JPH08252259A - Shock wave medical treatment device - Google Patents

Abstract

PURPOSE: To easily and exactly move a shock wave irradiating means while watching a focus mark so that a shock wave focus can be matched with the part to be treated by displaying the position of the shock wave focus to be moved together with the shock wave irradiating means on an X-ray radiographic image as the focus mark. CONSTITUTION: An applicator 5 is inclined by driving a moving device 9, and the angle of this inclination is detected by a sensor circuit 10 and transmitted to a controller 7. At the controller 7, the focus position of the applicator 5 is calculated, and respective wires are moved by controlling the moving mechanisms of respective X-wire and Y-wire directions on a marker display part 11 corresponding to this arithmetic result. In this case, a patient P is placed on a bed 4 and photographed by an X-ray radio graphing device 2, and X-rays transmitted through the patient P are displayed through an image processing circuit 2e onto an X-ray TV monitor 2f. At such a time, the intersectional image of respective wires arranged on X-ray passages is displayed on the X-ray radiographic image as a cross-shaped mark. Afterwards, respective X-ray tubes 2a and 2b are moved while watching the X-ray radiographic image.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a shock wave treatment apparatus for irradiating a treatment site of a patient, such as a calculus, with a shock wave focus to treat the treatment site, and more particularly to moving the patient using an X-ray fluoroscopic image. The present invention relates to a shock wave treatment device that positions a shock wave focus on the treatment site without doing so.

[0002]

2. Description of the Related Art A shock wave treatment device is a non-invasive treatment device for treating cancer cells, stones, etc. using a strong shock wave.

In this shock wave treatment device, in order to avoid irradiating the normal tissue other than the treatment site with the shock wave,
It is important that the shock wave focus be accurately aligned with the treatment site. There are various methods for this positioning, but among them, the method using an X-ray fluoroscopic image or an ultrasonic fluoroscopic image is often used.

Especially, the positioning by the X-ray fluoroscopic image is superior to the positioning by the ultrasonic image in the spatial resolution and the treatment site can be easily specified, and therefore, it is adopted by many doctors as the first option of the positioning method. There is.

As a shock wave treatment apparatus using an X-ray fluoroscopic apparatus for displaying an X-ray fluoroscopic image, for example, a shock wave source (applicator) is fixedly provided below a bed, and the position of the treatment site is recognized by X-ray fluoroscopy. However, there is a device in which the focus of the shock wave source is made to coincide with the position of the treatment site by moving the bed on which the patient is placed in the vertical and horizontal directions.

On the other hand, for example, when treating calculi (so-called calculus crushing), some extinguisher-type calculi have negative X-rays, and therefore the position of the calculi cannot be identified by normal X-ray fluoroscopy. Therefore, it was necessary to perform contrast or ultrasonic positioning. Among these, when considering positioning by ultrasonic waves and monitoring of the treatment site, it is desirable to move the imaging probe (ultrasonic probe) without moving the patient to monitor the treatment site, as in normal ultrasonic diagnosis. Therefore, in the type in which the probe is built in the shock wave source, it is necessary to give the shock wave source a degree of freedom.

From such a background, the shock wave treatment device can be positioned by an X-ray fluoroscopic image, and
A shock wave treatment device has also been proposed, which enables positioning by an ultrasonic image using an ultrasonic probe built in a shock wave source.

As such a shock wave treatment device, (1)
A type in which an X-ray tube is built in the shock wave source (for example,
(Disclosed in USP.5060634), (2) A type in which an X-ray fluoroscope is installed in a place different from the shock wave source, and the bed is slid between the shock wave source and the X-ray fluoroscope. , Etc. have been developed.

[0009]

However, the above-mentioned device for positioning by moving the bed on which the patient is placed in the vertical and horizontal directions improves the discomfort of the patient due to the movement of the bed. Was desired.

Further, in the shock wave treatment apparatus of the above type (1), since the X-ray path must be secured in the water, which is the shock wave propagation medium existing inside the shock wave source, an air bag or gas is taken in or out. You will need the equipment. For this reason,
The shock wave source became larger and the operability deteriorated. Further, when switching from the positioning based on the ultrasonic image to the positioning based on the X-ray image, it is necessary to take gas in and out, which takes a very long time and the treatment efficiency is poor.

On the other hand, in the shock wave treatment apparatus of the type (2), the shock wave source is made smaller than that of the type (1), but the patient is slid (moved) between the fluoroscope and the shock wave source. Since it has to be done, there is a problem that the treatment time is increased due to the movement and a position shift occurs between the treatment portion position based on the fluoroscopic image and the actual treatment portion position due to the movement of the patient.

The present invention has been made in view of the above-mentioned circumstances, and an object thereof is to require no extra equipment and to move a patient (bed) between the X-ray fluoroscope and the shock wave source. It is to perform X-ray positioning easily.

[0013]

In order to achieve the above object, a shock wave treatment apparatus according to claim 1 is a shock wave irradiating means for irradiating a shock wave toward a subject, and the test object generated by an X-ray generator. X-ray transparent image display means for detecting an X-ray transparent image on a monitor based on the detected X-ray, and detecting the X-ray transmitted through the X-ray transparent image from the X-ray transparent image. In a shock wave treatment device for recognizing a treatment site in a specimen and irradiating a shock wave by making a shock wave focus of the shock wave irradiating unit coincide with the treatment site, the shock wave irradiating unit is three-dimensional according to a predetermined operation mode. Moving means for moving in the direction, computing means for computing the position of the shock wave focus based on the position information of the shock wave irradiating means, and the X-axis based on the calculated shock wave focus position.
Focus marker display means for displaying a focus marker indicating the shock wave focus position on the fluoroscopic image is provided.

In particular, in the shock wave treatment device according to the second aspect, the position of the focus marker is moved independently of the actual position of the shock wave focus according to an operation mode different from the operation mode. Means and the focus marker moving means moves the focus marker to an arbitrary position on the X-ray fluoroscopic image, the focus position matches the movement position of the focus marker based on the movement position of the focus marker. Thus, there is provided interlocking means for interlocking the shock wave irradiating means.

Further, in the shock wave therapy apparatus according to the third aspect, the focus marker display means is formed of an X-ray non-transmissive material and is arranged on an X-ray passage connecting the X-ray generation section and the X-ray detection section. And a first marker body moving means for moving the marker body based on the focal position obtained by the calculating means, and the focal marker moving means is provided on the X-ray fluoroscopic image. A designating means for designating an arbitrary position on the second position, and moving the marker body based on the position designated by the designating means;
And marker means moving means.

Further, in the shock wave therapy apparatus according to claim 4, the focus marker display means is a marker image data generating means for generating marker image data representing the focus position obtained by the calculating means, and the marker. A first superimposing means for superimposing image data on the X-ray fluoroscopic image, wherein the focus marker moving means designates an arbitrary position on the X-ray fluoroscopic image, and the designation means. Marker image data generating means for generating marker image data representing the defined position, and second superimposing display means for superimposing the marker image data on the X-ray fluoroscopic image.

Particularly, in the shock wave treatment device according to the fifth aspect, the shock wave irradiation means has a built-in ultrasonic probe for monitoring the treatment site.

[0018]

The shock wave treatment apparatus of the present invention recognizes the treatment area in the subject from the X-ray fluoroscopic image displayed on the monitor by the X-ray fluoroscopic means, and makes the shock wave focus of the shock wave irradiation means coincide with the treatment area. Is irradiated to treat the treatment site.

Particularly, in the shock wave treatment device according to the first to fifth aspects, the moving means moves the shock wave irradiating means in the three-dimensional direction according to a predetermined operation mode, and the position information of the shock wave irradiating means at the time of this movement. Based on the above, the position of the shock wave focus is calculated by the calculating means. A focus marker is displayed by the focus marker display means based on the calculated shock wave focus position. As the focus marker display means, for example, a marker body is arranged on an X-ray passage connecting the X-ray generation section and the X-ray detection section, and the marker body is moved by the marker body moving means based on the focus position. To do. In this way, the focus marker indicating the shock wave focus position is displayed on the X-ray fluoroscopic image. That is, even if the shock wave irradiation means is moved, the focus position of the shock wave that moves according to the movement is displayed as a focus marker on the X-ray fluoroscopic image, so that the operator can easily change the shock wave focus position. Can be tailored to the treatment site.

Further, according to the shock wave treatment apparatus of the second aspect, the position of the focus marker is different from the actual position of the shock wave focus by the marker moving means according to the operation mode different from the predetermined mode. Move independently. Then, when the focus marker is moved to an arbitrary position on the X-ray fluoroscopic image by the focus marker moving means, the interlocking means causes the shock wave irradiating means to change the focus position based on the moving position of the focus marker. Interlock to match the movement position of. Therefore, the operator
The position of the shock wave focus can be moved simply by moving the focus marker.

[0021]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT An embodiment of a shock wave treatment device according to the present invention will be described below with reference to the accompanying drawings. In addition, in the present embodiment, a case where calculus fracture treatment is performed will be described.

(First Embodiment) FIG. 1 shows the configuration of a shock wave treatment apparatus according to the first embodiment. This shock wave treatment device
A treatment apparatus body 1 having a function of transmitting a shock wave for treatment toward a subject (hereinafter referred to as a patient) P, and X of the patient P
An X-ray fluoroscopic apparatus 2 for displaying a fluoroscopic image and a patient P
And an ultrasonic diagnostic apparatus 3 for displaying a tomographic image inside. In addition, the shock wave treatment device is used as the treatment device main body 1 and the X-ray fluoroscope 2 and is used as a bed 4 for patient placement.
It has.

The treatment apparatus main body 1 has an applicator 5 having a piezoelectric conversion element. In the applicator 5, an ultrasonic imaging probe (hereinafter, simply referred to as an ultrasonic probe) 3a that transmits / receives an ultrasonic signal to scan a required site in the patient P is a central axis a of the applicator 5.
Built in along _x .

Further, the treatment apparatus main body 1 is provided with a pulsar, a drive voltage generating circuit and the like, and a drive circuit 6 for supplying a drive output for transmitting a shock wave for treatment and an ultrasonic wave for exploring a treatment site to the piezoelectric element. Is equipped with.

Further, the treatment apparatus main body 1 is provided with a control apparatus 7 having a computer circuit for controlling the entire apparatus, and an input apparatus 8 for inputting a command from an operator to the control apparatus 7. The input device 8 has, for example, a command command unit such as a keyboard and a coordinate designation unit such as a trackball.

On the other hand, the applicator 5 includes a movable support device 9
Supported by This moving support device 9 is provided with a drive mechanism having a servo motor (not shown), etc., and the applicator 5 is operated by x, y, z shown in FIG. 1 based on a control signal from the control device 7 or a direct operation by an operator or the like.
The function of freely moving in the coordinate space, and the central axis of the applicator 5 (central axis of the ultrasonic probe 2a) a _x , from the axis passing through the center of the applicator 5 and parallel to the z axis shown in FIG. It has a function of tilting at a required angle toward the y-plane and a function of moving the ultrasonic probe 2b so as to be movable back and forth along the central axis. Further, the movement support device 9 includes a displacement sensor that detects the amount of movement of the applicator 5 in the x, y, z coordinate space, and the applicator 5 described above.
It has a sensor circuit 10 such as an angle sensor for detecting the inclination angle of the. The outputs of the sensor circuit 10 such as the displacement sensor and the angle sensor are connected to the control device 7.

The X-ray fluoroscope 2 is an X-ray tube 2a for generating X-rays by colliding an electron beam generated from an electron gun or the like with an anode surface which is a target, and an X-ray tube 2a for generating X-rays.
Image intensifier (II) that detects X-rays transmitted through the patient P by an X-ray detection surface and converts them into optical images.
2b and. X-ray tube 2a and I.D. I. 2b is
The bed is supported by the support arm 2c while maintaining its relative position, and is arranged to face the bed 1a.

The X-ray fluoroscope 2 comprises a support arm moving mechanism 2
d. The support arm moving mechanism 2d includes a drive mechanism (not shown) having a servo motor or the like, and based on the support arm 2c movement information sent from an input unit (not shown), the support arm 2c is shown in x, y, z coordinates shown in FIG. The support arm 2c has a function of freely moving in the space, and the support arm 2c is rotatable about the center of the support arm 2c. Further, the support arm moving mechanism 2d is provided with a sensor circuit (not shown) such as a displacement sensor for detecting the amount of movement of the support arm 2c in the x, y, z coordinate space and an angle sensor for detecting the tilt angle of the support arm 2c. Have The outputs of the sensor circuits such as the displacement sensor and the angle sensor are connected to the control device 7.

The X-ray tube 2a and the I.D. I. The marker display portion 11 is arranged on a so-called X-ray passage that connects 2b. As shown in FIG. 2, the marker display unit 11 includes a frame 11b having an opening 11a slightly larger than the X-ray irradiation area and an X-ray non-transmissive material, such as lead, which connects the inner surfaces of the opening 11a facing each other. Made of two wires 11c, 11d, of these wires 11c, 11d,
An x-direction moving mechanism 11e that moves (slides) one wire 11c along the x-direction as shown in FIG. 2 and a y-direction movement that moves (slides) the other wire 11d in the y-direction as shown in FIG. And a mechanism 11f.

The wires 11c and 11d are crossed (crossed when viewed from the z direction) as shown in FIG. 2, and the wires 11c and / or
By moving the wire 11d in the x direction and / or the y direction, the intersection can be freely moved in the xy plane. x-direction moving mechanism 11e and y
The direction moving mechanism 11f is connected to the control device 7, respectively.

Further, the X-ray fluoroscope 2 is equipped with an image processing circuit 2e and an X-ray TV monitor 2f. The image processing circuit 2e has a I.S. I. The optical image obtained by 2b is converted into an analog image signal, the converted analog image signal is converted into a digital image signal, desired image processing is performed if necessary, and then converted into an analog image signal again. It has a function to do. The X-ray TV monitor 2f is adapted to display the converted analog image signal.

On the other hand, the output of the ultrasonic probe 3a is connected to the ultrasonic signal transmitting / receiving circuit 3b. The ultrasonic signal transmission / reception circuit 3b has a function of scanning both ultrasonic signals by driving both ultrasonic transducers (not shown) in the ultrasonic probe 3a and receiving an echo signal. The output of the ultrasonic signal transmitting / receiving circuit 3b is connected to the ultrasonic image monitor circuit 3c. The ultrasonic image monitor circuit 3c converts the reception signal output from the ultrasonic signal transmission / reception circuit 3b into a TV scanning type image signal and outputs the signal.
It is designed to be displayed on the V monitor 3d.

Next, the overall operation of this embodiment will be described.

First, the operator performs X-ray fluoroscopy for the positioning of the calculi. At this time, the operator
In order to secure the field of view of the line, the drive mechanism of the direct moving device 9 is operated to tilt the applicator 5 from the initial position (the position shown by the broken line in FIG. 1; on the X-ray passage) at α ° (for example, 50 °). Let At this time, the sensor circuit 10 uses the applicator 5
The tilt angle (50 °) is detected and sent to the controller 7.

The control unit 7 reads the sent tilt angle into the internal memory, calculates the position of the focus position of the applicator 5 in the xy plane from the initial position by the tilt angle, and calculates the calculation. Based on the result, a marker body movement command is sent to the X-ray direction movement mechanism 11e and the y direction movement mechanism 11f of the marker display unit 11. As a result, the X-ray direction moving mechanism 11e and the y direction moving mechanism 11f move the wire 11c and the wire 11d in accordance with the sent movement command, and match the intersection with the focal position.

Then, the operator places the patient P on the bed 4, and the X-ray fluoroscope 2 (X-ray tube 2a and I.I.2b).
Is positioned in a direction perpendicular to the patient P), and an X-ray fluoroscopic image of the patient P is taken (vertical fluoroscopy). That is,
The patient P is exposed to X-rays from the X-ray tube 2a, and the patient P
X-rays transmitted through the I.V. I. 2b, converted into an X-ray fluoroscopic image via the image processing circuit 2e and sent to the X-ray TV monitor 2f. As a result, the X-ray fluoroscopic image of the patient P is displayed on the X-ray TV monitor 2f. An image of the intersection of the wires 11c and 11d arranged on the X-ray passage is displayed as a cross-shaped mark on the X-ray transparent image showing the focus position of the applicator 5. Hereinafter, this cross-shaped mark is referred to as a focus marker M1.

While performing the X-ray fluoroscopy in this way, the operator can see the X-ray fluoroscopy image displayed on the X-ray TV monitor 2f and use the support arm moving mechanism 2d to move the support arm 2c, that is, the X-ray tubes 2a and I. ． I. While moving 2b integrally, the calculus in the patient P (the X-ray fluoroscopic image thereof) is made to come to the center of the screen of the X-ray TV monitor 2f. The moving direction and the moving amount of the support arm 2c at this time are detected by the sensor circuit of the support arm moving mechanism 2d and sent to the memory (not shown) of the control device 7 as the support arm moving data.

Subsequently, the operator uses the support arm moving mechanism 2d to move the X-ray tube 2a and the I.D. I. 2b is integrally rotated by a predetermined angle (for example, 30 angles), and an X-ray fluoroscopic image is similarly taken (oblique perspective). Then, the X-ray tube 2a and the I.D.
I. The calculus is aligned with the center of the screen of the X-ray TV monitor 2f while moving 2b integrally in the body axis direction. At this time as well, the amount of movement of the support arm 2c (including the initial rotation angle) is similarly made by the sensor circuit of the support arm movement mechanism 2d.
Is detected, and this movement amount data is sent to the memory of the control device 7.

By the above operation, the three-dimensional position of the calculus can be grasped and the subsequent marker operation can be performed at the center of the perspective image.

This time, the X-ray tube 2a and the I.D. I. Two
Although b is moved integrally, the structure of the support arm moving mechanism 2d can be simplified by sliding the bed 4 and moving the patient P.

Subsequently, the control device 7 performs a so-called positioning process in which the focus position of the applicator 5 is matched with the three-dimensional position of the calculus. The operation modes at this time include a first mode and a second mode.

First, the first mode will be described. The control device 7 sends an applicator movement command to the moving device 9. In response to this command, the moving device 9 moves the applicator 5 so that its focus coincides with the previously obtained position of the calculus.

During this movement, the movement data of the applicator 5 by the movement device 9 is sent to the control device 7 through the sensor circuit 10. The control device 7 and the X-ray direction moving mechanism 11 according to the movement data from the moving device 9.
The e and y direction moving mechanism 11f performs the processing shown in FIG. That is, the control device 7 calculates the movement position of the shock wave focus of the applicator 5 based on the transmitted movement data (step S1), and the control device 7 then uses the X-ray of the marker display unit 11 based on this movement position. Direction moving mechanism 11
A marker body movement command is sent to the e and y direction movement mechanism 11f (step S2). As a result, the X-ray direction moving mechanism 11
The e- and y-direction moving mechanism 11f moves the wire 11c and the wire 11d in accordance with the sent movement command so that the intersection finally matches the movement position of the focal point (step S3).

At this time, as shown in FIG. 4, on the X-ray fluoroscopic image, the position (trajectory) of the shock wave focus of the applicator 5 that is actually moving is always displayed by the movement (trajectory) of the focus marker M1. Has been done. That is, the operator
The movement position of the shock wave focus position due to the movement of the applicator 5 can be easily grasped by the movement position of the focus marker M1.

When the position of the shock wave focus of the applicator 5 coincides with the three-dimensional position of the calculus by the processing of the moving device 9, the output sent from the sensor circuit 10 to the control device 7 becomes "0". In response to this "0" output, the control device 7
A movement stop command is sent to the X-ray direction moving mechanism 11e and the y-direction moving mechanism 11f (step S4), and the process ends.

Although the applicator 5 was moved while performing X-ray fluoroscopy, the X-ray fluoroscopic image was once frozen,
You can do it while watching the freeze image.

Next, the second operation mode will be described.

In the second operation mode, the operator designates the position coordinates of the calculus by moving the coordinate designating section such as a trackball based on the three-dimensional position information of the calculus (the second motion. It is assumed that the applicator 5 is stationary when performing the mode).

At this time, the control device 7 performs the processing shown in FIG. That is, the control device 7 sends a marker body movement command to the X-ray direction movement mechanism 11e and the y direction movement mechanism 11f of the marker display unit 11 based on the coordinate data sent by the designation by the coordinate designation unit of the input device 8 ( Step S
10). As a result, the X-ray direction moving mechanism 11e and the y-direction moving mechanism 11f move the wire 1 according to the sent movement command.
1c and the wire 11d are moved in order to make the intersection point coincide with the coordinate position of the calculus (step S11).

On the other hand, the control unit 7 sends an applicator movement command to the moving unit 9 based on the data at the position of the intersection based on the moving data of the wires 11c and 11d (step S12). In response to this command, the moving device 9
The applicator 5 is moved so that the focus of the applicator 5 always coincides with the movement position of the intersection (S13).

At this time, the movement (the locus) of the focus marker M1 moving to the position designated by the coordinate designating section.
It means that the applicator 5 is moved so that the position of the marker M1 therein and the position of the shock wave focus of the applicator 5 always match. That is, to describe with reference to FIG. 4, by moving the focus marker M1 to an arbitrary position on the X-ray fluoroscopic image displayed on the X-ray TV monitor 2f, the focus marker M1 and the position of the moving focus marker M1 are moved. This means that the applicator 5 is moved so that the focus position of the applicator 5 always matches.

X-ray moving mechanism 1 for the marker display section 11
When the intersection of the 1e and y-direction moving mechanism 11f coincides with the coordinate position of the calculus (that is, the focus marker M1 reaches the calculus position on the fluoroscopic image), the control device 7 stops moving to the moving device 9. A command is sent (step S14), and the process ends.

After the end of the first mode and the second mode (or while the mode is being executed), the inside of the living body can be monitored by the ultrasonic probe 3a built in the applicator 5. In the monitoring (or positioning) by the ultrasonic probe 3a, the refraction of the shock wave and the ease of passing the sound can be taken into consideration, so that the accuracy is high for the X-ray. In particular, if the ultrasonic probe 3a is constantly monitored after the shock wave focus has been positioned on the calculus by the above-mentioned X-ray fluoroscopic image, during treatment, for example,
Even if the position of the stone moves due to breathing or the patient's body movement, the TV monitor 3d monitors the movement.
It can be dealt with by grasping the ultrasonic image displayed on the screen and moving the applicator 5.

In this way, when the positioning by the X-ray fluoroscopic image is completed, the drive circuit is confirmed while confirming that the position of the shock wave is coincident with the position of the calculus by the ultrasonic image monitored by the ultrasonic probe 3a. 6 is driven. As a result, a shock wave irradiates the calculus at the focal point and crushes it.

That is, according to the present embodiment, since the focus marker M1 representing the shock wave focus position corresponds to the shock wave focus movement position, the shock wave focus movement position associated with the movement position of the applicator 5 is determined. It can be easily grasped by a perspective image. Accordingly, the shock wave focal position can be easily positioned with respect to the calculus position without moving the patient P to the fluoroscopic device 2 to the applicator 5.

Further, by moving the focus marker M1 representing the shock wave focus position, the applicator 5 can be moved so that the shock wave focus position moves to the movement position of the marker, so the moving device 9 is actually used. The position of the focus of the applicator 5 can be made to coincide with the calculus position without operating.

Even if the stone image is lost in the ultrasonic image, if the X-ray fluoroscopy is performed in this state, the current shock wave focus position is displayed as the focus marker M1 on the fluoroscopic image. The positional relationship between and the stone position becomes clear. As a result, it becomes possible to easily shift to the positioning by the X-ray fluoroscopic image.

Further, the marker display section 11 is not limited to the configuration shown in FIG. 2, and any method may be used as long as a marker body made of an X-ray non-transparent material is arranged on the X-ray passage. It may have any configuration.

In the present embodiment, the marker display portion 11 is provided on the X-ray passage in order to display the shock wave focus position on the X-ray fluoroscopic image, but the present invention is not limited to this. . For example, as shown in FIG. 6, instead of the marker display unit 11, a marker generation circuit 15 that generates marker data displayed on the X-ray TV monitor 2f may be provided.

The marker generation circuit 15 is used by the control device 7
In accordance with the focus position data sent from the device, for example, cross-shaped marker data is generated, and this marker data is combined with the position corresponding to the focus position data on the digital image signal processed by the image processing circuit 2e. Has become.

That is, according to the configuration of FIG. 6, the control device 7 calculates the focal position of the applicator 5 and then sends this focal position to the marker generating circuit 15. Then, the marker generation circuit 15 superimposes, for example, cross-shaped marker data M2 on the focus position of the digital image data processed by the image processing circuit 2e according to the sent focus position data.

Therefore, in the above-mentioned first operation mode, the position of the shock wave focus of the applicator 5 according to the movement of the applicator 5 is displayed as the focus marker M2 as shown in FIG.

Also in the second operation mode, the control device 7 sends the coordinate data sent from the coordinate designating section of the input device 8 to the marker generation circuit 15. The marker generation circuit 15 displays the marker data on the X-ray fluoroscopic image based on the sent coordinate data.

Then, the control device 7 sends an applicator movement command to the moving device 9 according to the moving position of the marker data, and the moving device 9 responds to this command so that the focus of the applicator 5 is the marker data. The applicator 5 is moved so as to always coincide with the moving position.

That is, the above-described configuration shown in FIG. 6 is substantially the same as the configuration shown in FIG. 1 except that the focus marker displayed on the perspective image is generated as electronic image marker data. Therefore, the effects described above can be obtained in substantially the same manner.

[0066]

As described above, according to the shock wave treatment device of the first to fifth aspects, the position of the shock wave focus that moves with the movement of the shock wave irradiation means is displayed as a focus marker on the X-ray fluoroscopic image. Therefore, the operator can easily move the shock wave irradiation means so that the shock wave focus coincides with the treatment site while visually recognizing the focus marker. That is, since the operability of the shock wave irradiation means associated with the positioning is improved, the positioning can be performed without moving the bed (patient above) from the X-ray fluoroscope to the shock wave irradiation means. Therefore, the burden on the patient due to the positioning can be reduced, and the positioning can be performed easily and in a short time. Further, in the configuration for performing the positioning, since no extra equipment is used, the above effect can be achieved while keeping the miniaturization of the device.

Further, in particular, according to the shock wave treatment apparatus of the second aspect, the operator moves the focus marker displayed on the X-ray fluoroscopic image to an arbitrary position (for example, a treatment site), whereby the shock wave treatment is performed. The irradiating means is interlocked so that its focal position coincides with the moving position of the focal marker.

Therefore, the operator can adjust the focal position of the shock wave irradiating means to the treatment site without moving the patient and without actually moving the shock wave irradiating means. As a result, the burden on the operator is greatly reduced and treatment efficiency is improved.

[Brief description of drawings]

FIG. 1 is a block diagram showing a schematic configuration of a shock wave therapy device according to an embodiment of the present invention.

FIG. 2 is a schematic perspective view showing a schematic configuration of a marker display unit in the embodiment.

FIG. 3 is a schematic flowchart showing an example of processing of the control device in the embodiment.

FIG. 4 is a view showing a focus marker that moves with movement of an applicator.

FIG. 5 is a schematic flowchart showing an example of processing of the control device in the embodiment.

FIG. 6 is a block diagram showing another schematic configuration of the shock wave treatment device according to the embodiment of the present invention.

[Explanation of symbols]

 1 shock wave treatment device 2 X-ray fluoroscope 2a X-ray tube 2b I. I. 2c Support arm 2d Support arm moving mechanism 2e Image processing circuit 2f X-ray TV monitor 3 Ultrasonic diagnostic device 3a Ultrasonic probe 3b Ultrasonic signal transmitting / receiving circuit 3c Ultrasonic image monitor circuit 3d TV monitor 4 Bed 5 Applicator 6 Driving circuit 7 Control device 8 Input device 9 Moving support device 10 Sensor circuit 11 Marker display unit 11a Opening 11b Frame 11c Wire 11d Wire 11e x-direction moving mechanism 11f y-direction moving mechanism 15 Marker generating circuit

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Shigemi Fujiwara 1385-1 Shimoishigami, Otawara-shi, Tochigi Stock company Toshiba Nasu factory inside

Claims (5)

[Claims] 1. A shock wave irradiating unit for irradiating a subject with a shock wave, and X-rays generated by an X-ray generation unit and transmitted through the subject are detected by an X-ray detection unit, and the detected X-rays are detected. X-ray fluoroscopic image display means for displaying an X-ray fluoroscopic image on the monitor based on the monitor, recognizing a treatment site in the subject from the X-ray fluoroscopic image, and setting the shock wave focus of the shock wave irradiation means to the treatment site. In a shock wave treatment device adapted to irradiate shock waves in accord with each other, moving means for moving the shock wave irradiating means in a three-dimensional direction according to a predetermined operation mode, and the shock wave focus based on position information of the shock wave irradiating means. And a focus marker display means for displaying a focus marker indicating the shock wave focus position on the X-ray fluoroscopic image based on the calculated shock wave focus position. Shock wave therapy apparatus characterized by and. 2. A focus marker moving means for moving the position of the focus marker independently of an actual position of the shock wave focus according to an operation mode different from the predetermined mode, and the focus marker moving means. When the focus marker is moved to any position on the X-ray fluoroscopic image, the shock wave irradiation means is interlocked so that the focus position matches the movement position of the focus marker based on the movement position of the focus marker. The shock wave treatment device according to claim 1, further comprising interlocking means. 3. The focus marker display means is made of an X-ray non-transmissive material, and is provided on an X-ray passage connecting the X-ray generation section and the X-ray detection section, and the marker body is provided. A first marker body moving means for moving the focus marker on the basis of the focus position obtained by the calculating means, and the focus marker moving means is a specifying means for specifying an arbitrary position on the X-ray fluoroscopic image; The shock wave treatment device according to claim 2, further comprising: second marker body moving means for moving the marker body based on a position designated by the designating means. 4. The focus marker display means superimposes the marker image data on the X-ray fluoroscopic image and the marker image data generating means for generating the marker image data representing the focus position obtained by the computing means. A first superimposing means, wherein the focus marker moving means is the X
Designating means for designating an arbitrary position on the fluoroscopic image, marker image data generating means for generating marker image data representing the position designated by the designating means, and the marker image data on the X-ray fluoroscopic image. The shock wave treatment device according to claim 2, further comprising a second superimposition display means for superimposing. 5. An ultrasonic image display means for monitoring the treatment site by transmitting and receiving ultrasonic signals to and from the inside of the subject by an ultrasonic probe to display an ultrasonic image inside the subject. 5. The shock wave treatment device according to claim 1, further comprising: an ultrasonic probe, wherein the ultrasonic probe is built in the shock wave irradiation means.