JPH11313831A - Ultrasonic therapeutic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prevent inconvenience of interfering with therapy due to ultrasonic energy of succeeding wave being damped by the influence of cavitation generated by preceding wave by irradiating the succeeding wave avoiding the cavitation generated by the preceding wave. SOLUTION: An ultrasonic irradiation area on an ultrasonic tomographic image in a testee is equally divided into four by two orthogonal straight lines passing the center of the irradiation area, to form first to fourth inner divided areas and each inner divided area is divided in small divided areas where an ultrasonic focus moves. The ultrasonic focus is controlled in movement so as to move in the different small divided areas in the different inner divided areas every ultrasonic irradiation. Succeeding wave can therefore be continuously irradiated avoiding the influence of cavitation generated by preceding wave.

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 a tumor or the like in a living body using ultrasonic waves.

[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. As a powerful ultrasonic source, an underwater discharge method, an electromagnetic induction method, a micro explosion method, a method using a piezo element, and the like are conceivable, and each has a disadvantage and an advantage. The method using a piezo element has the disadvantage that the pressure of the strong ultrasonic focus is small, but there is no small focus, no consumables, it is possible to arbitrarily control the strong ultrasonic intensity, and the phase control of the drive waveform applied to multiple piezo elements And the focus position can be controlled by performing such operations (JP-A-60-145131, USP-452616).
8). Further, the shape of the focal point can be changed by controlling the phase of the driving waveform (Japanese Patent Laid-Open No. 62-427).
73).

On the other hand, as one of the treatment techniques for malignant neoplasms, so-called cancer, hyperthermia has been attracting attention. This is based on the fact that tumor tissues have higher temperature sensitivity than normal tissues and die when heated to 42.5 ° C. or higher, and a method of locally heating a tumor site is particularly effective. It is.

As a method of heating, a method using electromagnetic waves such as microwaves has been preceded. However, it is difficult to selectively heat deep tumors due to electrical characteristics of a living body. Are limited to superficial (within 5 cm deep) tumors.

[0005] Therefore, a method using acoustic energy such as ultrasonic waves has been considered for treating deep tumors. This utilizes the characteristics of the convergence of the ultrasonic beam and the deep arrival depth. In addition, there has been reported a treatment method in which the above-mentioned heating treatment is advanced to heat the tumor portion to 80 ° C. or more, thereby burning out the tumor tissue (Japanese Patent Application No. 3-306).
No. 106).

[0006] The ultrasonic heating method includes an ultrasonic transducer in which a plurality of ultrasonic transducers having a spherical ultrasonic radiation surface are combined, or an annular transducer in which ring-shaped ultrasonic transducers are concentrically arranged. Those using an array ultrasonic transducer have been proposed. In particular, when an annular array ultrasonic transducer is used, the depth of focus can be changed.

Further, a phased array capable of changing the focus three-dimensionally by taking a step further has been proposed (US Pat. No. 4,526,168). In addition, a device in which a calculus crushing device and a heating / heating device are integrated has been proposed (Japanese Patent Application No. 3-306106).

As for the heating / heating device as described above, there has been proposed a method of uniformly heating / heating an affected part by utilizing a small focus which is a feature of the piezo method (Japanese Patent Application Laid-Open No. Sho 61). -209643).

[0009]

However, the conventional ultrasonic therapy apparatus irradiates an ultrasonic wave to an adjacent area while continuously moving the focal point of the ultrasonic wave, and alternately emits the ultrasonic wave to two distant points. There is no free treatment plan such as irradiation to the skin or irradiation to avoid obstacles such as bones, and there is a risk of damaging normal tissues as well as tumor tissues.

When a certain position is irradiated with continuous high-intensity ultrasonic waves, energy immediately after the start of irradiation reaches the target position without being disturbed. The generated bubbles reflect strong ultrasonic waves, and the energy reaching the focal point is attenuated. This is the same as in the case of irradiating strong ultrasonic waves while moving the focal point, if the moving speed is slow.

Cavitation means that when a strong ultrasonic wave passes through water, a very large pulling force acts on the water under the influence of a negative pressure accompanying the strong ultrasonic wave, and the water is torn off to generate bubbles (cavities). This is a phenomenon, and this bubble acts as a reflector of strong ultrasonic waves. Therefore, if a large amount of air bubbles due to cavitation are floating near the point where the strong ultrasonic wave is irradiated, the energy of the strong ultrasonic wave immediately next to the ultrasonic wave is weakened, and a sufficient therapeutic effect cannot be obtained.

The present invention has been made in view of the above-mentioned problems, and does not damage normal tissues even when continuously irradiating ultrasonic waves while moving the focal point to a predetermined portion of a subject. It is another object of the present invention to provide an ultrasonic treatment apparatus capable of preventing inconvenience in which the ultrasonic energy of the rear wave is attenuated by the influence of cavitation due to the front wave and hinders the treatment.

[0013]

According to the present invention, there is provided an ultrasonic therapy apparatus comprising: an ultrasonic generating means for generating an ultrasonic wave for irradiating a subject; An irradiation area dividing means for dividing an irradiation area of a subject to be irradiated with ultrasonic waves from the means into a plurality of divided irradiation areas, and a distance corresponding to a predetermined divided irradiation area; A focus position moving control means for moving and controlling the focal position of the ultrasonic wave emitted from the ultrasonic wave generating means so that the focal point of the ultrasonic wave emitted every time moves.

In the ultrasonic therapy apparatus according to the present invention, the irradiation area dividing means divides the irradiation area of the subject to be irradiated with the ultrasonic wave from the ultrasonic wave generating means into a plurality of divided irradiation areas, Movement control means is separated from the ultrasonic wave generating means so that the focal point of the ultrasonic wave irradiated from the ultrasonic wave generating means for each divided irradiation area moves at a distance corresponding to a predetermined divided irradiation area. The movement of the focal position of the ultrasonic wave is controlled.

[0015] Thereby, the focal position of the ultrasonic wave focused into the subject from the ultrasonic wave generating means can be controlled based on the divided area. The focal point of the ultrasonic wave is moved so as not to be affected by cavitation. The position can be controlled. For this reason, a free treatment plan regarding the irradiation position of the ultrasonic wave can be made. In addition, the occurrence of cavitation due to the front wave can prevent the disadvantage that the ultrasonic energy of the rear wave is lost, thereby enabling efficient heating and heating treatment without using wasteful energy. And the time required for treatment can be shortened.

[0016]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of an ultrasonic therapy apparatus according to the present invention will be described below with reference to the drawings.

[First Embodiment] FIG. 1 is a block diagram of an ultrasonic therapy apparatus according to a first embodiment of the present invention. In FIG. 1, the ultrasonic therapy device is
It has an “ultrasonic treatment section” and a “CT section for positioning”.

The ultrasonic treatment section comprises a spherical ultrasonic transducer 2 in which one or more irradiating intense ultrasonic waves for treatment are combined, a coupling liquid 4 for guiding the intense ultrasonic waves to a patient 3, It has an ultrasonic applicator 1 consisting of a water bag 5 for holding the coupling liquid 4 in a sealed state.

During treatment, the ultrasonic applicator 1
Is placed on the body surface, and the water bag 5 is brought into contact with the skin of the patient 3 using an ultrasonic jelly or the like (not shown). Then, after the focal point 6 coincides with the tumor 7, the ultrasonic vibrator 2 is driven by the drive circuit 8 to irradiate high-intensity ultrasonic waves.

In the ultrasonic treatment apparatus according to the first embodiment, an MRI is used as a positioning CT unit. In this MRI, a patient 3 is set on a motorized table 8 in a supine position, and is placed in an imaging gantry (not shown) in which a static magnetic field coil 9, a gradient magnetic field coil 10, and a transmitting / receiving RF coil 11 are incorporated. Sent in. At this time, the control circuit 1
The table moving device 13 moves the table 8 by the control of 2 to fix the patient 3 at a predetermined position (A position).

Next, the control circuit 12 activates the gradient magnetic field power supply 14 and the transmission / reception circuit 15 in accordance with a predetermined sequence (for example, T2-weighted imaging method) instructed from the console 16, and the patient 3
The image information of the multi-plane in the body is stored in a memory (not shown). This three-dimensional information is stored in C by the control circuit 12.
An arbitrary form such as a pseudo three-dimensional display using a wire frame is displayed on the RT 17 and is frozen.

Here, the operator inputs a treatment plan from the console 16 while viewing the image of the inside of the body including the tumor 7 which is a treatment site. Here, the treatment plan refers to the method of scanning the focal point 6, the irradiation intensity of ultrasonic waves, the time, the interval, and the like.

When the start of treatment is instructed from the console 16, the control circuit 12 moves the table 8 to move the patient 3 to the treatment position (B position). When the movement is completed, the control circuit 12 controls the mechanical arm 18 to move the applicator 1 to the treatment position.

At this time, the position of the focal point 6 of the strong ultrasonic wave in the body is determined in advance by a signal from an applicator position detecting device 19 composed of a potentiometer (not shown) attached to each part of the mechanical arm 18 and the like. The control circuit 12 calculates from the measured information on the mounting position of the MRI apparatus and the mechanical arm 18 and displays it on the MRI image of the CRT 17.

Further, not only the focus but also the incident path of the ultrasonic wave can be displayed together, which is considered to be useful in making a treatment plan in consideration of the influence of bones and the like in the middle.
The state of coincidence between the position of the focal point 6 and the initially determined focal position of the treatment plan is checked, the control circuit 12 instructs the drive circuit 8 to start ultrasonic irradiation, and the treatment is started.

Next, at the point in time when the treatment is considered to be in the middle or at the end, the ultrasonic irradiation is stopped, the applicator 1 is removed from the patient 3, the patient is moved to the A position, and the progress of the treatment is observed. This is performed in the same manner as in the above-described operation, and an MRI image around the tumor 7 is taken to examine a change in a living body.

Here, when the data of the T2-weighted image stored in the memory before the treatment and the present data are subtracted, the heat-denatured region can be clearly confirmed, and whether the treatment has been sufficiently performed or has been insufficiently performed. Can be used to determine if re-treatment is necessary. Also, this was included in the treatment plan from the beginning,
It is also possible to automatically take an image every predetermined treatment time.

When the initial treatment plan is completed and the situation is such that it is possible to determine that the treatment has been sufficiently completed by MRI, the operator terminates the treatment. At this time, the control circuit 12 can retrieve the history of the treatment condition from the memory and output the treatment record from the CRT 17 or the printer 20.

Further, as described in Japanese Patent Application Laid-Open No. 61-154667, it has been confirmed by experiments that a change appears on an ultrasonic image due to a temperature change or thermal denaturation. Effect determination is also possible.

As described above, in the first embodiment,
Since the tumor can be heated to a high temperature by sharply focused high-intensity ultrasound while accurately recognizing the tumor shape from the three-dimensional information, the tumor can be necrotized by high-temperature degeneration with low invasiveness to the patient and effectively. Further, since the treatment can be performed while recognizing the degenerated area, the entire tumor can be treated, and the risk of recurrence or metastasis due to omission of treatment can be reduced. Further, it is possible to prevent damage caused by applying excessively strong ultrasonic waves to a living body or a probe in a body cavity or by excessively humidifying, and to perform safe treatment.

Further, since the ultrasonic treatment can be performed while recognizing the three-dimensional shape of the tumor tissue imaged by MRI, the treatment can be performed easily and accurately. In addition, if the state after treatment is photographed on MRI, the effect of treatment can be immediately known. In this example, the MRI is used as the three-dimensional image forming apparatus, but an X-ray CT scanner may be used.

[Second Embodiment] FIG. 2 shows a second embodiment of the present invention.
FIG. 3 is a block diagram showing a configuration of the embodiment. In the present embodiment, a phased array is used as a source of high-intensity ultrasonic waves for treatment.

As shown in FIG. 3, the applicator 1a has a shape obtained by dividing a circular flat ultrasonic transducer into radial and circumferential directions, and has an ultrasonic probe 2 for imaging an ultrasonic tomographic image in the center.
01 is attached so as to be able to move back and forth and rotate. The drive circuit group 8a is divided into channels corresponding to the number of divided ultrasonic transducers, and is driven by independent timing signals delayed by the phase control circuit 204 by a signal from the control circuit 12. Thereby, the focal point of the ultrasonic wave is 6a in FIG.
As shown in FIG. 6b, it can be set at an arbitrary location three-dimensionally.

The operation of moving the focal position by the delay time control is described in detail in US Pat. No. 4,526,168. At this time, the applicator position detecting device 19 detects not only the entire position of the applicator 1a but also the relative position of the ultrasonic probe 201, and sends the data to the control circuit 12 and the ultrasonic imaging device 202. The control circuit 12 also sends information on the set focal position by the phased array to the ultrasonic imaging apparatus 202. For this reason, it is possible to display the status of the tumor 7 as the treatment site and the position of the focal point 6 on the ultrasonic imaging device 202 in real time even during the treatment.

On the CRT 17, as shown in FIG.
MRI freeze image 4 before applicator 1a installation
A tomographic position 402 currently being scanned by the ultrasonic probe 201, a focal region 403 of the therapeutic ultrasonic wave, and an incident path 404 of the therapeutic ultrasonic wave can be displayed on 01 in a superimposed manner.

In this embodiment, the MRI static magnetic field coil 9 and the gradient magnetic field coil 10 are Helmholtz-shaped, and a work hole 203 is provided at the center. The applicator 1 is made of a non-magnetic material. Therefore, the transmitting and receiving RF coil 1
If the direction of the patient 1 is adjusted, the patient 3 can be seen from above (or below).
Can be mounted directly without changing the position of the applicator 1. Thus, it is not necessary to take the patient 3 in and out as in the first embodiment, and it is possible to reduce the time lag between the treatment and the observation and the risk of movement of the patient 3 during the time.

Furthermore, since the shape of the affected part in the body can be accurately recognized based on the three-dimensional information and a treatment plan can be made in advance, the influence of an obstacle can be taken into consideration, and treatment waves can be omitted or shock waves can be applied to dangerous parts. In addition, the treatment can be performed while monitoring whether or not the shock wave irradiation is performed according to the treatment plan, and the risk of erroneous irradiation and the like can be reduced.

[Third Embodiment] FIG. 5 is a block diagram showing a configuration of a third embodiment of the present invention.

In the figure, the ultrasonic source 31 has a plurality of piezo elements arranged in a spherical shell so as to form a concave surface, and is coupled to a patient 33 via a water bag 32.
An ultrasonic probe 36 for drawing an ultrasonic image of the tumor 34 is provided at the center of the ultrasonic source 31.
The ultrasonic probe 36 is configured to be slidable and rotationally movable in the front-rear direction, and is connected to an ultrasonic diagnostic imaging device 38.

The drive circuit 40 drives the piezo element to irradiate the tumor 34 in the body of the patient 33 with ultrasonic waves.

In this example, a desired portion is irradiated with ultrasonic waves by using a phased array type piezo element as in the second embodiment. Therefore, by controlling the drive timing of the plurality of drive circuits 40 by the plurality of delay circuits 43, it is possible to operate the focal position, the sound field, and the heating / heating area without moving the applicator.

The drive circuit 40 and the drive trigger pulse generation circuit 44 are controlled by a control circuit 42. That is, at the time of heating and heating, a burst signal of a constant voltage is continuously output. At this time, power is supplied to the drive circuit by the power supply circuit 41. The configurations of the driving circuit 40 and the driving trigger pulse generating circuit 44 are described in Japanese Patent Application No. Hei.
306106 ".

The control circuit 42 calculates the focal point 35, the sound field area, and the heating / heating area at arbitrary positions, and converts these information into a digital scan converter 39 (hereinafter, referred to as a digital scan converter 39).
DSC39).

The DSC 39 superimposes the treatment mode information, the virtual focus 35 in the phased array, the sound field area and the heating / heating area on the ultrasonic image generated by the ultrasonic image diagnostic apparatus 38. Image is CR
It is displayed at T37. In the heating region and the heating region, the focal position, the shape, and the like can be approximately calculated by a fluid equation, a heat absorption coefficient of a living body, and the like.

On the CRT 37, a three-dimensional image 46 of the tumor in the patient's body may be synthesized and displayed based on information from the ultrasonic image. These calculations are performed by the control circuit 42. In addition, three-dimensional images of tumors in the body
Alternatively, imaging may be performed using an X-ray CT scanner.

FIG. 6 is an example of a screen displayed on the CRT 37, and shows a three-dimensional image of a tumor in a patient's body.
As for the tumor, for example, an equally-spaced cross section as shown in FIG.
As shown in FIG. 6 (b), the tumor 34
Is read into the image data input device 45,
The three-dimensional image synthesized by the integral calculation in the control circuit 42 is displayed on the CRT 37 again. This method is described in detail in JP-A-61-209643. The information on the outline of the tumor may be input from the CRT 37 using the light pen 49.

On the three-dimensional image 46, a location 48 heated and heated by irradiation calculated by the control circuit 42.
Is specified. At this time, the colors at the time of calculus crushing, at the time of heating and at the time of heating are different from each other. Therefore, an erroneous operation of excessively heating and heating does not occur.

Further, to clarify the positional relationship between the tumor and the ultrasonic probe, XYZ axes 47 are displayed on the three-dimensional image. Further, in order to create a three-dimensional image, the maximum diameter of each of the length, width and height of the tumor displayed on the CRT 37 as shown in FIG. The ellipsoid may be integrated by the control circuit 42 and displayed on the CRT 37 as a three-dimensional image.

FIGS. 8 and 9 show the order of irradiation positions when the focal positions in continuous irradiation during heating and heating are separated as much as possible so that energy loss due to cavitation is reduced. .

First, as shown in FIGS. 8 (a) and 8 (b), the tumor is divided vertically and horizontally by thicknesses Δd1 and Δd2, respectively. This thickness is determined by calculation in consideration of the focal spot size and the heat absorption coefficient of the living body within a range where heating and heating can be sufficiently performed when the ultrasonic waves are focused.

Next, each area is irradiated in the order shown in FIG. The focusing position is controlled by a control circuit. In this case, the range of focus movement is
A rectangle consisting of eight squares smaller than the focal size,
Do not irradiate the area where the tumor outline is not visible at all. In this way, destruction of normal tissue is reduced.

As described above, in the third embodiment of the present invention, the treatment position can be freely planned with respect to the irradiation position by moving the focal position based on the area and not necessarily continuously but freely. Also, by controlling the movement of the focal point so that the energy loss at the focal point of the strong ultrasonic waves due to the reflection of the strong ultrasonic waves by the bubbles generated by cavitation, without using wasteful energy, efficiently It can be heated and heated, and the time required for treatment can be shortened. In addition, since the location heated and heated by irradiation on the ultrasonic image is clearly indicated,
It does not cause erroneous operation such as excessive heating and heating.

[0053] Therefore, a free treatment plan for the irradiation position can be made, and safe and accurate treatment can be achieved. Also,
The loss of energy at the focal point of strong ultrasonic waves due to the effects of cavitation is reduced, heating and heating can be efficiently performed without wasting energy, and the time required for treatment is shortened, so that the burden on the patient can be reduced. Become like The focal point can be moved by mechanically moving the ultrasonic transducer.

[Fourth Embodiment] Next, a fourth embodiment according to the present invention will be described. In this example, MR
A coil in the body cavity is used as the RF coil of the I device. In this example, the static magnetic field coil 9 (see FIG. 2) is a Helmholtz type,
The gradient coil 10 is connected to Anderson (Gx, Gy) &
Maxwell (Gz) was provided with a work hole 203 at the center. Therefore, as shown in FIG.
By inserting the applicator 1 into the patient's body, the applicator 1 can be directly mounted by simply moving the applicator 1 up and down by the mechanical arm 18 (FIG. 2) without changing the position of the patient 3 from above (or below). This eliminates the need to move the patient 3 in and out of the gantry, thereby reducing the time lag between treatment and observation and the risk of movement of the patient 3 during that time.

When the initial treatment plan has been completed and the situation is such that it is possible to determine that the treatment has been sufficiently completed by the treatment effect determination by MRI, the operator ends the treatment. At this time, the control circuit 12 (FIG. 2) can retrieve the history of the treatment condition from the memory and output the treatment record from the CRT 17 or the printer 20.

FIG. 11 is an explanatory view of the probe in the body cavity. In this example, a case where a probe is inserted into the rectum for treating prostate cancer is shown. Body cavity probe 27
Controls information from the internal body coil 11a, a plurality of strong ultrasonic intensity sensors 61 and temperature sensors 60 on the side surface, a water bag 64 that fills a liquid around the body of the probe 27, and the information from the probe 27. Cable 63 for transmitting to circuit 12
And a water injection hose 62 for taking liquid in and out of the water bag 64.

First, the intracavity probe 27 is inserted into the rectum of the patient 3 near the tumor 7 (prostate cancer) in the patient so as to be at a position where strong ultrasonic waves pass. Next, a water bag 6 made of a highly elastic material covering the surface of the probe 27 is used.
4 is filled with liquid (water) 65 by controlling the water circuit 66,
Make sure that no gas enters the position where high-intensity ultrasonic waves pass. In the present embodiment, a plurality of high-intensity ultrasonic intensity sensors 61 (for example, PVDF film) and temperature sensors 60 (for example, thermocouples) are mounted on the surface of the water bag 64 and do not come into contact with the liquid 65. , And is in contact with the intestinal wall 28. Further, since the plurality of sensors 60 and 61 are evenly mounted on the side surface of the probe 27, it is not necessary to particularly consider the direction of the probe at the time of insertion.

When the tumor 7 is irradiated with strong ultrasonic waves from the applicator, a plurality of strong ultrasonic intensity sensors 61 and temperature sensors 60 measure the strong ultrasonic intensity and the temperature at each position. This information is sent to the control circuit 12. The control circuit 12 calculates the difference between the optimum value stored in advance and the maximum value of the information from the plurality of sensors, and changes the irradiation condition of the strong ultrasonic wave so that the difference disappears.
The phase control circuit 204 is controlled.

During treatment, the liquid 65 in the water bag 64 is
It circulates under the control of 6, and acts as a coolant for preventing damage to the intestinal wall due to heating. Here, the treatment of prostate cancer has been described, but the present invention can be similarly applied to tumors such as bladder and uterus.

In the fourth embodiment, an example in which an intracavity probe is used has been described by applying the embodiment shown in FIG. 2, but this is applied to the embodiment shown in FIG. It is also possible. In addition, the static magnetic field coil 9 and the gradient magnetic field coil 10 shown in FIGS. 1 and 2 may be arranged like the static magnetic field coil 9a and the gradient magnetic field coil 10a shown in FIG.

Although the treatment for cancer has been described in this example, it is apparent that the present invention can also be used for calculus crushing. As shown in FIG. 4, on the CRT 17, a tomographic position 402 currently scanned by the ultrasonic probe 21 and a focal region 403 of the therapeutic ultrasonic wave are displayed on an MRI freeze image 401 before the applicator 1 is mounted. The incident path 404 of the therapeutic ultrasonic wave can be superimposed and displayed.

[Fifth Embodiment] Next, a fifth embodiment of the present invention will be described.
An embodiment will be described. In this embodiment, M
A three-dimensional image of the subject is obtained by the RI device, a tomographic image of the treatment site is obtained as an ultrasonic image, and an MR two-dimensional image is reconstructed from the three-dimensional image. The images are referred to for diagnosis. Since the device is the same as that shown in FIG. 2, the description will be made with reference to FIG.

In FIG. 2, a patient 3 is set on a motorized table in a supine position, and is placed in an imaging gantry (not shown) in which a static magnetic field coil 9, a gradient magnetic field coil 10, and an RF coil 11 are built. It is sent by the table moving device 13 controlled by the control circuit 12.

Next, the control circuit 12 activates the gradient magnetic field power supply 14 and the transmission / reception circuit 15 according to a predetermined sequence (for example, T2-weighted imaging method) instructed from the console 16, and the patient 3
The three-dimensional image information of the body is stored in a memory (not shown). This three-dimensional information is transmitted to the
As shown in (a), the image can be displayed on the CRT 17 in an arbitrary form such as a pseudo three-dimensional display using a wire frame.

Next, the operator inputs a treatment plan from the console 16 while viewing the in-vivo MRI image 71 including the tumor 7 which is the treatment site.

Here, the treatment plan refers to a method of scanning a focus, a scan range, an irradiation intensity of ultrasonic waves, a time, an interval, and the like. Also, on the CRT 17, not only the focus,
The tomographic position 73 currently scanned by the ultrasonic probe 201
In addition, the focal region 75 of the therapeutic ultrasonic wave and the incident path 74 of the therapeutic ultrasonic wave can be displayed, which is considered to be useful for making a treatment plan in consideration of the influence of bones and the like in the middle. Further, the scanning range 72 of the focal point on the treatment plan can be shown, and the irradiation intensity, time, interval, etc. of the ultrasonic wave can be displayed on the screen. During the treatment, the color of the portion irradiated with the ultrasound changes so that the progress of the treatment can be seen at a glance.

FIG. 13B shows an ultrasonic tomographic image and an image 71a obtained by reconstructing the same tomographic image as the current ultrasonic wave from MRI three-dimensional image data, which are displayed side by side.

Here, even if the ultrasonic probe 201 is moved, the reconstructed image 71a is displayed so as to follow the ultrasonic image. Can be correctly grasped.

Conversely, if a large difference appears between the two screens, the patient's body is expected to move during the treatment, so that repositioning is performed. These statues also
Not only the current focal point, but also the tomographic position 73 currently being scanned by the ultrasonic probe 201 and the focal region 75 of the therapeutic ultrasonic wave
And the incident path 74 of the therapeutic ultrasonic wave, the scanning scanning range 72a of the focal point on the treatment plan when viewed on the tomography, the irradiation intensity of the ultrasonic wave,
Time, interval, etc. can be displayed on the screen.

The reconstructed image has the same scale as the ultrasonic tomographic image, but can be enlarged or reduced. FIG.
The images (a) and (b) can be displayed simultaneously.
The ultrasound image and the MRI image can be colored or changed in color as needed. These operations are
The calculation is performed by the control circuit 12.

The applicator position detecting device 19 and the control circuit 12 check whether the position of the focal point 6 matches the initially determined focal position of the treatment plan, and the control circuit 12 instructs the drive circuit 8a to start ultrasonic irradiation. Then, treatment is started.

The treatment is automatically performed under the control of the control circuit 12 in accordance with a predetermined treatment plan, but can also be performed manually. If the patient is out of the treatment plan during manual treatment, the user is notified by a warning sound, a screen display, or the like (not shown). However, when the surgeon determines that it is necessary, the treatment plan stored in the control circuit 12 is displayed on the console 1.
6 or can be changed by input from a light pen (not shown).

In this embodiment, since the working hole 203 is provided at the center of the MRI gantry, the transmitting and receiving R
If the orientation of the F coil 11 is adjusted, the applicator 1 can be directly moved without changing the position of the patient 3 from above (or below).
Can be directly mounted simply by raising and lowering with the mechanical arm 18. This eliminates the need to move the patient 3 in and out of the gantry, thereby reducing the time lag between treatment and observation and the risk of movement of the patient 3 during that time. Further, the MRI imaging unit and the high-intensity ultrasonic treatment unit may be separated, and the patient may be moved by the table moving device 13.

The ultrasonic irradiation is stopped at the time when it is considered to be in the middle or at the end of the initial treatment plan, the applicator 1 is removed from the patient 3, and the progress of the treatment is observed. This is performed in the same manner as the above-described operation, and an MRI image around the tumor 7 is taken to check a change in a living body. Here, as described in the “action”, the T stored in the memory before the treatment is used.
By subtracting the data of the 2-weighted image and the current data, the heat-denatured region can be clearly confirmed, and it can be determined whether the treatment has been sufficiently performed or whether the treatment is insufficient and re-treatment is necessary. It is also possible to incorporate this into the treatment plan from the beginning and automatically take an image at predetermined treatment times.

When it becomes possible to determine that the treatment has been completed sufficiently by the treatment effect determination by MRI, the operator ends the treatment. At this time, the control circuit 12 can retrieve the history of the treatment condition from the memory and output the treatment record from the CRT 17.

Here, a coil in a body cavity may be used as the RF coil for transmission / reception. Although the phased array is used for the ultrasonic transducer, it may be an annular array, or the focal point may be moved by mechanically moving the applicator.

Further, an X-ray CT may be used instead of the MRI apparatus. Although the present embodiment has described the treatment of a tumor, the present invention can be similarly applied to a device for crushing and treating a calculus in a body with powerful ultrasonic waves.

[0078]

The ultrasonic therapy apparatus according to the present invention can move the focal point of an ultrasonic wave at a predetermined distance. For this reason, the inconvenience of damaging normal tissues by continuously irradiating ultrasonic waves can be prevented.

Further, since the focal point of the ultrasonic wave can be moved at a predetermined distance, the irradiation of the rear wave can be performed while avoiding the cavitation generated by the front wave. It is possible to prevent a disadvantage that the ultrasonic energy of the back wave is attenuated and interferes with the treatment.

[Brief description of the drawings]

FIG. 1 is a block diagram of an ultrasonic therapy apparatus according to a first embodiment of the present invention.

FIG. 2 is a block diagram showing a configuration of a second exemplary embodiment of the present invention.

FIG. 3 is a schematic diagram of an applicator according to a second embodiment.

FIG. 4 is a diagram illustrating a display example of a CRT.

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

FIG. 6 is an explanatory diagram showing a three-dimensional image of a tumor in a living body created by calculation.

FIG. 7 is an explanatory diagram showing an example of a method for creating a three-dimensional image of a tumor in a living body.

FIG. 8 is an explanatory diagram showing a method for dividing a tumor image.

FIG. 9 is an explanatory diagram showing an irradiation order of ultrasonic waves.

FIG. 10 is an explanatory diagram showing a tumor part and its periphery according to a fourth embodiment of the present invention.

FIG. 11 is an explanatory view showing an intracavity probe and instruments provided around the probe.

FIG. 12 is an explanatory diagram showing a positional relationship between respective coils of a patient's MRI apparatus.

FIG. 13 is an explanatory diagram schematically showing imaging regions of an MRI image and an ultrasonic image.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Applicator 2 Ultrasonic transducer 3 Patient 4 Coupling liquid 5 Water bag 6 Focus 7 Tumor 8 Drive circuit 9 Static magnetic field coil 10 Gradient magnetic field coil 11 RF coil 12 Control circuit 13 Table moving device 14 Gradient magnetic field power supply 15 Transmission / reception circuit 16 Console 17 CRT 18 Mechanical arm 19 Applicator position detecting device 20 Printer 27 Intracavitary probe 28 Intestinal wall 31 Powerful ultrasonic source 32 Water bag 33 Patient 34 Tumor 35 Focus 36 Ultrasonic probe 37 CRT 38 Ultrasonic diagnostic imaging device 39 Digital Scan converter 40 Drive circuit 41 Power supply circuit 42 Control circuit 43 Delay circuit 44 Drive trigger pulse generation circuit 45 Image data input device 46 Three-dimensional image of tumor in living body 47 XYZ axis 48 Heated / heated part 49 Light pen Reference Signs List 60 temperature sensor 61 ultrasonic intensity sensor 64 water bag 65 water 71 MRI image 72 scanning range 73 tomographic position 75 focal region 201 ultrasonic probe 202 ultrasonic imaging device 203 working hole 204 phase control circuit 401 image 402 tomographic position 403 focal region 404 Incident path

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Yoshiharu Ishibashi 1 Toshiba-cho, Komukai-shi, Kawasaki-shi, Kanagawa Prefecture Inside Toshiba Research Institute, Inc. (72) Inventor Takuji Suzuki 1 Toshiba-cho, Komukai-shi, Kawasaki-shi, Kanagawa Inside Toshiba Research Institute, Inc. (72) Kozo Sato, Inventor Kozo Toshiba-cho, Kawasaki City, Kanagawa Prefecture 1 Inside Toshiba Research Institute, Inc. (72) Inventor Aya Ito 1-1-1, Shibaura, Minato-ku, Tokyo No. 1 Toshiba Corporation head office

Claims (3)

[Claims] 1. An ultrasonic wave generating means for generating an ultrasonic wave for irradiating an object, and an irradiation area division for dividing an irradiation area of the object to be irradiated with an ultrasonic wave from the ultrasonic wave generating means into a plurality of divided irradiation areas. Means, at a distance corresponding to a predetermined divided irradiation area, so that the focal point of the ultrasonic wave irradiated from the ultrasonic wave generating means for each divided irradiation area moves, so that the ultrasonic wave emitted from the ultrasonic wave generating means moves. An ultrasonic treatment apparatus comprising: a focus position movement control unit that controls movement of a focus position of a sound wave. 2. A tomographic image capturing means for capturing an ultrasonic tomographic image in a subject, wherein the irradiation area dividing means determines an ultrasonic irradiation area on a tomographic image picked up by the tomographic image capturing means. Divides into four equal parts by two straight lines passing through the center of the irradiation area and orthogonal to each other to form first to fourth medium division areas, and each of the medium division areas has a small focal point of the ultrasonic wave. Dividing into divided areas, the movement control means controls the movement of the focal point of the ultrasonic waves so that the focal point of the ultrasonic waves moves to a different small divided area in a different middle divided area for each irradiation of the ultrasonic waves. The ultrasonic therapy apparatus according to claim 1, wherein: 3. The ultrasonic treatment apparatus according to claim 1, wherein said ultrasonic wave generating means is formed by a phased array type piezo element.