JPH09276274A - Probe for ultrasonic treatment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic treatment probe which enables seeing whether or not a diseased part could be cauterized by application of an ultrasonic beam without being obstructed by a denatured protein tissue facing an acoustic vibrator. SOLUTION: An ultrasonic vibrator 21 for use in treatment, which transmits an ultrasonic beam in such a manner that the beam is focused on a focal point 31 is built in near the end of a hard insertion pipe 20, a freely curving part 19 is formed at the end of the vibrator 21, and a hard end 18 provided with an ultrasonic vibrator 17 for observation is formed at the end of the curving part 19. When the curving part 19 is curved upwards, the focal point 31 produced by the vibrator 21 is contained in a plane containing the ultrasonic observation range 46 of the vibrator 17, so that with a change in the value of the curving angle, the portions near the focal point can be observed from a certain direction different from the sending direction of the ultrasonic beam, so that even if attenuation is increased as the result of the protein denaturing of a tissue that is nearer to the vibrator 21 than the focal point, caused by the application of an ultrasonic beam, it is made possible to see whether or not the diseased part near the focal point could be cauterized, from an observed image without being obstructed by the tissue.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic observation and treatment probe for performing ultrasonic diagnosis in a body cavity and treatment by irradiation of focused ultrasonic waves.

[0002]

2. Description of the Related Art As the prior art, Japanese Patent Laid-Open No. 62-127
The therapeutic ultrasonic endoscope shown in Japanese Patent Publication No. 050 is known. This therapeutic ultrasonic endoscope is provided with a rotatable back-to-back observation ultrasonic transducer (image acquisition ultrasonic transducer) and a therapeutic ultrasonic transducer (treatment ultrasonic transducer) at the tip of the insertion portion. As a result, both ultrasonic diagnosis and ultrasonic treatment can be performed, and the diameter of the distal end of the endoscope insertion portion is reduced.

[0003]

Problems to be Solved by the Invention JP-A-62-1270
In the therapeutic ultrasonic endoscope disclosed in Japanese Patent Laid-Open No. 50, since the ultrasonic transducer for observation and the ultrasonic transducer for treatment are integrated back-to-back, the treatment and observation of the lesion are performed from the same direction. I could only do it.

When a therapeutic ultrasonic transducer is used for treatment, ultrasonic waves focused for treatment (abbreviated as therapeutic focused ultrasonic waves) generate heat at the focal point, causing tissue degeneration in the focal point portion. . The protein-denatured tissue has a different acoustic impedance from the surrounding tissue.

Therefore, ultrasonic waves are easily reflected at the protein-denatured portion. In addition, since ultrasonic waves are easily attenuated in protein-denatured tissue, therapeutic focused ultrasonic waves cannot reach further.

On the other hand, the heat conduction from the focal point and the action of the therapeutic focused ultrasonic wave cause protein degeneration in the tissue on the therapeutic ultrasonic transducer side of the focal point. Moreover, as the irradiation time of the focused ultrasonic wave becomes longer, the protein denatured region expands toward the vicinity of the therapeutic ultrasonic transducer according to the beam shape of the focused ultrasonic wave.

Therefore, when observation is performed from the same position by the ultrasonic transducer for observation, the ultrasonic wave for observation is attenuated by the tissue portion denatured by protein on the side of the ultrasonic transducer for treatment rather than the focal point, and There is a problem that it is difficult to confirm whether the lesion area set as the focal point can be cauterized reliably because the ultrasonic diagnostic image becomes difficult to observe.

The present invention has been made in view of the above-mentioned points, and an object thereof is not to be disturbed by a protein-denatured tissue on the therapeutic ultrasonic transducer side from the focusing point after irradiation with focused therapeutic ultrasonic waves. Another object of the present invention is to provide an ultrasonic therapeutic probe capable of confirming whether or not the lesion area near the focal point can be cauterized reliably with an observation image.

[0009]

An insertion part that can be inserted into a body cavity, an ultrasonic transducer for image acquisition provided on the distal end side of the insertion part, an ultrasonic transducer for image acquisition, and a length of the insertion part. Direction and a therapeutic ultrasonic transducer that is provided in the insertion portion and is transmitted so as to focus the ultrasonic beam on a focusing point, and a focusing of the therapeutic ultrasonic transducer that is provided on the distal end side of the insertion portion. A bending portion that allows at least one of the image acquisition ultrasonic transducer and the therapeutic ultrasonic transducer to move so that a point is located within an observation field of view of the image acquisition ultrasonic transducer. Therefore, by curving the bending portion, it is possible to arrange a focal point for performing treatment by the therapeutic ultrasonic transducer within the observation field of view of the ultrasonic transducer for image acquisition, and to irradiate the focused ultrasonic beam by the therapeutic ultrasonic transducer. After that, an ultrasonic observation image in the vicinity of the focal point can be obtained without being disturbed by the tissue in which the attenuation on the therapeutic ultrasonic transducer side from the focal point is increased.

[0010]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be specifically described below with reference to the drawings. (First Embodiment) FIGS. 1 and 2 relate to a first embodiment of the present invention, and FIG. 1 is a schematic view showing the entire configuration of an ultrasonic diagnostic treatment system including the first embodiment. FIG. 2 and FIG. 2 are views showing a state of using the ultrasonic therapeutic probe according to the first embodiment.

As shown in FIG. 1, an ultrasonic diagnostic treatment system 1A having the first embodiment is provided with an ultrasonic observation and treatment means for performing observation and treatment by ultrasonic waves. The ultrasonic treatment probe (hereinafter, simply referred to as an ultrasonic probe) 2A, the signal processing means 4 for performing signal processing on the ultrasonic observation means 3 built in the ultrasonic probe 2A, and the ultrasonic treatment means 5. An ultrasonic diagnostic treatment apparatus 7A having a driving drive voltage generating means 6 for driving, and a color monitor 10 as a display means 9 for displaying an ultrasonic image signal generated by signal processing for the ultrasonic observation means 3. Composed of.

As shown in FIG. 1, the ultrasonic probe 2A has a thin tubular insertion portion 11 so that it can be inserted into a body cavity.
A first grip portion 12 formed at the rear end of the insertion portion 11 and gripped by an operator; and a thick operation portion 13 formed adjacent to the rear of the grip portion 12 for performing a bending operation. , The second grip portion 14 formed adjacent to the rear of the operation portion 13.
And a connecting cord 15 extended from the grip portion 14. As shown in FIG. 1, the connector 16 provided at the end of the connection cord 15 can be detachably connected to the ultrasonic diagnostic treatment apparatus 7A.

The insertion portion 11 in this embodiment has a hard tip portion 18 on which an ultrasonic transducer for image acquisition or an ultrasonic transducer for observation 17 for obtaining an observation image by ultrasonic waves is arranged, and this tip portion. A bendable bendable portion 19 formed adjacent to the rear end of 18, and the bendable portion 19
It is composed of a long and hard insertion tube 20 extending from the rear end to the front end of the first grip portion 12, and a concave focusing type ultrasonic transducer for treatment or an ultrasonic treatment tube is provided inside the vicinity of the tip of the insertion tube 20. The sound wave vibrator 21 is arranged.

That is, in the present embodiment, one end of the bending portion 19 (specifically, the tip end portion 18 closer to the tip end than the bending portion 19 is sandwiched between the bending portions 19 on the tip end side of the insertion portion 11). ) Is provided with an ultrasonic transducer 17 for observation, and the ultrasonic wave for treatment is radiated (or, specifically, to the other side (specifically, near the tip of the insertion tube 20 on the rear end side of the bending portion 19) for treatment. A therapeutic ultrasonic transducer 21 for transmitting is provided.

The operation section 13 is provided with a bending operation knob 22 for performing a bending operation. By rotating the bending operation knob 22, the bending section 19 can be bent, for example, in the vertical direction. FIG. 2 shows a state of being curved upward. The configurations of the bending portion 19 and the bending operation knob 22 are similar to those of the bending portion and the bending operation knob of the endoscope.

The signal line 23 for observing means connected to the ultrasonic transducer 17 for observation is inserted through the insertion portion 11 and is transmitted through the connector 16 to generate a transmission pulse provided in the ultrasonic treatment apparatus 7A. A pulse generation circuit 24 and a reception processing circuit 2 that performs signal processing on the received ultrasonic echo signal.
5 is connected.

The output signal of the reception processing circuit 25 is converted into a standard video signal by a digital scan converter (abbreviated as DSC) 26, further input to the color monitor 10 via a mixer 27, and displayed on the display surface of the color monitor 10. The ultrasonic tomographic image 28 is displayed.

Further, the rotary member 40 of the bending operation knob 22 is connected with a (rotary) encoder 29 for detecting a bending amount or a bending angle. This encoder 29 is used for treatment in the ultrasonic diagnostic treatment apparatus 7A. It is connected to a focus point marker generation circuit 32 that generates a focus point marker signal for displaying a focus point marker 31 at an image position corresponding to the focus point 30 of the ultrasonic transducer 21.

The concave focusing type ultrasonic transducer 21 for treatment which is built in near the tip of the insertion tube 20 adjacent to the rear end of the bending portion 19 is also connected to the treatment signal line 33 inserted through the insertion portion 11, This treatment signal line 33 is used for the ultrasonic diagnostic treatment device 7A.
It is connected to a drive signal generating circuit 34 provided therein for generating a drive signal for therapy.

Further, a controller 35, which is provided in the ultrasonic diagnostic treatment apparatus 7A and controls the transmission pulse generation circuit 24, the reception processing circuit 25, and the drive signal generation circuit 34, inputs a key to instruct the level of the drive signal. The keyboard 36 and the foot switch 37 for instructing the output / stop of the drive signal are connected.

As shown in FIG. 1, the bending portion 19 has substantially ring-shaped bending pieces 38a, 38b, ... Connected so as to be rotatable in the longitudinal direction of the insertion portion 11. Bending piece 38a at the tip
The distal ends of the bending operation wires 39a and 39b are fixed to the insertion tube 20 by a fixing member (not shown).
The rear ends of these wires 39a, 39b inserted through
A base end of the bending operation knob 22 is attached and fixed to a rotatable rotating member 40 to form a bending mechanism.

As shown in FIG. 2, in this embodiment, the observation ultrasonic transducer 17 as the ultrasonic observation means 3 provided at the tip portion 18 is specifically an electronic linear scan type ultrasonic transducer 17a. Has been adopted. The therapeutic ultrasonic transducer 21 serving as the ultrasonic therapeutic means 5 provided near the distal end of the insertion tube 20 adjacent to the rear end of the curved portion 19 is a concave surface, and the ultrasonic beam emitted from this concave surface is gradually focused. A concave focusing type transducer is used.

Further, as shown in FIG. 1, an ultrasonic transmission medium 42 is enclosed in the internal space of the insertion tube 20 around the therapeutic ultrasonic transducer 21 and the ultrasonic beam of the therapeutic ultrasonic transducer 21 is sealed. An ultrasonic wave transmission window 43 formed of a member that transmits ultrasonic waves is formed on the transmission surface side through which the ultrasonic wave is transmitted or transmitted.
An ultrasonic wave can be sent out through the ultrasonic wave sending window 43.

In this case, the therapeutic ultrasonic transducer 21 has a circular shape, and one surface for emitting the ultrasonic wave is a concave surface having a predetermined curvature in the longitudinal direction and a concave surface having the same curvature in the width direction. I have to. In addition, this therapeutic ultrasonic transducer 21
Has a central axis in the longitudinal direction arranged along the central axis of the insertion tube 20, and the concave surface of the therapeutic ultrasonic transducer 21 has a curved portion 1
9 facing upwards.

The ultrasonic transducer 17 for observation arranged at the tip portion 18 has the curved portion 19 curved upward, and the ultrasonic transducer 17 for observation and the ultrasonic transducer 2 for treatment 2 are curved as shown in FIG.
1 and the ultrasonic transducer for observation 1
The ultrasonic transducer 17 for observation is arranged in the longitudinal direction of the distal end portion 18 so that the central axis of 7 in the longitudinal direction and the central axis of the therapeutic ultrasonic transducer 21 in the longitudinal direction exist in the same plane. . For example, it is arranged along the side surface (longitudinal direction) of the tip portion 18, which is the upper side when the bending portion 19 is bent.

Even when the value of the bending amount (bending angle) is changed, the longitudinal central axis of the observation ultrasonic transducer 17 and the longitudinal central axis of the therapeutic ultrasonic transducer 21 are Always refer to the same plane (referred to as the P plane.
It becomes a plane).

The observation ultrasonic transducer 17 is constructed by arranging a plurality of electronic linear scan type transducer elements in an array in the longitudinal direction, for example. Then, a plurality of electronic linear scan type transducer elements are sequentially driven electronically to obtain an ultrasonic tomographic image 28 by electronic linear scanning with respect to the ultrasonic observation region 46 indicated by the chain double-dashed line in FIG. .

Focusing point 30 of the ultrasonic transducer 21 for treatment
Exists on the P plane, and the ultrasonic observation region 46 also exists on the P plane. Therefore, if the focusing point 30 is set in the ultrasonic observation region 46 by changing the bending angle, the ultrasonic vibration for observation is set. An image including the focal point 30 is obtained on the ultrasonic tomographic image 28 obtained by the child 17. Also,
When the value of the bending angle is changed, the focusing point 30 inside (or outside) the ultrasonic observation area 46 moves according to the value.

The ultrasonic probe 2 constructed as described above
As shown in FIG. 2, A is inserted into a body cavity that has been insufflated through the trocar 44, and the therapeutic ultrasonic transducer 21 of the ultrasonic probe 2A is brought into contact with the back side of the organ 45 to be observed and treated. The bending operation is performed as it is, and the ultrasonic transducer 17 for observation of the tip portion 18 is also brought into contact with the surface of the organ 45.

In the bending operation, the rotating member 40 is rotated by rotating the bending operation knob 22 provided in the operation section 13 shown in FIG. 1, and the rotation of the rotating member 40 causes the pair of wires 39a and 39b to rotate. The pair of wires 39a, 39b, one of which is pulled and the other of which is loosened, move forward and backward, and the bending pieces 38a, 38b, ... Of the bending portion 19 can be bent on the pulled side.

Next, the ultrasonic diagnostic treatment apparatus 7A shown in FIG.
The transmission pulse from the transmission pulse generation circuit 24 is applied to the observation ultrasonic transducer 17 to excite the observation ultrasonic transducer 17 and emit the observation ultrasonic wave to the organ 45 side as shown in FIG. .

This observation ultrasonic wave is reflected by a portion having a different acoustic impedance, becomes a reflected ultrasonic wave, and is received by the observation ultrasonic transducer 17. The received ultrasonic wave is converted into an electric signal by the ultrasonic wave transducer 17 for observation, is processed by the reception processing circuit 25 through the observation signal line 23, and is converted into a video signal. This video signal is converted into a standard video signal (television signal) by the DSC 26, is input to the color monitor 10, and has a rectangular (including square) ultrasonic tomographic image 28 on its display surface by electronic linear scanning. Is displayed.

In this case, ultrasonic pulses are intermittently radiated in the range of the ultrasonic observation region 46 shown by the chain double-dashed line in FIGS.
(More specifically, 17a) is received and converted into an electric signal. The signals transmitted and received within the ultrasonic observation area 46 are processed by the reception processing circuit 25, and the DSC 26
After that, the tomographic image by the ultrasonic waves inside the organ, that is, the ultrasonic tomographic image 28 is extracted on the display surface of the color monitor 10. Therefore, the ultrasonic observation region 46 becomes an observation field of view by the observation ultrasonic transducer 17.

Further, the movement amount detected by the encoder 29 connected to the bending operation knob 22 is input to the focus point marker generation circuit 32, and the focus point marker generation circuit 32 receives the information input from the encoder 29 and the treatment. Timing for calculating the bending angle and the focusing point 30 by referring to the information of the distance to the focusing point 30 of the ultrasonic transducer 21 for the purpose of displaying the focusing point marker 31 at the image position of the focusing point 30 To output the focal point marker signal to the mixer 27, and
The focal point marker 31 is displayed on the ultrasonic tomographic image 28 by superimposing the image signal output from the SC 26.

This focal point marker 31 is used for the ultrasonic tomographic image 2
8, the bending portion 19 is operated to bend so as to adjust the position, and the focused point 3 of the therapeutic ultrasonic wave is set in the ultrasonic observation area 46.
Adjust so that 0 is positioned.

Next, a lesion area 47 is formed on the ultrasonic tomographic image 28.
The insertion part 11 is moved so that The position and the like of the insertion part 11 are moved so that the focus point marker 31 on the ultrasonic diagnostic image 28 matches the position of the lesion part 47, and the positioning is set. After the focus point marker 31 is positioned and set so as to match the position of the lesion portion 47, that is, the focus point 30 is set at the lesion portion 4.
After being set to the position 7, the drive signal generation circuit 34 irradiates the focused therapeutic ultrasonic wave having a necessary intensity from the concave focused ultrasonic transducer 21 shown in FIG.

The drive signal from the drive signal generation circuit 34 is
The signal level is higher than the signal level of the transmission pulse that drives the observation ultrasonic transducer 17, and the therapeutic ultrasonic transducer 21 has a concave shape, and each part of this concave shape is centered on the set focusing point. It is formed so as to exist in a spherical shape having a radius of curvature.

This concave focusing type ultrasonic transducer for medical treatment 21
The ultrasonic wave emitted by the
As shown in FIG. 2, the therapeutic focused ultrasonic wave region 48 is tapered, and propagates as a therapeutic focused ultrasonic wave having a beam shape that is focused at the focus point 30.

At the focus point 30, the ultrasonic wave having a very high intensity, that is, the acoustically high energy density is obtained. Therefore,
When a drive signal with a large amplitude is applied to the concave focusing transducer 21 with the lesion tissue placed near the focusing point 30, high-density acoustic energy based on the generated strong ultrasonic waves is concentrated on the focusing point 30. The drive signal is applied by stepping on the foot switch 37 to turn on the switch, and
Is executed by controlling the drive signal of the drive signal generation circuit 34 to be output.

When the high-intensity therapeutic focused ultrasonic wave is irradiated as described above, the lesion portion 47 set at the position of the focus point 30.
Causes abrupt temperature rise due to ultrasonic absorption in the focal point 30 and the living tissue in the vicinity thereof, and cauterizes the diseased tissue. When ultrasonic irradiation is continued, therapeutically focused ultrasonic waves are easily attenuated in protein-denatured tissues whose acoustic impedance is different from that of surrounding tissues, and the ultrasonic waves are likely to become thermal energy, so that the protein denatured region is expanded.

On the other hand, the tissue 49 on the therapeutic ultrasonic transducer 21 side of the focusing point 30 is also denatured by heat due to the heat conduction from the focusing point 30 and the action of the focused ultrasonic wave for treatment. When the application of the continuous wave drive signal to the concave-focusing type therapeutic ultrasonic transducer 21 is stopped by stopping the output of the drive signal of the drive signal generation circuit 34, the ablation treatment by ultrasonic irradiation can be ended. .

The application is stopped by stepping on the foot switch 37 to turn off the switch and the controller 35 stopping the output of the drive signal from the drive signal generating circuit 34. Further, by performing a level setting key input from the keyboard 36, the level of the drive signal output from the drive signal generation circuit 34 can be variably set.

The state of protein denaturation of the tissue after cauterization was
Observation is performed on the ultrasonic tomographic image 28 obtained by the electronic linear scan type ultrasonic transducer 17a.

In this embodiment, by changing the value of the bending angle, it is possible to perform ultrasonic observation from another angle different from the therapeutic ultrasonic wave sending direction. That is, when the therapeutic ultrasonic wave shown in FIG. 2 is focused and irradiated, the therapeutic ultrasonic vibration of a concave focusing type is more concentrated than the focused point 30 where the protein is denatured by heat conduction from the focused point 30 after the irradiation. Child 2
The tissue 49 on the first side also undergoes protein denaturation, and the attenuation of ultrasonic waves at that portion increases. In this case, when the therapeutic ultrasonic wave is transmitted in the same direction as the observation ultrasonic wave as in the conventional example (the attenuation in the tissue 49 on the front side of the focal point 30 becomes large. Therefore, it becomes difficult to observe the tissue state in the vicinity of the focusing point 30 (on the other side), whereas in the present embodiment, for example, as shown in FIG. Since observation with ultrasonic waves for observation can be performed, it is possible to eliminate such difficulty in observation.

Further, in the state as shown in FIG. 2, that is, in the case where the observation ultrasonic waves are observed from the side opposite to the direction in which the therapeutic ultrasonic waves are transmitted, the tissue in the vicinity of diverging after focusing at the focusing point 30 Even in the case where the protein is denatured (for example, the portion adjacent to the focusing point 30 in FIG. 2 and on the side opposite to the tissue 49 side), the value of the bending angle is changed to change the direction from another direction (the above (Without being disturbed by the organization)
It becomes possible to observe.

It is confirmed whether or not the lesioned part 47 has the protein degeneration necessary for necrosis of the lesioned cells.
Additional irradiation is carried out in the same manner as described above until the required protein denaturation is achieved, and the therapeutic treatment by irradiation with therapeutic ultrasonic waves is repeated. When it is confirmed that the lesion area 47 has been cauterized reliably, all the treatments are terminated.

According to the first embodiment, the ultrasonic observation means 3 and the ultrasonic treatment means 5 are arranged so that the ultrasonic radiation directions to the lesion area 47 can be irradiated from different directions. The ultrasonic observation image of the ultrasonic observation means 3 can be obtained without being hindered by the tissue 49 on the concave focusing transducer 21 side of the protein-denatured focusing point 30 due to the heat conduction of the focusing point 30 after the treatment shown in FIG. It is possible to confirm from the observation image whether or not the lesion 47 can be cauterized with certainty.

Therefore, cauterization can be repeated while confirming whether or not the lesion 47 can be cauterized with certainty by the ultrasonic observation image, and reliable observation and treatment of the lesion 47 can be easily performed.

The arrangement of the ultrasonic observation means 3, the bending portion 19, the ultrasonic treatment means 5, and the insertion tube 20 from the distal end portion 18 side of the insertion portion 11 of the first embodiment is set to the distal end of the insertion portion 11. The ultrasonic treatment means 5, the bending portion 19, the ultrasonic observation means 3, and the insertion tube 20 may be provided from the portion 18 side. That is, in FIG. 1, the ultrasonic ultrasonic transducer 21 for treatment may be built in the distal end portion 18 or the like, and the ultrasonic ultrasonic transducer 17 for observation may be provided near the distal end of the insertion tube 20.

Also in this case, by changing the value of the bending angle of the bending portion 19, the focal point 30 of the therapeutic ultrasonic transducer 21 is within the observation field of view of the ultrasonic ultrasonic transducer 17.
Can be set and its position can be moved. Further, the insertion tube 20 may be a flexible insertion tube or a flexible tube which is not rigid but bendable.

(Second Embodiment) Next, a second embodiment of the present invention will be described with reference to FIG. FIG. 3 shows an ultrasonic diagnostic treatment system 1B including the ultrasonic probe 2B of the second embodiment. Since the main configuration is similar to that of the first embodiment, only the changes will be described.

As shown in FIG. 3, in this embodiment,
The therapeutic ultrasonic transducer 21 which is the ultrasonic therapeutic means 5 formed in the insertion portion 11 is connected to the distal end of the flexible shaft 51 having flexible characteristics by a fixing means (not shown). The flexible shaft 51 has the insertion portion 1
It is inserted through the inside of 1, and is further connected to the moving plate 53 of the moving means 52 provided in the second holding portion 14 via the first holding portion 12 and the operating portion 13 by a fixing means (not shown). The flexible shaft 51 has, for example, a spiral tube structure in which a metal band is spirally wound.

Inside the flexible shaft 51, a therapeutic signal line 33 connected to the therapeutic ultrasonic transducer 21 is inserted as shown in an enlarged view. In addition, the therapeutic signal line 33 inserted through the flexible shaft 51.
Is a drive signal generation circuit 34 in the ultrasonic diagnostic treatment apparatus 7B.
Connected to

A ball screw screw hole 54 is provided in the moving plate 53 in a direction parallel to the axis of the insertion portion 11, and a ball screw 55 is inserted therethrough. The moving plate 53 is provided with a guide hole 53a parallel to the axial direction of the ball screw 55, and the guide hole 53a is provided with a linear guide 56 fixed to the second grip portion 14 by a fixing means (not shown). It has been inserted.

The hand side of the ball screw 55 is the second operation portion 1.
4 is connected to the rotating shaft of a stepping motor 57 which is fixed by a fixing means (not shown). The stepping motor 57 has a control circuit 6 via a motor driver 59 in a motor control means 58 provided in the ultrasonic diagnostic treatment apparatus 7B.
It is connected to 0. This control circuit 60 is the controller 3
5 and can be controlled via the controller 35 by a key input operation from the keyboard 36.

By rotationally driving the stepping motor 57, the moving plate 53 is moved in the axial direction of the ball screw 55, and along with this movement, the flexible shaft 51 is moved forward and backward in the axial direction of the insertion portion 11, and at the tip thereof. The therapeutic ultrasonic transducer 21 provided is also movable from a position near the tip of the insertion tube 20 to near the tip of the bending portion 19. The main setting positions are indicated by the two-dot chain line. Further, the position of the focal point 30 can also be moved as indicated by the chain double-dashed line when the therapeutic ultrasonic transducer 21 is moved.

An ultrasonic wave sending window 43 'is provided within the range in which the therapeutic ultrasonic vibrator 21 moves. Further, the ultrasonic transmission medium 42 is enclosed in the internal space (of the insertion portion 11) in the range where the therapeutic ultrasonic transducer 21 moves, so that ultrasonic waves can be transmitted through the ultrasonic transmission window 43 '. ing.

As a material of the bending piece forming the bending portion 19 used in this embodiment, a material that transmits ultrasonic waves is used. In the present embodiment, the therapeutic ultrasonic transducer 21 can be moved to the designated position in the axial direction by keying in the movement position from the keyboard 36. The moving position can be set, for example, as follows.

Based on the rotation amount of the stepping motor 57 by one control pulse transmitted by the control circuit 60, the control circuit 60 transmits to the stepping motor 57 a control pulse required to move to a designated movement position. . The switching of the moving direction is performed by the control circuit 60 rotating the stepping motor 57 forward and backward.

The control circuit 60 is connected to the focus point marker generating circuit 32, and the control circuit 60 sends information on the axial position of the insertion portion 11 of the therapeutic ultrasonic transducer 21 to the focus point marker generating circuit 32, The focus point marker generation circuit 32 also refers to this information when determining the generation position of the focus point marker 31.

The other structure is similar to that of the first embodiment, and the same constituent members are designated by the same reference numerals and the description thereof is omitted. Next, the operation of the present embodiment will be described. In the ultrasonic probe 2B of the present embodiment, when a movement position or movement instruction is given from the keyboard 36 or the like, the instruction is sent to the control circuit 60 via the controller 35, and the control circuit 60 is instructed. The motor driver 59 moves the stepping motor 57 so as to move by the moving amount.
The stepping motor 57 arranged in the moving means 52 is controlled to supply a control pulse for driving the. When the stepping motor 57 rotates, the rotation is the ball screw 5
5 is transmitted.

The rotation of the ball screw 55 and the ball screw screw hole 54 formed in the moving plate 53 allow the moving plate 53 to move.
And flexible shaft 51 connected to the moving plate 53
Is moved in the axial direction, and the therapeutic ultrasonic transducer 21 connected to the tip of the flexible shaft 51 is moved in the axial direction of the insertion portion 11.

The encoder 29 connected to the rotary member 40 of the bending operation knob 22 obtains the rotation amount of the rotary member 40,
The bending angle of the bending portion 19 is calculated. The position of the therapeutic ultrasonic transducer 21 in the insertion axis direction is calculated from the rotation amount of the stepping motor 57, the size of the ball screw 55, and the pitch of the ball screw 55, which is known from the number of control pulses transmitted to the stepping motor 57 by the control circuit 60. The information is sent to the focus point marker generation circuit 32.

The focusing point marker generation circuit 32 determines the focusing point 30 of the therapeutic ultrasonic transducer 21 from the bending angle of the bending portion 19 and the axial position of the insertion portion 11 of the therapeutic ultrasonic transducer 21, and determines the focusing point. A corresponding focal point marker signal is output to the mixer 27 so that the focal point marker 31 is displayed at the position of 30, and superimposing the video signal of the ultrasonic image for observation output from the DSC 26 to disconnect the ultrasonic wave. It is displayed on the image 28.

The bending portion 19 is bent to adjust the position so that the focusing point marker 31 appears on the ultrasonic tomographic image 28, and the focusing point 30 of the therapeutic focused ultrasonic wave is positioned in the ultrasonic observation region 46. State.

Next, on the ultrasonic tomographic image 28, a lesion area 47 is formed.
The insertion part 11 is moved so that The position of the insertion part 11 is moved so that the focus point marker 31 on the ultrasonic diagnostic image 28 matches the position of the lesion part 47. Further, the position of treatment is set by inputting the movement position from the keyboard 36 and moving the treatment ultrasonic transducer 21 in the axial direction.

After the setting of the positioning, the drive signal generating circuit 34 irradiates the focused therapeutic ultrasonic wave having the required intensity from the concave focused medical ultrasonic transducer 21 shown in FIG. Can be cauterized.

Further, it is possible to cauterize the lesion 47 while moving the therapeutic ultrasonic transducer 21 in the axial direction. By inputting the movement range from the keyboard 36, the therapeutic ultrasonic transducer 21 can be moved in the axial direction by the designated movement range amount. The setting method of the moving range is as follows.

Based on the amount of rotation of the stepping motor 57 by one control pulse transmitted from the control circuit 60, the control circuit 60 sends to the stepping motor 57 a control pulse of rotation required to move within a specified movement range. Send.

When the therapeutic ultrasonic transducer 21 is moving in the movement range, cauterization is performed while moving it in the axial direction by stepping on the foot switch 37 and applying a drive signal to the concave focusing transducer 21. You can When the movement of the movement range is completed, the cauterization is completed by stepping on the foot switch 37 to turn off the switch.

Further, the moving speed in the axial direction of the therapeutic ultrasonic transducer 21 can be changed by keying in the moving speed level from the keyboard 36. The setting method of the moving speed is as follows.

The moving speed can be increased by shortening the transmission interval of the control pulse transmitted by the control circuit 60. Further, if the transmission interval is lengthened, the moving speed can be reduced.

According to the second embodiment, since the ultrasonic treatment means 5 can be moved in the axial direction of the insertion portion 11, the cauterization range can be expanded. In addition, since it is possible to move the ultrasonic therapeutic means 5 to the portion to be cauterized,
It is possible to easily and accurately perform the alignment with the lesion 47.

(Third Embodiment) Next, a third embodiment of the present invention will be described with reference to FIG. FIG. 4 shows an ultrasonic diagnostic treatment system 1C including an ultrasonic probe 2C according to the third embodiment. Since the main configuration is similar to that of the second embodiment, only the changes will be described.

As shown in FIG. 4, the therapeutic ultrasonic transducer 21 as the ultrasonic therapeutic means 5 formed in the insertion portion 11 used in the ultrasonic probe 2C of this embodiment has the minimum curvature of the bending portion 19. It has the same focal point distance 72 as the radius 71. Further, in the present embodiment, the ultrasonic treatment means 5 has a structure that moves within the bending portion 19 (it may be movable on the insertion tube 20 side as in the second embodiment).
The other configurations are the same as those in the second embodiment.

Next, the operation of this embodiment will be described with reference to FIG. Since the main operation is similar to that of the second embodiment, only the changes will be described. It is inserted into the body cavity that has been insufflated through the trocar 44, the therapeutic ultrasonic transducer 21 of the ultrasonic probe 2C is brought into contact with the back side of the organ 45 to be observed and treated, and the bending operation is performed as it is to bend in the vertical direction. With the maximum amount, the observation ultrasonic transducer 17 of the tip portion 18 is also brought into contact with the surface of the organ 45.

The insertion section 11 is moved so that the lesion 47 is extracted on the ultrasonic tomographic image 28. Ultrasonic tomographic image 2
The focus point marker 31 displayed on 8 moves the position of the insertion part 11 so that it may be located in the lesion part 47 on the ultrasonic tomographic image 28. Then, as in the second embodiment, the therapeutic ultrasonic wave is transmitted from the therapeutic ultrasonic transducer 21 to perform the therapeutic treatment.

The present embodiment has the following effects. First,
In the second embodiment, the lesion 47 can be cauterized more reliably by prolonging the irradiation time of the therapeutic focused ultrasonic waves. However, when a high-intensity therapeutic focused ultrasonic wave is irradiated at the same position for a long time, the therapeutic focused ultrasonic wave absorbed and attenuated in the ultrasonic wave transmitting window 43 'raises the temperature of the ultrasonic wave transmitting window 43'. Go.

The surface of the organ 45 to be treated is in close contact with the ultrasonic wave sending window 43 '. This ultrasonic wave sending window 43 '
When the temperature rises to a temperature that causes protein denaturation of tissues,
The surface of the close-contacted organ 45 is denatured by heat conduction from the ultrasonic wave sending window 43 '.

Therefore, in the first and second embodiments, it is necessary to shorten the irradiation time. In the third embodiment, the focal point distance 72 of the therapeutic ultrasonic transducer 21 and
The minimum radius of curvature 71 of the curved portion 19 of the probe is the same. Therefore, when the bending amount is maximized, the therapeutic ultrasonic transducer 21 is moved so that the position of the focal point 30 does not change. Therefore, the same portion can be continuously cauterized without moving the therapeutic ultrasonic transducer 21 to raise the temperature of the ultrasonic wave sending window 43 '.

Since the temperature of the ultrasonic wave sending window 43 'does not rise, only the lesioned portion 47 can be cauterized without denaturing the surface of the organ 45 with protein.

(Fourth Embodiment) Next, a fourth embodiment of the present invention will be described with reference to FIG. FIG. 5 shows an ultrasonic diagnostic treatment system 1D including the ultrasonic probe 2D of the fourth embodiment. Since the main configuration is similar to that of the first embodiment, only the changes will be described.

As shown in FIG. 5, the therapeutic ultrasonic transducer 21 as the ultrasonic treatment means 5 formed in the insertion portion 11 used in the ultrasonic probe 2D of this embodiment has a plurality of transducer elements ( Since it is fixed to the bending piece as described below, it is formed of a vibrator bending piece) 75.
Each transducer bending piece 75 is attached to the bending portion 19 by a fixing means (not shown).
Is fixed to the upper surface side (in the case of bending) of the bending piece forming the.

Each transducer bending piece 75 fixed to the bending piece by a fixing means (not shown) is connected to an independent treatment signal line 33, and all the treatment signal lines 33 are subjected to ultrasonic diagnosis. It is connected to the drive signal generating circuit 34 'in the treatment device 7D.

The therapeutic ultrasonic transducer 21 used in this embodiment has the same focusing point distance 72 as the minimum radius of curvature 71 of the bending portion 19. The other configurations are the same as those in the first embodiment. Next, the operation of the present embodiment will be described. Since the main operation is similar to that of the first embodiment, only the changes will be described.

The therapeutic ultrasonic transducer 21 of the ultrasonic probe 2 is inserted through the trocar 44 into the body cavity that has been insufflated.
Is brought into contact with the back side of the organ 45 to be observed and treated, and the bending operation is performed as it is to maximize the upward bending amount.
The observation ultrasonic transducer 17 is also brought into contact with the surface of the organ 45.

The insertion portion 11 is moved so that the lesion 47 is extracted on the ultrasonic tomographic image 28. The insertion point 11 is positioned so that the focus point marker 31 displayed on the ultrasonic tomographic image 28 is located at the lesion 47 on the ultrasonic tomographic image 28.
Move the position of.

The controller 35 sends a voltage from the drive signal generating circuit 34 'by keying in the number of the therapeutic ultrasonic transducer 21 (more specifically, the transducer bending piece 75) to be used from the keyboard 36. The signal line 33 for use is selected, and the voltage is applied only to the therapeutic ultrasonic transducer 21 which is key-in. The number of the therapeutic ultrasonic transducer 21 and the number of the therapeutic signal line 33 correspond to each other.

The present embodiment has the following effects. In the fourth embodiment, the focal point distance 72 of the plurality of transducer bending pieces 75 arranged on the bending portion 19 and the bending portion 1 of the probe are set.
9 is the same as the minimum radius of curvature 71. Therefore, it is possible to irradiate the lesion portion 47 with the therapeutic focused ultrasonic wave with high output power by irradiating the therapeutic focused ultrasonic wave once.

When the lesioned portion 47 is irradiated with therapeutic focused ultrasonic waves of high output power, the lesioned portion 47 at the focal point 30 position has a temperature rise time due to ultrasonic absorption attenuation at the focal point 30 and the living tissue in the vicinity thereof. Faster than in the third embodiment,
Irradiation time is short.

Further, since the therapeutic ultrasonic transducer 21 to be used can be selected, it is possible to adjust the power of the therapeutic focused ultrasonic waves for cauterizing the lesion 47, and to perform cauterization according to the size of the lesion 47. It is possible to do.

(Fifth Embodiment) Next, a fifth embodiment of the present invention will be described with reference to FIG. FIG. 6 shows an ultrasonic diagnostic treatment system 1E including the ultrasonic probe 2E of the fifth embodiment. Since the main configuration is similar to that of the first embodiment, only the changes will be described. Since the main configuration is similar to that of the first embodiment, only the changes will be described.

As shown in FIG. 6, the observation signal line 23 connected to the observation ultrasonic transducer 17 formed at the tip portion 18 used in this embodiment is inserted into the insertion portion 11 and Transmission pulse generation circuit 2 in the ultrasonic diagnostic treatment apparatus 7E
4 and the reception processing circuit 25. The reception processing circuit 25 is connected to the comparator 81, and the comparator 81 is connected to the address generator 82. The address generator 82 is connected to the arithmetic circuit 83, and the arithmetic circuit 83 is connected to the focus point marker generating circuit 32. The focus point marker generation circuit 32 is connected to the mixer 27, and the mixer 27 is connected to the color monitor 10.

The ultrasonic probe 2E of this embodiment is different from the ultrasonic probe 2A of FIG. 1 in that the operation section 13 and the like are provided with a switch (not shown) for instructing enlargement of an image.
This switch is connected to the reception processing circuit 25 via a signal line (not shown), and the reception processing circuit 25 performs signal processing for enlarged display by operating this switch. The other configurations are the same as those in the first embodiment.

Next, the operation of this embodiment will be described. Since the main operation is similar to that of the first embodiment, only the changes will be described. Transmission pulse generation circuit 24 of ultrasonic diagnostic treatment apparatus 7E
Is transmitted to the observation ultrasonic oscillator 17 to excite the observation ultrasonic oscillator 17 and emit the observation ultrasonic wave to the organ 45 side. This observation ultrasonic wave is reflected by a site having a different acoustic impedance, and the observation ultrasonic transducer 1
Received at 7.

The received ultrasonic wave is converted into an electric signal by the ultrasonic wave transducer 17 for observation, and is processed by the reception processing circuit 25 through the observation signal line 23 and converted into a video signal. This video signal includes an echo image 84 of the therapeutic ultrasonic transducer 21 as shown by the chain double-dashed line in FIG.
Further, the echo image 84 of the therapeutic ultrasonic transducer 21 is a high-level echo image as compared with the echo image of the living tissue.

The video signal signal-processed by the reception processing circuit 25 is output to the comparator 81 and then to the DSC 26. The signal converted into the standard video signal by the DSC 26 is input to the color monitor 10, and the color monitor 10 receives the signal.
Is displayed as an ultrasonic tomographic image 28 on the display surface. Note that FIG. 6 shows the color monitor 10 in an enlarged display over the entire display surface.

The comparator 81 compares the input signal with the comparison potential, and when the input signal exceeds the comparison potential, outputs a high level logic signal. This means that the echo image 84 of the therapeutic ultrasonic transducer 21 is detected from the signal input to the comparator 81.

The address generator 82 counts and outputs the address value when the input signal is a high-level logic signal, that is, when the echo image 84 of the therapeutic ultrasonic transducer 21 is detected. The address value in this case is counted and output when the echo image 84 of the therapeutic ultrasonic transducer 21 is detected. The address value in this case indicates the shape of the echo image 84 of the therapeutic ultrasonic transducer 21.

The arithmetic circuit 83 calculates the area and diameter from the input address value. Further, the position of the focusing point 30 of the therapeutic ultrasonic transducer 21 is calculated from the area and the diameter. The calculation result of the arithmetic circuit 83 is input to the focus point marker generating circuit 32.

The focusing point marker generating circuit 32 superimposes the focusing point marker 31 on the video signal output from the DSC 26 by the mixer 27 and displays it on the ultrasonic tomographic image 28.

This embodiment has the following effects. Since the position of the therapeutic ultrasonic transducer 21 can be detected on the ultrasonic tomographic image 28, rather than calculating the display position of the focus point marker 31 from the rotation angle of the bending operation knob 22 as in the first embodiment. The focus point marker 31 can be displayed at an accurate position on the ultrasonic tomographic image 28. In addition, the lesion 47 can be cauterized more reliably.

In the above-described embodiment, for example, the observation ultrasonic transducer 17 is not limited to the one that performs the electronic linear scan, but may be the one that performs the electronic sector scan, the electronic radial scan, or the electronic convex scan. It may be performed, or mechanical linear scan, sector scan, radial scan, or the like may be performed.

Further, for example, the back surface side (opposite side of the ultrasonic wave sending surface) of the therapeutic ultrasonic transducer 21 having a concave shape is plate-shaped (may be divided into a plurality in the longitudinal direction if necessary). By attaching a voltage to the piezoelectric element and applying a voltage to the piezoelectric element, the piezoelectric element can be bent in the longitudinal direction to change the substantial curvature of the ultrasonic wave transmitting surface of the therapeutic ultrasonic transducer 21. It may be possible to provide focusing point distance changing means capable of changing the distance to the focusing point. Note that different embodiments may be configured by partially combining the above-described embodiments and the like.

[0105]

[Appendix 2] 1. An insertion portion that can be inserted into a body cavity, an ultrasonic transducer for image acquisition provided on the distal end side of the insertion portion, the ultrasonic transducer for image acquisition and the insertion portion separated in the longitudinal direction of the insertion portion. A therapeutic ultrasonic transducer that is provided to send the ultrasonic beam so as to focus the ultrasonic beam, and a focal point of the therapeutic ultrasonic transducer that is provided on the distal end side of the insertion portion and that is used for the image acquisition ultrasonic transducer. To be in the field of view of
An ultrasonic therapeutic probe, comprising: a curved portion that allows at least one of the image acquisition ultrasonic transducer and the therapeutic ultrasonic transducer to move.

2. The ultrasonic therapeutic probe according to appendix 1, wherein the ultrasonic transducer for image acquisition is arranged on a tip side of the curved portion, and the ultrasonic transducer for treatment is arranged in the insertion portion after the curved portion. 3. The ultrasonic therapeutic probe according to appendix 2, wherein the therapeutic ultrasonic transducer has a rigid insertion tube portion behind the curved portion from a position where the therapeutic ultrasonic transducer is provided to a rear end of the insertion portion.

4. The ultrasonic therapeutic probe according to appendix 2, wherein the therapeutic ultrasonic transducer has a flexible insertion tube portion from a position where the therapeutic ultrasonic transducer is provided to a rear end of the insertion portion, behind the curved portion. 5. The ultrasonic therapeutic probe according to any one of appendices 1 to 4, further comprising moving means for moving the therapeutic ultrasonic transducer in an axial direction of the insertion portion. (Operation of Supplementary Note 5) The treatment range of the ultrasonic therapeutic means can be expanded, and the ultrasonic therapeutic means and the lesion can be easily and accurately aligned.

6. 6. The ultrasonic therapeutic probe according to appendix 5, wherein the minimum radius of curvature of the curved portion is substantially matched with the focal length of the therapeutic ultrasonic transducer. (Operation of Supplementary Note 6) It is possible to surely treat only a lesion portion without causing protein denaturation on the surface of the treated organ.

7. A plurality of the therapeutic ultrasonic transducers are provided in the axial direction of the bending portion, and the minimum radius of curvature of the bending portion is substantially matched with the focal length of each of the wave-treating ultrasonic transducers. The ultrasonic therapeutic probe according to any one of 1 to 3. (Operation of Supplementary Note 7) The irradiation time of the therapeutic ultrasonic waves by the ultrasonic therapeutic means is shortened, and irradiation can be performed according to the size of the lesion by selecting the ultrasonic therapeutic means to be used.

8. When the therapeutic ultrasonic transducer is driven, the position and focus position of the therapeutic ultrasonic transducer are determined from a driving unit that performs an image acquisition operation by the image acquiring ultrasonic transducer and an ultrasonic image acquired by the drive control unit. 5. The method according to any one of supplementary notes 1 to 4, further comprising: a calculating unit that calculates the position of the therapeutic ultrasonic transducer and a display control unit that displays the calculated position and focus position of the therapeutic ultrasonic transducer in the ultrasonic image. Ultrasonic therapy probe. (Operation of Supplementary Note 8) A focus point marker is displayed at an accurate position,
The lesion can be treated more reliably.

[0111]

As described above, according to the present invention, the insertion part that can be inserted into the body cavity, the ultrasonic transducer for image acquisition provided on the distal end side of the insertion part, and the ultrasonic transducer for image acquisition. And a treatment ultrasonic transducer which is provided in the insertion portion while being separated from each other in the longitudinal direction of the insertion portion, and which sends out an ultrasonic beam so as to focus the ultrasonic beam on a focusing point, and the treatment ultrasonic transducer provided on the distal end side of the insertion portion. So that the focal point of the ultrasonic transducer for use is located in the observation field of view by the ultrasonic transducer for image acquisition, a bending portion that makes at least one of the ultrasonic transducer for image acquisition and the ultrasonic transducer for treatment movable. Since the curved section is provided, the therapeutic ultrasonic wave can be placed in the observation field of view of the ultrasonic transducer for image acquisition. While it is possible to arrange a focal point for treatment by the Sducer, after irradiation of the focused ultrasonic beam by the therapeutic ultrasonic transducer, without being disturbed by the tissue where the attenuation on the therapeutic ultrasonic transducer side from the focal point is large, An ultrasonic observation image near the focus point can be obtained.

[Brief description of drawings]

FIG. 1 is a configuration diagram of an ultrasonic diagnostic treatment system including an ultrasonic treatment probe according to a first embodiment of the present invention.

FIG. 2 is a view showing a state of using the first embodiment.

FIG. 3 is a configuration diagram of an ultrasonic diagnostic treatment system including an ultrasonic treatment probe according to a second embodiment of the present invention.

FIG. 4 is a configuration diagram of an ultrasonic diagnostic treatment system including an ultrasonic treatment probe according to a third embodiment of the present invention.

FIG. 5 is a configuration diagram of an ultrasonic diagnostic treatment system including an ultrasonic treatment probe according to a fourth embodiment of the present invention.

FIG. 6 is a diagram showing a configuration of an ultrasonic diagnostic treatment apparatus according to a fifth embodiment of the present invention.

[Explanation of symbols]

 1A ... Ultrasonic diagnostic treatment system 2A ... Ultrasonic treatment probe 3 ... Ultrasonic observation means 4 ... Signal processing means 5 ... Ultrasonic treatment means 6 ... Treatment drive signal generating means 7A ... Ultrasonic diagnostic treatment apparatus 9 ... Display means 10 ... Color monitor 11 ... Insertion portion 13 ... Operation portion 17 ... Observation ultrasonic transducer 18 ... Tip portion 19 ... Bending portion 20 ... Insertion tube 21 ... Treatment ultrasonic transducer 22 ... Curving operation knob 24 ... Transmission pulse generation Circuit 25 ... Reception processing circuit 26 ... DSC 28 ... Ultrasonic tomographic image 30 ... Focus point 31 ... Focus point marker 32 ... Focus point marker generation circuit 45 ... Organ 46 ... Ultrasound observation area 47 ... Lesion site

Claims (1)

[Claims] 1. An insertion part that can be inserted into a body cavity, an ultrasonic transducer for image acquisition that is provided on the distal end side of the insertion part, an ultrasonic transducer for image acquisition that is separated from the longitudinal direction of the insertion part. And a therapeutic ultrasonic transducer that is provided in the insertion part and that sends the ultrasonic beam so as to focus the ultrasonic beam on the focusing point; and a focusing point of the therapeutic ultrasonic transducer that is provided on the distal end side of the insertion part An ultrasonic treatment, comprising: a curved portion that allows at least one of the image acquisition ultrasonic transducer and the therapeutic ultrasonic transducer to move so as to be located within an observation field of view by the acquisition ultrasonic transducer. Probe.