JPH10305041A - Ultrasonic therapy system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prevent ultrasonic waves from being shielded by ribs or the like by allowing ultrasonic waves for therapy to be in an almost fan-like shape. SOLUTION: An ultrasonic wave generation source 2 for therapy is fan-shaped comparatively thin such as with thickness less than about 20 mm at the time of passage between ribs, for example, so as to irradiate a therapy object from the gap of ribs 6 with strong ultrasonic waves for therapy. Plural piezo elements similar to conventional ones are arranged in the shape of the spherical shell, only several piezo elements among them are selectively driven and as a result, the object can be irradiated with fan-shaped strong ultrasonic waves for therapy as well. Besides, a special fan-shaped clinical ultrasonic wave generation source 2 can be constituted as well. Thus, the therapy object 6 is irradiated without shielding ultrasonic waves with ribs 16.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus for treating an affected part by intensively irradiating ultrasonic waves from outside the body.

[0002]

2. Description of the Related Art In recent years, a calculus crushing device for crushing calculus non-invasively by irradiating a powerful ultrasonic wave from outside the body for the treatment of calculus disease has been put into practical use and attracted attention. The method of using a piezo element as a high-intensity ultrasonic source has a small focus, no consumables, can control the intensity of high-intensity ultrasonic waves arbitrarily, and can control the focal position by controlling the phase of the drive waveform applied to multiple piezo elements Has excellent advantages (Japanese Unexamined Patent Publication No.
No. 145131, U.S. Pat. No. 4,526,168).

[0003] In addition, for the treatment of prostatic hypertrophy and the like,
As a relatively invasive treatment method, a hyperthermia treatment method, which treats a treatment target by irradiating an affected part in the body with electromagnetic waves or ultrasonic waves from outside the body, has been implemented. This is a treatment method in which the diseased part is heated to 42.5 ° C. or more to destroy only the cells to be treated, utilizing the fact that the tissue to be treated is relatively weaker to heat than the normal tissue. In addition, heat treatment for raising the temperature of the affected area to 60 ° C. or higher and causing heat denaturation in pathological tissues has attracted attention.
No. 1-013956 "and" Japanese Patent Application Laid-Open No. 5-137733.
As shown in the publication, the powerful ultrasonic wave generated outside the body by the piezo element is focused on the treatment site inside the body,
Devices for heating and treating cancer by heat generation due to absorption of ultrasonic energy of tissue have been researched and developed.

[0004] In addition, a therapeutic method of irradiating a cancer with a powerful bals-like powerful ultrasonic wave that crushes a calculus, instead of generating heat by ultrasonic waves, and necrosis cells by the mechanical force has been studied (Hoshi). , S. et al .: J. Uro.
logic, Vol. 146: 439, 1991. ).

[0005] An example actually used clinically is E
Treatment of bladder cancer at DAP (France) (external radiation)
(G. Va11ancien et al .: Eur.
Urol 1993, 23 (suppl 1), pp4
8) Treatment of prostate treatment (radial rectal irradiation) performed by Focal Surgery (USA) (Stephan)
See Madersbacher et al. : Cance
r res Aug 1995 Vol. 55, pp33
46, 1995).

A conventional ultrasonic transducer for treatment is shown in FIG.
As shown in (a) and (b), the ultrasonic wave is formed in a spherical shell shape so as to be focused at a geometric focus.

[0007] By the way, since the organs such as the liver are accommodated in the ribs as shown in FIG. 12, when the heat treatment is performed by the ultrasonic waves, the reduction of the energy reached by the shielding of the ultrasonic waves by the ribs becomes a problem.

For example, when an ultrasonic wave is applied to the liver from above the ribs using a spherical shell type vibrator having an aperture diameter of 100 mm, about 70% of the total radiated ultrasonic waves are shielded by the ribs and reach the focal position only about 70%. It will be 30%. Ultrasonic energy also drops to about 30%. In order to compensate for the loss of shielding, a method of increasing the input energy is conceivable. However, since the strength on the skin surface becomes extremely high, there is a risk that an accident such as a burn may occur.

[0009] The ultrasonic therapy apparatus also has the following problems. The vibrator (piezo element) used for calculus crushing is driven by a high voltage of several kV, but one driving time is several μs.
There is no need to worry about fever.

However, in the hyperthermia treatment, the vibrator is operated at 60 W /
It is driven by a continuous wave of about ² cm ² . At this time, it is known that heat is generated inside the vibrator due to hysteresis loss, dielectric loss (tan δ), and mechanical loss (1 / Q). Depending on the degree of heat generation, the electric characteristics of the piezo element change, causing not only energy loss but also deterioration of the backing material and the like in the vicinity thereof, which may cause a failure of the device.

[0011] Therefore, effective cooling of the vibrator is required, and it has been proposed to attach a radiation fin or other cooling device to the vibrator (Japanese Patent Application Nos. 6-248480, 6). -315979).

However, the installation of these cooling devices complicates the structure of the applicator, increases the time required for manufacturing, and reduces the operability of the applicator.

[0013]

SUMMARY OF THE INVENTION It is an object of the present invention to provide an ultrasonic treatment apparatus capable of effectively avoiding shielding of an ultrasonic wave by a rib or the like.

Another object of the present invention is to provide an ultrasonic therapy apparatus capable of effectively cooling a transducer with a simple structure.

[0015]

According to the present invention, there is provided an ultrasonic treatment apparatus for treating a treatment target by irradiating the treatment ultrasonic wave to the treatment target in a focused manner, wherein the treatment ultrasonic wave is formed in a substantially fan shape. It is characterized in that it is possible.

The maximum thickness of the fan-shaped therapeutic ultrasonic wave is 20 m.
m or less.

In order to generate the fan-shaped therapeutic ultrasonic waves, there is provided a substantially strip-shaped or substantially elliptical piezo element which is curved at a constant curvature in the major axis direction.

The piezo element is curved in the minor axis direction at the same curvature as the major axis direction.

In order to generate the fan-shaped therapeutic ultrasonic waves, there are provided a plurality of piezo elements arranged in a substantially strip shape or a substantially elliptical shape curved at a constant curvature in the long axis direction.

The piezo element has a spherical shell shape.

The apparatus has means for individually changing the directions of the plurality of piezo elements.

The fan-shaped therapeutic ultrasonic waves can be generated in plurality.

Further, according to the present invention, a therapeutic ultrasonic wave generated by an ultrasonic generating source is introduced into a subject via a coupling liquid contained in a water bag, and the affected part in the subject is treated. In the ultrasonic therapy apparatus, a means for circulating the coupling liquid between the water bag and the heat exchanger is provided for cooling the ultrasonic generation source.

The circulating means has a nozzle for discharging the coupling liquid into the water bag, and the nozzle is provided so as to spray the coupling liquid to the ultrasonic generating source.

[0025] The circulating means has a water inlet for taking in the coupling liquid from the water bag, and a discharge port for discharging the coupling liquid into the water bag. , And the discharge port is provided at a peripheral portion of the ultrasonic wave generating source.

A plurality of the discharge ports are provided at a peripheral portion of the ultrasonic wave generating source.

[0027] The circulating means has a water intake for taking in the coupling liquid from the water bag, and the water intake is provided on the back side of the ultrasonic wave generating source.

Further, the present invention provides the ultrasonic treatment apparatus comprising: a vibrator for generating therapeutic ultrasonic waves for treating an affected part in a subject; and a backing material provided on a back surface of the vibrator. The backing material has a thermal conductivity of 1
0 W / (m · K) or more.

The backing material is aluminum, silver,
It contains at least one kind of metal of copper.

(Function) In the present invention, the treatment target ultrasonic wave can be irradiated to the treatment target through, for example, the space between the ribs.

In the present invention, the vibrator can be effectively cooled by diverting the coupling liquid by circulating between the water bag and the heat exchanger.

Further, in the present invention, since the thermal conductivity of the backing material is 10 W / (m · K) or more, the heat generated by the vibrator can be quickly absorbed from the vibrator. Therefore, the vibrator can be effectively cooled.

[0033]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The preferred embodiments of the present invention will be described below with reference to the drawings. The ultrasonic therapy device includes a calculus crushing device and an ultrasonic thermotherapy device. The present invention is applicable to any of these devices.

(First Embodiment) FIG. 1 is a block diagram showing an ultrasonic therapy apparatus according to a first embodiment of the present invention. The applicator 1 includes a therapeutic ultrasonic wave source 2 that generates the therapeutic ultrasonic waves in a focused manner, and a coupling liquid 4 that guides the therapeutic ultrasonic waves from the therapeutic ultrasonic wave source 2 to the patient 3 with less loss. And a water bag 5 for sealing the coupling liquid 4. At the time of treatment, the patient 3 is fixed on the treatment table 10, and then the applicator 1 is put on the body surface of the patient 3, and the water bag 5 is brought into contact with the skin of the patient 3 via ultrasonic jelly or the like (not shown). Let it.

A hole 17 is formed at a substantially central portion of the therapeutic ultrasonic generator 2, and an ultrasonic probe 8 is inserted therein. Note that the ultrasonic probe 8 may be of an outline type provided outside the therapeutic ultrasonic wave generation source 2. Here, the former structure will be described. The ultrasonic probe 8 may be detachable from the applicator 1 or may be fixed to the hole 17. The ultrasonic probe 8 is provided so as to be able to slide in the front-rear direction and to move axially. The movement of the slide and the rotation of the shaft is manually or by the control circuit 11 and the probe position control circuit 1.
3 is realized.

The ultrasonic diagnostic apparatus 14 includes the ultrasonic probe 8
Is configured to scan the cross section of the patient 3 with imaging ultrasonic waves through the interface, reconstruct a tomographic image of the cross section including the focal point 7 of the cooperative ultrasonic wave for treatment, and display the tomographic image on a CRT (not shown). . In addition, the ultrasonic diagnostic apparatus 14 is configured to be able to display the position of the focal point 7 on a tomographic image with a marker. Using this function, the applicator 1 and the patient 3 are moved so that the focal point 7 matches the treatment target 6 while confirming the position of the treatment target (calculus or treatment target) 6 in the body on the tomographic image. Can be. After confirming the coincidence between the treatment target 6 and the focal point 7 on the tomographic image, the driving circuit 12 drives the therapeutic ultrasonic wave generating source 2 to irradiate a strong ultrasonic wave, and the treatment target existing at the ultrasonic focal point 7 Treat 6. Further, the surgeon can make a treatment plan from a tomographic image, and confirm the therapeutic effect by comparing ultrasonic images of the inside of the body before and after the irradiation with high-intensity ultrasonic waves.

FIG. 2A shows the therapeutic ultrasonic wave generator 2 viewed from the focal point 7 side. FIG. 3A shows a longitudinal sectional view of the therapeutic ultrasonic generator 2, and FIG. 3B shows a transverse sectional view of the therapeutic ultrasonic generator 2. The therapeutic ultrasonic wave source 2 has a relatively thin shape, for example, a substantially fan-like shape having a thickness of 20 mm or less when passed between the ribs, so that the therapeutic ultrasonic wave can be irradiated to the treatment target from the gap between the ribs 16. It is configured to be capable of irradiating (or a thin wedge-shaped) therapeutic intense ultrasonic wave. Specifically, as in the past, a plurality of piezo elements are arranged in a spherical shell shape, and only some of the piezo elements are selectively driven. The treatment ultrasonic wave source 2 may be configured to irradiate a sound wave or to specially irradiate only a fan-shaped strong treatment ultrasonic wave. Here, the latter example will be described.

It should be noted that the above-mentioned substantially fan shape is clearly distinguished from the conventional conical shape. In other words, no matter how long the vertical cross section is inserted, the conical shape shows a fan shape with almost the same cross-sectional shape (the same narrow angle). Although the fan has a fan shape, the narrow angle of the fan in the cross section in the thickness direction is much smaller than the narrow angle of the fan in the cross section in the width direction, that is, a very thin wedge shape.

The ultrasonic wave generating source 2 is provided inside a substantially strip-like or substantially elliptical frame 9 which is curved in the long axis direction at a constant curvature and has the same shape as the frame 9 as shown in FIG. One processed piezo element 21 is attached, or a plurality of piezo elements 22 are arranged in one or multiple rows as shown in FIG. The position of the focal point 7 is
The position of the ultrasonic wave source 2 is determined geometrically according to the curvature of the frame 9. This piezo element 21 (or 22)
The maximum width of the opening surface of the rib is, for example, 20 mm when passing between ribs.
To generate fan-shaped therapeutic ultrasonic waves less than mm
For example, it is provided at 30 mm or less.

In order to further reduce the focal size, the frame 9 is preferably curved in the short axis direction at the same constant curvature as the long axis direction.

As shown in FIG. 2 (c), a hole 17 for inserting the probe 8 is formed in a substantially central portion of the therapeutic ultrasonic wave generating source 2. The corners of the therapeutic ultrasound source 2 may be angular or rounded.

As described above, in the present embodiment, the therapeutic ultrasonic waves can be irradiated in a relatively thin fan shape, so that the therapeutic ultrasonic waves can be radiated from the gaps between the ribs 16 without being shielded by the ribs 16. The treatment target 6 can be reached.

As shown in FIGS. 4A and 4B,
Two or more ultrasonic generating sources 2 having the same shape may be provided, and the therapeutic ultrasonic waves may be irradiated toward the treatment target 6 from the gap between the plurality of ribs. In this case, the ultrasonic therapy apparatus has a structure and a control circuit for individually adjusting the angles of the plurality of ultrasonic sources 2 so that the respective intense ultrasonic waves for treatment coincide.

As shown in FIGS. 5A and 5B,
A plurality of spherical piezo elements 24 may be provided on the frame 9. In this case, the plurality of spherical piezo elements 24 are provided on the frame 9 with their respective angles adjusted so that the respective focal points (Fa, Fb,..., Ff) converge at one place.

(Second Embodiment) FIG. 6 shows a configuration diagram of an ultrasonic therapy apparatus according to a second embodiment. FIG. 7 is a longitudinal sectional view of the ultrasonic generator 2 'of FIG. In these drawings, the same parts as those in FIG. 1 are denoted by the same reference numerals, and detailed description is omitted.

As in the first embodiment, a plurality of disk-shaped piezo elements 25 are arranged in a row inside a strip-shaped frame 9 curved in the long axis direction at a constant curvature. The piezo element 25 does not have to have a disk shape, and may have a spherical shell shape. In the case of a spherical shell shape, the fitting angle of the aperture 7 is adjusted by a fitting type vibrator (reference numeral P is a vibrator, reference numeral 20 is a frame) as shown in FIG. It is conceivable to select and use different oscillators (FIG. 8A)
reference). As shown in FIG. 8, it is preferable to reinforce the spherical shell-shaped piezo element main body P with a frame 20. Like the first embodiment, the opening diameter of the piezo element 25 is preferably about 20 mm or less so that a fan-shaped therapeutic ultrasonic wave having a maximum thickness of 20 mm or less can be obtained.

The piezo elements 25 are individually supported by the angle adjuster 18 so that their directions can be freely changed individually. By controlling the respective directions, as shown in FIG. 7, the depth and the direction of the focal point 7 'can be freely changed while the applicator 1 is fixed. This control is realized by the transducer angle control circuit 19 according to the depth and orientation of the treatment target 6 specified on the tomography via the pointer 22.

According to this embodiment, in addition to the effects of the first embodiment, the depth and direction of the focal point 7 'can be freely changed while the applicator 1 is fixed.

This effect can also be obtained with a so-called phased array. In this case, a plurality of flat piezo elements are arranged in a line, and the drive timing of each of the plurality of flat piezo elements is
This is realized by individually controlling the phase control circuit 26 in FIG. 9 so that the ultrasonic waves from the respective piezo elements are focused at one point at a desired depth.

Although the shape of the frame 9 has been described as a rectangular shape, a frame 27 having a spherical shell shape may be used as shown in FIG. In this case, the mounting of the water bag 5 and the base for fixing the water bag 5 to the body surface include the frame 2.
This is because the circular shape of 7 is considered to have better stability.

(Third Embodiment) FIG. 13 shows the configuration of an ultrasonic therapy apparatus according to a third embodiment. FIG.
(A) shows a cross section of the applicator 101 of FIG. The applicator 101 includes a therapeutic ultrasound generating source 102 in the form of a spherical shell for irradiating high-intensity therapeutic ultrasonic waves, a coupling liquid 104 for guiding the high-intensity ultrasonic waves to a patient 103, and a water bag holding the coupling liquid 104. 105. In the therapeutic ultrasonic generator 102, for example, a plurality of transducers (piezo elements) are densely attached to the inner surface of a spherical shell-shaped frame, and a backing material 106 for absorbing vibration is provided on the back of the transducer. Become.

The coupling liquid circulation system 120 includes the water bag 10
5 is configured so that the coupling liquid 104 in the liquid 5 can be absorbed, cooled, and returned to the water bag 105 after cooling. By such a circulation, the ultrasonic wave source 102
Can be cooled.

At the time of treatment, the patient 10 is placed on the treatment table 119.
After fixing 3, the applicator 101 is placed on the body surface of the patient 103, and the water bag 105 is replaced with an ultrasonic jelly or the like (not shown).
Through the skin of the patient 103.

A hole 1 is provided at a substantially central portion of the applicator 101.
25 is opened, and the ultrasonic probe 113 is inserted therein. The ultrasonic probe 113 is connected to the applicator 10
1 may be removable, or the applicator 10
It may be fixed to 1. The ultrasonic diagnostic apparatus 116
The section of the patient 103 is scanned via the ultrasonic probe 113, a tomographic image relating to the section is reconstructed based on the obtained echo signals, and the tomographic image is displayed.

The ultrasonic probe 113 is provided so as to be slidable in the front-rear direction and rotatable, and can be moved under the control of the control circuit 114 and the probe position control circuit 117. It is also possible to move manually.

The position of the ultrasonic focus 107 is displayed as a marker on a CRT (not shown) of the ultrasonic diagnostic apparatus 116, and the object 108 to be treated in the body is displayed on the ultrasonic image.
While confirming the position of the ultrasonic wave 107, the ultrasonic
The applicator 101 can be moved via the mechanical arm 118 or the patient 103 can be moved to coincide with 08.

After confirming the coincidence between the object to be treated 108 and the focal point 107 by the ultrasonic diagnostic apparatus 116, the driving circuit 115 drives the therapeutic ultrasonic wave generating source 102 to irradiate a powerful ultrasonic wave for therapeutic treatment. Is heated to a high temperature to perform treatment. Further, the surgeon can make a treatment plan based on the in-vivo images obtained by the ultrasonic diagnostic apparatus 116, and can confirm the treatment effect by comparing the in-vivo ultrasonic images before and after the intense ultrasonic irradiation.

Next, the coupling liquid circulation system 120 which is a feature of this embodiment will be described. As shown in FIG. 14A, a water intake 111 is opened at a substantially central portion of the ultrasonic wave source 102, and a water absorption pipe 112 is connected to the water intake 111. The peripheral portion of the ultrasonic generating source 102 outside the therapeutic ultrasonic path 122 so that the coupling liquid 4 is sprayed onto the surface of the ultrasonic generating source 2 and does not block the path of the therapeutic ultrasonic wave. In addition, a plurality of nozzles (discharge ports) 110 for discharging the coupling liquid 104 are provided discretely or in an arcuate manner (see FIG. 16).
A drain pipe 109 is connected to the nozzle 110.

By providing the water intake port 111 and the nozzle 110 in this manner, the inside of the water bag 105 is
04 flows so as to trace the surface of the transducer from the peripheral edge of the ultrasonic generator 2 toward the top. With this flow, the ultrasonic generation source 2 (vibrator) can be efficiently cooled.

FIG. 14B shows the structure of the coupling liquid circulation system 120. The amount of the coupling liquid 104 in the water bag 105 is adjusted in advance according to the depth so that the focal point 107 coincides with the treatment target 108. Therefore, it is necessary to keep the amount of the coupling liquid 104 in the water bag 105 constant during the circulation. For this purpose, a so-called dual tubing pump having two pump systems for water absorption and drainage, having the same rotating shaft and draining the same amount of water absorption without requiring special control. 131 is adopted as a circulation pump. The operation of the double tubing pump 131 allows the water bag 105 and the cooling device 1
Coupling liquid 1 with 32 warm reservoir tanks
04 is cycled. The coupling liquid 104 in the heat retaining reservoir tank is always kept in a cooling state (for example, 10 ° C.), and the cold coupling liquid 104 can be returned to the water bag 105. Further, in order to maintain a good degassing state of the coupling liquid 104 in the heat retaining reservoir tank, the coupling liquid 104 circulates between the heat retaining reservoir tank and the deaerator 133.

As described above, in order to adjust the amount of liquid in the water bag 105, the intake port of the small tubing pump 134 is attached to a part of the drain pipe 109 separately from the double tubing pump 131. . Then, the coupling liquid 1 whose water is taken by the small tubing pump 134
04 is drained to a warming reservoir tank.

As described above, according to the present embodiment, the ultrasonic generator 102 (vibrator) can be effectively cooled with a simple configuration.

The water suction nozzle and the discharge port 110 may be modified as follows. For example, as shown in FIG.
The load applied to 1 can be somewhat reduced. In addition, as shown in FIG. 17, the drain nozzle 110 may not be disposed on the entire peripheral edge of the ultrasonic generation source 102, but may be provided only at two opposing locations. In addition, the water inlet 111 may be arranged on the periphery of the ultrasonic generator 102 as shown in FIG. Further, as shown in FIG. 19, the coupling liquid 104
2 may be arranged so as to be blown obliquely upward.
In this case, the blown-up coupling liquid 4 flows so as to go up to the water inlet 111 while circling the inner surface of the ultrasonic generation source 102, and the ultrasonic generation source 102 can be cooled effectively.

The heat generated by the ultrasonic source 102 is generated not only by the surface (the surface that emits strong ultrasonic waves) always in contact with the coupling liquid 4 but also by the back surface (usually an air backing).
Also transmitted to. Therefore, in consideration of cooling of the back surface of the ultrasonic wave source 102, the coupling liquid 104 may be circulated also on the back side as shown in FIG. Since the back surface of the ultrasonic generator 102 is on the drive electrode side, it is necessary to insulate it from the front surface (earth). At this time, it is necessary to avoid using a material having poor heat conductivity that lowers heat dissipation as the insulator. Also, in order to minimize the emission of the ultrasonic wave to the back surface, the ultrasonic wave source 102
A material having an acoustic impedance that is significantly different from the acoustic impedance of the above is preferred. For these reasons, as shown in FIG. 20, a thin air layer 123 is used as an insulator,
This is a thin aluminum plate 124 insulated from the back of the vibrator.
And circulating the coupling liquid 104 thereon. Alternatively, a material filled with grease (not shown) having good heat conductivity may be used instead of the air layer 123. In the embodiment shown in FIG.
Passes through the drain pipe 109, enters the water bag 105 from the discharge nozzle 110, cools the surface of the ultrasonic wave source 102,
After coming out from the water inlet 111 to the back surface of the ultrasonic wave source 102 and cooling the back surface of the ultrasonic wave source 102, the water absorbing pipe 11
Water is absorbed from 2. Note that the structure is not limited to the structure shown in FIG. 20 as long as the coupling liquid 104 passes through the front surface and the back surface of the ultrasonic wave source 102.

(Fourth Embodiment) FIG. 21 shows a cross section of a backing material which is a main part of a fourth embodiment. In the fourth embodiment, the backing material 12 provided on the back surface of the vibrator to absorb the vibration to the back side.
6 is used to further enhance the cooling effect of the ultrasonic wave source 102, and should be used alone or in combination with the third embodiment.

That is, by utilizing the heat capacity of the backing material 126, it is possible to reduce the possibility that the heat generated by the ultrasonic generating source 102 accumulates in the ultrasonic generating source 102 having a small heat capacity and becomes high in temperature. As a material of the backing material 126, since the thermal conductivity of PZT ceramics used as a piezo element is 2 to 4 W / (m · K), the thermal conductivity is 10 W /
By selecting a metal such as aluminum, silver, copper or the like having a value of (m · K) or more, heat can be quickly diffused.

When a metal is used for the backing material 126, the insulation from the surroundings is determined by placing the air layer 12 between the ultrasonic generator 102 and the backing material 126 as shown in FIG.
8 and the like, and the backing material 126 has a cable 12 for supplying electric power to the therapeutic ultrasonic generator 102.
7 may be provided, or as shown in FIG. 22, the backing material 126 may be brought into direct contact with the therapeutic ultrasonic wave generating source 2, and this may be regarded as an electrode to connect the cable 127. Good. In this case, it is conceivable to provide an insulator 130 around the backing material 126 to insulate it from the surroundings.

As shown in FIG. 23, when a plurality of piezo elements constituting the ultrasonic wave source 102 'are arranged in a plane and the focus 107 can be formed at an arbitrary position by delay control, Cooling of the ultrasonic generating source 102 'by the coupling liquid 104 can be performed in the same manner.

When the coupling liquid is circulated as in the above-described embodiment, it is essential to keep the amount of the coupling liquid in the water bag constant. This is because, when the amount of drainage and the amount of water injected becomes unbalanced and the amount of coupling liquid in the water bag changes, the size of the water bag having elasticity changes accordingly. May cause water leakage accidents, and even before this happens, the adhesion between the water bag and the body surface will decrease and the treatment wave will not reach the body, There is a risk of getting off the affected area. The fifth embodiment described below is for the purpose of preventing such a situation.

(Fifth Embodiment) FIG. 24 shows a fifth embodiment of the present invention.
1 shows a configuration of an ultrasonic therapy apparatus according to an embodiment. The applicator 201 is an ultrasonic source 202 for irradiating the therapeutic ultrasonic waves, a water bag 205 attached to the ultrasonic source 202, and sealed between the ultrasonic source 202 and the water bag 205, And a coupling liquid 204 for guiding high-intensity ultrasonic waves to the patient 3 with less loss. When performing treatment, the patient 203 is fixed on the treatment table 228, and then the applicator 201 is placed on the body surface of the patient 203, and the water bag 205 is placed on the skin of the patient 203 via ultrasonic jelly or the like (not shown). Make contact.

As shown in FIG. 25, the ultrasonic wave source 202 has one or a plurality of ultrasonic transducers formed in a spherical shell shape or arranged in a spherical shell shape. Is geometrically determined by the curvature of the spherical shell 206
To focus on. The applicator 201
The mechanical arm 8 controlled by the control circuit 7 can freely move in an arbitrary direction in an arbitrary direction in an arbitrary posture, either electrically or manually.

The applicator 201 includes a patient 203
An ultrasonic probe 210 connected to an ultrasonic diagnostic apparatus 209 is provided in order to obtain an ultrasonic image of the inside of the body and use it for positioning the focus 206 and the affected part 212. The ultrasonic probe 210 may be removable with respect to the applicator 201, or may be fixed to the applicator 201. Here, a hole is made in a substantially central portion of the ultrasonic wave source 202, and the ultrasonic probe 210 is inserted here. The ultrasonic probe 210 is configured to be able to slide in the front-rear direction and to rotate, and can move under the control of the control circuit 207 and the probe position control circuit 211. It is also possible to move manually.

A CRT (not shown) of the ultrasonic diagnostic apparatus 209 displays a focus marker indicating the position of the ultrasonic focus 206 together with the ultrasonic image, and displays the focus marker on the ultrasonic image (not shown). The user can move the applicator 201 and the patient 203 so that the ultrasonic focus 206 coincides with the affected part 212 while confirming the position of the affected part 212 in the body.

After confirming the coincidence between the affected part 212 and the focal point 206 by the ultrasonic diagnostic apparatus 209, the driving circuit (group) 213 drives the ultrasonic wave source 202 to irradiate a powerful ultrasonic wave to coincide with the ultrasonic focal point 206. The affected area 212 is heated to a high temperature for treatment. Further, the surgeon makes a treatment plan based on the in-vivo image (not shown) by the ultrasonic diagnostic apparatus 209, and confirms the treatment effect by comparing the in-vivo ultrasonic image before and after the intense ultrasonic irradiation. You can do it.

When the ultrasonic wave source 202 generates heat when irradiating the affected part 212 with continuous waves, the temperature of the coupling liquid 204 rises due to the heat. The liquid 204 needs to be cooled. Further, in order to prevent the influence of cavitation generated when irradiating strong ultrasonic waves, the coupling liquid 204 is used.
Need sufficient degassing. For this reason, in the present embodiment, as shown in FIG. 26, the coupling liquid 204 stored in the reservoir 216 is cooled by the cooling device 217, and the degassing device 18 is used to cool the coupling liquid 204.
Degas to 5 mg / l or less.

Further, the coupling liquid 204 is supplied to the applicator 201 through the water supply port 219 and the drain port 220 of the coupling liquid 204 provided on the ultrasonic wave source 202 or a backing material for fixing the water bag 205 thereto. Tubing pump (main pump) 2 which has excellent consistency in the amount of inflow and outflow in order to circulate between the pump and the reservoir 216.
15 are provided. In this example, a double tubing pump is used for circulating the coupling liquid 204. However, a plurality of pumps may be used to inject and drain water to and from the applicator 201.

By the way, to solve the problem that the size of the elastic water bag 205 is changed mainly due to the mismatch between the water injection amount and the drainage amount, the double tubing pump 215 is used. In addition to the adoption, the following measures have been taken.

As shown in FIG. 27, the countermeasure is to reduce the drainage amount of the coupling liquid 204 from the applicator 201 and
Auxiliary pump 22 for finely adjusting at least one of the amount of coupling liquid 204 injected into applicator 201 and the amount of water injected.
1 are provided, and flow meters 222 and 223 are provided at the water inlet 219 and the water outlet 220 of the applicator 201, respectively, to separately measure the amount of water injected and the amount of water discharged to the applicator 201 constantly or at regular intervals, The control circuit 207 compares the water injection amount data and the drainage amount data measured by the flow meters 222 and 223, and the control circuit 207
The output of the auxiliary pump 221 is controlled by the water circuit control circuit 214 in accordance with the difference data between the water injection amount and the drainage amount so that the water injection amount and the drainage amount match with high accuracy.

Next, the circulation operation will be described in detail. The circulating operation of the coupling liquid 204 may be performed continuously during the generation period of the therapeutic ultrasonic wave, but it is preferable that the circulating operation having the risk of shifting the position of the focal point 206 be as small as possible. A method for this will be described below.

When the circulation of the coupling liquid 204 is continued during the treatment for a long time, it can be said that it is extremely difficult to unbalance the suction amount and the discharge amount of the main pump 215 during this long time. If the balance is lost, the size of the water bag 205 becomes unstable, and the ultrasonic focus 206 may be shifted. Therefore, the circulation operation is stopped until the water temperature in the applicator 201 reaches the dangerous value (upper limit value), that is, the circulation operation is performed only while the water temperature in the applicator 201 exceeds the upper limit value. A method is conceivable.

More specifically, as shown in FIG.
Is provided with a temperature sensor 224 using a thermoelectric body or the like, and measures the water temperature of the coupling liquid 204 in the water bag 205 together with the surface temperature of the ultrasonic wave generating source 202 at all times or at a fixed time. I do. Then, this water temperature data is compared with the upper limit value by the control circuit 207, and the control circuit 2
According to the comparison result from 07, when the water temperature in the applicator 201 exceeds the upper limit, the main pump 215 is activated, and when the water temperature falls below the upper limit, the operation of the main pump 215 is stopped. The control circuit 214 controls the main pump 215. Of course, during this circulation, the flow rate of the water injected into the applicator 201 and the flow rate of the drainage are monitored by the flow meters 222 and 223, and the two are controlled so that they match.

When the water temperature exceeds the upper limit, the control circuit 207 may issue a warning using light, sound, or the like, and the operator may manually start the circulation of the coupling liquid 204. . In addition, regardless of whether the coupling liquid 204 exceeds or does not exceed the upper limit, the coupling liquid 204 may be periodically circulated for a predetermined period at regular intervals. Furthermore, if the water temperature does not fall below the upper limit even after the circulation operation is continued for a certain period of time, it is determined that an abnormal situation has occurred, and the control circuit 207 transmits the abnormality to the operator using light or sound. Alternatively, some measures such as an emergency stop may be urged.

Further, as described above, the amount of water injected and the amount of drainage of the coupling liquid 204 are adjusted by using the auxiliary pump 221 to suppress the variation in the size of the water bag 205 with high accuracy. In order to further improve the accuracy, a change in the size (diameter) of the water bag 205 may be actually measured using a tension sensor or the like. In this case, the water bag 20 may be constantly or at a fixed time interval by the tension sensor.
5 is measured for tension. Then, the tension data is compared by the control circuit 207 with the tension immediately before or a predetermined time before. According to the comparison result from the control circuit 207, the water circuit control circuit 214 determines that the current tension is higher than the immediately preceding tension. The main pump 215 is controlled so as to slightly decrease the output of the pump 215 and slightly increase the output of the main pump 215 when the current tension is lower than the immediately preceding tension. Instead of the tension sensor, a sensor of another principle such as a pressure sensor may be used. Since the change in the tension of the water bag 205 is caused not only by the increase or decrease of the coupling liquid 204 but also by the change in the shape of the water bag 205, only a warning is issued when the reference value is exceeded,
The operator may determine whether to increase or decrease the flow rate.

Next, an effective degassing method will be described based on experimental results. FIG. 29 shows the dependence of the deaeration time on the water temperature required for decreasing the dissolved oxygen amount from the saturated state to 2.5 mg / l. Since the amount of saturated dissolved oxygen in water changes depending on the water temperature, and the higher the water temperature, the lower the amount.Therefore, from the experimental results, it is better to start degassing from a high water temperature than to start degassing from a low water temperature. It turns out that it takes less time to worry.

Therefore, in this embodiment, a water temperature sensor 227 is provided in the reservoir 216 as shown in FIG. 30 in order to efficiently perform degassing and reduce the time required for the degassing. Then, for example, the reservoir 216 is filled with normal tap water, and the water temperature at that time is measured. The water temperature data is compared with a set value (for example, 20 degrees Celsius) by the control circuit 207, and when the water temperature is lower than the set value (20 degrees Celsius), the water temperature control circuit 226 is controlled to reduce the water temperature to 20 degrees Celsius. To a degree. In this state, the tap water is degassed until the dissolved oxygen amount becomes 2.5 mg / l or less, for example.
The time required for the degassing can be shortened and the treatment can be started early. Here, the reason why the water temperature at the time of degassing was set to 20 degrees Celsius is that after the degassing was completed, the coupling liquid 204 during treatment was used.
Considering the water temperature conditions, for example, the cooling time for cooling to 10 ° Celsius, if the water temperature is set too high to reduce the degassing time, the degassing time situation can be shortened. Instead, the cooling time is prolonged, and eventually the time until the start of treatment may be prolonged.

In the above description, the ultrasonic wave generating source 202 has a spherical shell shape, but it may be a phased array in which plate vibrators are arranged in a plane. In addition, although the ultrasonic heat treatment apparatus has been described, it may be used for an ultrasonic calculus crushing apparatus.

The present invention is not limited to the above embodiment, but can be implemented in various modifications.

[0088]

According to the present invention, it is possible to irradiate the treatment object with a substantially fan-shaped treatment ultrasonic wave through, for example, the space between the ribs, so that the shielding of the ultrasonic wave by the ribs or the like can be effectively avoided.

Further, according to the present invention, by circulating between the water bag and the heat exchanger, the coupling liquid can be diverted to effectively cool the vibrator.

Further, in the present invention, since the heat conductivity of the backing material is 10 W / (m · K) or more, the heat generated by the vibrator can be quickly absorbed from the vibrator. It can be cooled effectively.

Further, according to the present invention, even when the coupling liquid is circulated to cool the heated ultrasonic wave generating source, the amount of the coupling liquid in the water bag is kept constant with high accuracy. Accordingly, it is possible to suppress the problem that the size of the water bag fluctuates and the position of the focal point shifts.

[Brief description of the drawings]

FIG. 1 is a configuration diagram of an ultrasonic irradiation apparatus according to a first embodiment.

FIG. 2 is a view of the therapeutic ultrasound source in FIG. 1 as viewed from a focal point side.

FIG. 3 is a view showing a shape of a therapeutic ultrasonic wave generated from the therapeutic transducer of FIG. 1;

FIG. 4 is a diagram showing an arrangement of a plurality of therapeutic ultrasound sources.

FIG. 5 is a view showing another embodiment of the therapeutic ultrasonic generator of FIG. 2;

FIG. 6 is a configuration diagram of an ultrasonic therapy apparatus according to a second embodiment.

FIG. 7 is a sectional view of the ultrasonic generator of FIG. 6;

FIG. 8 is a plan view of the vibrator of FIG. 7;

FIG. 9 is a diagram showing a form to which a phased array is applied.

FIG. 10 is a diagram showing another embodiment to which a spherical shell-shaped frame is applied.

FIG. 11 is a schematic diagram showing a configuration of a conventional ultrasonic wave generating source.

FIG. 12 is a schematic diagram showing a positional relationship between a rib and a liver.

FIG. 13 is a configuration diagram of an ultrasonic therapy apparatus according to a third embodiment.

14 is a diagram showing a cross-sectional configuration and a circulatory system configuration of the applicator of FIG.

FIG. 15 is a view showing another embodiment of the drainage pipe of FIG. 14;

FIG. 16 is a diagram showing the arrangement of the ejection nozzles in FIG.

FIG. 17 is a diagram showing another embodiment of a discharge nozzle.

FIG. 18 is a view showing another embodiment of the suction / drainage system.

FIG. 19 is a diagram showing another embodiment of a discharge nozzle.

FIG. 20 is a diagram showing another embodiment in which the back surface of the vibrator is also cooled by the coupling liquid.

FIG. 21 is a sectional view of a main part of an ultrasonic therapy apparatus according to a fourth embodiment.

FIG. 22 is a view showing another embodiment of the backing material of FIG. 21.

FIG. 23 is a diagram showing another embodiment to which a phased array is applied.

FIG. 24 is a configuration diagram of an ultrasonic therapy apparatus according to a fifth embodiment of the present invention.

FIG. 25 is a cross-sectional view of the applicator of FIG. 24.

FIG. 26 is a diagram showing a circulation path of the coupling liquid in FIG. 24.

FIG. 27 is a diagram showing a control system of a main pump and an auxiliary pump.

FIG. 28 is a diagram showing a configuration including a water temperature sensor of an applicator.

FIG. 29 is a graph showing the dependence of the deaeration time required for decreasing the dissolved oxygen amount from a saturated state to 2.5 mg / l on the water temperature.

FIG. 30 is a view showing a modification of the fifth embodiment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Applicator, 2 ... Ultrasonic source for treatment, 3 ... Patient, 4 ... Coupling liquid, 5 ... Water bag, 6 ... Treatment target, 7 ... Ultrasonic focus, 8 ... Ultrasonic probe, 9 ... Frame, 10: bed, 11: control circuit, 12: drive circuit, 13: probe position control circuit, 14: ultrasonic diagnostic apparatus, 15: mechanical arm.

 ──────────────────────────────────────────────────続 き Continued on the front page (72) Inventor Satoshi Aida 1385-1 Shimoishigami, Otawara-shi, Tochigi Pref. Toshiba Nasu Plant

Claims (15)

[Claims] 1. An ultrasonic treatment apparatus for treating a treatment target by irradiating the treatment ultrasonic wave to the treatment target in a focused manner, wherein the treatment ultrasonic wave can be formed in a substantially fan shape. Ultrasonic therapy device. 2. A plurality of transducers arranged in a substantially strip shape or a substantially elliptical shape curved at a constant curvature in a long axis direction in order to generate the substantially fan-shaped therapeutic ultrasonic waves. The ultrasonic therapy device according to claim 1, wherein 3. The ultrasonic therapy apparatus according to claim 2, wherein the vibrator has a spherical shell shape. 4. The ultrasonic therapy apparatus according to claim 2, further comprising means for individually changing the directions of the plurality of transducers. 5. The ultrasonic treatment apparatus according to claim 1, wherein a plurality of the substantially fan-shaped therapeutic ultrasonic waves can be generated. 6. An ultrasonic therapy apparatus for introducing a therapeutic ultrasonic wave generated by an ultrasonic generating source into a subject via a coupling liquid contained in a water bag and treating an affected part in the subject. In, in order to cool the ultrasonic source,
An ultrasonic treatment apparatus comprising means for circulating the coupling liquid between the water bag and a heat exchanger. 7. The circulating means has a nozzle for discharging the coupling liquid into the water bag, and the nozzle is provided so as to spray the coupling liquid to the ultrasonic generation source. The ultrasonic therapy apparatus according to claim 6, wherein 8. The circulating means has a water intake for taking out the coupling liquid from the water bag, and a discharge opening for discharging the coupling liquid to the water bag, wherein the water intake is provided with the ultrasonic wave. 7. The ultrasonic therapy apparatus according to claim 6, wherein the discharge port is provided at a substantially central portion of the source, and the discharge port is provided at a peripheral portion of the ultrasonic source. 9. An ultrasonic treatment apparatus comprising: a vibrator for generating therapeutic ultrasonic waves for treating an affected part in a subject; and a backing material provided on a back surface of the vibrator, wherein the backing material is An ultrasonic therapy apparatus having a thermal conductivity of 10 W / (m · K) or more. 10. An ultrasonic wave generated by an ultrasonic generating source is introduced into a subject via a coupling liquid sealed between the ultrasonic generating source and a water bag, and an affected part of the subject is affected. An applicator configured to treat, a reservoir for storing the coupling liquid, a main pump for circulating the coupling liquid between the applicator and the reservoir, and An ultrasonic therapy apparatus, comprising: an auxiliary pump for finely adjusting at least one of a drainage amount of a coupling liquid and a water injection amount of the coupling liquid into the water bag. 11. The ultrasonic treatment apparatus according to claim 10, wherein the main pump is a double tubing pump. 12. The ultrasonic therapy apparatus according to claim 10, further comprising a control circuit for controlling an output of said auxiliary pump in order to keep a coupling liquid amount in said water bag constant. 13. The apparatus according to claim 1, further comprising: a flow meter for measuring a drainage amount of the coupling liquid from the water bag, and a flow meter for measuring a water injection amount of the coupling liquid into the water bag. Item 11. The ultrasonic treatment device according to Item 10. 14. A control circuit for controlling the main pump so that circulation is performed only while the temperature of the coupling liquid in the water bag exceeds a predetermined upper limit value. The ultrasonic therapy apparatus according to claim 10, wherein 15. The apparatus according to claim 15, further comprising at least one of a cooling device for cooling the coupling liquid in the reservoir and a degassing device for degassing the coupling liquid in the reservoir. Item 11. The ultrasonic treatment device according to Item 10.