the two is small, the living body 1 has to be moved. This increases the burden on the living body and deteriorates the diagnostic efficiency.

An object of the present invention is to eliminate the above-mentioned problems, and to provide a calculus breaking device which reduces the burden on the living body and improves the diagnostic ability.

[0011]

In order to achieve the above object, the present invention provides a crushing section for crushing a calculus of a patient by focusing energy of strong ultrasonic waves from outside the body, and an X-ray for the patient. It is provided with an X-ray tube for exposure and an X-ray detector which is arranged so as to face the X-ray tube across a living body and detects X-rays transmitted through the patient.

[0012]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described in detail below with reference to the drawings.

FIG. 1 is a block diagram showing an embodiment according to the present invention. The same components as the conventional example shown in FIG.
Since they are indicated by the same numbers and the operations are the same, the description thereof will be omitted.

The part where the calculus 2 is present absorbs X-rays, so that the amount of transmission is smaller than that of the example tissue. However, as the calculi are crushed, the smaller calculi penetrate, and the X-rays penetrate through the gaps between the crushed calculi, so that the X-ray transmission amount gradually increases. Therefore, the crushing condition can be grasped by observing the change in the X-ray transmission amount. The transmission amount detector 8 detects the amount of X-ray transmission, and the keyboard 11
As shown in FIG. 2, the area 14 of the calculus portion 2 of the display screen 15 is designated by using, so that only the X-ray transmission amount in the designated area is detected. Since the size and shape of the calculus 2 differ depending on the patient, the X-ray transmission amount before treatment is first stored in the storage unit 12, and the difference from the transmission amount during treatment becomes a certain value or more. Comparison circuit 1
Compare with 3. When the difference in the amount of permeation exceeds a certain value, the comparison circuit 13 determines that the calculus has been crushed into sufficiently small pieces, and sends a crushing end signal to the controller 10. The controller 10 receives the crushing end signal and stops the driving of the discharge power supply 4 to end the treatment.

The constant value set in the comparison circuit 13 is obtained by experimentally measuring the relationship between the amount of permeation and the size of crushed stones while changing the size and shape of the stones. If the size of the crushed stone is about 5 mm, it will be discharged, so set the value of the amount of permeation when it becomes smaller than that.

FIG. 3 is a configuration diagram showing another embodiment according to the present invention.

The crushing concave ultrasonic transducer 20 and the ultrasonic tomographic image detecting probe 21 are integrated and arranged toward the calculus 2 in the living body 1 through the water bag 22. The crushing treatment is performed by driving the vibrator 20 by the drive circuit 23 while the focal point of the crushing concave ultrasonic transducer 20 is aligned with the calculus 2 portion and concentrating the ultrasonic energy also on the calculus portion. Be done.

The alignment is performed by moving the crushing probe 20 and the tomographic image detecting probe which are integrated so that the stone is located at the center of the screen while displaying the calculus portion on the screen by the tomographic image detecting probe. Be done.

Different from the X-ray, the crushing condition is confirmed by detecting the reflection intensity of the ultrasonic wave from the calculus portion, and the same procedure is performed thereafter.

In the above-mentioned embodiment, the crushing is based on the energy of the shock wave due to the electric discharge and the focusing energy of the strong ultrasonic waves, but it is also possible to carry out the method of focusing the shock wave by using other explosives.

Further, the energy source for crushing and the positioning method can be implemented in combination with each other.

As the crushing progresses, the crushed calculi are scattered in a certain range, and when the calculus portion is displayed, it seems that the calculus becomes a little larger because the resolution is not high.
By utilizing this, it is possible to judge the end of crushing by detecting the change in the area of the calculus.

It is also possible to determine the end of crushing by a combination of a change in the amount of transmitted X-rays or a reflected wave of ultrasonic waves and a change in the area of the calculus portion.

[0024]

As described above, according to the present invention, the calculus is crushed by the focused energy of strong ultrasonic waves, so that the patient is not moved when the deviation between the calculus and the focused position of strong ultrasonic waves is small. Since it is possible to perform the alignment, it is possible to reduce the burden on the patient as a result and improve the diagnosis efficiency.

[Brief description of drawings]

FIG. 1 is a block diagram showing an embodiment according to the present invention.

FIG. 2 is a diagram showing a display screen according to the embodiment of the present invention.

FIG. 3 is a block diagram showing another embodiment of the present invention.

FIG. 4 is a block diagram showing a conventional example.

[Brief description of reference numerals]

DESCRIPTION OF SYMBOLS 1 ... Living body, 2 ... Stone, 3 ... Rotating ellipsoidal mirror, 4 ... Discharge power supply, 5 ... Discharge gap, 6 ... X-ray detector, 7 ... Display device, 8 ... Transmission amount detection part, 9 ... X-ray tube 10 ... Controller, 11 ... Keyboard, 12 ... Storage part, 13 ... Comparison circuit, 14 ... Stone area, 15 ... Display screen, 20 ... Fracture concave vibrator, 21 ... Tomographic image detection probe, 22 ...
Water bag, 23 ... Driving circuit, 24 ... Transmission / reception circuit, 25 ... Reflection intensity detection section, 26 ... Display circuit, 27 ... Storage section, 28 ... Comparison section, 29 ... Controller, 30 ... Keyboard

Claims (3)

[Claims] 1. A crushing unit for crushing a patient's calculi by focusing energy of strong ultrasonic waves from outside the body, an X-ray tube for irradiating the patient with X-rays, and a living body for the X-ray tube. A calculus breaking device provided with an X-ray detector arranged to face each other and detecting X-rays transmitted through the patient. 2. The crushing portion is a plurality of ultrasonic transducers having a concave shape as a whole.
The described stone crushing device. 3. The calculus breaking device according to claim 1, wherein the crushing unit and the X-ray tube are integrally arranged.