JPH0852152A - Ultrasonic medical treatment device - Google Patents

Abstract

PURPOSE:To precisely inject medicine into the focus of ultrasonic waves set on the part to be treated by attaching a pressure receiving part at the top of a piercing needle to make it recognize that the top of the needle has reached the part to be treated when the ultrasonic signal received at the pressure receiv ing part is judged to be larger than the prescribed value. CONSTITUTION:The ultrasonic diagnosis device 9 takes a picture near the part 5 to be treated, and the picture is shown on the screen of the monitor 10. The applicator 4 is adjusted so that the focus 6 of the applicator is placed on the part 5 to be treated. Then ultrasonic waves for deep examination are generated from the vibrator 2, and the piercing needle 8 is pierced into the part 5 to be treated. The piezoelectric film 20 attached at the top of the needle 8 receives the ultrasonic waves for deep examination, and the receiving signal is inputted to the echo level judgement circuit 13. When the receiving signal is larger than the prescribed marginal value set by the marginal value prescription circuit 14, it is judged that the needle has reached the part to be treated, and then, medicine is to be supplied to the part 5 to be treated through the needle 8 by operating the syringe 7.

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 irradiating a treatment site in a living body with strong ultrasonic waves to crush stones and necrose tumors.

[0002]

2. Description of the Related Art In recent years, ultrasonic medical treatment apparatuses have been widely used as medical diagnostic apparatuses have been developed. The ultrasonic treatment device is a shock wave treatment device that irradiates and crushes stones such as gallstones formed in the body with strong ultrasonic waves, and a tumor in the body is irradiated with ultrasonic waves for a long time and heat is applied to necrosis. In any case, there is a hyperthermia treatment device that contacts the applicator with multiple ultrasonic transducers attached to the body surface of the subject and adjusts the focus of each ultrasonic transducer to the treatment site. Irradiate sound waves, crush stones, and treat hyperthermia.

In such an ultrasonic treatment apparatus, recently, a drug showing an antitumor effect due to acoustic activity such as hematopolyfin is injected into a vein of a living body, and then a therapeutic superulcer is directed toward a tumor to be treated. A so-called sonochemical treatment technique is employed in which only a drug collected at a tumor site is activated by irradiating a sound wave to selectively treat the drug. The conventional technique of this sonochemical treatment will be described below with reference to FIG.

As shown in the figure, an applicator 104 is arranged on the body surface of the subject 101, and the applicator 104 is arranged in a spherical shell shape (which is an arc shape because the cross section is shown in the figure). It has a plurality of ultrasonic transducers 102 provided and a probe 103 provided at the center of the ultrasonic transducers 102. The ultrasonic transducer 102 irradiates therapeutic ultrasonic waves toward the treatment region 110 (ultrasonic focus 111) of the subject 101, and is connected to a pulsar 108 that supplies ultrasonic pulses to each transducer 102. The pulsar 108 is driven by being supplied with a voltage from a high voltage power supply 109.

On the other hand, the probe 103 irradiates the imaging region including the treatment region 110 with ultrasonic waves and receives the echo signal generated by the ultrasonic waves.
It is connected with 6. Then, the ultrasonic diagnostic apparatus 106
The ultrasonic image obtained at is displayed on the monitor 107. Therefore, the operator adjusts the focus 111 and the treatment site 110 so as to coincide with each other while looking at the image displayed on the monitor 107.

Further, a drug having an antitumor effect due to acoustic activity such as hematopolyfin is injected into the vein of the subject by the puncture needle 105. Then, this drug is used for a few hours (4
After about 5 hours), the tissue selectivity starts to exert an effect at the treatment site. Then, when therapeutic ultrasonic waves are irradiated from the applicator 104 toward the treatment site 110 at this time, the antitumor effect is increased due to the acoustically active effect of the drug, and the therapeutic effect is improved.

[0007]

As described above, in the sonochemical treatment using the conventional ultrasonic treatment apparatus, in addition to the effect of tissue selectivity of the drug itself, the action of activation of the drug against ultrasonic waves and shock waves is also provided. Is used to activate only in the affected area for treatment, thereby enhancing localization of the antitumor effect.

However, in the case of conventional therapeutic techniques, since the drug is delivered to the tumor site through a vein, it is necessary to administer more drugs than necessary in order to obtain the desired antitumor effect. It has the drawback of causing great pain to the patient. In addition, there is a time lag (time delay) before the drug gathers at the tumor site, and in order to obtain a sufficient effect, it is necessary to accurately grasp the timing at which the therapeutic ultrasonic wave should be irradiated after injection depending on the affected area. However, in reality, it is very difficult to grasp the timing and perform ultrasonic treatment at an appropriate time.

The present invention has been made to solve such a conventional problem, and an object thereof is to directly and accurately inject a drug into an ultrasonic focal point set in a treatment target region. An object is to provide a possible ultrasonic treatment device.

[0010]

In order to achieve the above object, a first invention of the present application is to provide an applicator having a plurality of ultrasonic transducers, and ultrasonic waves for exploration and therapeutic ultrasonic waves from the ultrasonic transducers. In the ultrasonic treatment apparatus including a voltage source that supplies a voltage to irradiate the subject, a photographing means for photographing an image in the vicinity of a treatment region by the ultrasonic treatment apparatus, and a puncture needle directed to the ultrasonic focus of the applicator. A puncturing means capable of puncturing, a pressure-receiving portion that is attached to the tip portion of the puncture needle and that receives the probe ultrasonic waves emitted from the ultrasonic transducer, and a signal value received by the pressure-receiving portion. Determining means for determining whether or not the value is equal to or more than a predetermined set value, and a predetermined value on the ultrasonic image captured by the image capturing means when the signal value is determined to be equal to or more than the set value by the determining means Display means for displaying the mark Bet is a feature.

The second invention of the present application comprises an applicator having a plurality of ultrasonic transducers capable of transmission and reception, and a high voltage source for supplying a voltage to irradiate therapeutic ultrasonic waves from the ultrasonic transducers. In the ultrasonic treatment apparatus, a photographing means for photographing an image in the vicinity of a treatment region by the ultrasonic treatment apparatus, a puncture means capable of inserting the puncture needle toward the ultrasonic focus of the applicator, and a puncture needle It is attached to the tip,
A transmitting unit capable of transmitting an ultrasonic wave for exploration, a determining unit for determining whether the exploration signal value from the transmitting unit received by the ultrasonic transducer is equal to or more than a predetermined set value, Display means for displaying a predetermined mark on the ultrasonic image photographed by the photographing means when the judging means judges that the signal value is equal to or more than the set value.

[0012]

In the first invention of the present application configured as described above, the surgeon of the applicator can see the image near the treatment target region photographed by the photographing means such as an ultrasonic diagnostic apparatus or an X-ray CT apparatus. Focus the ultrasonic focus on the area to be treated. And
The puncture needle of the puncture means is inserted with the ultrasonic focus. At this time, since the pressure receiving portion is attached to the tip of the puncture needle,
The ultrasonic signal received by the pressure receiving unit increases as it approaches the ultrasonic focus. Therefore, when the determination means determines that the magnitude of the ultrasonic signal becomes larger than the predetermined value, it is recognized that the tip portion of the puncture needle has reached the ultrasonic focus, that is, the treatment target site. Then, by injecting a drug exhibiting an antitumor effect by acoustic activity from the puncture needle at this position, the drug can be injected only in the vicinity of the treatment target site. Therefore, the drug is not diffused to other than the treatment target site, and the drug is not administered more than necessary, so that side effects on the patient can be reduced. Further, since the drug reaches the treatment target site at the same time as the drug injection, the timing of the treatment after the injection is not considered, and the maximum therapeutic effect can be obtained immediately after the drug is injected.

In the second invention of the present application, the tip portion of the puncture needle has a transmitting portion capable of transmitting ultrasonic waves for exploration, and the ultrasonic transducers provided in the applicator provide the ultrasonic transducers. Receive sound waves. Then, the received ultrasonic intensity becomes maximum when the position of the transmitter, that is, the tip position of the puncture needle reaches the focal position of the applicator, so that the received ultrasonic intensity becomes larger than a predetermined value. At the position, it can be recognized that the tip of the puncture needle has reached the focal position. As a result, the puncture needle can be reliably brought to the treatment target site, and the subsequent operation can be performed in the same manner as in the first aspect of the invention.

[0014]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 shows a first ultrasonic treatment apparatus to which the present invention is applied.
It is a block diagram which shows an Example. As shown in the figure, this ultrasonic treatment device has an applicator 4 having a plurality of transducers 2 arranged in a spherical shell shape and capable of irradiating ultrasonic waves toward a treatment site 5 in a living body, A probe 3 provided at the center of the applicator 4, a pulser 15 for outputting ultrasonic pulses to each transducer 2, a high voltage source 16 for supplying a high voltage and a low voltage to the pulser 15, a low voltage source 17, an ultrasonic diagnostic apparatus 9 that captures an ultrasonic image near the treatment site 5 by transmitting and receiving ultrasonic waves from the probe 3, and a monitor that displays the ultrasonic image captured by the ultrasonic diagnostic apparatus 9 on the screen. 10 and
have. Reference numeral 1 is a water bag.

A puncture needle 8 is provided on the side of the applicator 4.
A guide mechanism 18 for inserting the
The puncture needle 8 connected to the syringe 7 via the guide mechanism 18 can be inserted toward the ultrasonic focus 5.
FIG. 2 is a detailed configuration diagram of the puncture needle 8. As shown in the figure, a piezoelectric film 20 capable of receiving ultrasonic waves emitted from the transducer 2 is attached to the tip of the puncture needle 8. Further, as shown in FIG. 1, the puncture needle 8 is connected to a receiving circuit 11 for taking in an ultrasonic signal received by the piezoelectric film 20, and the output is supplied to an echo level judging circuit 13.

The echo level judgment circuit 13 compares the predetermined threshold value set by the threshold value setting circuit 14 with the ultrasonic signal received by the receiving circuit 11, and
When the ultrasonic signal becomes larger, this result is output to the display output circuit 12. The display output circuit 12
Then, in response to this result, a mark indicating that the puncture needle 8 has reached the treatment site 6 is displayed on the monitor 10.

Next, the operation of this embodiment will be described.
First, an image of the vicinity of the treatment site 5 is taken by the ultrasonic diagnostic apparatus 9, and the image is displayed on the monitor 10. Then, while looking at this screen, the operator adjusts the applicator 4 so that the focus 6 of the applicator 4 matches the position of the treatment site 5.

Then, the switch 31 is connected to the low voltage source 17 side to supply a low voltage to the pulsar 15 to cause the transducer 2 to generate an ultrasonic wave for exploration. Next, when the puncture needle 8 is inserted toward the treatment site 5, the piezoelectric film 20 attached to the tip of the puncture needle 8 receives the ultrasonic waves for exploration, and the echo level is received via the reception circuit 11. Judgment circuit 1
3 is supplied. On the other hand, the puncture needle 8 is photographed by the ultrasonic diagnostic apparatus 9 and displayed on the monitor 10, so that the operator can confirm that the tip of the puncture needle 8 approaches the treatment site 5 while looking at it. Then, when reaching the treatment site 5 (a position substantially the same as the focal point 6), the echo level determination circuit 13 receives the ultrasonic signal more than the predetermined threshold value set by the threshold setting circuit 14. Becomes larger, this result is output to the display output circuit 12.

Thereafter, the display output circuit 12 is connected to the monitor 10.
The operator is made to recognize that the tip of the puncture needle 8 has reached the focal point 6 by using a marker or the like on the image. Then, the operator confirms this, operates the syringe 7, and administers the medicine filled in the syringe 7 to the treatment site 5 via the puncture needle 8. afterwards,
The switch 31 is switched to connect to the high voltage source 16 side, and therapeutic ultrasonic waves are generated from the applicator 4 to perform sonochemical treatment.

In this way, in this embodiment, since the drug can be directly administered to the treatment site, it is possible to prevent the drug from spreading to other than the treatment site and prevent side effects. Like Further, since the treatment with the therapeutic ultrasonic waves can be performed at the same time as the administration, the timing setting of the treatment becomes extremely easy.

In this embodiment, the piezoelectric film 20 is attached to the tip of the puncture needle 8, but a guide tube for inserting the puncture needle is provided and the piezoelectric film 20 at the tip of the guide tube is attached. You may do it. Further, although the treatment site 5 is dosed with the syringe 7, a pump or the like may be connected to the puncture needle 8 when continuous administration is required. In this case, the pump and the pulsar 15 may be electrically interlocked with each other to automatically control the timing of medication and irradiation of ultrasonic waves. Further, in the present embodiment, the applicator 2 is driven by two voltage sources, the high voltage source 16 and the low voltage source 17, but the intensity of the therapeutic ultrasonic wave is sufficiently low and it can be applied to the living body unless it is used in combination with a drug. If the applicator 2 is not affected, only the therapeutic ultrasonic wave is driven by the single voltage source, and this may be used as the exploratory ultrasonic wave.

FIG. 3 is a block diagram showing a second embodiment of the present invention. This embodiment is different from the first embodiment described above in that
The point where the trigger generation circuit 21 and the delay value setting circuit 22 are provided, the point that the vibrator 2 arranged in the applicator 4 is not limited to the spherical shell shape, and the insertion direction of the puncture needle 8 can be freely changed. What you can do is different.

The delay value setting circuit 22 arbitrarily sets the irradiation timing of ultrasonic waves from each transducer 2.
The trigger setting circuit 21 outputs a trigger to the pulsar 15 according to this setting. Thereby, the position of the ultrasonic focus 6 can be set arbitrarily. Further, a guide mechanism 18 as shown in FIG. 4 is formed in order to make the insertion direction of the puncture needle 8 variable. That is, the spherical fixing portion 23 is in contact with the applicator 4, and the puncture needle 8 penetrates into the spherical fixing portion 23. Since this spherical fixing portion 23 is rotatable with respect to the applicator 4, the direction of the puncture needle 8 can be arbitrarily changed by rotating it.

In the second embodiment thus constructed, the operation of matching the treatment site 5 and the ultrasonic focus 6 can be performed by setting the delay value setting circuit 22, and the puncture needle 8 to the focus position is used. The insertion can be performed by determining the direction by the guide mechanism 18. The other procedures are the same as those in the above-described first embodiment, and the description thereof will be omitted.

The second embodiment thus constructed is effective in determining the focal position with the applicator 4 in contact with the brain surface, such as in the treatment of brain tumors. That is, it is difficult to move the applicator 4 on the surface of the brain, and it is extremely useful to be able to change the focus position while the applicator 4 is fixed.

FIG. 5 is a block diagram showing a third embodiment of the present invention. Compared with the first embodiment described above, in this embodiment, the piezoelectric film 20 for receiving ultrasonic waves is attached to the tip of the puncture needle 8 in the first embodiment, whereas in this embodiment the probe film for exploration is used. The difference is that a piezoelectric film that can irradiate ultrasonic waves is used. Along with this, each ultrasonic transducer 2 uses one that can receive ultrasonic waves, and a receiving circuit 25 that takes in the ultrasonic waves is provided. The output of this receiving circuit is the echo level judging circuit 1 similar to that of the first embodiment.
3 is supplied. Further, the threshold setting circuit 14, the display output circuit 12, the monitor 10, the ultrasonic diagnostic apparatus 9, and
The pulsar 15 is similar to that of the first embodiment. It should be noted that the oscillator 2 need not be irradiated with the ultrasonic waves for exploration.
The low voltage source 17 shown in FIG. 2 is not necessary, and instead the low voltage source 24 is connected to the puncture needle 8 so that the piezoelectric film at the tip of the puncture needle 8 can be supplied with a voltage for ultrasonic wave transmission for exploration. ing.

Next, the operation of the third embodiment will be described. First, an image of the vicinity of the treatment site 5 is taken by the ultrasonic diagnostic apparatus 9, and the image is displayed on the monitor 10. Then, while looking at this screen, the surgeon focuses on the applicator 4 through the focus 6
The applicator 4 is adjusted so that is aligned with the position of the treatment site 5.

Then, the low voltage source 24 is driven to drive the puncture needle 8
Ultrasonic waves for exploration are emitted from a piezoelectric film (not shown) attached to the tip of the. Next, the puncture needle 8 is attached to the treatment site 5.
When the ultrasonic wave emitted from the piezoelectric film is received by the vibrator 2, the ultrasonic wave emitted from the piezoelectric film is taken into the receiving circuit 25. Then, it is supplied to the echo level determination circuit 13. On the other hand, the puncture needle 8 is photographed by the ultrasonic diagnostic apparatus 9 and displayed on the monitor 10, so that the operator can confirm that the tip of the puncture needle 8 approaches the treatment site 5 while looking at it. Then, when reaching the treatment site 5 (a position substantially the same as the focal point 6), the echo level determination circuit 13 receives the ultrasonic signal more than the predetermined threshold value set by the threshold setting circuit 14. Becomes larger, this result is output to the display output circuit 12. After that, the display output circuit 12 makes the operator recognize that the tip of the puncture needle 8 has reached the focal point 6 with a marker or the like on the image of the monitor 10.

In this way, the operator can focus the tip of the puncture needle 8 on the focal point 6
Then, the sonochemical treatment by ultrasonic waves is performed by the same procedure as in the first embodiment. And, also in such a third embodiment, the same effect as that of the above-mentioned first embodiment can be obtained.

FIG. 6 is a block diagram showing a fourth embodiment of the present invention. In this embodiment, as compared with the first embodiment, an image in the vicinity of the treatment site 5 is photographed using the ultrasonic diagnostic apparatus in the first embodiment, but in this embodiment, an X-ray CT capable of photographing a three-dimensional image is used. The difference is that the device is used.

The X-ray CT apparatus has a bed 2 on which a subject is placed.
8 and a gantry 29 that captures a three-dimensional image, and an image processing device 27 that processes the captured image. The applicator 4 is supported by a multi-axis arm 30.

Next, the operation of the fourth embodiment will be described. First, an X-ray CT apparatus is used to select 3
Dimension scan. Then, the operator designates the affected area to be treated on the CT image, and also designates the approach direction of the applicator 4 in consideration of the route through which the applicator 4 punctures. Then, the multi-axis arm 30 is operated according to this approach direction, and the applicator 4
The applicator 4 is positioned so that the focal point and the treatment site coincide with each other.

Next, the switch 31 is operated to connect the low-voltage source 17 to the pulser 15, and the applicator 4 generates ultrasonic waves for exploration. On the other hand, the operator inserts the puncture needle toward the treatment site under the guide of the CT image displayed on the monitor 10. Then, the operator confirms the position of the puncture needle on the CT image and also confirms the change in the received wave intensity at the tip of the puncture needle on the same image. Also, the echo level determination circuit 1
In No. 3, it is judged that the focus is reached when the received wave intensity becomes larger than the value designated by the threshold value setting circuit 14 in advance, and a marker or the like is displayed on the CT image.
After that, the operator confirms that the position information of the puncture needle on the CT image and the intensity of the received wave are maximized, and knows that the tip of the puncture needle has reached the focus from the display of this marker and fixes the puncture needle. To do.

The procedure thereafter is similar to that of the first embodiment, and sonochemical treatment is performed. Also in the fourth embodiment having such a configuration, the same effect as that of the first embodiment can be obtained. Further, in the present embodiment, since the three-dimensional information is obtained by the X-ray CT apparatus prior to the positioning of the therapeutic applicator, it is possible to easily realize the positioning in consideration of the proper puncturing direction. Further, although the three-dimensional X-ray CT apparatus is used in the present embodiment, an MRI apparatus may be used as long as it is possible to display an image at a high speed to the extent that there is no problem in performing a puncture. In this case, the puncture needle, the therapeutic applicator and the like must be made of a non-magnetic material.

[0035]

As described above in detail, according to the present invention, it is possible to make a desired treatment through the puncture needle accurately positioned at the focal points of the therapeutic ultrasonic wave and the shock wave source based on the ultrasonic signal at the tip. Since an appropriate amount of drug for the antitumor effect can be directly injected into the affected area, treatment with reduced side effects on the patient can be performed with maximum effect immediately after injection of the drug.

[Brief description of drawings]

FIG. 1 is a configuration diagram showing a first embodiment of the present invention.

FIG. 2 is an explanatory diagram showing a detailed configuration of a puncture needle.

FIG. 3 is a configuration diagram showing a second embodiment of the present invention.

FIG. 4 is an explanatory diagram showing a configuration of a guide mechanism according to a second embodiment.

FIG. 5 is a configuration diagram showing a third embodiment of the present invention.

FIG. 6 is a configuration diagram showing a fourth embodiment of the present invention.

FIG. 7 is a configuration diagram showing a conventional example.

[Explanation of symbols]

1 Water Bag 2 Transducer 3 Probe 4 Applicator 5 Treatment Area 6 Focus 7 Syringe 8 Puncture Needle 9 Ultrasonic Diagnostic Device 10 Monitor 11, 25
Receiver circuit 12 Display output circuit 13 Echo level determination circuit 14 Threshold setting circuit 15 Pulser 16 High voltage source 17,24 Low voltage source 18 Guide mechanism 19
Living body 20 Piezoelectric film 21 Trigger generation circuit 22
Delay value setting circuit 23 Spherical fixing part 27 Image processing device 28 Bed 29 Gantry 30 Multi-axis arm 31 Switch

Claims (7)

[Claims] 1. An ultrasonic therapy apparatus comprising: an applicator having a plurality of ultrasonic vibrators; and a voltage source for supplying a voltage to irradiate the search ultrasonic waves and the therapeutic ultrasonic waves from the ultrasonic vibrators. In, a photographing means for photographing an image in the vicinity of a treatment area by the ultrasonic treatment device, a puncture means capable of inserting a puncture needle toward the ultrasonic focus of the applicator, and a puncture needle attached to the distal end portion of the puncture needle. A pressure receiving unit that receives the ultrasonic waves for exploration emitted from the ultrasonic transducer; a determination unit that determines whether or not the signal value received by the pressure receiving unit is equal to or greater than a predetermined set value; And a display unit for displaying a predetermined mark on the ultrasonic image captured by the image capturing unit when the determination unit determines that the signal value is greater than or equal to the set value. Treatment device. 2. The super applicator according to claim 1, wherein the applicator has a delay value setting means capable of adjusting an ultrasonic wave irradiation timing from each transducer to arbitrarily set an ultrasonic wave focal position. Sound wave therapy device. 3. The ultrasonic therapeutic apparatus according to claim 1, wherein the imaging unit is an ultrasonic diagnostic apparatus in which a probe is arranged near the center of the applicator. 4. The X-ray CT apparatus capable of photographing a three-dimensional image, wherein the photographing means is an X-ray CT apparatus.
The ultrasonic treatment device according to any one of claims. 5. An ultrasonic treatment apparatus comprising an applicator having a plurality of ultrasonic transducers capable of transmitting and receiving, and a high voltage source for supplying a voltage to irradiate therapeutic ultrasonic waves from the ultrasonic transducers. An imaging unit that captures an image of a region near a treatment area by the ultrasonic treatment apparatus, a puncture unit that can insert a puncture needle toward an ultrasonic focus of the applicator, and a puncture needle that is attached to a distal end portion of the puncture needle; A transmitting unit capable of transmitting an ultrasonic wave for exploration, a determining unit that determines whether the exploration signal value from the transmitting unit received by the ultrasonic transducer is a predetermined set value or more, Display means for displaying a predetermined mark on the ultrasonic image taken by the imaging means when the determination means determines that the signal value is greater than or equal to a set value. Sound wave therapy device. 6. The ultrasonic therapeutic apparatus according to claim 5, wherein the imaging means is an ultrasonic diagnostic apparatus in which a probe is arranged near the center of the applicator. 7. The ultrasonic therapeutic apparatus according to claim 5, wherein the imaging means is an X-ray CT apparatus capable of imaging a three-dimensional image.