JPH0884740A - Treatment apparatus - Google Patents

Abstract

PURPOSE: To generate thermal modification in a region to be treated by suppressing the side effect due to the irradiation with ultrasonic waves by successively emitting ultrasonic waves from a partial region remote with respect to an ultrasonic source and separating a predetermined distance or more in a timewise continuing or approaching irradiation region and leaving a time interval for a predetermined time or more in a spatially continuing or approaching irradiation region. CONSTITUTION: Ultrasonic waves of high intensity are applied to the limited region in the vicinity of a focal point and a region (treatment region) 107 wherein a tumor is present is uniformly cuaterized while the focal point 106 is scanned. In this case, a timewise continuing or approaching irradiation region is irradiated with ultrasonic waves so as to separate a predetermined distance or more and, when this region is absent, the place remotest from a start point is irradiated in all of regions. A positionally continuing or approaching region is irradiated so as to leave an interval of a predetermined time or more. By this constitution, the side effect to an unexpected region or the the expansion of a thermally modified region is suppressed and thermal modification can be accurately generated in an aimed region. Therefore, the safety and certainty of treatment can be enhanced.

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 treating a tumor in a living body using ultrasonic waves.

[0002]

[Prior art]

(1) Recently, MIT (Minimally Invasive Treatment)
The flow of minimally invasive treatment, which is called, is drawing attention in various fields of medicine. One example is the practical application of a calculus crushing device that non-invasively crushes and cures calculi by irradiating strong ultrasound from outside the body for the treatment of calculi, and this has greatly changed the treatment method for urinary calculi. . As a method of generating intense ultrasonic waves used in this calculus breaking device, an underwater discharge method, an electromagnetic induction method, a minute explosion method, a piezo method, etc. are known. Among these, especially the piezo method in which a cooperative ultrasonic wave is generated by a piezo element is disclosed in, for example, Japanese Patent Laid-Open No.
As described in 0-145131, USP-4526168 and the like, it is possible to make a small focal point, there is no consumable item, a strong ultrasonic pressure can be arbitrarily controlled, and by controlling the phase of the driving voltage applied to a plurality of piezo elements. It has attracted attention because it has excellent advantages such as the ability to control the focal position arbitrarily.

On the other hand, MIT is one of the keywords in the field of tumor treatment. Especially in the case of malignant neoplasms, so-called cancers, since most of the treatments rely on surgical operations, the functions and external morphology of the original organs are often greatly impaired, and even if they prolong life. Since a large burden remains on the patient, QOL (Quality
It is strongly desired to develop a treatment method and a treatment device that are less invasive in consideration of (of life).

Under such a trend, hyperthermia therapy has been attracting attention as one of the cancer treatment techniques. This is a therapeutic method that selectively kills cancer cells only by heating and maintaining the affected area at 42.5 ° C. or higher by utilizing the difference in heat sensitivity between tumor tissue and normal tissue. As a heating method, a method using electromagnetic waves such as microwaves has been preceded, but it is difficult to selectively heat a deep tumor due to the electrical characteristics of the living body by this method, and the depth of 5
Good results cannot be expected for tumors larger than 10 cm.
Therefore, for treatment of deep tumors, a method using ultrasonic energy with good focusing and high penetration has been considered (Japanese Patent Laid-Open No. 61-13955).

Further, by further advancing this hyperthermia treatment method, ultrasonic waves generated by a piezo element are focused on the affected area and the tumor area is heated to 80 ° C. or higher to instantly denature or heat denature the tumor tissue. A treatment for necrosis has also been reported (G. Vallancien et.al .: Progress in Uro. 1991, 1, 84-8).
8, Japanese Patent Application Laid-Open No. 61-13955, Japanese Patent Application No. 3-306106
etc). Unlike conventional hyperthermia, this treatment involves the irradiation of ultrasound with extremely high intensity in a localized area near the focus, so it is necessary to irradiate the area in which the tumor is present while scanning the focus. There is. In particular, when irradiating with a powerful ultrasonic wave of several thousand W / cm ² , it is considered that cavitation caused by irradiation and a change in acoustic characteristics due to thermal denaturation of an affected area pose a serious problem. In the area where cavitation occurs, heat generation by ultrasonic waves is likely to occur, and if the next irradiation is performed immediately after irradiating a certain position with strong ultrasonic waves, the cavitation generated in the previous irradiation will cause an unexpected position. Fever is induced and can sometimes cause side effects.

In order to solve this problem, there has been proposed a method of controlling so that strong ultrasonic waves are not continuously applied to adjacent parts (Japanese Patent Application No. 4-43603). However, in this method, there is no description about how to control irradiation when there is no choice but to irradiate a strong ultrasonic wave to a nearby site.

(2) Also, instead of heat generation by ultrasonic waves,
Therapies for irradiating the cancer with strong ultrasonic waves in a pulsed manner that breaks stones and necroticizing the cells by its mechanical force have also been studied (for example, Hoshi, S. et al .: J. Urolo
gy, Vol.146: 439, 1991.). By the way, by using these ultrasonic therapy devices, it is possible to reduce the burden on the patient because it is not necessary to open the abdomen, but on the other hand, because it is not possible to directly see the affected area, necessary information in the body during treatment and A means for obtaining the position of the treatment target is required.

In the conventional ultrasonic treatment apparatus, there is a method of using an ultrasonic tomographic image when positioning the focus of intense ultrasonic waves, but the tumor to be treated has a three-dimensionally complicated shape. However, it is very difficult to treat the entire tumor evenly with a two-dimensional image. Therefore, a combination with a three-dimensional image using ultrasonic waves has been proposed as in Japanese Patent Laid-Open No. 61-209643. However, ultrasonic waves do not show the back of air-containing organs such as bones and lungs, and ultrasonic information cannot be obtained. An accurate three-dimensional image cannot be obtained based on it. Further, in this conventional example, it is only necessary to confirm the relative position between the focus and the treatment site,
There was no means to judge the effect of the treatment, and it was not possible to decide whether to continue or terminate the treatment until after several weeks to several months.

Therefore, the above-mentioned ultrasonic treatment apparatus and MRI that collects three-dimensional information in the living body and displays an image of the inside of the body.
A method of combining (magnetic resonance imaging system) or X-ray CT is also considered. For example, Japanese Patent Application Laid-Open No. 2-161434 describes an apparatus for performing treatment such as puncture based on an MRI image.

Further, in Japanese Patent Application No. 5-228744, in order to prevent erroneous irradiation of normal tissue and to perform reliable treatment in an ultrasonic treatment apparatus, an affected area is surely heated to a high temperature by using an image diagnostic apparatus. It also describes the real-time monitoring of the surrounding normal tissue for not overheating and the measurement of the heating position. For example, non-invasive temperature measurement is possible using the temperature dependence of chemical shift of MRI (Y. Ishihara et al .: Proc. 11th A
nn. SMRM Meeting, 4803, 1992). Here, the amount of change in chemical shift due to temperature change is measured using a phase mapping method in which the static magnetic field distribution is replaced with a phase distribution for imaging.

The most problematic point in carrying out such heating treatment is the movement of the treatment target. In the living body, there are inevitable movements such as respiration, pulsation, and the like, which causes the following problems.

First, when the treatment target moves, ultrasonic radiation is applied to a region different from the treatment planned region set in the treatment plan before the treatment, and the normal tissue is damaged.
Secondly, if the phase mapping method is used when the above-mentioned temperature measurement is performed, it is necessary to acquire a reference image before heating and calculate the difference for each image pixel. Moreover, since the relaxation time of the heat-denatured part due to heating changes, the denatured part can be imaged and used to confirm the therapeutic effect (Japanese Patent Application No. 05-
228744), the degenerated part can be observed more clearly by calculating the difference from the image before treatment. However, when the difference is obtained as described above, an error occurs because the difference between different pixels is calculated when the treatment target moves between imaging.

In order to reduce these effects, it is necessary to detect the target motion vector. As a result, the irradiation position of the treatment energy can be changed with respect to the movement to follow the movement, and the error can be reduced by performing the difference processing by correcting the image to be subjected to the difference processing by the moved amount. In JP-A-62-217976, a perturbation is applied to an imaging probe in an ultrasonic temperature distribution measuring apparatus and the imaging surface is moved in a direction having a large correlation coefficient, so that the difference in the same region of interest is tracked according to the movement. A calculating device is described.

Regarding the motion vector detecting method, some methods have been considered in the field of image processing. A method that uses the image data as it is, such as a pattern matching method or a gradient method, is generally used (essentially equivalent to a method that adds a perturbation to calculate a correlation coefficient), but performs a Fourier transform of the image,
Motion vectors can also be calculated by calculating the product of the spatial frequency domain or the inverse Fourier transform of the quotient, and then calculating the cross-correlation function or impulse response.
"Multidimensional signal processing of TV images", Nikkan Kogyo Shimbun).

However, when a general pattern matching method or the like is used to detect the motion, the images are gradually shifted and the least square error between the images is calculated each time. Therefore, especially in the case of three dimensions, the motion vector is calculated. It takes a huge amount of calculation to calculate. Although the motion can be detected by calculating the correlation coefficient as described above, it takes time to detect the motion vector because each correlation coefficient is calculated by giving a three-dimensional perturbation. Even in the case of calculating the cross-correlation function, if it is calculated as it is in real time, a two-dimensional convolution integral is calculated, which also takes time to process. However, in order to follow the movement of the object, real-time movement information is necessary.

(3) Furthermore, Japanese Patent Application No. 05-228744
Describes that the relaxation times T1 and T2 change due to thermal denaturation of the tissue, so that the thermal denaturation portion can be visualized by these emphasized images, and the therapeutic effect can be confirmed.

(4) In recent years, many MRI systems having an open-type magnet that can be easily accessed from the outside have been announced.
Utilization as I
Etc. In such an MRI, the operator is the MR
Treatment can be performed while monitoring with I.

On the other hand, in MRI, it is possible to excite only one point at an arbitrary position by performing selective excitation in each of the x, y, and z directions. In addition, a technique that excites an arbitrary shape in an arbitrary shape with one excitation has been reported (CJ Hardy, and HECline, Journal of Magnetic
Resonance, vol.82, pp.647-654, 1989). If this is used, only the NMR signal at a certain position can be obtained. It is also possible to locally excite three-dimensionally with one excitation (J. Pauly
et al .: "Three-Dimensional π Pulse", Proc. 10th A
nn.SMRM Meeting, 493, 1991). It is also considered that these are applied to the sequence of the temperature monitor of heat treatment by ultrasonic waves (US Pat. No. 5,307,812).
issue).

In addition, in an experiment using a piece of heat treatment using focused ultrasonic waves, it was found that when the irradiation time is lengthened, the degeneration region spreads toward the front side along the irradiation axis,
It has been found that the heating area does not always match the focus (Fujimoto et al., Journal of the Japan Society for ME Science, JJME, vol.
32 Suppl., Pp.125). Therefore, temperature monitoring during treatment becomes very important.

(5) Further, as means for monitoring the treatment site in the patient's body, for example, in a calculus crushing device, a strong ultrasonic pulse (shock wave) for calculus crushing is proposed as disclosed in Japanese Patent Laid-Open No. 63-5736. ) Is not irradiated, a weak ultrasonic wave for calculus exploration is applied to analyze the reflection signal from the calculus, and a device for irradiating a shock wave only when the calculus and the focus match is known. In addition, as a heating treatment apparatus using intense ultrasonic waves, a monitoring system using MRI, CT, or an ultrasonic diagnostic apparatus has been proposed, as described in Japanese Patent Application Laid-Open No. 4-43603. However, in a heating device using an ultrasonic diagnostic device as a monitoring device, there is a problem that therapeutic ultrasonic waves affect monitoring and real-time monitoring during treatment cannot be performed.

To solve this problem, Japanese Patent Application No. 60-241
As proposed in Japanese Patent Laid-Open No. 436, there is known an apparatus that irradiates a therapeutic ultrasonic wave when the in-vivo image is not configured so that the therapeutic ultrasonic wave does not affect the in-vivo image. Further, in the ultrasonic heating device that performs monitoring using MRI or CT, a device dedicated to monitoring must be prepared separately from the treatment energy source, which increases the installation space of the device and increases the cost burden. There was a drawback.

To solve the above problems, Japanese Patent Laid-Open No. 1943/1993
As described in JP-A-59-59, a therapeutic ultrasonic energy generation source in which a piezo element for calculus crushing and a piezo element for heating and heating treatment are integrated is proposed, and a piezo device for calculus crushing during heating and heating treatment. A device is known in which the element is used as a weak ultrasonic wave generation source for investigation of a treatment area.

(6) By the way, in the ultrasonic treatment apparatus for focusing the ultrasonic waves from the outside of the body as described above, when treating a region where the bone is on the upper side, for example, the brain or the liver,
Since the therapeutic ultrasonic waves are reflected, it is difficult to irradiate the affected area with sufficient energy. Further, when treating a very deep region near the center of the body, the frequency must be lowered in order to increase the degree of progress of ultrasonic waves, which causes a problem that the focal size becomes large. Here, the size W of the ultrasonic focus in the azimuth direction is R / A * f (A:
It is known to be proportional to the oscillator diameter, R: oscillator curvature, f: ultrasonic frequency, that is, inversely proportional to the frequency f.

In order to solve such a problem, attempts have recently been made to put a transducer for radiating therapeutic ultrasonic waves into a body cavity for treatment. For example, NT
Noninvasive transrectal ultrasound dev by Sanghvi et al.
ice for prostate tissue visualization and tisue ab
lation in the focal zone using high intensity foc
In used beam., J Ultrasound Med., 1991; 10: 104-109, an attempt was made to insert a transducer into the rectum to treat a prostate that has become enlarged in the transrectal wall.

(7) Further, in the above-mentioned tumor treatment apparatus, an ultrasonic tomographic image is used for positioning the focus, but the tumor to be treated often has a three-dimensionally complicated shape. It is very difficult to treat the entire tumor evenly with a three-dimensional image. Then, Japanese Patent Laid-Open No. 61-2096
Although a combination with a three-dimensional image using ultrasonic waves is also proposed as described in Japanese Patent Publication No. 43-43, the ultrasonic waves do not show the rear of air-containing organs such as bones and lungs, and ultrasonic information is also obtained. However, an accurate three-dimensional image could not be obtained.

Moreover, in the conventional example, the relative position between the focal point and the treatment site is simply confirmed, there is no means for determining the effect of the treatment, and the continuation / termination of the treatment cannot be determined until after several weeks to several months. It was Therefore, an MR that collects three-dimensional information in the living body as a CT and displays an image of the inside of the body
A method using I can be considered. However, MRI does not always perform image reconstruction in real time.
For this reason, it is not possible to capture the fast movements caused by the patient's breathing and body movements. CT to prevent erroneous irradiation due to this movement
In addition to the above, an ultrasonic image device may be used in combination (Japanese Patent Laid-Open No. 5-300910). At this time, by providing a means for obtaining the relative position between the ultrasonic probe for obtaining a tomographic image and the focal point of the therapeutic ultrasonic wave, the focal point position is displayed on the ultrasonic image, and further the two-dimensional or three-dimensional image obtained by CT is obtained. Shows the position of the ultrasonic tomographic image displayed at that time on the three-dimensional in-vivo image,
The ultrasonic tomographic image can be used in accordance with the treatment plan made earlier.

Furthermore, it has been reported that the state of tissue degeneration due to heat can be confirmed by MRI T2 images (Fere
nc A. Jolesz et al .: MR Imaging of Laser-Tissue Int
eractions). Therefore, these two MRIs before and after treatment
By observing the difference in the images, it is possible to determine the biological action / treatment effect of this treatment, and the treatment can be performed while checking the untreated area, so that a sufficient treatment effect can be secured with a minimum of irradiation.

[0028]

[Problems to be Solved by the Invention]

(1) In the conventional ultrasonic therapy device, the irradiation position is not optimally controlled when the tumor region in the body is treated, so that an unexpected site is affected or sufficient heat is applied to the targeted site. There was a possibility that denaturation could not occur.

A first object of the present invention is to provide a safe and reliable treatment device capable of suppressing side effects due to ultrasonic irradiation to an unexpected site and causing sufficient thermal denaturation at the site to be treated. It is in.

(2) In the conventional ultrasonic therapy device,
When the treatment target moves, it will irradiate ultrasonic waves to a site different from the planned treatment site, which may damage normal tissue.To avoid this, the motion vector is detected and the irradiation position of the therapeutic energy is changed. In this case, a general pattern matching method or a method of detecting a motion vector by calculating a correlation coefficient takes a long time to detect, and there is a problem that real-time motion detection that can follow the movement of the treatment target cannot be performed. It was

A second object of the present invention is to detect the movement of an object to be imaged between a plurality of images in real time by using a processing procedure peculiar to MRI, and to perform accurate medical treatment in a manner that always follows the movement. It is to provide a treatment device capable of

(3) The erroneous irradiation prevention function described in Japanese Patent Application No. 5-228744 is a check function in advance, and the temperature is not monitored during the actual irradiation of treatment. However, the living body has movements such as respiratory movements and body movements, and may move during treatment irradiation. In such a case, temperature measurement is important as a check for an abnormality in the irradiation state. However, in the heat treatment, since the focus region is momentarily heated to a high temperature and treated, the temperature measurement requires a fairly high time followability (real-time property). On the other hand, since the energy irradiation position is known in advance, the measurement range can be limited, and since it is known that the temperature distribution is gentle, it is sufficient even if the high spatial resolution of a normal image cannot be obtained.
In addition to temperature, it is also necessary to obtain data showing the therapeutic effect with high time resolution, and a measurement method that gives priority to time resolution is necessary.

However, when such a temperature measurement is carried out, if it is attempted to capture it as a distribution, the number of encodings is taken in a time (repetition time) required for one excitation in the case of capturing one image, for example, in a normal spin echo sequence. It takes time. For example, if the repetition time is 2 seconds and the number of encoding times is 128, it takes about 5 minutes. On the other hand, high-speed imaging such as field echo and ultra-high-speed imaging such as echo planner have been devised, but even field echo requires several seconds for imaging, and ultra-high-speed imaging requires several hundreds.
ms is required. Further, even if imaging is performed at high speed, the reconstruction process thereafter requires some time, resulting in a time lag of about several seconds, which makes accurate temperature control impossible. The heat treatment causes a high temperature at an instant, so a time lag of several seconds is dangerous.

A third object of the present invention is to provide an accurate and safe treatment apparatus capable of checking whether energy irradiation is normal during actual treatment by obtaining temperature information of only a specific portion in real time during treatment irradiation. To provide.

(4) When performing ultrasonic treatment, a temperature monitor for preventing erroneous irradiation is very important, but the ultrasonic monitor cannot measure the temperature distribution with high accuracy.
Although the temperature distribution can be measured by MRI, the irradiation direction of therapeutic ultrasonic waves is arbitrary, and ultrasonic transducer three-dimensional imaging is required, and it takes time to image with a normal imaging method, and real-time performance is poor, resulting in therapeutic efficiency. Becomes very bad.

Particularly when an operator directly operates a hand probe type ultrasonic treatment apparatus using an open type MRI, the region that the operator wants to see for aligning the treatment apparatus is near the treatment site. If the imaging region is not controlled in accordance with the position and angle of the treatment device, the treatment region will deviate from the imaging region, or carelessly imaging a large region will take too much imaging time to reduce the efficiency of treatment. Therefore, also in MRI, an ultrasonic therapeutic apparatus by MRI monitoring capable of measuring temperature distribution, which is as easy as operating an ultrasonic probe and has a real-time property, is desired.

Further, as the denaturation progresses, the denaturation region spreads toward the front side along the irradiation axis, so that it is most important to monitor the temperature distribution on the irradiation axis. Even if the temperature distribution of one line including the focal point is obtained by local excitation, if it is not along the irradiation axis, when the heating region is displaced in the front direction of the irradiation axis, it will deviate from the imaging line and temperature monitoring will be impossible. I will end up.

A fourth object of the present invention is to provide a treatment apparatus capable of constantly performing high-speed temperature monitoring of a treatment target site.

(5) In an apparatus for irradiating ultrasonic waves for focus investigation when the shock wave pulse for treatment is not irradiated, the ultrasonic waves for treatment must be operated in the pulse mode, resulting in intermittent treatment and poor efficiency. . Moreover, real-time monitoring is not possible with an apparatus that irradiates therapeutic ultrasonic waves when an in-vivo image is not configured. Furthermore, an ultrasonic therapy device that monitors changes in the treatment area using a piezo element for calculus breaking during heating / heating treatment is used for heating / heating therapy in which the calculus breaking ultrasonic source has a different fundamental frequency. Since the ultrasonic wave generation sources are arranged on the same applicator, not only the applicator becomes large, but also two kinds of driving means having different fundamental frequencies are required.

A fifth object of the present invention is to provide an accurate and safe treatment apparatus that enables real-time monitoring of a treatment target without the above problems.

(6) When the position to be treated is close to the wall as in the above-mentioned device used transrectally, the distance R is small as shown in the above equation, so that the ultrasonic transducer for treatment is used. Even if the diameter A is small, it can be sufficiently focused and the frequency can be increased, so that it was possible to further focus and increase the peak ultrasonic intensity. Further, since the rectum is a relatively large lumen and the patient suffers relatively little pain, it was easy to insert a relatively large transducer.

However, when a transducer is orally inserted to treat the liver, the pancreas, etc. through the stomach wall, the diameter of the oscillator must be increased because the treatment site is relatively deep. However, there is a problem that the esophagus, which is a passage route, is narrow within the stomach, but the size is limited considering the patient's pain.

Recently, a technique of inserting a tube into the abdominal cavity from the surface of the body and performing an operation using an endoscope and forceps has become popular, but an ultrasonic therapy apparatus should be used here. However, there was a similar problem.

Therefore, a sixth object of the present invention is to provide a therapeutic apparatus capable of efficiently treating a relatively deep region inside a body cavity by using ultrasonic waves.

(7) When heat treatment is performed by irradiating the body with strong ultrasonic waves, accurate positioning is required to prevent body damage due to erroneous irradiation. However, ultrasonic transducers are placed at the coordinates in the MRI gantry. It is difficult to match the focal point positions of the MRI, the applicator, and the patient, so that it is difficult to match the positions of the existing MRI device and the newly purchased ultrasonic heating device, for example. is there. Since it is necessary to manually align the two points of the MRI and the applicator, and the applicator and the patient, it takes time and labor for the operator, and it is necessary to attach the applicator position detection device to the MRI device, and the cost of the device. Is higher.

A seventh object of the present invention is to provide a treatment apparatus capable of performing accurate treatment by aligning only the patient and the applicator.

[0047]

[Means for Solving the Problems]

(1) The treatment device according to the first invention has an ultrasonic source,
Irradiation means for focusing and irradiating an ultrasonic wave from the ultrasonic source to a treatment target site in the subject, means for obtaining three-dimensional image information in the subject, and the treatment target from the three-dimensional image information. Means for extracting a three-dimensional region of a part; means for dividing the three-dimensional region into a plurality of sections having a predetermined thickness; means for dividing the section into a plurality of partial regions having a predetermined size; An irradiation control unit that controls the irradiation of the therapeutic ultrasonic wave from the irradiation unit to a partial region in a predetermined procedure. Then, the irradiation control means, as the predetermined procedure (a) irradiating the ultrasonic source with the ultrasonic waves in order from a partial region belonging to a section farther from the ultrasonic source, (b) temporally continuous or close ultrasonic waves Use a procedure that satisfies the three principles of separating the distance between the sub-regions of the sound wave irradiation target by a predetermined distance or more, and (c) leaving a time interval between the sub-regions of the ultrasonic wave irradiation target that are spatially continuous or close to each other by a predetermined time or more. It is characterized by

Here, it is preferable that the above-mentioned predetermined distance and predetermined time correspond to the distance and time at which the influence of cavitation generated by the irradiation of therapeutic ultrasonic waves is lost. Further, it is desirable that the predetermined thickness and the size of the partial region defined in the section are determined by the shape of the ultrasonic source and the focus heat generation shape determined by the driving method.

Further, in the first aspect of the present invention, a tomographic image of this image diagnostic apparatus is interlocked with an image diagnostic apparatus for acquiring and imaging a tomographic image of the inside of the subject and variable energy focusing position of the ultrasonic source. It is preferable to have a tomographic image acquisition position control unit that controls the position of the ultrasonic source or the signal excitation position so that the acquisition position (plane / volume) does not change, and an image display unit that displays the acquired tomographic image.

An ultrasonic image diagnostic apparatus is used as the image diagnostic apparatus, and a combination of B mode and C mode or volume (3D) data is acquired as a tomographic image.

(2) The treatment apparatus according to the second invention recognizes the treatment target site in the subject based on the image information in the subject collected by the magnetic resonance diagnostic apparatus, and irradiates the therapeutic energy. In a treatment device for performing treatment by irradiating the treatment target area with treatment energy from a means, a means for collecting spatial frequency data of image information in the subject and an image temporally adjacent to the spatial frequency data. Means for determining the impulse response or cross-correlation function of the patient and detecting the movement of the patient from the peak point of the impulse response or cross-correlation function, and the therapeutic energy by the therapeutic energy irradiation means according to the movement detected by this means. And means for changing the irradiation position of.

Here, the impulse response is obtained by calculating the quotient between the two images of the spatial frequency data and by performing the inverse Fourier transform of the quotient. On the other hand, the cross-correlation function calculates the product between the images of the two spatial frequency data and is obtained from the inverse Fourier transform of the product.

In the second invention, it is desirable to move the image based on the detected movement of the patient to obtain the difference.

(3) The therapeutic apparatus according to the third aspect of the invention recognizes the treatment target site in the subject based on the image information in the subject collected by the magnetic resonance diagnostic apparatus, and irradiates the therapeutic energy. In a treatment device for performing treatment by irradiating treatment energy to the treatment target portion from a means, a means for setting a temperature measurement portion during the irradiation of the treatment energy by the treatment energy irradiation means, and the setting means It is characterized by comprising means for acquiring temperature information using local excitation by the magnetic resonance diagnostic apparatus for the temperature measurement site, and means for displaying the temperature information acquired by this means.

Further, the means for setting the temperature measurement site during treatment irradiation is a means for irradiating weak energy to such an extent that the tissue in the subject is not damaged, and a means for irradiating the weak energy by the magnetic resonance diagnostic apparatus. Of temperature distribution, means for comparing the measured temperature with a preset value, and means for deciding the temperature measurement site based on the comparison result.

(4) The treatment apparatus according to the fourth aspect of the present invention recognizes a treatment target site in the subject based on image information in the subject collected by the magnetic resonance diagnostic apparatus, and irradiates therapeutic energy. In a treatment apparatus for performing treatment by irradiating the treatment target region with a treatment energy from a means, a means for detecting an irradiation direction and an irradiation position of the treatment energy by the treatment energy irradiation means, and a means for detecting the irradiation direction. A means for setting a temperature measurement site according to the irradiation direction and position, a means for acquiring temperature information using the local excitation by the magnetic resonance diagnostic apparatus for the temperature measurement site set by this means, and a means for acquiring the temperature information. And means for displaying the temperature information.

Further, it is characterized in that it further comprises means for controlling the therapeutic energy according to the temperature information.

Further, the means for setting the temperature measurement portion is characterized by setting a portion including the irradiation axis of the therapeutic ultrasonic waves.

Further, the means for detecting the irradiation direction and irradiation position of the therapeutic energy irradiation means is constituted by an encoder.

(5) The treatment apparatus according to the fifth aspect of the present invention includes an ultrasonic wave irradiating means for irradiating a therapeutic object in the subject with a therapeutic ultrasonic wave, and a drive means for driving the ultrasonic wave irradiating means. Detection means for detecting the reflected wave signal of the therapeutic ultrasonic wave from the inside of the subject separately from the drive signal supplied from the drive means to the ultrasonic wave irradiation means, and the reflection detected by the detection means. Analysis means for analyzing the wave signal,
A control means for controlling the drive means based on the analysis result of the analysis means.

Further, in the fifth invention, an imaging ultrasonic probe for acquiring an image inside the subject, a means for reconstructing an image inside the subject, a reconstructed image and an ultrasonic irradiation means for treatment. It further comprises means for obtaining a relative positional relationship with and, and means for superimposing and displaying information on the treatment target region on the reconstructed image.

(6) A therapeutic apparatus according to a sixth aspect of the present invention is a therapeutic apparatus for irradiating a subject with therapeutic ultrasonic waves for treatment, wherein a plurality of ultrasonic vibrations for irradiating the therapeutic ultrasonic waves are provided. In the first state, at least two ultrasonic transducers overlap with each other in the relative positions of the therapeutic applicator having a child and the plurality of ultrasonic transducers, and in the second state, the at least two ultrasonic transducers Relative position changing means for changing so as to reduce the overlap, and the relative position becomes the first state when the relative position changing means is inserted into the subject of the treatment applicator, and when the treatment is performed, the relative position is changed to the first state. Means for controlling the relative position to be in the second state.

Here, when the ultrasonic transducers are concave transducers, the relative positions are set so that the plurality of ultrasonic transducers have substantially the same focal position at the start of treatment, and the ultrasonic transducers are set to have the same focal position. It is preferable that each difference in the distance to the focal point be an integral multiple of the wavelength.

Further, when the plurality of ultrasonic transducers are array transducers, it is desirable to provide a drive means capable of controlling the drive timing and power of each element. further,
Even when the multiple oscillators are concave oscillators and the relative positions are set so that they have approximately the same focal position at the start of treatment, a drive means that can control the drive timing and power of each oscillator is provided. It is preferable to have.

(7) The therapeutic apparatus according to the seventh aspect of the present invention recognizes the treatment target site in the subject based on the image information in the subject collected by the magnetic resonance diagnostic apparatus, and supplies the therapeutic energy. In a treatment device for performing treatment by focusing and irradiating the treatment target portion, a treatment applicator having a treatment energy irradiation means for irradiating the treatment energy and a housing for housing the treatment energy irradiation means, It is characterized in that the housing is provided with a reference marker formed of a material that can be detected by the magnetic resonance diagnostic apparatus and for positioning the therapeutic applicator with respect to the magnetic resonance diagnostic apparatus.

Further, in the seventh invention, it is preferable to provide means for varying the focal position of ultrasonic energy by the therapeutic energy irradiating means. The focal position changing means may be configured to control the focal position based on, for example, two-dimensional and three-dimensional coordinates based on a plurality of reference markers.

[0067]

[Action]

(1) In the first aspect of the present invention, the position / time control during the irradiation of therapeutic ultrasonic waves is optimized, so that side effects to unexpected parts and expansion of the heat degeneration region are suppressed, and the targeted part is also suppressed. Can accurately induce heat denaturation. This improves the safety and certainty of treatment.

(2) In the second invention, the spatial frequency data, which is the raw data collected by the magnetic resonance diagnostic apparatus, is used as it is, and the inverse Fourier transform of the quotient or product in the spatial frequency domain is calculated. The motion vector can be calculated at high speed by calculating the impulse response or cross-correlation function between two images and detecting the peak point. As a result, the speed of calculation can be increased as compared with the conventional motion detection using real space image data, and the motion vector between images can be detected in real time. Therefore, using this motion vector, the treatment energy irradiation position can be made to follow the movement of the treatment target site, and erroneous irradiation can be prevented.

Further, the difference error can be reduced by shifting the images according to the movement and acquiring the difference between the images.

(3) When performing heat treatment, the operator determines the most noticeable part in the treatment and inputs it to the control means.
Specifically, several points are selected, such as the center of the treatment target where the temperature must rise sufficiently and the peripheral important tissues where the temperature should not rise. Then, during irradiation of the therapeutic energy, the magnetic resonance diagnostic apparatus excites the above-mentioned several points by the local excitation method, measures temperature information based on the excited points, and displays them on the screen. Here, since the measurement points are limited and the processing such as reconstruction is simplified, the measurement time is greatly shortened. Further, by not displaying a huge amount of measurement data, it is possible to provide only necessary information without giving unnecessary confusion to the operator.

Further, at this time, first, a predetermined weak therapeutic energy is applied, and the temperature at that time is compared with a preset value to determine whether or not the treatment site coincides with the energy concentration point. Since it is possible to judge whether unnecessary energy causing side effects is irradiated in the surrounding important tissues, it is possible to judge at high speed by using the above characteristics to increase the treatment energy and start the treatment, or to stop the treatment. Can be repositioned.

Therefore, in the treatment apparatus using the magnetic resonance diagnostic apparatus, it can be confirmed that the treatment is normal and no abnormal fever is occurring during the treatment irradiation, and safe and accurate treatment can be performed.

(4) In the fourth invention, attention is paid to the fact that the information on the focal point of ultrasonic waves is the most important, and it is sufficient as a heating monitor if the surface including the ultrasonic irradiation axis can be constantly monitored. By obtaining the position and angle information and controlling the imaging so that the slice plane including the ultrasonic irradiation axis is always imaged based on the information, the treatment can always be monitored at high speed without obtaining a three-dimensional image. Become. In addition, the hand probe type treatment apparatus enables easy and interactive monitoring of the irradiation area as if an ultrasonic diagnostic apparatus were used.

(5) In the fifth aspect of the invention, the therapeutic ultrasonic wave reflected by the object to be treated is received via the piezo element, and for example, a signal obtained by combining this received signal and the drive signal is used to drive the piezo element. By subtracting the drive signal supplied from, it becomes possible to detect only the received signal separately from the drive signal. Furthermore, by analyzing the detected reflected wave signal, it becomes possible to monitor the change in the treatment target in real time, and by controlling the treatment ultrasonic wave according to the change in the treatment target based on it, a safe and reliable treatment Irradiation of sound waves is possible.

(6) In the sixth invention, in the subject,
Especially when inserting a therapeutic applicator into a body cavity, the size of the therapeutic transducer is defined by the diameter of the entrance of the insertion section. Is changed so as to overlap each other to reduce the maximum diameter (first state). Then, when the applicator is once inserted into the body cavity and the periphery of the applicator is widened, the relative positions of the plurality of ultrasonic transducers are changed so that the overlapping portions are small and the overall opening diameter is maximized. (Second state). Since ultrasonic waves can be focused through a larger opening, ultrasonic energy can be sharply focused even on a relatively deep part of an organ, which enables efficient treatment.

Here, when concave vibrators are used as the plurality of ultrasonic vibrators, after insertion into the body cavity, the focal points of the ultrasonic vibrators are made to coincide with each other, whereby a sharp focus of therapeutic ultrasonic waves can be obtained. At that time, since the ultrasonic transducers that overlap each other are moved, the distance from the focal point to each ultrasonic transducer is different. However, by setting the distance difference to an integral multiple of the wavelength, multiple ultrasonic transducers Even if they are driven with the same phase, that is, with the same drive circuit, the phases at the focal points can be matched. Therefore, the plurality of ultrasonic transducers operate as if they were one concave transducer. Therefore, this applicator can be easily inserted even through a narrow insertion hole such as the oral cavity, and can be used as a therapeutic applicator having a large effective area.

When array transducers are used as the plurality of ultrasonic transducers, even if each transducer has, for example, a flat plate shape, it can be moved to the same position by changing the drive timing of each element on the drive circuit side. A focus can be formed. The point that the opening diameter can be changed before and after insertion of the applicator by changing the relative positions of these vibrators is the same as when the concave vibrator is used. Further, as long as the drive circuit is capable of controlling the drive timing, it is not always necessary to set the distance from the focus to an integral multiple of the wavelength as described above even when the concave vibrator is used.

Furthermore, when the output of each oscillator or the drive circuit coupled to each oscillator can be changed independently, the output is changed according to the difference in the distance to the set focus, and the solid angle per solid angle seen from the focus is changed. Since the energy density can be made constant, a more ideal sound field can be formed.

(7) In the seventh invention, the coordinates based on the reference marker (reference point) placed on the housing of the ultrasonic source, that is, the coordinates in the ultrasonic therapeutic apparatus can be imaged simultaneously with the inside of the subject. . Therefore, it is possible to determine the position in the body of the focus controlled based on the coordinates in the ultrasonic therapy apparatus without detecting the relative position between the ultrasonic therapy apparatus and the magnetic resonance diagnostic apparatus. Therefore, the magnetic resonance diagnostic apparatus for imaging the inside of the subject and the ultrasonic therapy apparatus can be combined without providing a special position detection mechanism.

[0080]

Embodiments of the present invention will be described below with reference to the drawings.

(Embodiment 1) FIG. 1 is a block diagram showing the configuration of an embodiment according to the first invention. The applicator 101 for treatment is a piezo element (group) that generates strong ultrasonic waves.
102, a coupling solution 104 that guides intense ultrasonic waves to the patient 103, and a coupling film 105. The piezo element group 102 is configured by arranging a plurality of piezo elements for irradiating a treatment site with intense ultrasonic waves for treatment as, for example, an annular array or a linear array. It should be noted that a single spherical shell-shaped piezoelectric element may be used to irradiate the treatment site with intense ultrasonic waves for treatment. Degassed water is usually used as the coupling solution 104.

At the time of treatment, first, the patient 103 is placed on a bed and the table moving device 134 fixes the patient 103 at a predetermined position. Then, from the working hole 135, the applicator 10
1 is placed on the body surface of the patient 103, and the coupling film 105 is brought into contact with the skin by ultrasonic jelly or the like (not shown). Then, based on the drive phase information from the system controller 119, the drive circuit 109 is driven by a plurality of timing signals, each of which is given a predetermined delay by the phase control circuit 136.
And the drive circuit 109 controls the piezo element group 102
By driving each of the piezo elements in (1) in a predetermined phase relationship, therapeutic intense ultrasonic waves are directed toward the focal point 106. By such drive phase control, the focal point 106 of the intense ultrasonic wave can be set three-dimensionally at an arbitrary position. This principle is described, for example, in USP-4,526,168.

At this time, the applicator position detecting device 110
Detects position information of the applicator 101 from a signal from a mechanical arm 111 that movably supports the applicator 101, and sends the position information data to the system controller 119. The system controller 119 displays, on the CRT display 117, the focus 106 and the ultrasonic wave incident path of the intense ultrasonic wave for treatment in superimposition with the in-vivo shape image information based on the position information data and the drive phase information.

Here, in this embodiment, MRI is used as an image diagnostic apparatus. That is, the system controller 119 activates the gradient magnetic field power supply 132 and the transmission / reception circuit 133 according to a predetermined sequence (for example, T2-weighted imaging method) instructed by the console 120, and stores image information of the multi-plane of the patient 103 in a memory (not shown). To do. The three-dimensional information on this memory is stored in the system controller 11
9 is displayed on the CRT display 117.

Further, the system controller 119 extracts the affected area from the three-dimensional image information obtained prior to the treatment, and slices the affected area according to a predetermined thickness (for example, ultrasonic focus size in the depth direction). Then, each of the plurality of sections obtained by the slice is divided and displayed in a plurality of partial areas (hereinafter, referred to as voxels) that are predetermined by the focus size.

Furthermore, in order to keep the degassing degree of the coupling solution (degassed water) 104 in the applicator 101 constant and prevent the body surface and the piezo element group 102 from generating heat, the system controller 119 controls them. The coupling solution 104 is degassed and cooled by the water treatment circuit 121.

FIG. 2 is a diagram for explaining the irradiation procedure of the therapeutic intense ultrasonic waves in each section in one slice. In the treatment method of this embodiment, ultrasonic waves of extremely high intensity are applied to a localized region near the focus, and the region 106 (the treatment site) where the tumor is present is uniformly cauterized while scanning the focus 106. Is. Especially 1k-100k
When irradiating a very strong ultrasonic wave of W / cm ² ,
Cavitation that occurs with irradiation and changes in acoustic characteristics due to thermal denaturation of the affected area are considered to be major problems. In the area where cavitation occurs, heat generation by ultrasonic waves is likely to occur, and immediately after irradiating a certain position with strong ultrasonic waves, the next irradiation is performed at a nearby location, and the cavitation generated by the previous irradiation causes an unexpected position. Fever is induced and can sometimes cause side effects. In order to solve this problem, it is necessary to set the time and space intervals of ultrasonic wave irradiation and sufficiently irradiate the cavitation, and then perform irradiation to the adjacent region. To this end, the present invention employs the following intense ultrasonic wave irradiation procedure.

(Procedure 1): Ultrasonic waves are radiated to irradiation areas that are continuous or close to each other in time, separated by a predetermined distance (r) or more as shown in FIG. 2 (a).

Here, the predetermined distance is a distance which is not affected by the cavitation generated in the immediately preceding irradiation, and for example, the focal point size (intensity distribution) in the azimuth direction.
When the distance is 2 mm, it is considered that there is almost no influence of the irradiation just before if the distance is 10 mm or more, which is five times as large as that. The distance between the two regions mentioned here indicates the distance between the centers (centers of gravity) of the respective regions.

(Procedure 2): When there is no area corresponding to Procedure 1, the farthest position from the starting point is irradiated in all areas.

(Procedure 3): Irradiation is performed between irradiation areas that are adjacent (continuous) or close to each other in terms of position, with an interval of a predetermined time or more. This state is shown in FIG.

Here, the predetermined time is a time until the cavitation generated in the focal region when the intense ultrasonic wave is irradiated is almost disappeared. Specifically, although it varies depending on the medium and the state of the body, it is known from the results of the animal experiments conducted by us that an interval of 5 seconds to 30 seconds or more is necessary.

The actual irradiation procedure will be described with reference to an example.
In the case of FIG. 2 (b1), the areas 1 and 5 are shown in FIG. 2 (b2).
As shown in FIG. 2 (c2), if the regions 1 and 2 are adjacent to each other as shown in FIG. 2 (c2), they may be adjacent to each other. It is necessary to perform irradiation at intervals of. At this time, the region 3 is also adjacent to the region 1, but there is no problem because the irradiation timings of these regions 1 and 3 are already separated by time t or more.
Further, in the case of FIG. 2 (d1), the area 1 and the area 2, the area 2
Since the region 3 and the region 3 are separated by the distance r or more, continuous irradiation is possible, but since the region 1 and the region 3 are adjacent to each other, it is necessary to control the irradiation time so that the irradiation timing between them is separated by the time t or more.

(Procedure 4): In the case of procedure 2, that is, in the case of FIG. 2 (d1), the ultrasonic waves are irradiated with an interval of a separately determined time. The separately determined time is, for example, a simple proportional calculation of the distance r capable of continuous irradiation and the distance d between the two regions, and can be set as follows (see FIG. 2 (d2)).

T ′ = T + (t−T) (1−d / r) (seconds) Further, not limited to this, irradiation is performed at intervals of a time t between all areas having a distance equal to or smaller than continuous irradiation. Is also possible. However, in this case, the total treatment time will be slightly longer.

FIG. 3 is a flowchart showing the above procedure. This processing is executed by the system controller 119 of FIG. First, after deciding the starting point of the irradiation position of the therapeutic high-intensity ultrasonic waves, it is judged whether or not it is possible to irradiate the point (next point) to be irradiated next with a distance r or more from the starting point (S101). If so, it is further checked whether or not there are a plurality of runner-up candidates (S10).
2). If YES is determined in S102, the point closest to the starting point is set as the next point, and if No is determined, one of the candidates is set as the next point. Then, the starting point and S102
The ultrasonic wave irradiation time interval between the next point determined in step S104 to S104 is set to T seconds. This corresponds to the case of FIG.

On the other hand, if No in S101, the farthest point from the starting point is the next point (S10
5) Further, it is checked whether or not the next point and the starting point are adjacent to each other (S106). When it is determined No in S106, the ultrasonic wave irradiation time interval between the starting point and the next point is t ′.
Leave for a second. This corresponds to the case of FIGS. 2 (e1) and (e2).

Further, when the result of S106 is Yes, the ultrasonic wave irradiation time interval between the starting point and the next point is set to be t seconds apart. This is shown in FIG. 2 (b1) (b2) (c
1) (c2) (d1) (d2).

If the intense therapeutic ultrasonic wave is applied on the basis of the procedure described above, it is possible to perform all the irradiation in the shortest time or in a time corresponding to it. A flowchart of this procedure is shown in FIG.

FIG. 4 shows another procedure of intense ultrasonic wave irradiation. This is done by dividing each section into several groups in advance, and numbering each group in order from 1 to A-1 and B-
1, C-1 ... A-2, B-2, C-2 ,. In this method, if the cavitation remaining time is set to be t or more when the number of groups is once made in advance, continuous irradiation to adjacent places can be avoided in most cases. However, since this method is not perfect, it is possible to realize a more reliable irradiation procedure by combining it with the methods of procedure 3 and procedure 4 described above.

(Embodiment 2) FIG. 5 is a block diagram showing the structure of another embodiment according to the first invention. The applicator 101 for treatment is a piezo element group 1 that generates intense ultrasonic waves.
02, the coupling solution 104 that guides high-intensity ultrasonic waves to the patient 103, the coupling film 105, the ultrasonic probe 8 that acquires an image of the affected area, and the Zθ stage 113 and Xθ that move and rotate the positions of the ultrasonic probe. It is composed of a stage 114. The piezo element group 2 is composed of one or a plurality of elements that emit intense therapeutic ultrasonic waves. At the time of treatment, the applicator 110 is placed on the body surface of the patient 103, and the coupling film 105 is brought into contact with the skin using an ultrasonic jelly (not shown) or the like. Then, after the focal point 106 of the intense ultrasonic wave is made to coincide with the affected area 107, the driving circuit 109 drives the piezo element group 102 to irradiate the focal point 6 with the intense ultrasonic wave.

The movement of the applicator 101 is performed by controlling the mechanical arm 111 through the system controller 119 based on the information input by the operator from the console 120 and the auxiliary input device 118. It is also possible to scan / treat the treatment range on the affected area image acquired in advance according to a fixed procedure (Japanese Patent Laid-Open No. 05-
(See Japanese Patent Publication No. 49551). For the image of the affected area, the ultrasonic diagnostic apparatus 115 is used here, and a signal obtained by transmitting and receiving ultrasonic waves with the ultrasonic probe 108 is used as the ultrasonic diagnostic apparatus 115.
And reconstruct it as a B-mode image or a 3D image
It is displayed on the RT display 117.

The movement of the ultrasonic probe 108 is performed by controlling the Zθ stage 113 and the Xθ stage 114 by the stage controller 112. Further, in order to keep the degree of degassing of the coupling solution 104 in the applicator 101 constant and prevent the body surface and the piezo element group 102 from generating heat, the water treatment circuit 121 uses the coupling solution 1
The deaeration process of 04 and cooling are performed.

Next, the moving mechanism of the applicator 101 will be described. 6A and 6B are views showing the positional relationship between the piezoelectric element group 102 and the ultrasonic probe 108 for explaining the moving mechanism, where FIG. 6A is a side view and FIG. 6B is a top view.

The feature of this embodiment is that the focus position 10 is mechanically adjusted.
It is that the ultrasonic image can always be monitored in real time from the same position when 6 is moved. That is, in the conventional device, the ultrasonic transducer is moved at the same time when the applicator is normally moved, so that it is not possible to always monitor in the same situation. On the other hand, in the present embodiment, when the piezo element group 102 moves from the solid line to the broken line position, the Zθ stage 113 and the Xθ stage 114 are controlled by the stage controller 12, and the position / slice direction of the probe 8 (in this figure, It is possible to move the piezo element group 102 without changing the plane direction of the ultrasonic B-mode image. This makes it possible to acquire images at the same position during treatment, so the position, size, and state of the tumor should be confirmed in advance on the image, and the changes between that image and the image during irradiation should be imaged. It is possible to easily confirm how far the treatment is progressing.

FIG. 7 shows another example of a system (applicator section) for performing treatment by scanning the focal point 106 within the affected area 107 without changing the position / tomographic direction of the ultrasonic probe. (A) is an XYZ stage 122, (b) is Zθ
By using the φ stage 123, the ultrasonic probe 1
Cautery treatment of the affected area is possible without moving the position 08 and the direction of the fault at all.

(Embodiment 3) FIG. 8 is a block diagram showing the structure of another embodiment according to the first aspect of the present invention, except that the piezoelectric element group 102 has a two-dimensional array structure.
Is the same as. In this embodiment, for example, USP-4,52
Similarly to 6 and 168, the focus position is scanned by controlling the drive phase of each element of the piezo element group 102. Also in this embodiment, the ultrasonic probe 108 is moved in the same manner as described above.
It is possible to move the position of the focal point 106 of the intense ultrasonic wave without rotating it.

Next, referring to FIG. 9, an image display method on the CRT display 117 during treatment in this embodiment will be described. First, the ultrasonic B-mode image 1 on the left side of FIG.
In FIG. 26, the affected part (tumor) 107 is sliced and displayed substantially perpendicular to the ultrasonic wave incident direction. From the results of experiments conducted by the inventors, it is known that the region that is heat-denatured by ultrasonic heating has a large change in acoustic characteristics compared to the surrounding normal tissue, and the heat-denatured region is closer to the front than the focus. If so, it is possible that not enough acoustic energy will propagate thereafter. Therefore, it is considered necessary to sequentially perform irradiation from the back of the tumor mass during treatment. Therefore, the slice thickness is determined to be approximately the same size in consideration of the focus size in the depth direction of the ultrasonic wave, and in this case, the slice is divided into four sections from "1" to "4" from the deepest one. However, the irradiation order is also displayed so as to follow this order.

On the right side of FIG. 9A, the ultrasonic addition C mode image 127 of each section is displayed. Addition C
The mode image is image information of a section having a certain thickness, that is, an image obtained by adding reflection signals returned from the section in the thickness direction. As a result, it is possible to intuitively understand the cross section as a plane, and it is possible to display by emphasizing more by adding the high echo part of the modified region. In this figure, section "3" is currently being irradiated, and that fact is clearly displayed. The point 125 currently irradiated is displayed in a different color in the cross section.

In the display example of FIG. 9A, "irradiating" is displayed beside the section being irradiated, but only the section being irradiated is displayed in a different color in each sectional image. Instead of clearly indicating the irradiation point 125 by a different color, for example, blinking display can be performed.

Further, as shown in FIG. 9B, in order to grasp how far the irradiation is currently progressing in the image being irradiated and how many unirradiated areas exist, the irradiated area / unirradiated area / It is also possible to clearly display the area 125 currently being illuminated by color.

Further, instead of displaying the B-mode image as shown in FIGS. 9A and 9B, an ultrasonic three-dimensional image is displayed as shown in FIG. Stereoscopic enlarged image 129 of the section No. 1 and its addition C mode image 1
By displaying 27 together, it is possible to provide a more visually recognizable image interface. Then, it is possible to input the contour and size of the tumor on this image using the auxiliary input device 118 such as a mouse or a light pen, and proceed with the treatment based on the information.

As described above, according to the first aspect of the present invention, it is possible to perform accurate monitoring by the image diagnostic apparatus during the intense ultrasonic irradiation treatment. Furthermore, because the position and time control during irradiation are optimized, unexpected side effects and expansion of the heat degeneration region are suppressed, and heat degeneration can be accurately induced at the targeted site, so it is safe and reliable. Ultrasonic heating treatment can be realized.

(Embodiment 4) FIG. 10 is a block diagram showing a structure according to an embodiment of the second invention. In this embodiment, a magnetic resonance imaging apparatus (MRI) is used as the image diagnosis apparatus, and an ultrasonic therapy apparatus is used as the treatment apparatus.

In FIG. 10, the static magnetic field magnet 201 is excited by the excitation power source 202 and applies a uniform static magnetic field in the z direction to the subject 203. The gradient magnetic field coil 204 is arranged in a static magnetic field magnet, is driven by a drive circuit 206 controlled by a sequence controller 205, and has magnetic fields in three directions of x, y, and z orthogonal to the subject 203 on the bed 207. Gradient magnetic fields Gx, Gy, and Gz whose strength changes linearly are applied. The high frequency coil 208 is a transmission / reception coil and is arranged in the gradient magnetic field coil 204.

Under the control of the sequence controller 205, the high frequency signal from the transmitter 209 is transmitted by the duplexer 2
The high-frequency magnetic field generated by the high-frequency coil 208 is applied to the high-frequency coil 2 on the bed 207.
08 is applied to the object 3 to be examined. High frequency coil 208
For example, a saddle type coil, a distributed constant type coil, or a quadrature transmission coil configured by using these can be used to generate a uniform high-frequency magnetic field in the region of the subject 203 to be imaged. When the treatment target is limited and a higher S / N ratio is desired, a surface coil may be used for transmission / reception or reception. If a surface coil is used for reception, a uniform coil is used for transmission.

The reception signal obtained by receiving the magnetic resonance signal from the subject 203 by the high frequency coil 208 is sent to the receiving unit 211 via the duplexer 210. The duplexer 210 is for switching and using the high frequency coil 208 for transmission and reception, transmits a high frequency signal from the transmission unit 209 to the high frequency coil 208 during transmission, and receives a reception signal from the high frequency coil 208 during reception. It acts to lead to 211.

The received signal is detected and band-limited by the low-pass filter, and then the sequence controller 205
Is sent to the data collection unit 212 under the control of. The data collection unit 212 collects received signals and performs A / D conversion, and sends the image reconstruction data to the electronic computer 213.

The electronic computer 213 is controlled by the console 214, performs image reconstruction processing including a two-dimensional Fourier transform on the image reconstruction data input from the reception unit 211, and also controls the sequence controller 205. The image data obtained by the electronic computer 213 is supplied to the image display 215 and is displayed as an image.

On the other hand, a piezoelectric element group (not shown) for generating focused ultrasonic waves is arranged in the ultrasonic applicator 216, and is attached to the subject 203 with a water bag (not shown). An independent drive circuit group 217 is connected to each element of the piezo element group, and a phase control circuit group 218 is further coupled to the drive circuit group 217. The drive circuit group 217 is the power source 21.
The voltage pulse whose intensity is determined by the potential of 9 is applied to each element of the piezo element group in response to the trigger from the phase control circuit group 218. Power supply 219 and phase control circuit group 218
Are controlled by the electronic computer 213. It is well known that when ultrasonic waves are transmitted using a piezo element, the focus position can be electronically moved three-dimensionally by controlling the drive phase of each element (for example, US Pat. No. 4,526). , 168). Thus, by generating a delayed pulse so that the focal point is focused on the treatment site, it is possible to sequentially treat the treatment site without moving the applicator 216.

Although the focus movement is electronically controlled here, it may be mechanically moved. When mechanically moving the focal point, the piezo element should be one spherical shell-shaped oscillator, drive a plurality of oscillators at the same time, or use the phase control circuit group 118.
May be fixed. Also,
The focus movement may be combined with electronic control and mechanical control. For example, electronic control may be performed in the depth direction, and the piezo element may be mechanically translated in the azimuth direction.

Next, a method of detecting movement between images using the spatial frequency data in this embodiment will be described.

First, the case where the impulse response is used will be described. If an object moves between a plurality of images, the image after the movement is equivalent to the image before the movement, which is obtained by convolving and integrating the impulse moved by the motion vector. Figure 11
The image signal will be described with one line. Figure 11
When (a) is the original image f (x) and FIG. 11 (c) is the moved image g (x), (c) replaces the motion vector in (a) with the deviation from the center (0). 11B is equivalent to the impulse h (x) shown in FIG. This relationship is expressed by the following equation.

G (x) = f (x) * h (x) (1) h (x) = σ (x−a) * represents a convolution integral, and σ (x) represents a delta function.

Therefore, FIG. 11B is obtained by calculating the impulse response between the two images of FIGS. 11A and 11C, and the shift from the center of this peak becomes the motion vector. An MRI image is generally obtained by acquiring spatial frequency data, which is a magnetic resonance signal, and performing a Fourier transform on the spatial frequency data. Therefore, after the data acquisition, before the reconstruction, 2
The motion vector can be detected by calculating the quotient (that is, the transfer function) of the frequency data of one image and reconstructing it.

For both sides of equation (1), g (x) → G
(Kx), h (x) → H (kx), f (x) → F (k
x () is Fourier transformed into G (kx) = F (kx) · H (kx) (2) ∴H (kx) = G (kx) / F (kx) (3), and the transfer function H (kx) of The impulse response h (x), which is the inverse Fourier transform, can be easily calculated. For specific calculation of the transfer function, a Wiener filter, an adaptive filter, an optimum filter, etc. are used in addition to simple division for each frequency.

Next, the case where the cross-correlation function is used will be described below. When the cross-correlation function of two images is calculated, it has a peak at the position where the two images have the highest correlation, and thus the motion vector can also be calculated from this. Two
The cross-correlation function w (x) of two images f (x) and g (x) is

[0128]

[Equation 1] Is. As is clear from this equation, a that maximizes W (x) is the motion vector. Also in this case, the following (5)
The cross-correlation function can be calculated by calculating the product of two image data in the frequency domain as in the formula and taking the inverse Fourier transform.

W (kx) = F (kx) · G (kx) (5) In the case of such processing in the frequency domain, a window is applied to reduce the influence of discontinuity at the edge of the image. Is also necessary. Here, for simplification, the description is made in one dimension, but in two dimensions or three dimensions, the motion vector can be calculated from the collected spatial frequency data.

In the case of adapting to the temperature distribution measurement, particularly in the case of the phase mapping method of chemical shift temperature measurement, this is a method in which the temperature change is reflected in the phase information of the image, and the absolute value image shows the morphology. An absolute value image is used for detection, and the difference is calculated between the phase images whose positions have been corrected based on this.

FIG. 12 schematically shows a method of detecting a motion from data obtained by MRI, correcting the motion and calculating a difference. (A) and (b) are the collected spatial frequency data. Calculate the transfer function (c) between them,
Reconfigure (a), (b), and (c) as in (d), (e), and (f). Then, (d) and (e) are moved by the motion vector obtained from (f) to calculate the difference. For example, when (a) is an image obtained before ultrasonic irradiation and (b) is an image obtained during ultrasonic irradiation, the difference between the two is calculated, and the change (h) due to the temperature change is drawn.

Next, a treatment procedure using this motion detecting function will be described with reference to the flowchart shown in FIG. First, the case of using the phase mapping method of chemical shift temperature measurement will be described.

First, a three-dimensional high-definition image is taken by MRI before treatment (step S201), a treatment site is set on this image, and a treatment plan is prepared (step S20).
2). Immediately before the treatment, the patient is placed in the gantry (step S203), and a three-dimensional image for alignment is captured (step S204). Next, a positional shift between the three-dimensional image obtained in step S203 and the treatment plan image obtained in step S201 is detected (step S205), and whether the amount of the shift is less than a threshold value. (Step S206), if it is equal to or more than the threshold value, it is determined that the position is displaced, the motion vector is detected using the motion vector detection method, and the displacement is corrected using this motion vector ( Step S207).

If it is determined in step S206 that the position is not displaced, or if the displacement is corrected in step S207, an initial image of the temperature distribution (three-dimensional) is taken immediately after that, and the continuous image is continuously recorded. The measurement of various temperature distributions (the morphological image is also acquired at the same time) is started (step S208), and these image data are stored in the memory (step S20).
9). While obtaining this image, the motion vector for the initial image or the previous image is detected (step S210), and at the same time, the image is reconstructed (step S211). After moving the position of the subsequent image so as to cancel the movement, the difference between the phase images is calculated (step S212) to obtain the temperature distribution image.

On the other hand, ultrasonic irradiation for treatment is performed independently of MRI imaging. That is, N focus positions are sequentially set (steps S214 to S216 → S220), and ultrasonic irradiation is performed (step S221). After the treatment of all the set focal positions is completed, MRI imaging is performed (step S217). When a sufficient therapeutic effect is confirmed in the planned treatment site (step S218), the treatment is terminated (step S219). At this time, the coordinate reference is changed from time to time by the information of the motion vector obtained in step 210 from the MRI side (step S221). Further, the heating position (hot spot) can be detected from the temperature distribution obtained during ultrasonic irradiation. If the hot spot is displaced from the planned treatment area, the ultrasonic irradiation side is controlled to correct it.

When a hot spot is observed by detecting an image change due to the temperature of the T1-weighted image (T1: vertical relaxation time), the treatment can be performed in the same manner, but the image for which the difference is taken is the absolute value image. That is different. Further, in the case of a T1-weighted image, a position where the intensity of the image signal changes from a threshold value given in advance may be detected as a hot spot without calculating the difference. In this case, the motion vector information is used only for correcting the ultrasonic wave irradiation position.

FIG. 14 is a schematic diagram showing the temporal flow of motion correction based on the initial image and FIG. 15 is based on the previous image. In FIG. 14 and FIG. 15, a time table of one irradiation is performed when irradiation for the first time is performed so as not to damage the tissue, and the hot spot is confirmed to be at the planned treatment site and the therapeutic irradiation is performed. Shows. In FIG. 14, the movement relative to the reference image is always detected, and the temperature change from the reference image is measured. In FIG. 15, the movement with respect to the immediately preceding image is detected, and the change in the temperature with respect to the immediately preceding image is also measured. Therefore, the movement is performed on the immediately preceding image, and the cumulative temperature distribution is calculated for the temperature change. In such a case, in order to reduce the cumulative error, for example, once every 10 times of imaging, the movement of the image with respect to the initial image is detected and the coordinates are corrected.

As described above, according to the second aspect of the present invention, in the treatment apparatus using the image diagnostic apparatus, the motion vector is detected at a higher speed than the conventional one from the spatial frequency data continuously obtained by MRI. The error of the difference image is reduced in real time, and the coordinate shift due to movement is reduced.
Safe and accurate treatment becomes possible.

(Embodiment 5) Next, an embodiment of the third invention will be described. The basic configuration of the apparatus of this embodiment is the same as that of the fourth embodiment shown in FIG.

FIG. 16 shows a sequence in which the temperature of a point is measured in real time by chemical shift temperature measurement by local excitation according to this embodiment. RF is a high frequency pulse, Gx, Gy,
Gz is a gradient magnetic field, and daq is a data acquisition period. Here, spin echo is applied, and one-shot local excitation on the xy plane and normal selective excitation in the z direction are used for local excitation to locally excite a point (strictly speaking, a cylindrical shape). However,
Even if such gradient magnetic field control is not performed, only one desired echo signal can be obtained by slicing in each of the x, y, and z directions as shown in FIG. In these cases, the data acquisition is completed in one sequence execution without using the read and encode gradient magnetic fields. As data, the signal intensity in the excited voxel is observed. Here, when the one-dimensional Fourier transform is performed, the spectrum is observed, so that the spectrum intensity of water can be more selectively observed. The temperature measurement at this point is the phase mapping method of chemical shift temperature measurement (Y. Ishihara et al .: Proc.
11th Ann. SMRM Meeting, 4803, 1992), the difference between the phase data of the obtained signal and the phase data of the reference data may be calculated.

The following is a description of the treatment procedure using this temperature measurement, in which one of a plurality of treatment points set during the treatment planning is treated. A schematic diagram of this temporal flow is shown in FIG.

First, for example, a three-dimensional image of the temperature distribution when weak heating is performed to such an extent that the tissue is not affected (C
1) Check the heating area (hot spot) in advance, and confirm the deviation from the set position, and set the local excitation point to the maximum heating point or the area that exceeds the preset temperature threshold. Set (C2). This threshold is determined from the temperature at which tissue is affected by high-power therapeutic high-intensity ultrasound irradiation. The process steps at this time are shown in FIG. When the temperature distribution as shown in FIG. 22 (a) is obtained, only the portion equal to or higher than the threshold value is extracted as shown in FIG. Extract as in (c). Here, the temperature measurement site is determined from the temperature distribution image, but the operator may specify a site to be temperature monitored, such as a treatment site or a site that should not be heated, from a separately obtained morphological image.

Next, therapeutic high power irradiation is performed, and at the same time, chemical shift temperature measurement is performed at the temperature measurement point set in C2 (C3). Then, when the expected temperature rise is obtained at the desired portion, irradiation is continued (C4 →
C5) If the temperature rise is not sufficient, there is a risk of focus shift, so irradiation is stopped (C4 → C6) and an alarm is issued. For a region that is not desired to be heated, a threshold value is set to the upper limit of the temperature at which the temperature does not damage the tissue, and when the temperature is exceeded, the treatment is stopped and an alarm is generated.
Then, the same treatment is applied to the next focus.

The measured temperature is displayed as a temperature change with time on the sub-windows 221 and 222 on the display (for example, the image display of FIG. 10) as shown in FIG. 18, and the measured position is shown on the main window. It is indicated by an arrow in the morphological image. When the temperature graph exceeds the dangerous temperature or the temperature rise is abnormal, the temperature is displayed in different colors to notify the operator of the abnormality. Further, the position shape 22 of the ultrasonic transducer is included in the morphological image.
3 and the geometric focus 224 may be superimposed and displayed. Furthermore, the temperature distributions obtained at the time of irradiation with weak ultrasonic waves may be displayed in an overlapping manner or may be switched and displayed.

Next, the case where the treatment is performed while measuring the one-dimensional temperature distribution on the ultrasonic irradiation axis at high speed will be described. The sequence at this time is shown in FIG. Here, a case is shown where local excitation is performed twice in the x and y directions and only one line on the z axis is excited. A field echo sequence is used as the sequence, and z is used for reading in the z-axis direction.
Obtain a one-dimensional temperature distribution in the axial direction. During actual use, the excitation direction is set using the oblique imaging method so as to match the irradiation direction (on the irradiation axis). At this time, the vector directions of the first excitation, the second excitation, and the read gradient are all orthogonal to each other.

Further, the case of treating one of a plurality of treatment points set at the time of treatment planning in the treatment procedure using the temperature measurement will be described. A schematic diagram of this temporal flow is shown in FIG.

First, a three-dimensional image of the temperature distribution when weakly heated to such an extent that the tissue is not affected is taken (C1),
Check the heating area (hot spot) in advance to confirm the deviation from the set position, and further check the local excitation line for the maximum heating point, or for the area (s) where the preset temperature threshold is exceeded. It is set to include (C2). The setting procedure at this time is the same as in FIG. As with the point temperature measurement, the operator may specify the line to be monitored.

Next, therapeutic high power irradiation is performed, and at the same time, chemical shift temperature measurement is performed on the temperature measurement line set at C2. Here, the spatial frequency data obtained after one-time excitation is subjected to one-dimensional Fourier transform (C
3) Calculate the one-dimensional temperature distribution (C4). Then, when the expected temperature rise is obtained at the desired portion, the irradiation is continued (C5 → C6), and when the temperature rise is not sufficient, the irradiation may be stopped (C5 → C6) because there is a risk of defocusing.
7) Generate an alarm. For a region that is not desired to be heated, a threshold value is set to the upper limit of the temperature at which the temperature does not damage the tissue, and when the temperature is exceeded, the treatment is stopped and an alarm is generated. Hereinafter, the same treatment is performed for the next focus.

Then, the representative points of the temperature distribution measured at C4 are displayed as shown in FIG. Alternatively, as shown in FIG. 21, the temperature distribution may be displayed again on the morphological image on the main window each time the temperature is measured by changing the color and superimposing. In this case, the planned heating profile is displayed in a different color or with a dotted line, and an alarm is generated when there is a deviation from that. The temperature distribution may be displayed by displaying the measurement line in the main window and displaying it in the sub-window indicated by the arrow.

The morphological image shown so far may be an image obtained before the treatment or an image obtained after the heating of one heating point is completed.

Further, the temperature obtained during the treatment irradiation in the same treatment sequence may be used as a control for the ultrasonic irradiation. For example, as shown in FIG. 26, the temperature change expected from the irradiation conditions is compared with the actually measured temperature by discriminating the difference between the two (C1), and the ultrasonic irradiation power is adjusted so as to eliminate this difference. Control (C2). example,
For example, if the measured temperature is lower than the set temperature, the irradiation power may be controlled to increase.

Next, a method of simultaneously performing temperature monitoring and confirmation of the therapeutic effect will be described.

Here, the temperature measurement is performed by points or lines, and relaxation time emphasis data is acquired almost at the same time. Regarding T2 (transverse relaxation time) enhancement, temperature measurement is continuously performed at points or lines during ultrasonic irradiation, and when the temperature after irradiation returns to a normal temperature, a T2-weighted image is acquired and the next irradiation starts immediately. . At this time, when obtaining the T2 weighted signal, the treatment time can be shortened by measuring the T2 weighted signal at the scheduled treatment point using the local excitation instead of the image in the procedure as shown in FIG. it can. At this time, since the relaxation time also changes when the temperature rises, this may be corrected by the temperature obtained by the chemical shift temperature measurement. By doing so, the temperature monitor and the treatment effect can be confirmed at the same time.

After irradiation of weak ultrasonic waves as shown in FIG.
After measuring the image or temperature and confirming the position and temperature, if there is no abnormality, immediately apply strong ultrasonic waves to reduce the time lag between checking and actual treatment irradiation. Positional shift can be reduced.

Regarding the longitudinal relaxation time T1, if a field echo is used during temperature measurement, the absolute value image is T1.
An enhanced image can be obtained at the same time. Since it is known that the relaxation time T1 also changes due to denaturation, the temperature of a point or line is measured during the irradiation of therapeutic ultrasonic waves,
The therapeutic effect is also determined from the absolute value image of the temperature distribution measured during the irradiation of the weak ultrasonic wave before the irradiation of the next focus.

FIG. 24 shows a sequence in which temperature measurement and T1 and T2 weighted images are acquired in the same sequence.
0 is shown. This is CPMG (Carr-Purcell-Meiboom-Gil
l) A sequence is applied, and a signal of a plurality of echo times can be obtained by using a 180 ° pulse a plurality of times after locally exciting one point. For example, from the phase of the signal obtained at a short echo time TE1. The T1 weighted signal is obtained from the temperature and the absolute value, and the long echo time T
A T2-weighted signal is obtained from the absolute value at E2.

Also in this case, the T1 and T2 emphasized signals may be corrected from the temperature. As a result, the temperature can be monitored and the therapeutic effect can be confirmed with a single excitation. Repeat time TR at this time
And shorten the 90 ° pulse to a pulse with an Ernst angle,
The temperature may be measured by a field echo and then a 180 ° pulse may be applied to acquire the T2W signal.

In the fifth embodiment, the pin echo sequence and the field echo sequence are used as the MRI pulse sequence, but other sequences can be similarly used if they include local excitation. In addition, in Example 5, ultrasonic waves were used as therapeutic energy in order to particularly treat a deeply affected area. A laser is used when a large amount of energy is required to be applied at one time, and a microwave is used when an energy is applied to a wide area. It is possible to perform heat treatment by appropriately using, for example, and the present invention can be applied to all temperature monitors at this time.

As described above, according to the third aspect of the present invention, in the therapeutic apparatus using the magnetic resonance diagnostic apparatus, the temperature measurement at a necessary point of the temperature monitor obtained in advance using the local excitation method is performed in real time. Therefore, it is possible to provide a safe treatment device capable of detecting an abnormality during irradiation.

(Embodiment 6) Next, an embodiment of the fourth invention will be described. The basic configuration of the apparatus of this embodiment is the same as that of the fourth embodiment shown in FIG.

In this example, a procedure for performing treatment while measuring the one-dimensional temperature distribution on the ultrasonic irradiation axis at high speed will be described. Here, the irradiation axis is an axis connecting the center of the spherical surface of the spherical shell-shaped ultrasonic vibrator and the center of the vibrator. The pulse sequence at this time is shown in FIG. Here, a case is shown in which local excitation is performed twice in the x and y directions and only one line of the z axis is excited. A field echo sequence is used as the pulse sequence, and the z-axis lead is used to read z.
Obtain a one-dimensional temperature distribution in the axial direction. During actual use, the excitation direction is set using the oblique imaging method so as to match the irradiation direction (on the irradiation axis). At this time, the vector directions of the first excitation, the second excitation, and the read gradient are all orthogonal to each other.

Regarding the detection and control of the position and irradiation axis direction of the ultrasonic applicator 216, there are a case where the position and the irradiation axis direction are controlled by the electronic computer 213, and a case where the operator controls them through the electronic computer 213. It is divided into the case where the operator directly moves the applicator.

First, FIG. 28 shows a control flow in the former case. The electronic computer 213 sets the position and angle of the applicator 216 as previously determined at the time of treatment planning and sets the sequence controller 205 and the applicator drive system 231.
And calculate the ultrasonic irradiation axis accordingly. The imaging condition is determined so as to include the axis, and the temperature is measured during heating.

Further, the treatment procedure at this time will be described below by exemplifying a case where one of a plurality of treatment points set at the time of treatment planning is treated. Further, this temporal flow is the same as that of FIG. 20 used in the fifth embodiment.

Referring to FIG. 20, first, the temperature distribution when the weak heating is performed to the extent that the tissue is not affected is three-dimensionally imaged (C1), and the heating site (hot spot) is previously determined. Confirm and confirm the deviation from the set position, and further set the local excitation line so as to include the maximum heating point or a plurality of sites that exceed a preset temperature threshold value (C2). . The setting procedure at this time is shown in FIG.
The same as in 2. At this time, imaging may be performed on a plane including the axis already aligned with the irradiation axis or the multi-slice thereof.

Next, therapeutic high power irradiation is performed, and at the same time, chemical shift temperature measurement is performed on the temperature measurement line set at C2. Here, the spatial frequency data obtained after one-time excitation is subjected to one-dimensional Fourier transform (C
3) Calculate the one-dimensional temperature distribution (C4). Then, if the expected temperature rise is obtained at the desired site (C5 → C6), the irradiation is stopped (C5 → C6), and if the temperature rise is not sufficient, the irradiation may be stopped (C5 → C6).
C7), an alarm is generated. For a region that is not desired to be heated, a threshold value is set to the upper limit of the temperature at which the temperature does not damage the tissue, and when the temperature is exceeded, the treatment is stopped and an alarm is generated. Hereinafter, the same treatment is performed for the next focus.

Then, of the temperature distribution measured at C4, representative points are displayed as shown in FIG. Alternatively, as shown in FIG. 21, the temperature distribution may be displayed again on the morphological image on the main window each time the temperature is measured by changing the color and superimposing. In this case, the planned heating profile is displayed in a different color or with a dotted line, and an alarm is generated when there is a deviation from that. The temperature distribution may be displayed by displaying the measurement line in the main window and displaying it in the sub-window indicated by the arrow.

Next, a case where the operator controls the applicator 216 via the electronic computer 213 will be described.
As shown in FIG. 29, first, the operator inputs the position and angle data to the electric potential calculator 213 from the keyboard 231 or the morphological image displayed on the display by the electronic calculator 213 and the computer graphics of the ultrasonic applicator 216 (both. Based on the (pseudo three-dimensional image), the applicator in the image is moved to the mouse 232 or the 3D pointer 23.
3. When moving using the keyboard 231, the position and angle data at that time are fed back to the imaging conditions of MRI, and the temperature distribution of the line and surface including the irradiation axis is collected. Note that a three-dimensional display or the like may be used for actual three-dimensional display.

Next, a case where the operator directly moves the applicator 216 will be described.

FIG. 30 shows the configuration of a hand probe type ultrasonic therapeutic applicator using an MRI monitor. Here, an open type MRI magnet 300 is used. Encoders 301, 302 and 303 are rotation detection type encoders, and encoders 304, 305 and 306.
Is a translation detection type encoder, which enables rotation and movement of the translation meter with 6 degrees of freedom. When the operator grasps the grasping portion 307 and aligns the grasping portion 307 with the affected area, signals from the respective encoders 301 to 306 can be sent to the computer to constantly calculate and grasp the position and angle of the applicator 216. MR of these position and angle data
It is fed back to the imaging condition of I and the data of the line including the irradiation axis or the surface is collected. In the case of line data acquisition, a pulse sequence as shown in FIG. 27 is used, and in the case of a surface, a normal MRI two-dimensional imaging pulse sequence is used.

Although an encoder is used to detect the position and angle of the applicator 216 here, an optical gyro may be used instead of the encoder. A schematic diagram in this case is shown in FIG.
It is shown in FIG. The positions of two points of the applicator 216 are measured by the optical gyros 311 and 312. The position information is sent to the electronic computer 213, and MRI imaging suitable for the position is performed.

It is also possible to detect the position and angle using a television camera. FIG. 32 shows a schematic diagram of the detection method at this time. Here, cameras 323 and 324 are installed in two directions, and self-lighting pointers 321 and 322 such as LEDs are provided in the applicator. Light from these pointers 321 and 322 can be emitted from two directions. It is possible to measure, calculate the position of the three-dimensional pointer from the positions of the cameras 323, 324, and calculate the position and angle of the applicator 216.

At this time, a display such as a liquid crystal display which is not easily affected by the magnetic field is placed in a shielded room at a position where the operator can see it while operating it, and a morphological image of the surface including the irradiation axis and a temperature distribution image are placed there. Is displayed. The morphological image at this time may be constructed from previously obtained three-dimensional image data, or images on the same plane may be collected alternately or simultaneously with the temperature distribution. Alternatively, the morphological image may display three-dimensional data as a pseudo three-dimensional image, and a two-dimensional or one-dimensional temperature distribution image may be superimposed and displayed therein.

The operator operates the mouse 23 as shown in FIG.
When the treatment is performed interactively by controlling the input device such as the 2, 3D pointer 233 or the applicator 216, a switch is installed in the input device or the applicator 216. Then, first, morphological images are continuously acquired in real time on the surface including the irradiation axis, and the morphological image and the planned heating site are displayed in an overlapping manner. The applicator 216 or the input device is moved so that the planned treatment site (affected part) and the planned heating site are aligned with each other. When a match is confirmed, the switch is operated and ultrasonic heating is performed with a very weak intensity to such an extent that tissue is not damaged.
The temperature distribution is measured at the same time under the control of the electric potential calculator 213, and it is determined whether or not the heated portion in the measured temperature distribution coincides with the planned portion by using the electronic calculator 213, and the electronic calculator 213 automatically controls the strength. Immediately apply ultrasonic waves.

However, since the positional deviation occurs three-dimensionally, when the two-dimensional or one-dimensional imaging is performed, the positional deviation may occur in the slice direction. At this time, know the temperature rise with respect to the irradiation power in advance, and if it does not reach this, it is judged that the position shift has occurred, the temperature is similarly measured in another slice, and the slice direction is compared with this. Know the maximum heating position of. Alternatively, multi-slice imaging may be performed to detect a three-dimensional positional deviation. Further, although it may be orthogonal or simply intersect, the temperature distributions of a plurality of screens may be imaged, and the slices including the maximum temperature rise points in the respective planes may be imaged again.

The operator may confirm the coincidence between the heated region and the planned treatment region, and the intense ultrasonic wave may be manually irradiated by another switch, or the planned heating region and the heating region at the time of weak heating. If it can be confirmed by computer, strong ultrasonic waves may be automatically emitted. Alternatively, a phased array may be used for the piezo element, and the deviation at this time may be electronically corrected by phase control.

Further, in this embodiment, ultrasonic waves are used as the treatment energy in order to particularly treat the deep affected area. However, if a large amount of energy is required to be applied at one time, a laser is used. Can also perform heat treatment using microwaves and the like, and the method of this embodiment can be applied to all temperature monitors at this time. At this time, the temperature of the surface including the irradiation axis may be measured even with a laser, for example.

As described above, according to the fourth aspect of the present invention, in the treatment apparatus using the magnetic resonance diagnostic apparatus, the temperature information of the part corresponding to the treatment position can be constantly obtained at high speed, and the treatment efficiency and safety can be improved. High treatment is possible.

(Embodiment 7) FIG. 33 is a diagram showing the structure of an embodiment according to the fifth invention. In the figure, an ultrasonic applicator 401 is composed of a piezo element 402, an ultrasonic probe 40 for imaging and a flexible water bag 404 inserted and arranged in the center thereof. As shown in the figure, the applicator 401 is a propagation medium 40 of acoustic energy made of a substance whose acoustic impedance is close to that of a living body in order to treat a treatment target 406 in the body of a patient 405.
The patient 405 is abutted via 7 (for example, water).

The piezo element 402 is driven by the drive circuit 408. The drive circuit 408 is connected to the control circuit 409, and adjusts the drive voltage of the piezo element 402 by a control signal from the control circuit 409. Drive circuit 40
There are two output terminals 8 and they are independent of each other, but output the same signal. One output terminal of the drive circuit 408 is connected to one input of the piezo element 402 and the received wave detection circuit 410, and the other output terminal is connected to the other input of the received wave detection circuit 410.

The received wave detection circuit 410 detects the reflected ultrasonic signal from the treatment target 406 which is superimposed on the drive voltage. Level detection circuit 411 and phase shift detection circuit 412
Detects the level and phase of the reflected wave signal from the received wave detection circuit 410, and outputs these information to the control circuit 409.
Output to.

In this embodiment, the in-vivo image acquired by the diagnostic ultrasonic probe 403 and the ultrasonic diagnostic apparatus 413 and the information on the change of the treatment area from the control circuit 409 are transferred to the digital scan converter (DSC) 414. It is displayed on the CRT display 415 via.

Next, the operation of the present embodiment will be described by taking an ablation treatment using strong ultrasonic waves as an example.

The present embodiment is characterized in that the change in the treatment area is detected in real time by the intense ultrasonic waves for treatment emitted from the piezo element 402 toward the treatment object 406. Due to the therapeutic ultrasonic waves radiated from the piezo element 402 toward the focal point, the temperature in the focal region is 60 degrees Celsius in a few seconds.
Raise to ~ 80 ° C. As a result, the living tissue in the focal region undergoes thermal denaturation and dies. After that, when the irradiation of ultrasonic energy is further continued, the heat-denatured region expands. Since the acoustic characteristics of this heat-denatured necrotic living tissue are different from those of normal cells, ultrasonic waves are reflected at the interface between the heat-denatured portion and normal tissue. Also, the absorption coefficient of ultrasonic energy in the heat-denatured region is different from that of normal cells.

Therefore, as described below, by detecting the reflected wave from the vicinity of the heat-denatured region and measuring the amplitude thereof, it is possible to know whether or not there is a change (heat-denatured state) in the treatment region. Furthermore, even in a situation where the heat-denatured region expands, it becomes possible to monitor it by detecting the phase shift of the reflected wave with time.

The ultrasonic waves reflected near the heat-denatured region propagate to the applicator 410 side and reach the piezo element 402. After that, the piezoelectric element 402 is vibrated, and the ultrasonic energy is converted into electric energy by the piezoelectric element 402. In general, since the electric energy of reflected ultrasonic waves is smaller than the driving electric energy of the piezo element 402, it is difficult to detect the reflected ultrasonic components.

Therefore, in this embodiment, only a reflected wave signal component is detected by applying a signal that cancels the drive signal, which is an electric signal, to the input side of the received wave detection circuit 410. The principle will be described with reference to FIG. FIG. 34 shows
Piezo element 2, drive circuit 408 and received wave detection circuit 4
It is a figure which shows 10 roughly. There are two output stages of the drive circuit 408, and separate elements, which are transistors 431 and 432 in this example, are used. Of course, the output element may be an IC such as an operational amplifier, or another semiconductor element such as a thyristor, and in short, the output element may be configured so as not to affect the input stage.

A piezo element 402, which is a load, is connected to the collector side of the transistor 431. The same signal is input to the transistors 431 and 432, and the same signal as the drive signal applied to the piezo element 402 can be taken out from the collector of the transistor 432. A signal in which the reflected wave signal component from the vicinity of the heat-denatured region is superimposed on the drive signal appears at the collector of the transistor 431.

The signals from the collectors of the transistors 431 and 432 are input to the received wave detection circuit 410,
The difference signal is detected by the differential amplifier 433. The differential amplifier 433 detects the difference signal and at the same time amplifies it to output a signal component in which the drive signal component is canceled, that is, a reflected wave signal component.

The magnitude of the reflected wave signal component detected by the received wave detection circuit 410 in this way is determined by the level detection circuit 4 of FIG.
11, the control signal is supplied to the drive circuit 408 by the control circuit 407 when it is equal to or more than the threshold value, and the irradiation of the therapeutic ultrasonic wave from the piezo element 402 is immediately or for a fixed time. Stop later. The time width from when the level detection circuit 411 determines that the magnitude of the reflected wave signal component is equal to or larger than the threshold value until the irradiation of the therapeutic ultrasonic wave is stopped can be set using the input unit 416. For example, when it is desired to expand the heat-denatured region to some extent, this time width may be lengthened. The threshold given to the level detection circuit 411 can be arbitrarily set by the operator using the input unit 416. In addition, it is possible to set the treatment procedure such as stopping the irradiation of therapeutic ultrasonic waves after the reflected wave above the threshold continues for a certain period of time, so that the therapeutic effect required by the operator can be obtained. .

As the treatment area expands, the applicator 401 is also applied to the boundary surface where a part of the therapeutic ultrasonic waves is reflected.
Since it shifts to the side, the time from the irradiation until the reflected wave is obtained is gradually shortened, and the phase shift of the reflected wave signal occurs. By detecting this phase shift by the phase shift detection circuit 412, it is possible to know the expansion of the heat-denatured region. Furthermore, by integrating this phase shift amount,
A measure of the amount of expansion of the heat-denatured region from the focus position can be obtained.
From this, it is possible to perform control such as stopping the irradiation when the expansion of the heat-denatured region exceeds a set value. Here, the phase shift detection circuit 412 is configured to convert the phase shift into a voltage and output the voltage, and can be configured by a well-known PLL circuit or a phase comparator.

In addition, the use of the present invention makes it possible to measure not only the heat-denatured state of the focal region but also the state of cavitation generation, the degree of temperature rise, and changes in the body surface. These are realized by comparing the amplitude change and phase shift of the reflected wave signal with those characteristic to them.

The change of the treatment target obtained as described above is superimposed on the in-vivo ultrasonic image acquired by the ultrasonic diagnostic apparatus and displayed on the CRT display 415 to notify the operator. As this display method, for example, a mark indicating a heat denatured area is displayed over the focus, and the size of the mark is changed according to the amount of movement of the denatured area to the applicator 401 side, or the body surface of the patient 405. It is also conceivable to use it for detecting an increase in temperature or denaturation in the device and issuing a warning.

(Embodiment 8) FIG. 35 shows a structure of another embodiment according to the fifth invention. Note that in FIG. 35, the ultrasonic probe 4 for imaging shown in FIG. 33 is used.
03, the ultrasonic diagnostic apparatus 413, the digital scan converter 411, and the CRT display 415 are abbreviate | omitted and shown.

In this embodiment, 2 of the received wave detection circuit 410 is used.
One input is connected to the piezo element 402, the drive circuit 408, and the memory 419 newly provided. In FIG. 35, a reflected wave signal for one wavelength or several wavelengths immediately after irradiation of therapeutic ultrasonic waves is converted into a digital signal by the A / D converter 418, and then stored in the memory 419.

Immediately after the irradiation of therapeutic ultrasonic waves, there is no heat-denatured region, so the signal at the electrical signal input end of the piezo element 402 is a composite signal of the drive signal and the minute reflected wave signal from the living tissue. . When the treatment progresses and the heat degeneration region appears, a change occurs in the reflected wave signal, which is detected to obtain information on the heat degeneration. As this procedure, the received wave detection circuit 410 having the configuration shown in FIG. 36 is used.

That is, as shown in FIG. 36, the drive signal (received signal) on which the reflected wave signal component received by the piezo element 402 is superimposed is first converted into a digital signal by the A / D converter 441. The signal stored in the memory 419 is adjusted by the phase and level adjustment circuit 442 according to the output and phase of the drive circuit 408 according to the control signal from the control circuit 409. Then, in the subtractor 443, A
The output signal of the phase / level adjustment circuit 442 is digitally subtracted from the output signal of the / D converter 441,
As a result, only the reflected wave signal component is extracted. The output signal of the memory 419 may be converted into an analog signal by the D / A converter 444, and then the difference from the analog signal from the piezo element 402 may be taken. The subsequent operation is the same as that in FIG. 33, the change in the amplitude and the phase shift of the reflected wave signal are detected, and the control ultrasonic wave is controlled by the control circuit 8 based on these information. Note that the output stage D in FIG.
By removing the A / A converter 444, the level detection circuit 411, the phase shift detection circuit 412 and the control circuit 4 of FIG.
08 may be configured by digitizing. In this embodiment,
Although the signal of one wave or several waves immediately after the irradiation of the therapeutic ultrasonic wave is acquired and stored in the memory 419, the drive signal waveform may be stored in advance in the memory 419 at the time of manufacturing.

(Embodiment 9) FIG. 37 is a diagram showing the configuration of another embodiment according to the fifth invention, which is an example in which a drive signal used in detecting a reflected wave signal is created by another oscillator. . In this embodiment, the output and phase of the oscillator 420 are controlled by the control circuit 409 so as to correspond to the magnitude and phase of the output of the drive circuit 408. This oscillator 420
It is the same as the seventh embodiment except that the difference between the output and the received signal is taken.

(Embodiment 10) FIG. 38 shows a structure of still another embodiment according to the fifth invention. In this embodiment, the applicator 401 uses the annular array ultrasonic wave generation sources 402a to 402f. The annular array ultrasonic wave generation sources 402a to 402f are configured by a plurality of piezo element groups, and are configured by being divided into a set of a plurality of concentric rings. Each ring can be driven independently, and the drive timing can also be controlled independently.

In this embodiment, the reflected wave signal detection method described in the seventh embodiment is applied to the annular array type ultrasonic wave generation source 402a.
.About.402f for each ring. Here, when the heat-denatured region is changed to the front, by calculating the phase shift for each ring, it is possible to quantitatively detect to what position the axis of the applicator 401 has been denatured. By controlling irradiation based on this data, safer and more reliable treatment becomes possible.

Further, by arranging the piezo elements in a two-dimensional array to construct a therapeutic ultrasonic wave generating source, it is possible to realize a focus moving type therapeutic apparatus utilizing the present invention.

As described above, according to the fifth aspect of the invention, by detecting and analyzing the reflected wave of the therapeutic ultrasonic wave from the treatment area, the ultrasonic treatment system enables real-time monitoring of the treatment area. Furthermore, by controlling the therapeutic ultrasonic waves based on the obtained information on the treatment area, safe and reliable treatment can be realized.

(Embodiment 11) FIG. 39 is a diagram showing the structure of an applicator according to an embodiment of the sixth invention. As the support body 501 for insertion into the body cavity, a flexible tube having a certain strength is used. For this reason,
The operator can freely adjust the inclination of the tip portion by the hand of the applicator.

A transducer 502a for emitting therapeutic ultrasonic waves,
502b are formed in semicircular shapes each having a concave shape and different sizes, and are fixed to the support body 501 so that the vibrator 502b can rotate relative to the vibrator 502a about the rotation axis 503. Has been done. Oscillator 5
Since 02a and 502b have a semicircular shape, the relative rotation changes the overlapping area of the transducer 502b with respect to the transducer 502a viewed in the ultrasonic wave transmission direction.

Leads for supplying drive signals to the vibrators 502a and 502b are not shown, but are connected to a drive circuit body (not shown) through the inside of the support 501. Also,
A flexible film 504 is attached to the support 501 in a watertight manner so as to cover the whole of the vibrators 502a and 502b, and degassed water or the like is discharged from an opening 505 of a tube (not shown) passing through the support 501. By supplying and draining the liquid for ultrasonic coupling, the size of the outer shape of the applicator can be adjusted. Further, by circulating this coupling liquid, it is possible to cool the body surface / vibrator surface.

FIG. 40 shows the applicator A-of FIG.
A'section is shown. As shown in FIG.
Although a and 502b have different concave radii of curvature, the oscillator 502b having a smaller radius of curvature is larger than the oscillator 502b having a larger radius of curvature.
The same geometric focus 506 is provided by arranging the same on the inner side of 02a by the difference in the radius of curvature.
Further, a rotation mechanism 507 for rotating and moving the vibrator 502b around the rotation shaft 503 is attached inside the support body 501, and the operator used, for example, a wire or the like provided at the hand of the support body 501. The rotating mechanism 507 can be operated by an operating mechanism (not shown). This structure is a technique known to those skilled in the art.

As shown in FIGS. 39 and 40, the applicator is inserted into the body cavity of the patient, for example, the stomach through the esophagus, with the transducer 502a overlapping the transducer 502b. In this state, the vibrator 502a and the vibrator 502b overlap each other, so that the maximum diameter of the applicator is reduced, so that the applicator can be easily inserted into the body cavity. Then, once the tip of the applicator reaches the inside of the stomach, the operator operates the rotation mechanism 507 by the above-mentioned operation mechanism to rotate the vibrator 502b by approximately 180 °, and the vibrator 502b is moved relative to the vibrator 502a. Figure 4 without overlapping
1 and the state shown in FIG. 42. In this state, the opening diameter of the transducers 502a and 502b as a whole is maximized, and the ultrasonic energy can be sharply focused to a deep portion. Further, at this time, the flexible film 504 does not interfere with the rotating vibrator 502b, and further increases the amount of coupling liquid inside in order to make sufficient contact with the patient.

Here, the radius of curvature of the vibrators 502a and 502b, that is, from the geometric focus 506 to the vibrators 502a and 50b.
The distances R1 and R2 to 2b are different, but the distance difference ΔR = R1-R2 is configured to be an integral multiple of the wavelength of the therapeutic ultrasonic wave. As an example, when 4 MHz is used as the ultrasonic frequency, the thickness of the vibrators 502a and 502b is about 0.5 mm when using a normal PZT. Although not shown, a space of 1 mm or more is required as a distance difference ΔR between the vibrators 502a and 502b for backing for holding the vibrators 502a and 502b and routing of electric wires. Further, assuming that the sound velocity of the coupling liquid is 1500 m / sec, the wavelength in the coupling liquid is 0.375 mm, so ΔR is an integer multiple of that, and is set to 1.875 mm which is, for example, 5 wavelengths. There is. Therefore, even if the oscillators 502a and 502b are simply electrically connected in parallel and connected to the same drive circuit,
The ultrasonic waves emitted from the oscillators 502a and 502b have the same phase at the geometric focus 506, and there is no significant problem in focus formation.

However, strictly speaking, the oscillators 502a and 502b are
Since the distance from the geometric focus 506 is different,
When the respective transducers 502a and 502b are taken into consideration from 06, the ultrasonic wave intensity per unit solid angle is slightly unbalanced (the transducer 502b is larger than the transducer 502a). In order to prevent this, for example, a method of dividing the drive voltage applied to each of the transducers 502a and 502b at an appropriate division ratio so that the ultrasonic intensity per unit solid angle on the drive circuit side becomes equal. You should take.

As described above, according to the embodiment, the geometric focus can be increased by making the maximum diameter of the applicator small when inserting into the body cavity and facilitating the insertion and increasing the opening of the entire vibrator during treatment after insertion. It becomes possible to perform efficient treatment by sharpening the focal point in (1) and generating strong ultrasonic waves only in the localized area.

(Embodiment 12) FIG. 43 is a block diagram of an ultrasonic therapy apparatus according to an embodiment of the sixth invention, showing the construction of an applicator and apparatus body particularly suitable for use with a laparoscope. ing.

In FIG. 43, the support 511 is a rigid cylinder, and an angle mechanism 512 capable of changing the angle at the tip of the applicator is constructed at the tip. Two sets of vibrators 513a and 513b are provided as in the eleventh embodiment, but in this embodiment, these vibrators 513a and 513b are flat plates and each surface is divided into a plurality (N pieces) of elements. It has a two-dimensional array structure.

The vibrators 513a and 513b are slidable in the lateral direction. When the vibrators 513a and 513b are inserted, they are completely overlapped with each other, and when the insertion is completed, they are moved by hand operation. Each array element of these vibrators 513a and 513b is coupled to an independent drive circuit group 514, and the drive timing of each is determined by a trigger signal transmitted from the delay circuit group 516 in accordance with a signal from the control circuit 515. As a result, a variable position focus 517 is formed. At this time, the condition of the treatment target in the vicinity of the focal point 517 is controlled by using the ultrasonic transducer for image 518 and the ultrasonic diagnostic apparatus 519 which are provided in the support 511 in the vicinity of the treatment transducers 513a and 513b. CR via circuit 515
The T display 520 forms a tomographic image. Here, the control circuit 515 obtains the position of the focal point 517 by calculation, and superimposes it on the image of the CRT display 520 and displays it. Then, during the treatment, the water control circuit 521 fills the coupling liquid through the opening 505 in the flexible film 504 at the tip of the applicator by the instruction from the control circuit 515, and heating of the vibrators 513a and 513b itself is expected. If necessary, circulate to cool.

FIG. 44 shows an example of the above-mentioned slide type moving mechanism. Two vibrators 53 are attached to the tip of the support 531.
2a and 533b are attached. Oscillator 532
The a and 563b are linear arrays in the longitudinal direction of the support 521, and have a concave shape in the width direction.
The pendulum 532a is fixed to the support 531 and the oscillator 532b is a groove 534 obliquely formed on the support 531.
It is fixed to a column 533 that can slide inside. The pillar 533 slides along the groove 534,
The longitudinal movement of the support body 531 is converted into the sliding movement of the oscillator 532b.

As a result, after the vibrator 532b is slid, the vibrators 532a and 532b have the positional relationship shown in FIG. 45 and have the common concave geometrical focus 535. Further, in the longitudinal direction of the vibrators 532a and 532b, a focus can be formed by the electron focusing action of the linear array. The flexible film for coupling is omitted in FIGS. 44 and 45.

As described above, according to the sixth aspect of the invention, since the therapeutic ultrasonic transducer having a large opening can be inserted into the body cavity having a very narrow insertion portion, the treatment at a deep position from the visceral surface can be performed. The subject can also be irradiated with very focused and powerful ultrasound waves for efficient treatment.

(Embodiment 13) FIG. 46 is a block diagram of an embodiment according to the seventh invention. First, the configuration of the applicator 601 in FIG. 46 will be described with reference to FIG. As shown in FIG. 47, the applicator 601 includes an ultrasonic transducer 602 for irradiating therapeutic high-intensity ultrasonic waves and a high-intensity ultrasonic wave for the patient 603.
Coupling liquid 604 that leads to, and the coupling liquid 6
A water bag 605 for sealing 04 and a housing 633 for accommodating them.

The housing 625 is provided with three or more reference points (608A, 608B, 608C) for use in focus positioning, which will be described here as three points. The reference points 608A, 608B, 608C are formed of a material that can be clearly drawn on the MRI image and can be easily distinguished from the substance of the living body, and the material is more preferably a non-magnetic material. Specifically, it may be one in which oils are injected into the holes of the housing material, or one in which rubbers or resins are attached.

As shown in FIG. 48, an ultrasonic transducer 602
Has a shape obtained by dividing a circular flat piezoelectric element in the radial direction and the circumferential direction. When treating, applicator 60
1 is placed on the body surface, and the water bag 605 is brought into contact with the skin of the patient 603 through ultrasonic jelly or the like (not shown). And
The drive circuit group 6 after the focus 607 is aligned with the tumor 606
At 11, the ultrasonic transducer 602 is driven to irradiate strong ultrasonic waves, and the treatment site that coincides with the focus 607 is maintained at a high temperature for treatment.

In this example, a phased array was used as a strong ultrasonic wave generation source. Therefore, by controlling the drive timing of the drive circuit group 611 by the phase control circuit group 610, the applicator 601 and the ultrasonic transducer 6
The focus position, sound field, and heating / heating area can be operated without moving 02. The drive circuit group 611 is divided into channels of the number of divided ultrasonic transducers 602,
It is driven by an independent timing signal delayed by the phase control circuit group 610 based on the signal from the heat treatment apparatus control circuit 609. As a result, the ultrasonic focus 60
7 can be set in any place three-dimensionally. The operation of moving the focus position by the delay time control is performed by, for example, USP-4,
526 and 168.

Next, positioning and MRI in this embodiment.
The image capturing unit will be described.

First, the patient 603 is set on the treatment table 620, and with the applicator 601 attached, the RF coil 619, the static magnetic field coil 617, and the static magnetic field coil 617 are controlled by the table moving device 613 controlled by the MRI control circuit 614. It is fed into a gantry (not shown) for MRI imaging in which a gradient magnetic field coil 618 is built.

The MRI control circuit 614 uses the gradient magnetic field power source 6
16 and the transmission / reception circuit 615 from the console 621 in a predetermined sequence (for example, T2 weighted imaging method: T2
Lateral relaxation time), the three-dimensional image information inside the body of the patient 603 including the reference points 608A, 608B, 608C of the applicator 601 is stored in a memory (not shown). This three-dimensional information is C by the MRI control circuit 614.
Although it can be displayed on the RT display 612,
As described in Japanese Patent Laid-Open No. 5-300910, it is possible to display in any form such as a pseudo three-dimensional display using a wire frame.

Next, the tumor 606 and the focal point 607 are aligned. Here, the CRT display 612 is shown in FIG.
As shown in FIG. 9, M in the patient's body including the reference point 608A
The RI two-dimensional image is displayed. The operator inputs the position of the reference point 608A on the MRI coordinate 626 to the heating device control circuit 609. Alternatively, the MRI control circuit 614 may recognize the reference point 608A of the applicator 601 and send the coordinate information to the heating treatment apparatus control circuit 609. The same operation is performed on the remaining reference points 608.
The applicator 601 is also positioned by performing the same for B and 608C.

As shown in FIG. 49, the CRT display 612 can display the applicator coordinates 625 of the heat treatment apparatus control circuit 609, overlapping the MRI image 622. However, the applicator coordinates 625 in the example of FIG. 49 are three-dimensional and two-dimensional coordinates with the reference point 608A as the origin.
Since the coordinates of the focal point 607 are set with reference to the reference point 608A, alignment of the applicator 601 and treatment planning are performed according to the applicator coordinates 625. For example, via an input device 623 such as a light pen or a touch panel,
The position of the focal point 607 is designated on the CRT display 612, and this information is stored in the heating device control circuit 609. At this time, the input device 623 such as a touch panel or a light pen on the CRT display 612 displays the MRI coordinate 62.
The operation at 6 and the operation at the applicator coordinate 625 can be switched and used, and when designating an arbitrary cross section on the MRI three-dimensional image, the operation can be performed at the MRI coordinate as usual.

As for the focal point 607, as shown in FIG. 49, the MRI image 622 of the CRT display 612 is displayed.
Displayed above. The ultrasonic wave incident path 624 can also be displayed together.

When the heat treatment apparatus control circuit 609 detects a match between the position of the focus 607 and the position of the tumor 606 stored in the built-in memory, it starts the ultrasonic irradiation and drives the drive circuit group 6
11 is instructed, and the treatment is started. here,
It is also possible to capture the MRI image of the affected part including the reference point 608A immediately before irradiating the intense ultrasonic waves each time and confirm the coincidence status between the reference point 608A and the coordinates of the MRI image. The reference point 608A was initially determined by the patient's movement such as respiratory movement.
When the heating device control circuit 609 deviates from the point on the RI coordinate by a certain value or more, the heating device control circuit 609 controls the driving circuit group 611 to stop the driving of the ultrasonic transducer 602. This operation captures a three-dimensional image of MRI including all the reference points 608A, 608B, 608C, and when any of these three reference points deviates from the original point by a predetermined value or more, ultrasonic wave irradiation is performed. It may be stopped.

[0228] The irradiation of ultrasonic waves is stopped at the time when it is considered to be in the middle or at the end of the initial treatment plan, and the progress of treatment is observed. This is performed by taking an MRI image around the tumor 606 and examining the change in the living body, as described above. During this time, the applicator 601 remains attached to the patient 603. When the subtraction of the T2 weighted image data stored in the memory before the treatment and the data of this time is taken, the heat-denatured region can be clearly confirmed, and the treatment is sufficiently performed or insufficient. Can determine if retreatment is required. It is also possible to incorporate such a treatment effect determination step into the treatment plan from the beginning so that MRI images around the tumor 606 are automatically taken at predetermined treatment times.

At the place where the treatment is considered to be completed, an MRI three-dimensional image of the inside of the body is taken by the same operation as described above. At this time, the surface including the portion where the treatment leakage is suspected is input device 62.
3 is designated on the CRT display 612, and for example, an MRI two-dimensional image of the portion is displayed and investigated in detail, and when the treatment leakage is confirmed, the portion (point or range) is applicator on the CRT display 612. When the coordinate 625 is instructed, the information is sent to the heat treatment apparatus control circuit 609, and the heat treatment apparatus control circuit 609 controls the phase control circuit group 610 so as to focus on the designated treatment leakage portion in the body. , The drive circuit group 611 is driven, and heating treatment is added.

When it is judged that the treatment has been completed by the judgment of the treatment effect by MRI, the operator finishes the treatment. At this time, the MRI control circuit 614 can retrieve the history of treatment conditions from the memory and output the treatment record from the CRT display 612.

Various modifications can be made to this embodiment. For example, a body cavity coil may be used as the transmitting / receiving RF coil 619. In addition, the ultrasonic transducer 6
Although the phased array is used for No. 02, an annular array may be used instead of this, or a method of moving the applicator 601 mechanically to move the focus may be used.

Also, as shown in FIG.
An ultrasonic probe 628 is inserted into an ultrasonic probe insertion hole 629 provided in the center or a part of 27, and this is connected to an ultrasonic diagnostic apparatus 630 so that an ultrasonic image inside the body can be observed in real time. Good. The ultrasonic probe 628 is configured to be able to slide and rotate in the front-rear direction. Then, the relative position between the ultrasonic probe 628 for obtaining the ultrasonic tomographic image and the focal point 607 of the therapeutic ultrasonic wave is obtained, and the focal position 607 is displayed on the ultrasonic image based on the information of the relative position, and further the MRI is performed. The position of the ultrasonic tomographic image that is being displayed at that time is shown on the two-dimensional or three-dimensional in-vivo image obtained in step 3, and the ultrasonic tomographic image can be used in accordance with the treatment plan established earlier. These methods are
It is described in detail in JP-A-5-300910.

Further, the applicator 601 does not have to be a so-called upper approach which is attached to the patient 603 from above as in the present embodiment, but an applicator whose movement is controlled by a mechanical arm (not shown) constitutes a lower approach. However, it can be used.

(Embodiment 14) FIG. 51 is a block diagram of another embodiment according to the seventh invention. First, the configuration of the applicator 631 in FIG. 51 will be described with reference to FIG. In this embodiment, the ultrasonic transducer 632 has a fixed focus and is of a type that mechanically moves the focus (Japanese Patent Laid-Open No. 63-99234).
3). The applicator 631 uses an ultrasonic transducer 632 for irradiating intense ultrasonic waves for treatment and a powerful ultrasonic wave for the patient 60.
3, a coupling liquid 604 that leads to 3, a water bag 605 that seals the coupling liquid 604, and a housing 633 that stores these. The housing 633 has a plurality of applicator-side reference points (here, two points will be described) 63.
8A and 638B are attached. These applicator side reference points 638A and 638B are
A plurality of subject-side reference points (here, two points will be described) 6
39A, 639B for exactly matching, for example, as shown in FIG. 53, the applicator side reference point 638.
A and 638B may have a concave shape, and convex object-side reference points 639A and 639B may be fitted therein. Further, as another configuration, as shown in FIG. 54, convex applicator reference points 641A and 641B may be fitted into concave object-side reference points 640A and 640B.

The ultrasonic transducer 632 is obtained by cutting out a single piezoelectric element into a spherical shell shape. In the housing 633 filled with the coupling liquid 604, the transducer position control circuit 6
The vertical movement by the support rod 634 controlled by 35 and the swing by the bearing 637 also controlled by the oscillator position control circuit 635 are possible.

At the time of treatment, the applicator 631 is placed on the body surface of the patient 603 as in the thirteenth embodiment, and the water bag 605 is brought into contact with the skin of the patient 603 via an ultrasonic jelly (not shown). The focal point 607 is made to coincide with the tumor 606 by the transducer position control circuit 635, and then the ultrasonic transducer 632 is driven by the drive circuit 636 to irradiate strong ultrasonic waves to maintain the treatment site coincident with the focal point 607 at a high temperature. To treat.

Next, the positioning and MRI in this embodiment.
The image capturing unit will be described.

First, the patient 603 has a reference point 63 on the subject side.
9A and 639B are reference points 638 of the applicator 631.
It is attached at a position that exactly matches A and 638B.
The reference points 639A and 639B on the subject side are suitable as disposable protrusions having strong adhesive force, and can be clearly drawn on the MRI image, and are easily distinguished from the substance of the living body. , And more preferably non-magnetic material. Specific examples include rubbers and resins. Next, the applicator 631 is mounted on the patient 603, at this time the reference points 638A, 638B and 639.
Make sure that the positions of A and 639B are exactly the same. Thus set on the treatment table 620 and the reference point 639
The patient 603 to which A and 639B are attached is an imaging gantry in which an RF coil 619, a static magnetic field coil 617, and a gradient magnetic field coil 618 are incorporated by a table moving device 613 controlled by an MRI control circuit 614 (Fig. (Not shown).

Next, the MRI control circuit 614 instructs the gradient magnetic field power source 616 and the transmission / reception circuit 615 from the console 621 in a predetermined sequence (for example, T2-weighted imaging method).
Activated by the applicator reference point 638A (Example 1
Patient 60 including a reference point 608 of 3)
The three-dimensional image information in the three bodies is stored in a memory (not shown). This three-dimensional information can be displayed on the CRT display 612 by the MRI control circuit 614.

Tumor 606 visualized on MRI three-dimensional image
The operation of focusing the focus 607 of the ultrasonic transducer 632 on the position of and the method of performing the treatment plan are the same as those in the thirteenth embodiment. The confirmation of the treatment status during the treatment and the processing after the treatment are the same as in the thirteenth embodiment, but in the fourteenth embodiment, the position of the applicator 631 and the position of the patient 603 are physically fixed at a plurality of points. Therefore, even if the applicator 601 is once removed from the patient 603 during the treatment, it can be reliably returned to the original position.

In this embodiment, two applicator-side reference points and two subject-side reference points are shown, but three reference points are provided to make the position more stable. Is also effective. In the above description, the representative reference point is the origin ((X, Y, Z) = (0,
0, 0)), but (X, Y, Z) may be given an arbitrary value.

As described above, according to the seventh invention, it is only necessary to align the applicator of the heat treatment apparatus and the subject during the ultrasonic heat treatment, and the conventional CT apparatus can be used. Since it is not necessary to incorporate a special mechanism for detecting the relative position of the heat treatment device, accurate alignment can be performed even when the CT device and the heat treatment device are separately configured, and patient safety can be ensured. At the same time, the cost of the device can be reduced.

[0243]

According to the first aspect of the present invention, an accurate diagnosis can be performed by the image diagnostic device during the intense ultrasonic irradiation treatment. Furthermore, because the position and time control during irradiation are optimized, unexpected side effects and expansion of the heat degeneration region are suppressed, and heat degeneration can be accurately induced at the targeted site, so it is safe and reliable. Ultrasonic heating treatment can be realized.

According to the second invention, in the treatment apparatus using the image diagnostic apparatus, by detecting the motion vector from the spatial frequency data continuously obtained by MRI at a higher speed than before, the error of the difference image can be obtained in real time. To reduce
The coordinate deviation due to movement is reduced, and safe and accurate treatment is possible.

According to the third invention, in the therapeutic apparatus using the magnetic resonance diagnostic apparatus, it becomes possible to measure the temperature at a necessary point of the temperature monitor obtained in advance by using the local excitation method in real time. It is possible to provide a safe treatment device that can detect abnormalities during irradiation.

According to the fourth aspect of the present invention, in the therapeutic apparatus using the magnetic resonance diagnostic apparatus, the temperature information of the part corresponding to the therapeutic position can be constantly obtained at high speed, and the medical treatment with high therapeutic efficiency and safety is possible. Become.

According to the fifth invention, by detecting and analyzing the reflected wave of the therapeutic ultrasonic wave from the treatment area, it is possible to monitor the treatment area in real time by the ultrasonic treatment system. Furthermore, by controlling the therapeutic ultrasonic waves based on the obtained information on the treatment area, safe and reliable treatment can be realized.

According to the sixth aspect of the invention, since the therapeutic ultrasonic transducer having a large opening can be inserted into a body cavity having a very narrow insertion portion, it can be very focused even on a treatment target located deep from the visceral surface. Efficient treatment can be performed by irradiating the powerful ultrasonic waves.

According to the seventh invention, it is only necessary to position the applicator of the heat treatment apparatus and the subject at the time of ultrasonic heat treatment, and the relative position of the CT apparatus and the heat treatment apparatus as in the conventional case. Since it is not necessary to incorporate a special mechanism for detecting the temperature, accurate alignment can be performed even when the CT device and the heating treatment device are separately configured, and safety for the patient can be ensured and the cost of the device can be reduced. It can be reduced.

[Brief description of drawings]

FIG. 1 is a block diagram showing the configuration of an embodiment according to the first invention.

FIG. 2 is a schematic diagram for explaining a procedure of irradiating strong ultrasonic waves in the example.

FIG. 3 is a flowchart showing a procedure for irradiating strong ultrasonic waves in the same embodiment.

FIG. 4 is a view for explaining another irradiation procedure of strong ultrasonic waves in the same embodiment.

FIG. 5 is a block diagram showing the configuration of another embodiment according to the first invention.

FIG. 6 is a diagram showing a positional relationship and an operation of the ultrasonic probe and the transducer in the embodiment.

FIG. 7 is a diagram showing another example of a mechanism for changing the relative positions of the ultrasonic probe and the transducer.

FIG. 8 is a diagram showing a configuration of an embodiment when the two-dimensional array according to the first invention is used.

FIG. 9: CR during intense ultrasonic irradiation treatment in the same Example
The figure which shows the T image display example

FIG. 10 is a block diagram of an embodiment of the second invention.

FIG. 11 is an explanatory diagram of a concept of motion in the embodiment.

FIG. 12 is a schematic diagram for explaining motion correction during temperature measurement by MRI in the same example.

FIG. 13 is a flow chart showing a treatment procedure incorporating a motion correction method from an image in the embodiment.

FIG. 14 is a schematic diagram showing a temporal flow when performing motion detection and temperature change detection with respect to a reference image in the embodiment.

FIG. 15 is a schematic diagram showing a temporal flow when motion detection and temperature change detection are performed on an image obtained immediately before in the same embodiment.

FIG. 16 shows point excitation (2) according to the third embodiment of the invention.
Schematic diagram showing an MRI pulse sequence of one-dimensional one-shot local excitation)

FIG. 17 is a schematic diagram showing an ultrasonic wave irradiation using point excitation and a data processing procedure in the example.

FIG. 18 is a view showing an example of temperature display means at the time of point excitation in the same Example.

FIG. 19 is a line-excited MR according to an embodiment of the third invention.
Schematic diagram showing the I sequence

FIG. 20 is a schematic diagram showing an ultrasonic wave irradiation using line excitation and a data processing procedure in the example.

FIG. 21 is a diagram showing an example of temperature distribution display means during line excitation in the same Example.

FIG. 22 is a schematic diagram showing a procedure for determining a temperature measurement point from a temperature distribution in the example.

FIG. 23 is a treatment sequence diagram for simultaneously performing temperature measurement and relaxation time emphasis signal measurement according to the embodiment of the third invention.

FIG. 24 is an MRI pulse sequence diagram for performing temperature measurement and relaxation time emphasis signal measurement in the same sequence according to the third embodiment of the invention.

FIG. 25 shows M of point excitation according to the third embodiment of the invention.
Schematic diagram showing RI pulse sequence (when three α ° pulses are used)

FIG. 26 is a schematic diagram of a temporal flow in the case of feeding back the temperature measured during treatment irradiation according to the embodiment of the third invention to the treatment irradiation.

FIG. 27 is a line-excited MR according to an embodiment of the fourth invention.
Schematic diagram showing an I-pulse sequence

FIG. 28 is a flow chart of control signals for computer control according to the embodiment.

FIG. 29 is a schematic diagram showing the control means of the applicator in the computer display according to the embodiment.

FIG. 30 is a schematic diagram of a position / angle detecting means by an encoder of the hand probe type ultrasonic applicator according to the embodiment.

FIG. 31 is a schematic diagram of a position / angle detection unit using an optical gyro of the hand probe type ultrasonic applicator according to the embodiment.

FIG. 32 is a schematic diagram of a position / angle detecting means by a television camera of the hand probe type ultrasonic applicator according to the embodiment.

FIG. 33 is a block diagram showing an embodiment according to the fifth invention.

FIG. 34 is a circuit diagram of a main part of a drive circuit and a received wave detection circuit for explaining means for detecting a reflected signal from a received signal in the same example.

FIG. 35 is a block diagram showing another embodiment according to the fifth invention.

FIG. 36 is a circuit diagram of a main part of a received wave detection circuit for explaining means for detecting a reflected signal from a received signal in the same example.

FIG. 37 is a block diagram showing another embodiment according to the fifth invention.

FIG. 38 is a block diagram showing yet another embodiment according to the fifth invention.

FIG. 39 is a configuration diagram of an embodiment of an ultrasonic applicator according to the sixth invention.

40 is a cross-sectional view of the ultrasonic applicator of FIG. 39 taken along the line AA ′.

FIG. 41 is a configuration diagram of another embodiment of the ultrasonic applicator according to the sixth invention.

42 is a cross-sectional view of the ultrasonic applicator of FIG. 41 taken along the line BB ′.

FIG. 43 is a configuration diagram of an embodiment of a therapeutic apparatus according to the invention.

FIG. 44 is a configuration diagram of another embodiment of the ultrasonic applicator according to the sixth invention.

FIG. 45 is a configuration diagram of yet another embodiment of the ultrasonic applicator according to the sixth invention.

FIG. 46 is a configuration diagram of an embodiment according to the seventh invention.

FIG. 47 is a configuration diagram of an applicator in the example.

FIG. 48 is a configuration diagram of an ultrasonic transducer in the example.

FIG. 49 is a diagram showing a display screen on a CRT display in the example.

FIG. 50 is a configuration diagram of another embodiment according to the seventh invention.

FIG. 51 is a configuration diagram of another embodiment according to the seventh invention.

FIG. 52 is a configuration diagram of an applicator in the example.

FIG. 53 is a view showing an example of how to provide reference points in the embodiment.

FIG. 54 is a diagram showing another example of how to provide the reference points in the embodiment.

[Explanation of symbols]

101 ... Applicator 102 ... Piezo element group 103 ... Patient 104 ... Water 105 ... Coupling film 106 ... Strong ultrasonic focus 107 ... Affected part (tumor) 108 ... Ultrasonic probe 109 ... Drive circuit 110 ... Applicator position detection device 111 ... Mechanical arm 112 ... Stage controller 113 ... Zθ stage 114 ... Xθ stage 115 ... Ultrasound image diagnostic device 116 ... Digital scan converter 117 ... CRT 118 ... Auxiliary input device 119 ... System controller 110 ... Console 121 ... Water treatment circuit 122 ... XYZ stage 123 ... Zθφ stage 124 ... Instruction cursor 125 ... Heating point 126 ... Ultrasonic wave B
Mode image 127 ... Ultrasound addition C mode image 128 ... Ultrasound 3
D image 129 ... Treatment block stereoscopic enlarged image 121 ... Static magnetic field coil 122 ... Gradient magnetic field power supply 123 ... Transmitting / receiving circuit 124 ... Table moving device 125 ... Working hole 126 ... Phase control circuit 201 ... Static magnetic field magnet 202 ... Excitation power supply 203 ... Enclosure Specimen 204 ... Gradient magnetic field coil 205 ... Sequence controller 206 ... Gradient magnetic field coil drive circuit 207 ... Bed 208 ... High frequency coil 209 ... Transmitting unit 210 ... Duplexer 211 ... Receiving unit 212 ... Data collecting unit 213 ... Electronic computer 214 ... Console 215 ... Image Display 216 ... Ultrasonic applicator 217 ... Drive circuit group 218 ... Phase control circuit group 219 ... Power supply (for pulse generation) 221 ... Temperature distribution display window 222 ... Temperature distribution display window 223 ... Ultrasonic transducer position display 224 ... Setting Focus 3 01-303 ... Rotation detecting encoder 304-306 ... Translation detecting encoder 307 ... Grasping part 401 ... Ultrasonic applicator 402 ... Piezo element 403 ... Imaging ultrasonic probe 404 ... Flexible water bag 405 ... Patient 406 ... Treatment target 407 ... Ultrasonic propagation medium 408 ... Drive circuit 409 ... Control circuit 410 ... Received wave detection circuit 411 ... Level detection circuit 412 ... Phase shift detection circuit 413 ... Ultrasound diagnostic device 414 ... DSC 415 ... CRT display 416 ... Input unit 418 ... A / D converter 419 ... Memory 420 ... Oscillator 501 ... Support 502 ... Ultrasonic transducer 503 ... Rotating shaft 504 ... Flexible film 505 ... Opening 506 ... Focus 507 ... Rotation moving mechanism 511 ... Support 512 ... Angle mechanism 513 ... Ultrasonic transducer 514 ... Drive circuit group 15 ... Control circuit 516 ... Delay circuit group 517 ... Focus 518 ... Ultrasonic transducer for image 519 ... Ultrasonic diagnostic device 520 ... CRT display 521 ... Water control circuit 531 ... Support body 532 ... Ultrasonic transducer 533 ... Strut 534 ... Moving groove 535 ... Focus 601 ... Applicator 602 ... Ultrasonic transducer 603 ... Patient 604 ... Coupling liquid 605 ... Water bag 606 ... Tumor 607 ... Focus 608A to 608
C ... Reference point 609 ... Heat treatment apparatus control circuit 610 ... Phase control circuit group 611 ... Drive circuit group 612 ... CRT 613 ... Table moving device 614 ... MRI control circuit 615 ... Transceiver circuit 616 ... Gradient magnetic field power supply 617 ... Static magnetic field coil 618 ... Gradient magnetic field coil 619 ... RF coil 620 ... Treatment table 621 ... Console 622 ... MRI image 623 ... Input device 624 ... Ultrasonic incident path 625 ... Applicator coordinate 626 ... MRI coordinate 627 ... Ultrasonic transducer 628 ... Ultrasonic probe 629 ... Probe insertion hole 630 ... Ultrasonic diagnostic device 631 ... Applicator 632 ... Ultrasonic vibrator 633 ... Housing 634 ... Support rod 635 ... Transducer position control circuit 636 ... Drive circuit 637 ... Bearing 638A, 638B ... Applicator side reference point 639A, 639B ... Cover Specimen side reference point 640A, 640B ... Subject side reference point 641A, 641B ... Applicator side reference point

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Mariko Shibata No. 1 Komukai Toshiba-cho, Sachi-ku, Kawasaki-shi, Kanagawa Within the Corporate Research and Development Center, Toshiba Corporation (72) Satoshi Aida Komukai Toshiba, Sachi-ku, Kawasaki-shi, Kanagawa Town No. 1 Incorporated company Toshiba Research and Development Center (72) Inventor Kazuya Okamoto Komukai Toshiba Town No. 1 in Komukai Toshiba Town, Kawasaki City, Kanagawa

Claims (7)

[Claims] 1. An irradiation unit having an ultrasonic wave source, which focuses and irradiates an ultrasonic wave from the ultrasonic wave source to a treatment target region in a subject, and obtains three-dimensional image information in the subject. Means, means for extracting a three-dimensional region of the treatment target region from the three-dimensional image information, means for dividing the three-dimensional region into a plurality of sections having a predetermined thickness, and a plurality of sections having a predetermined size. And a means for dividing into a plurality of partial areas, and an irradiation control means for controlling the plurality of partial areas to irradiate the therapeutic ultrasonic waves from the irradiation means in a predetermined procedure, and the irradiation control means, Irradiate the ultrasonic waves in order from a partial area that belongs to a section farther from the ultrasonic source, separate a predetermined distance or more between the partial areas that are continuous or close in time, and are spatially continuous. Or near Therapy device, characterized in that it satisfy the condition control of the time interval between ultrasonic irradiation target partial region spaced a predetermined time to. 2. A treatment target region in the subject is recognized based on image information in the subject collected by a magnetic resonance diagnostic apparatus, and treatment energy is applied to the treatment target region from the treatment energy irradiation means. In a treatment device for performing treatment by irradiation, a means for collecting spatial frequency data of image information in the subject, and an impulse response or cross-correlation function between images temporally adjacent to each other than the spatial frequency data is obtained, It is provided with means for detecting the movement of the patient from the peak point of the impulse response or cross-correlation function, and means for changing the irradiation position of the therapeutic energy by the therapeutic energy irradiation means according to the movement detected by this means. A treatment device characterized by the above. 3. A treatment target region in the subject is recognized based on image information in the subject collected by a magnetic resonance diagnostic apparatus, and treatment energy is irradiated from the treatment energy irradiation means to the treatment target region. In a treatment apparatus for performing treatment by irradiation, means for setting a temperature measurement site during the treatment energy irradiation by the treatment energy irradiation means, and the magnetic resonance diagnostic apparatus for the temperature measurement site set by this means A therapeutic apparatus comprising: a unit for acquiring temperature information using local excitation; and a unit for displaying the temperature information acquired by this unit. 4. A treatment target region in the subject is recognized based on image information in the subject collected by a magnetic resonance diagnostic apparatus, and treatment energy is applied to the treatment target region from the treatment energy irradiation means. In a treatment device for performing treatment by irradiation, means for detecting an irradiation direction and an irradiation position of the therapeutic energy by the therapeutic energy irradiation means, and a temperature measurement site set according to the irradiation direction and position detected by this means Means, means for acquiring temperature information using the local excitation by the magnetic resonance diagnostic apparatus for the temperature measurement region set by this means, and means for displaying the temperature information acquired by this means. A treatment device characterized by: 5. An ultrasonic wave irradiating means for irradiating a therapeutic ultrasonic wave to a treatment target in the subject, a driving means for driving the ultrasonic wave irradiating means, and the therapeutic ultrasonic wave from the inside of the subject. Detecting means for detecting the reflected wave signal separately from the driving signal supplied from the driving means to the ultrasonic wave irradiating means, analyzing means for analyzing the reflected wave signal detected by the detecting means, and the analyzing means And a control means for controlling the driving means based on the analysis result of the means. 6. A therapeutic apparatus for irradiating a subject with therapeutic ultrasonic waves for treatment, comprising: a therapeutic applicator having a plurality of ultrasonic transducers for irradiating the therapeutic ultrasonic waves; The relative position of the ultrasonic transducers is changed so that at least two ultrasonic transducers overlap each other in the first state and decrease in at least two ultrasonic transducers in the second state. And a relative position changing means such that the relative position is in the first state when the treatment applicator is inserted into the subject, and the relative position is in the second state during treatment. And a means for controlling the treatment. 7. A treatment target region in the subject is recognized based on image information in the subject collected by a magnetic resonance diagnostic apparatus, and therapeutic energy is focused and applied to the treatment target region. A therapeutic applicator having a therapeutic energy irradiating means for irradiating the therapeutic energy and a housing for accommodating the therapeutic energy irradiating means, and the magnetic resonance diagnostic apparatus can detect the therapeutic applicator in the housing. And a reference marker for positioning the therapeutic applicator with respect to the magnetic resonance diagnostic apparatus.