JPWO2020145409A1 - Ultrasound diagnostic imaging device and treatment device for armpit or hyperhidrosis - Google Patents

Abstract

Provided is an ultrasonic diagnostic imaging apparatus that visualizes and displays a subcutaneous condition, and a treatment apparatus for armpit or hyperhidrosis equipped with the ultrasonic diagnostic imaging apparatus. The ultrasonic diagnostic imaging apparatus according to the embodiment of the present application includes an ultrasonic probe 11, a sectional echo image generation apparatus 13, and an ultrasonic diagnostic imaging apparatus 14 that analyzes a sectional echo image and recognizes a sweat gland. The ultrasonic probe 11 has a substantially rectangular contact surface 11a having a long side and a short side, and can scan at least in the long side direction and the short side direction, and generates a cross-sectional echo image. The device 13 displays a cross-sectional echo image based on a scanning signal obtained by scanning the ultrasonic probe 11 in the length direction and operating in the short side direction on the surface of the skin of a living body, and the analyzer 14 displays a cross-sectional echo image based on the cross-sectional echo image. , Information on location and depth or information on location, spread, invasion and invasion of malignant tumors of the skin is obtained and displayed.

Description

The present invention is effective in preoperative diagnosis, postoperative diagnosis, and recurrence diagnosis of eccrine glands and apocrine glands, which are sweat glands existing under the skin of the human body, and information on the distribution state, density, position, and depth, or benign skin. The present invention relates to an ultrasonic diagnostic imaging apparatus that visualizes and displays the diagnosis, position, spread state, invasion depth, and invasion degree of a malignant tumor, and a treatment apparatus for armpit or hyperperspiration equipped with this ultrasonic diagnostic imaging apparatus.

Eccrine glands are sweat glands that are present on the skin of almost the whole body, and are particularly abundant on the head, face, and back. Most of the sweat in the human body comes from this eccrine gland. Most of the sweat from the eccrine glands is water, and other than water, the main component is salt. On the other hand, the apocrine glands are sweat glands that exist especially in the armpits, ears, areola and genital area, and the sweat from the apocrine glands contains 70% to 80% of water, proteins, lipids, ammonia, etc. There is. Unpleasant odors such as so-called axillary odor are caused by sweat from the apocrine glands.

Since excessive sweat secretion from these apocrine glands and eccrine glands causes axillary odor (armpit) and hyperhidrosis, treatment methods for suppressing excessive sweating have been conventionally studied. For example, Patent Document 1 includes an electrode needle and a cooling portion having a through hole through which the electrode needle can be inserted, the cooling portion is brought into close contact with the skin surface of a living body, and the electrode needle is projected from the cooling portion. Disclosed is a publication suppression device that generates heat on the tip side of the electrode needle by energizing the electrode needle, thereby destroying the sweat glands on the tip side of the electrode needle. Destruction of sweat glands by such a publication inhibitor can suppress excessive sweat secretion from apocrine glands or eccrine glands.

The sweat glands to be destroyed by the publication suppression device exist at various depths from the dermis to the subcutaneous tissue, but the thickness of the dermis and the subcutaneous tissue varies not only among individuals but also depending on the part of the living body. Therefore, in order to reliably destroy the sweat glands, it is necessary to heat the entire depth direction from the dermis to the subcutaneous tissue while gradually changing the puncture depth of the electrode needle according to the thickness of the dermis and the subcutaneous tissue. There is.

However, since the conventional publication suppression device does not have a means for detecting the distribution and depth of the apocrine gland and the eccrine gland of the living body (including the dermis and the subcutaneous tissue; the same applies hereinafter), the range to be heated by the electrode and the range to be heated by the electrode are not provided. As a result of not being able to grasp the depth, there is a risk that the living body may be overheated or the heating may be insufficient. Therefore, there is a demand for a means capable of confirming the location and depth of apocrine glands and eccrine glands in advance. In addition, even with surgical methods such as excision surgery and deletion surgery, surgery was performed without knowing the range and depth.

In addition, since there is no diagnostic method for the current diagnosis of skin cancer, the tissue is scraped from the surface layer of the skin, the pathological tissue is diagnosed after reaching the cancer tissue, and the treatment as skin cancer is decided. Then, when skin cancer does not appear at a shallow position, a primitive diagnostic method is adopted in which the tissue is further scraped to determine whether or not there is skin cancer. Therefore, there is a demand for the development of a means capable of visualizing and displaying the state of the tissue below the surface of the skin in the depth direction and confirming the position, spread state, depth of invasion, etc. of the cancer.

JP-A-2017-086096 Japanese Unexamined Patent Publication No. 2014-247054

On the other hand, as a means for visualizing the tissue inside the living body, a method and a system for ultrasonic tissue treatment using an ultrasonic probe are known. For example, in Patent Document 2, an ultrasonic imaging / therapeutic probe is used, and when the facial fascia (SMAS: Superficial musculo-aponeurotic system) is contracted to perform face lift, the ultrasonic imaging / therapeutic probe is used. It is disclosed that the subcutaneous cross-sectional structure including SMAS is visualized and displayed, and the SMAS is heated and contracted by supplying ultrasonic energy from an ultrasonic imaging / therapeutic probe to perform face lift. .. Further, in paragraphs [0051] to [0071] of Patent Document 2, the subcutaneous cross-sectional structure including sweat glands such as apocrine glands and eccrine glands is visualized and displayed by an ultrasonic imaging / therapeutic probe, and ultrasonic waves are used. It is also disclosed to treat these tissues by supplying ultrasonic energy from an imaging / therapeutic probe.

Then, in paragraph [0062], "the imaging transducer can be operated at a frequency of about 2 MHz to 75 MHz or more, and the therapeutic energy is introduced at a frequency of about 500 kHz to 15 MHz, usually 2 MHz to 25 MHz. Along with the statement, "For example, as shown in FIG. 2B, typical treatment methods and systems are first in region of interest 206, as shown in FIG. 2B." Region 222 is imaged and configured to display region 224 on display 208 in order to facilitate identification of the therapeutic area and surrounding structure, such as identification of sweat glands 230. " 2P and FIG. 2Q show an example in which the sweat gland is displayed on the display unit.

As described above, Patent Document 2 tentatively recognizes the description of displaying the sweat gland by the ultrasonic imaging / therapeutic probe, but in the description of Patent Document 2, what kind of configuration of the ultrasonic imaging / therapeutic probe is used. It is completely unknown whether to use, what frequency to use for imaging the sweat glands, and how to manipulate and display the ultrasound imaging / therapeutic probe. Since the eccrine glands and apocrine glands are located at a shallow depth of only a few mm under the skin, for example, 0.5 to 3.5 mm, a clear cross-sectional echo image of the sweat glands can be obtained with a conventional ultrasonic probe. As far as the inventor knows, an ultrasonic probe was used to obtain cross-sectional echo images of sweat glands as shown in FIGS. 2P and 2Q of Patent Document 2. No example was known.

The present invention has been made to solve the above-mentioned problems of the prior art. That is, the present invention visualizes and displays eccrine glands, apocrine glands, or malignant tumors of the skin, which are sweat glands existing under the skin of the human body, by using an ultrasonic probe, and the position and distribution state of the detected sweat glands. And an ultrasonic diagnostic imaging device capable of obtaining information on the position, spread state and depth of invasion of a malignant tumor of the skin without deepening, and a treatment device for armpit or hyperhidrosis equipped with this ultrasonic diagnostic imaging device. The purpose is to do. The malignant tumor of the skin includes skin cancer, malignant melanoma and the like.

The ultrasonic diagnostic imaging apparatus according to the first aspect of the present invention is
With an ultrasonic probe,
A cross-section echo image generator that generates a cross-section echo image from a scanning signal from the ultrasonic probe, and a cross-section echo image generator.
An analyzer that analyzes the cross-section echo image from the cross-section echo image generator and recognizes the subcutaneous state,
It is an ultrasonic diagnostic imaging device with
The ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, and can scan at least in the long side direction and the short side direction.
The cross-sectional echo image generator displays a cross-sectional echo image based on a scanning signal obtained by scanning the ultrasonic probe in the length direction and operating in the short side direction on the surface of the epidermis of a living body.
The analyzer is characterized in that information on the state below the epidermis of the living body is obtained and displayed based on the cross-sectional echo image.

According to the ultrasonic diagnostic imaging apparatus of the first aspect of the present invention, the ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, and scans in the long side direction and the short side direction. The cross-sectional echo image is displayed based on the scanning signal obtained by scanning the ultrasonic probe in the length direction and operating in the short side direction on the surface of the skin of the living body by the cross-sectional echo image generator. Therefore, a cross-sectional echo image in which the state below the epidermis of the living body is well displayed can be obtained. In addition, since the cross-sectional echo image shows the condition below the epidermis of the living body well, the analyzer can accurately recognize the condition below the epidermis of the living body and accurately recognize the range requiring treatment. ..

In the ultrasonic diagnostic imaging apparatus of this aspect, the states below the epidermis of the living body include information on the distribution state of sweat glands, information on the position of sweat glands, information on the depth of sweat glands, information on the position of malignant tumors on the skin, and skin. It can be at least one of information about the spread state of the malignant tumor of the skin, the degree of invasion of the malignant tumor of the skin, or the degree of infiltration of the malignant tumor of the skin.

According to the ultrasonic diagnostic imaging apparatus of this aspect, information on the distribution state, position and depth of apocrine glands and eccrine glands, or the position, spread state, invasion degree and invasion degree of malignant tumors of the skin can be easily confirmed. It will be easier to treat armpits and hyperhidrosis or malignant tumors of the skin.

In the ultrasonic diagnostic imaging apparatus of this aspect, the ultrasonic probe is a linear probe in which ultrasonic driving elements are arranged in a row, and it is preferable that the driving frequency is 20 MHz or more.

The higher the drive frequency of the ultrasonic probe, the higher the resolution can be obtained, and it becomes possible to obtain an image of a part closer to the skin surface. Also, when a linear probe is used, the ultrasonic wave is not diffused, which is good. It becomes possible to obtain a cross-sectional echo image in a narrow range of high image quality. The driving frequency of the more preferable ultrasonic probe is 30 MHz or more. In particular, when the driving frequency of the ultrasonic probe is 30 MHz or higher, a cross-sectional echo image with clear image quality can be obtained. Therefore, even in a moving image, the position and depth of the sweat glands and the distribution state or the position of a malignant tumor on the skin , Spread, depth and infiltration can be clearly recognized. Further, in order to increase the resolution, the number of elements of the linear probe type ultrasonic probe is preferably 128 elements or more, more preferably 192 elements or more, still more preferably 256 elements or more, and specifically. For example, those having about 200 elements or those having 400 to 600 elements or more can be used. The larger the number of elements (the higher the element density), the better the resolution.

Further, in the ultrasonic diagnostic imaging apparatus of the above aspect, the analyzer determines the measurement range by scanning in the direction along the long side direction of the ultrasonic probe, and the short length of the ultrasonic probe in the determined measurement range. The state below the epidermis of the living body can be grasped by scanning in the direction along the side direction.

According to the ultrasonic diagnostic imaging apparatus of this aspect, since the ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, it is along the long side direction of the ultrasonic probe. By scanning in the direction, the condition below the epidermis of the living body can be clearly judged, and the range in which treatment is required can be grasped. Furthermore, scanning in the direction along the short side can obtain a good cross-sectional echo image over a wide area. This makes it possible to diagnose the distribution and condition of malignant tumors of sweat glands and skin.

Further, in the ultrasonic image diagnostic apparatus of such an embodiment, it is preferable that the cross-sectional echo image generation apparatus obtains a 3D ultrasonic echo image at a position where a state below the epidermis of the living body is obtained.

According to the ultrasonic diagnostic imaging apparatus of this aspect, since the state below the epidermis of the living body is accurately obtained, useless data such as a 3D ultrasonic echo image in a position where sweat glands do not exist is reduced, and a cross section is obtained. The processing load of the echo image generator and the analyzer is reduced.

Further, in the ultrasonic diagnostic imaging apparatus of such an embodiment, the sectional echo image generating apparatus selects at least one of the sectional echo images before and after the injection of the anesthetic solution under the surface of the epidermis of the living body and after the treatment. It is preferable to display the image.

According to the ultrasonic diagnostic imaging apparatus of the said aspect, each of the ultrasonic echo image before the treatment, the ultrasonic echo image after the injection of the anesthetic solution, and the ultrasonic echo image after the treatment can be used alone or by any two ultrasonic waves. Since the echo image and the three ultrasonic echo images can be appropriately selected and displayed, the therapeutic effect can be accurately determined.

Further, in the ultrasonic diagnostic imaging apparatus of such an embodiment, it is preferable that the analyzer is provided with AI (artificial intelligence) means.

AI means is a field in which technological progress is rapid, and by training using many ultrasonic echo images, it becomes possible to accurately and automatically obtain information on the state below the epidermis of a living body. By using AI means, for example, the distribution and condition of sweat glands and skin, the distribution, position and range of malignant tumors of skin can be diagnosed.

Further, the device for treating armpit or hyperhidrosis according to the second aspect of the present invention is
A treatment device for armpit or hyperhidrosis, comprising an ultrasonic diagnostic imaging apparatus according to any one of the above embodiments, a sweat suppression device that destroys sweat glands, and a control unit that controls the sweat suppression device. It is characterized in that the sweating suppressing device is controlled based on the state below the epidermis of the living body obtained by the ultrasonic diagnostic imaging apparatus.

According to the device for treating armpit or hyperhidrosis of such an embodiment, the distribution state of sweat glands, the position and depth of sweat glands are accurately obtained by the ultrasonic diagnostic imaging device, and therefore the protruding position of the electrode needle in the sweat suppression device. , The protrusion length and the energization timing can be accurately controlled, and the therapeutic effect of armpit or hyperhidrosis is improved. By combining with the above-mentioned diagnosis by the ultrasonic diagnostic imaging device, especially the above-mentioned diagnosis using the AI means, the distribution range of the sweat glands that require treatment is automatically set, and the setting and control of the treatment device are accurate. Can be done.

In the device for treating armpit or hyperhidrosis of the said aspect, the sweat suppression device has an electrode needle whose protrusion length can be adjusted, and the control unit controls the protrusion length of the electrode needle in multiple stages. At the same time, it is preferable to control the energization of the electrode needle at each stage.

According to the device for treating armpit or hyperhidrosis in such an embodiment, the sweat glands can be substantially completely destroyed, and the therapeutic effect of armpit or hyperhidrosis can be improved. The length of protrusion of the electrode needle from the cooling part is the shallowest in which sweat glands are confirmed to exist, for example, apocrine glands and eccrine glands are abundantly present in the range of 0.5 to 3.5 mm subcutaneously. After inserting it to the position, it may be energized, then 0.5 mm may be inserted and energized, and then 0.5 mm may be inserted and energized, and the like may be repeated. Alternatively, the sweat glands may be inserted to the deepest position where the presence of sweat glands is first confirmed, and then the reverse operation may be performed.

In the device for treating armpit or hyperhidrosis according to this aspect, the sweat suppression device includes the electrode needle and a cooling portion having a through hole through which the electrode needle can be inserted, and the cooling portion is a living body. By bringing the electrode needle into close contact with the skin surface and projecting the electrode needle from the cooling portion to energize the electrode needle, the tip side of the electrode needle is heated, thereby destroying the sweat gland on the tip side of the electrode needle. The position of the electrode needle on the surface of the biological skin of the inhibitor, the depth of protrusion from the cooling portion, the timing of energization of the electrode needle, the period of energization of the electrode needle, or the strength of energization of the electrode. It is preferable that it is possible to control at least one of them.

As described above, according to the ultrasonic diagnostic imaging apparatus of the present invention, a sectional echo image in which the subcutaneous condition is well displayed can be obtained by the sectional echo image generation apparatus, and moreover, the subcutaneous condition can be accurately displayed by the analyzer. Treatment of armpits, hyperhidrosis or malignant skin tumors because it is possible to obtain information on the distribution state of sweat glands, the position and depth of sweat glands, or the position, spread state and depth of invasion of malignant tumors of the skin. Will be able to accurately recognize the required range. Further, according to the device for treating armpit or hyperhidrosis of the present invention, the distribution state of sweat glands, the position and depth of sweat glands are accurately obtained by the ultrasonic diagnostic imaging device, so that the electrode needle in the sweat suppression device can be used. The protrusion position, protrusion length and energization timing can be accurately controlled, and the therapeutic effect of armpit or hyperhidrosis is improved.

It is a schematic diagram of the ultrasonic diagnostic imaging apparatus of this invention. It is explanatory drawing of the dimension of an ultrasonic probe and a long axis direction and a short axis direction. FIG. 3A is a side view of the antiperspirant device used in the embodiment of the present invention, and FIG. 3B is a partial cross-sectional view taken along the line IIIA-IIIA of FIG. 3A. It is an electron micrograph of the stained skin tissue. 5A-5G are examples of armpit observations of a 12-year-old female. 6A to 6F are examples of side observations of a 19-year-old female. 7A-7E are examples of armpit observations of a 55-year-old female. 8A-8E are observation examples of the lateral surface of the right thigh of a 53-year-old man. 9A-9E are examples of observations on the dorsal side of an 18-year-old man. 10A and 10B are examples of armpit observations of a 55-year-old female. 11A and 11B are examples of armpit observations of a 38-year-old female. 12A-12D are observation examples of the armpit of a 13-year-old female who complained of recurrence after surgery using the antiperspirant device of the embodiment. 13A and 13B are preoperative observations of a 14-year-old female with palmoplantar hyperhidrosis. 14A-14F are observation examples using a 33 MHz drive probe beside a 14-year-old female. 15A-15D are preoperative video capture images of a 14 year old female using a 33 MHz drive probe beside her. 16A-16D are captured images of a post-local anesthesia video using a 33 MHz drive probe beside a 14 year old female.

Hereinafter, the ultrasonic diagnostic imaging apparatus and the treatment apparatus for armpit or hyperhidrosis according to the embodiment of the present invention will be described with reference to the drawings. However, each embodiment shown below exemplifies an ultrasonic diagnostic imaging apparatus and a treatment apparatus for armpit or hyperhidrosis for embodying the technical idea of the present invention, and the present invention is incorporated into these. It is not intended to be specified. The present invention is equally applicable to other embodiments included in the claims.

[Ultrasound diagnostic imaging equipment]
First, the outline of the ultrasonic diagnostic imaging apparatus 10 used in the present invention will be described with reference to FIG. The ultrasonic image diagnostic device 10 itself is already well known, and as shown in FIG. 1, an ultrasonic probe (probe) 11, an input / output (I / O) unit 12, and an echo image generation unit are used. A thirteenth, an analysis unit 14, and a display unit 15 are provided. Of these, the I / O 12, the echo image generation unit 13, and the analysis unit 14 form the signal processing unit 16. As the display unit 15, a general liquid crystal display device or an organic EL display device can be used.

The I / O unit 12 supplies an ultrasonic drive signal having a predetermined frequency to the ultrasonic probe 11, receives an echo signal received by the ultrasonic probe 11, and supplies it to the echo image generation unit 13. The echo image generation unit 13 generates a signal corresponding to the cross-section echo image based on the echo signal, and the cross-section echo image is displayed on the display unit 15 based on the signal corresponding to the cross-section echo image. Further, the signal corresponding to the cross-sectional echo image generated by the echo image generation unit 13 is also supplied to the analysis unit 14, and the analysis unit 14 recognizes the sweat glands by using, for example, AI, and the distribution state of the sweat glands. Signals relating to the position and depth of the sweat glands are generated, these signals are stored and supplied to the echo image generation unit 13, and are appropriately displayed on the display unit 15. The echo image generation unit 13 corresponds to the cross-section echo image generation device in the present invention, and the analysis unit 14 corresponds to the analysis device in the present invention.

As the ultrasonic probe 11, a commercially available one is used, and here, a so-called hockey stick type ultra-high frequency linear probe is used. Although not shown individually, the contact surface 11a on the distal end side of the ultrasonic probe 11 is a linear probe in which a large number of, for example, 126 or more ultrasonic elements are arranged in a row. In the linear probe, unless an ultrasonic lens is used, the ultrasonic wave is vertically incident on the skin, so that the ultrasonic wave does not diffuse and a cross-sectional echo image in a narrow range can be obtained with good image quality.

In addition, when the frequency of ultrasonic waves is increased, ultrasonic waves are absorbed in the vicinity of the skin, but since most sweat glands are present in a shallow range of 0.5 mm to 3.5 mm subcutaneously, the skin surface. It becomes possible to obtain a cross-sectional echo image in the vicinity with high sensitivity. Further, when the number of ultrasonic elements is increased, the resolution is increased and a high-definition cross-sectional echo image can be obtained.

As shown in FIG. 2, the dimensions of the contact surface 11a portion of the ultrasonic probe 11 used in the ultrasonic diagnostic imaging apparatus 10 of the embodiment are 3 to 5 mm in width and about 3 cm in length. 126 or more individual ultrasonic elements, and in some cases 256 or more, are arranged in a row in the length direction. Specifically, the number of ultrasonic elements may be, for example, about 200, or may be, for example, 400 to 600 or more. The direction corresponding to the length direction of the contact surface 11a in FIG. 2 is the long axis direction, and the direction corresponding to the width direction is the short axis direction.

The ultrasonic probe 11 has a substantially rectangular contact surface 11a having a long side and a short side, and the scanning direction of the ultrasonic probe includes a scanning direction along the long side direction and a scanning direction along the short side direction. It is possible to accurately and efficiently obtain the distribution state of the sweat glands by properly using the direction. When determining the treatment range, first scan along the long side direction to grasp the distribution range of the sweat glands. That is, in scanning along the long side direction, the width that can be scanned (length of the short side) is narrow, but the display range (length of the long side) along the scanning direction is wide, so that the sweat glands can be clearly identified. Once the distribution range of the sweat glands is known, the distribution of the sweat glands over a wide area should be efficiently grasped by scanning along the short side direction and scanning with a wide scanable width (length of the long side). Can be done. Moreover, since the cross-sectional echo image obtained in this way has higher resolution and higher quality than the conventional one, the analysis unit 14 recognizes the sweat glands more accurately, and the distribution state of the sweat glands and the sweat glands You will be able to obtain information about the position and depth.

Further, according to the ultrasonic diagnostic imaging apparatus 10 of the embodiment, the position and depth of the sweat gland are accurately determined by the analysis unit 14, so that the position and the depth of the sweat gland are accurately determined, so that the position is centered on the long axis direction on the contact surface of the ultrasonic probe 11. A 3D ultrasonic echo image can be obtained by rotating the ultrasonic probe 11 and performing rotational scanning, or by scanning along the short side direction of the ultrasonic probe 11. Moreover, since the distribution range of the sweat glands is grasped by the scanning direction along the long side direction and the direction along the short side direction described above, that is, the position where the sweat glands do not exist is known in advance. Acquisition of useless 3D data is reduced, and the processing load of the cross-sectional echo image generation unit 13 and the analysis unit 14 is reduced.

In the treatment of armpit or hyperhidrosis, the anesthetic is injected before the treatment, so the images displayed on the display unit 15 are before the treatment (before the injection of the anesthetic), after the injection of the anesthetic, and It is preferable to be able to appropriately select and display the three types of images after treatment. This makes it possible to recognize the therapeutic effect more accurately. The image after the injection of the anesthetic tends to be easier to grasp the position of the sweat gland by the ultrasonic probe 11 than the image before the injection of the anesthetic.

[Sweat suppression device]
Next, with reference to FIG. 3, a sweat suppression device 20 used in combination with the ultrasonic diagnostic imaging device 10 of the embodiment will be described. The combination of the ultrasonic diagnostic imaging apparatus 10 and the sweating suppressing apparatus 20 corresponds to the armpit or hyperhidrosis treatment apparatus 50 of the present invention. However, as the sweating suppressing device 20, not only the one shown in FIG. 3 but also other well-known configurations can be used.

The sweat suppression device 20 includes an electrode needle 21, a cooling member 22, a support 23, and a drive device 24 as main components. The electrode needle 21 is made of a conductive metal material such as stainless steel, and is tapered so that the tip portion 21a can be punctured. The portion of the electrode needle 21 other than the tip portion 21a is covered with an insulating film 21b made of an electrically insulating material. A plurality of electrode needles 21 are arranged in a matrix and are fixed to a rectangular plate-shaped holder 25.

For the electrode needle 21, for example, about 20 to 30 needles (or more) are preferably arranged, and the distance between the adjacent electrode needles 21 is set to, for example, about 0.5 to 3 mm (more preferably 1 to 3 mm). Is preferable. The thickness of each electrode needle 21 is preferably about 0.1 to 0.3 mm, for example. The arrangement shape of the plurality of electrode needles 21 may be various shapes such as an annular shape and a polygonal shape in addition to the matrix shape. The holder 25 is made of a plastic material or the like, and a recess 25a is formed in the center thereof. An elastically deformable engaging protrusion 25b is provided on the inner peripheral surface of the recess 25a. The tip portion 21a of the electrode needle 21 is formed in a blunt needle shape that penetrates the skin and the subcutaneous tissue but does not penetrate the membrane tissue portion between the subcutaneous tissue and the muscular layer, whereby sweat glands may be present. Only vulnerable depth areas can be safely punctured.

The cooling member 22 includes a Pelche element 26, a cooling plate 27, and a heat dissipation block 28. The Pelche element 26 has a known configuration in which a p-type semiconductor and an n-type semiconductor are thermally arranged in parallel. A cooling plate 27 is provided on the heat absorption side of the Pelche element 26, and a heat dissipation block 28 is provided on the heat generation side of the Pelche element 26. Is provided. A plurality of Pelche elements 26 having an appropriate size are arranged in a matrix. The cooling plate 27 and the heat radiating block 28 have a plurality of openings 27a and 28a formed in the gaps between the plurality of Pelche elements 26, and the plurality of openings 27a and 28a facing each other penetrate the front and back surfaces of the cooling member 22. The holes 29 are formed. The cooling plate 27 has a flat cooling portion 27b on the surface side, and the cooling portion 27b can be brought into close contact with the skin of the human body or the like.

The cooling unit 27b is provided with a contact detection sensor 30 that detects the contact state between the punctured portion such as the epidermis of the human body and the cooling unit 27b on the surface avoiding the opening 27a at the substantially center. The contact detection sensor 30 is composed of a pressure sensor having a thin thickness (for example, about 0.1 mm), and outputs a contact signal or a non-contact signal with the punctured site.

The support 23 includes a rectangular housing portion 31 in a plan view that opens downward in FIG. 3A, and a cylindrical portion 32 connected so as to communicate with the center of the top plate of the housing portion 31. The electrode needle 21 is held inside the portion 31. The housing portion 31 has a guide groove 31a formed in the vicinity of the openings of the pair of side walls facing each other. The cooling member 22 is supported by the support 23 so that the heat dissipation block 28 can slide along the guide groove 31a, and the tip portion 21a of each electrode needle 21 is supported at a closed position covering the opening of the housing portion 31. Faces the through hole 29, and the electrode needle 21 can be inserted into the through hole 29. The guide groove 31a is provided with a terminal portion (not shown), and when the cooling member 22 is in the above-mentioned closed position, the Pelche element 26 can be energized.

The drive device 24 includes a drive motor 33 including a servomotor and the like, an encoder 34 for detecting the number of rotations of the drive motor 33, and a rod 36 that moves forward and backward due to the rotation of the drive motor 33. A shaft 35 is connected to the rotating shaft 33a of the drive motor 33, and a threaded portion 35a is formed on the outer peripheral surface of the shaft 35. The rod 36 is formed in a hollow cylindrical shape, and is slidably housed in the cylindrical portion 32 of the support 23. A nut 36a screwed to the threaded portion 35a of the shaft 35 is fixed to the inner peripheral surface of the rod 36. On the other hand, a protrusion 36b is provided on the outer peripheral surface of the rod 36, and the protrusion 36b engages with the groove portion 32a formed on the inner peripheral surface of the cylindrical portion 32, so that the rod 36 cannot rotate. There is. With the above configuration of the drive device 24, the rod 36 can be advanced to the lower side of FIG. 3B by the rotation of the drive motor 33, and the amount of advance of the rod 36 can be controlled based on the detection of the encoder 34.

An engaging recess 36c is formed on the outer peripheral surface of the tip end side (lower end side of FIG. 3A) of the rod 36, and the rod 36 is fitted into the recess 25a of the holder 25 to make the engaging recess 36c into the engaging protrusion 25b. By engaging, the holder 25 can be detachably fixed to the rod 36. In this way, the holder 25 can be pressed by the drive device 24, and the tip portion 21a of the electrode needle 21 can be made to appear and disappear from the cooling portion 27b by advancing and retreating the rod 36, as shown by the broken line in FIG. 3A. The amount of protrusion of the electrode needle 21 from the lowermost surface of the cooling unit 27b can be set to, for example, about 0.1 to 10 mm.

Further, a terminal (not shown) for supplying power to each electrode needle 21 when the holder 25 is attached is provided at the tip of the rod 36, and each electrode needle is provided on an externally installed high frequency oscillator (not shown). 21 is electrically connected. The electrode needle 21 can apply a high-frequency current between the electrode needle 21 and a surface electrode (not shown) separately arranged on the surface of the human body in a state of being punctured into the human body, thereby heating the biological tissue in the vicinity of the electrode needle 21. can do. When a plurality of electrode needles 21 are provided, a high frequency current may be applied between two adjacent electrode needles 21.

The electrode needle 21, the cooling member 22, and the drive device 24 can be energized manually by operating a switch of the operation unit 40 provided on the cylindrical portion 32 of the support 23. The sweating suppression device 20 of the present embodiment can be connected to a control device 45 that can be installed outside such as a personal computer, and the contact detection sensor 30 detects the contact state (contact or non-contact). The signal is input to the control device 45, and the energization of the electrode needle 21, the cooling member 22, and the drive device 24 can also be controlled by the control device 45.

Further, the ultrasonic diagnostic imaging apparatus 10 has an output unit (not shown) that outputs an ultrasonic echo image and an analysis result, and information from the output unit is input to the control device 45. Since information such as the diagnosis result from the ultrasonic diagnostic imaging device 10 is input to the control device 45, the treatment range (range such as distribution and depth of sweat glands) can be appropriately grasped by using the information. Then, the sweating suppressing device 20 can be controlled. Based on the information, the control device 45 determines the position of the electrode needle on the surface of the biological skin of the sweat suppression device, the depth of protrusion from the cooling portion, the timing of energization of the electrode needle, the period of energization of the electrode needle, and the electrode. It is possible to control the strength of energization to. It is also possible to include the control parameters used in the control device 45 in the information of the diagnosis result from the ultrasonic image diagnosis device 10. As control parameters, in addition to information such as sweat gland distribution, sweat gland position, sweat gland depth range, and sweat gland density, information necessary for treatment according to each site, for example, an electrode needle on the surface of the biological epidermis of a sweat suppression device. It is possible to include information such as the timing of energization of the electrode needle, the period of energization of the electrode needle, and the strength of energization of the electrode according to the position and the depth of protrusion from the cooling unit. In particular, when the ultrasonic diagnostic imaging apparatus 10 is provided with AI means, it is possible to obtain information necessary for more detailed treatment. Further, since the control device 45 stores information on the past treatment history of the patient, it is possible to control the sweating suppression device 20 in consideration of the past treatment history. Further, all or part of the signal processing unit 16 of the ultrasonic diagnostic imaging apparatus 10 and all or part of the control device 45 can be shared and realized as a control means such as one personal computer. It is also possible to use AI for the calculation in the control device 45. In this case, a lot of treatment history information and a lot of information from the ultrasonic diagnostic imaging device 10 are used for each treatment range and treatment site in this treatment. It is possible to determine the control parameters of the sweating suppression device 20 of the above.

Further, the amount of protrusion of the electrode needle 21 is controlled by obtaining information on the distribution state of sweat glands, the position and depth of sweat glands obtained by the analysis unit 14 of the ultrasonic diagnostic imaging apparatus 10 (see FIG. 1) described above. It is also possible to display on the display unit of 45 and automatically control the protrusion amount and energization of the electrode needle 21. The control device 45 can also be built in the operation unit 40, and the control device 45 corresponds to the control unit in the treatment device for armpit or hyperhidrosis of the present invention. In order to display the information on the distribution state of the sweat glands, the position and the depth of the sweat glands obtained by the analysis unit 14 of the ultrasonic diagnostic imaging apparatus 10 on the display unit of the control device 45, the ultrasonic diagnostic imaging apparatus 10 and the control device 45 LAN, IEEE1394 serial bus, wired such as USB, infrared communication, Bluetooth (registered trademark), wireless such as IEEE802.11, etc. can be used, or manual input may be performed.

Next, a method of using the sweating suppressing device 20 having the above configuration will be described. First, the holder 25 including the electrode needle 21 is attached to the rod 36 of the drive device 24. With the cooling member 22 retracted from the support 23 and the opening of the housing portion 31 opened, the holder 25 is engaged with the engaging protrusion 25b and the engaging recess 36c to fix the holder 25 to the rod 36. be able to. Next, the cooling portion 27b of the cooling member 22 is brought into close contact with the surface of the epidermis of the punctured site including the sweat glands. When the distribution state of sweat glands is confirmed by the ultrasonic diagnostic imaging apparatus 10, if the surface of the skin is marked so that the site to be punctured by the sweat suppression apparatus 20 can be known, the range where there are no sweat glands requiring treatment. It is preferable because it can suppress heating up to.

When the cooling unit 27b and the surface of the skin are in close contact with each other, a contact signal is input from the contact detection sensor 30 to the control device 45. In this state, the control device 45 rotates the drive motor 33 of the drive device 24 by the operation of the operation unit 40. Since the nut 36a is screwed with the shaft 35 in a state where the protrusion 36b is engaged with the groove portion 34a and cannot rotate, the rod 36 advances according to the rotation amount of the drive motor 33, and each electrode needle 21 advances. Gradually protrudes from the cooling unit 27b.

In general, most of the apocrine glands and eccrine glands are substantially present in the range of 0.5 mm to 3.5 mm subcutaneously. When the existence range of the sweat glands is determined by the ultrasonic diagnostic imaging apparatus 10 and it is found that the sweat glands are present in the range of, for example, 1.5 mm to 3.0 mm, the protrusion depth L of the electrode needle 21 is first set to 1. The operation of energizing with a protrusion of 5 mm, then energizing with a further lengthening of the protrusion amount of 0.5 mm, and then energizing with a further lengthening of the protrusion amount of 0.5 mm is repeated, and this is the protrusion amount of the electrode core 21. It may be repeated until the value becomes 3.0 mm, and finally the needle may be pulled out. On the contrary, the electrode needle 21 may be driven from the deeper side to the shallower side.

As a result, uniform heating can be performed along the depth direction of the punctured site, and the entire sweat gland existing in this region can be efficiently and reliably destroyed. The heat energy supplied from the electrode needle 21 may be changed according to the depth interval, and the larger the depth interval, the larger the heat energy may be supplied. The heat energy can be supplied by using various substances such as high frequency waves, radio waves, and microwaves.

Since the periphery of the puncture site is cooled by the close contact of the cooling portion 27b on the surface of the epidermis, it is possible to prevent burns and improve pain relief during puncture and heat energy supply. If a partial anesthetic is injected subcutaneously in advance to bring the cooling portion 27b into close contact, not only can an analgesic effect be obtained, but also, as will be described later, the sweat glands of the sweat glands by the ultrasonic probe 11 of the ultrasonic diagnostic imaging apparatus 10 can be obtained. Sweat glands can be well recognized in the echo image.

[Subcutaneous electron micrograph image]
First, in order to explain the structure of the skin tissue, an electron micrograph image of the skin tissue sample obtained by collecting and staining the skin tissue is shown in FIG. The subcutaneous tissue has a dermis layer having a thickness of about 0.5 mm below the epidermis, and apocrine glands and eccrine glands are present under the dermis layer. The depth of existence of these apocrine glands and eccrine glands is about 0.5 mm to 3.5 mm. The lower part of the poklin gland and the eccrine gland is the fat layer. It is known that the thickness of the epidermis varies greatly depending on the site, is thin in the ears and sides, and is thick in the palms and soles.

[Observation example]
In the following, in order to confirm the effect of the treatment device 50 for armpit or hyperhidrosis of the present invention, the above-mentioned ultrasonic diagnostic imaging device 10 is used at each site of 10 patients.
(1) Before treatment
(2) After injecting an anesthetic subcutaneously, and
(3) After performing the treatment using the above-mentioned sweat suppression device 20
In addition to obtaining ultrasonic cross-sectional echo images at the three time points, 3D ultrasonic echo images in any of the above states (1) to (3) were also obtained as appropriate. The results are shown in FIGS. 5 to 14.

However, at the positions where each ultrasonic cross-sectional echo image and 3D ultrasonic echo image were taken, the ultrasonic probe was removed after the measurement before treatment was completed once with the ultrasonic probe, and the anesthetic was injected again. Since the measurement is performed by bringing the ultrasonic probe into contact with the position that seems to be the same, a slight deviation occurs. Therefore, from a microscopic point of view, it does not necessarily show images of the same measurement point. This also applies after injection of the anesthetic and after treatment.

For the scanning range of the ultrasonic probe 11, a reference point is first determined, and from the reference point, for example, from the hand to the axil, about 50 mm is scanned along the long side direction of the ultrasonic probe 11, and then peripheral ultrasonic waves are scanned. The distribution state of the sweat glands was determined by scanning about 30 mm along the long side direction of the probe 11. Then, at the position where the presence of the sweat gland was confirmed, a cross-sectional echo image of the sweat gland was obtained by scanning in two directions perpendicular to the short side direction of the ultrasonic probe 11.

Further, in the treatment by the sweating suppressing device 20, the protrusion depth L of the electrode needle 21 is first energized as the shallowest existing depth based on the existing depth range of the sweat glands obtained in advance by the ultrasonic diagnostic imaging device 10. Then, the operation of energizing by further increasing the protrusion amount by 0.5 mm and then energizing by further increasing the protrusion amount by 0.5 mm is repeated, and the protrusion amount of the electrode needle 21 is the deepest existence depth. I did it until it became.

In Observation Examples 1 to 7, an Aprio i-800 (trade name) manufactured by Canon Medical Systems Corporation was used as the ultrasonic diagnostic imaging apparatus, and a high-frequency linear probe PLI-2020BT (trade name) was also used as the ultrasonic probe. Further, the ultrasonic probe has about 200 ultrasonic elements, and 22 MHz ultrasonic waves were used for the measurement. Then, the distribution state of the sweat glands is obtained by scanning in the direction along the long side direction of the ultrasonic probe, and further, the cross-sectional echo image of the sweat glands is obtained by scanning in the direction along the short side direction, thereby treating the sweat glands. The range is specified. The three-dimensional ultrasonic echo image is obtained by rotating the contact surface of the ultrasonic probe about the major axis direction or by scanning along the minor axis direction. Further, in the three-dimensional ultrasonic echo image, the ultrasonic cross-sectional echo image shown on the left side is for confirming that the blood vessel is not damaged. As an antiperspirant device, View Hot III (trade name), which is an induction heating method using an electrode needle, was used. Further, in Observation Examples 8 to 10, an ultrasonic probe having an ultrasonic element number of about 400 to 600 and using an ultrasonic wave of 33 MHz was used for the measurement.

In each drawing of the following observation example, the portion marked with a circle, an ellipse, a square, or the like is the existence range of the sweat gland. In the present embodiment, the analysis unit 14 of the ultrasonic diagnostic imaging apparatus 10 analyzes the distribution of these sweat glands, and grasps the distribution of the sweat glands, the position of the sweat glands, the depth range of the sweat glands, the density of the sweat glands, and the like.

[Observation example 1]
5A is an example of side observation of a 12-year-old woman, FIG. 5A is before treatment, FIG. 5B is after subcutaneous injection of anesthetic, FIG. 5C is after treatment, and FIG. 5D is treatment at another position. After that, each is an ultrasonic cross-sectional echo image, FIG. 5E is a 3D ultrasonic echo image before treatment, FIG. 5F is a 3D ultrasonic echo image after subcutaneous injection of an anesthetic, and FIG. 5G is after treatment.

According to the ultrasonic cross-sectional echo images shown in FIGS. 5A to 5D, apocrine sweat glands and eccrine glands (hereinafter, may be simply referred to as “sweat glands”) both before treatment (FIG. 5A) and after injection of anesthetic solution (FIG. 5B). Was confirmed well, but it was confirmed that the sweat glands had substantially disappeared after the treatment (FIGS. 5C and 5D). This can also be confirmed from FIGS. 5E to 5G of the 3D ultrasonic echo image. Further, according to the ultrasonic echo images shown on the left side of each of FIGS. 5E to 5G, since there is no blood leaked region particularly in FIG. 5G, the blood vessel is damaged during the treatment. It was confirmed that there was no such thing.

[Observation example 2]
FIG. 6 is an observation example of the side of a 19-year-old woman, FIG. 6A is an ultrasonic cross-sectional echo image before treatment, FIG. 6B is an ultrasonic cross-sectional echo image after subcutaneous injection of an anesthetic agent, and FIG. 6C is after treatment. 6D is a pre-treatment image, FIG. 6E is a pre-treatment image viewed from a direction different from that of FIG. 6D, and FIG. 5F is a post-treatment 3D ultrasonic echo image.

According to the ultrasonic cross-sectional echo images shown in FIGS. 6A to 6C, the sweat glands were well confirmed both before the treatment (FIG. 6A) and after the injection of the anesthetic solution (FIG. 6B), but after the treatment (FIG. 6C), the sweat glands were confirmed well. Was confirmed to have virtually disappeared. This can also be confirmed from FIGS. 6D to 6F of the 3D ultrasonic echo image.

[Observation example 3]
FIG. 7 is an observation example of the side of a 55-year-old woman, FIG. 7A is an ultrasonic cross-sectional echo image before treatment, FIG. 7B is an ultrasonic cross-sectional echo image after subcutaneous injection of an anesthetic, and FIG. 7C is after treatment. 7D is a pre-treatment and FIG. 7E is a post-treatment 3D ultrasound echo image.

According to the ultrasonic cross-sectional echo images shown in FIGS. 7A to 7C, the sweat glands were well confirmed before the treatment (FIG. 7A), but the outline of the sweat glands was not clear after the injection of the anesthetic solution (FIG. 7B). After confirming it, it was confirmed that the sweat glands had virtually disappeared after the treatment (FIG. 7C). This can also be confirmed from FIGS. 7D and 7E of the 3D ultrasonic echo images. Further, according to the ultrasonic echo images shown on the left side of each of FIGS. 7D and 7E, since there is no blood leaked region particularly in FIG. 7E, the blood vessel is damaged during the treatment. It was confirmed that there was no such thing.

[Observation example 4]
FIG. 8 is an observation example of the lateral surface of the right thigh of a 53-year-old man, FIG. 8A is an ultrasonic cross-sectional echo before treatment, FIG. 8B is after subcutaneous injection of an anesthetic, and FIG. 8C is after treatment. 8D is an image before treatment and FIG. 8E is a 3D ultrasonic echo image after treatment.

According to the ultrasonic cross-sectional echo images shown in FIGS. 8A to 8C, the sweat glands were well confirmed before the treatment (FIG. 8A), but the outline of the sweat glands was not clear after the injection of the anesthetic solution (FIG. 8B). After confirming it, it was confirmed that the sweat glands had virtually disappeared after the treatment (FIG. 8C). This can also be confirmed from FIGS. 8D and 8E of the 3D ultrasonic echo images.

[Observation example 5]
9A is an example of observation on the dorsal side of an 18-year-old man, FIG. 9A is an ultrasonic cross-sectional echo image before treatment, FIG. 9B is an ultrasonic cross-sectional echo image after subcutaneous injection of an anesthetic, and FIG. 9C is after treatment. Yes, FIG. 9D is a pre-treatment and FIG. 9E is a post-treatment 3D ultrasound echo image.

According to the ultrasonic cross-sectional echo images shown in FIGS. 9A to 9C, the sweat glands were well confirmed before the treatment (FIG. 9A), but the outline of the sweat glands was not clear after the injection of the anesthetic solution (FIG. 9B). After confirming it, it was confirmed that the sweat glands had virtually disappeared after the treatment (Fig. 9C). This can also be confirmed from FIGS. 9D and 9E of the 3D ultrasonic echo images.

[Observation example 6]
FIG. 10 is an observation example of the armpit of a 55-year-old female, FIG. 10A is a 3D ultrasonic echo image before the treatment, and FIG. 10B is a 3D ultrasonic echo image after the treatment.

According to the 3D ultrasonic echo images shown in FIGS. 10A and 10B, the sweat glands were well confirmed before the treatment (FIG. 10A), but the sweat glands were substantially disappeared after the treatment (FIG. 10B). Was confirmed. This can also be confirmed from FIGS. 9D and 9E of the 3D ultrasonic echo images. Further, according to the ultrasonic echo images shown on the left side of each of FIGS. 10A and 10B, since there is no blood leaked region particularly in FIG. 10B, the blood vessel is damaged during the treatment. It was confirmed that there was no such thing.

[Observation example 7]
FIG. 11 is an example of axillary observation of a 38-year-old female, FIG. 11A is a 3D ultrasonic echo image before the treatment, and FIG. 11B is a 3D ultrasonic echo image after the treatment.

According to the 3D ultrasonic echo images shown in FIGS. 11A and 11B, the sweat glands were well confirmed before the treatment (FIG. 11A), but the sweat glands were substantially disappeared after the treatment (FIG. 11B). Was confirmed.

[Observation Example 8]
FIG. 12 is an observation example of the side of a 13-year-old woman who complained of recurrence after surgery using the sweat suppression device of the embodiment, and FIGS. 12A and 12B are an ultrasonic cross-sectional echo image and a 3D ultrasound of a non-recurrence site, respectively. It is a cross-sectional echo image, and FIGS. 12C and 12D are an ultrasonic cross-sectional echo image and a 3D ultrasonic cross-sectional echo image of a recurrence site.

No recurrence is seen in the ultrasonic cross-section echo image shown in FIG. 12A and the 3D ultrasonic cross-section echo image shown in FIG. 12B. However, in the ultrasonic cross-sectional echo image shown in FIG. 12C and the 3D ultrasonic cross-sectional echo image shown in FIG. 12D, a sweat gland image was seen at the site shown by the frame, and it was judged that the recurrence occurred.

[Observation example 9]
FIG. 13 is an example of preoperative observation of the eccrine gland of a 14-year-old woman with palmoplantar hyperhidrosis, FIG. 13A is an ultrasonic cross-sectional echo image, and FIG. 13B is also a 3D ultrasonic cross-sectional echo image.

According to FIGS. 13A and 13B, it was confirmed that when the ultrasonic probe of the embodiment was used, sweat glands at a thick part of the epidermal layer such as the palm could be clearly observed.

[Observation Example 10]
FIG. 14 is an example of observation of an apocrine gland using a 33 MHz driven probe beside a 14-year-old woman, FIG. 14A is an ultrasonic cross-sectional echo image before treatment, and FIGS. 14B and 14C are ultrasonic cross-sectional echo images after local hemp. 14D is a 3D ultrasonic cross-sectional echo image before treatment, FIG. 14E is an ultrasonic cross-sectional echo image after treatment, and FIG. 14F is a 3D ultrasonic cross-sectional echo image after treatment.

According to FIGS. 14A to 14F, when the ultrasonic probe used in the embodiment is driven at a high frequency of 33 MHz, as is clear from FIGS. 5A to 5G when the ultrasonic probe is driven at 22 MHz, before treatment and It can be seen that a clearer image can be obtained even after the treatment. In particular, by comparing FIGS. 14A to 14D with FIGS. 14E and 14F, it becomes possible to better understand the apocrine gland image and its disappearance state.

In addition, the ultrasonic cross-sectional echo image by the preoperative moving image using the 33MHz drive probe of the side of the above 14-year-old female is shown in FIG. 15, and the ultrasonic cross-section echo image by the moving image after the local hemp is shown in FIG. 16, respectively. .. FIGS. 15 and 16 show images when the ultrasonic probe is scanned from a position where the apocrine gland does not exist, and the apocrine gland, which is the treatment site of the armpit, is clearly recognized even by the moving image. You will be able to.

The ultrasonic diagnostic imaging apparatus of the above embodiment can display not only a cross-sectional image of one cross section of a still image but also an ultrasonic cross-sectional echo image including a 3D image and a moving image. In the ultrasonic diagnostic imaging apparatus of the above embodiment, AI means such as a neural network or a convolutional neural network, which has an advantage in image recognition, is incorporated and trained by using an ultrasonic echo image as teacher data. To be able to quickly and accurately obtain information on the distribution state of sweat glands, the position and depth of sweat glands, the position of malignant tumors of the skin, the spread state, the depth of infiltration, and the degree of infiltration from the ultrasonic echo images of the subjects. become. Also in this case, not only the cross-sectional image in one cross section of the still image but also the ultrasonic cross-sectional echo image including the 3D image and the moving image can be used. In particular, by using ultrasonic cross-sectional echo images using moving images, it is possible to analyze sweat glands and malignant tumors of the skin with higher accuracy.

In the observation example using the ultrasonic diagnostic imaging apparatus of the above embodiment, an example in which ultrasonic cross-sectional images of eccrine glands and apocrine glands are displayed is shown. For example, when this ultrasonic diagnostic imaging apparatus is used for skin cancer. When applied to, a good diagnostic effect on skin cancer can be obtained. That is, according to the ultrasonic image diagnostic apparatus of the above embodiment, the cross-sectional echo image generation device can obtain a cross-sectional echo image in which the subcutaneous state is well displayed, so that the position, spread state, and invasion depth of the skin cancer can be determined. It can be clearly displayed and can contribute to the improvement of the therapeutic effect of skin cancer. For example, by using the 33 Mhz ultrasonic probe described in Observation Examples 8 to 10, it is possible to make a particularly excellent diagnosis of skin cancer within 1 cm from the skin surface layer. Similarly, it is possible to diagnose a malignant tumor of the skin including skin cancer and malignant melanoma.

10 ... Ultrasonic diagnostic imaging device 11 ... Ultrasonic probe (probe)
11a ... Contact surface 12 ... Input / output (I / O) section
13 ... Echo image generation unit 14 ... Analysis unit 15 ... Display unit 20 ... Sweating suppression device 21 ... Electrode needle 21a ... Tip
21b ... Insulation film 22 ... Cooling member 23 ... Support 24 ... Drive device 25 ... Holder 25a ... Recess 25b ... Engagement protrusion 26 ... Perche element 27 ... Cooling plate 27a ... Opening 27b ... Cooling part 28 ... Heat dissipation block 28a ... Opening 29 ... Through hole 30 ... Contact detection sensor 31 ... Housing part 31a ... Guide groove 32 ... Cylindrical part 32a ... Groove part 33 ... Drive motor 33a ... Rotating shaft 34 ... Encoder
35 ... Shaft 35a ... Screw part 36 ... Rod 36a ... Nut 36b ... Protrusion part 36c ... Engagement recess 40 ... Operation part 45 ... Control device
50 ... Treatment device for armpit or hyperhidrosis

Claims (10)

With an ultrasonic probe,
A cross-section echo image generator that generates a cross-section echo image from a scanning signal from the ultrasonic probe, and a cross-section echo image generator.
An analyzer that analyzes the cross-section echo image from the cross-section echo image generator and recognizes the subcutaneous state,
It is an ultrasonic diagnostic imaging device with
The ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, and can scan at least in the long side direction and the short side direction.
The cross-sectional echo image generator displays a cross-sectional echo image based on scanning signals obtained by scanning in the length direction and scanning in the short side direction of the ultrasonic probe on the surface of the epidermis of a living body.
The analyzer is an ultrasonic diagnostic imaging apparatus, characterized in that it obtains and displays information on a state below the epidermis of the living body based on the cross-sectional echo image. The states below the epidermis of the living body include information on the distribution state of sweat glands, information on the position of sweat glands, information on the depth of sweat glands, information on the position of malignant tumors on the skin, information on the spread state of malignant tumors on the skin, and information on the spread of malignant tumors on the skin. The ultrasonic diagnostic imaging apparatus according to claim 1, wherein the device is at least one of information regarding the degree of invasion of a malignant tumor or the degree of infiltration of a malignant tumor of the skin. The ultrasonic diagnostic apparatus according to claim 1 or 2, wherein the ultrasonic probe is a linear probe in which ultrasonic driving elements are arranged in a row and has a driving frequency of 20 MHz or more. The analyzer determines the measurement range by scanning in the direction along the long side direction of the ultrasonic probe, and scans the living body in the determined measurement range in the direction along the short side direction of the ultrasonic probe. The ultrasonic diagnostic imaging apparatus according to any one of claims 1 to 3, further comprising grasping a state below the epidermis. The ultrasonic image diagnostic device according to any one of claims 1 to 4, wherein the cross-sectional echo image generation device can obtain a 3D ultrasonic cross-sectional echo image. The cross-section echo image generator is characterized in that at least one of before and after injection of an anesthetic solution under the surface of the epidermis of a living body and after treatment is selected and displayed. Item 6. The ultrasonic diagnostic imaging apparatus according to any one of Items 1 to 5. The ultrasonic diagnostic imaging apparatus according to any one of claims 1 to 6, wherein the analyzer includes AI (artificial intelligence) means. A treatment device for armpit or hyperhidrosis, comprising the ultrasonic diagnostic imaging apparatus according to any one of claims 1 to 7, a sweat suppression apparatus that destroys sweat glands, and a control unit that controls the sweat suppression apparatus. ,
The control unit is a treatment device for armpit or hyperhidrosis, which controls the sweat suppression device based on the state below the epidermis of the living body obtained by the ultrasonic diagnostic imaging device. The sweat suppression device has an electrode needle whose protrusion length can be adjusted, and has an electrode needle.
The armpit or hyperhidrosis according to claim 8, wherein the control unit controls the protrusion length of the electrode needle in multiple stages and controls the energization of the electrode needle at each stage. Treatment device. The sweating suppressing device includes the electrode needle and a cooling portion having a through hole through which the electrode needle can be inserted, the cooling portion is brought into close contact with the skin surface of a living body, and the electrode needle is projected from the cooling portion. The tip side of the electrode needle is heated by energizing the electrode needle, thereby destroying the sweat glands on the tip side of the electrode needle.
The control unit is the position of the electrode needle on the surface of the biological skin of the sweat suppression device, the depth of protrusion from the cooling unit, the timing of energization of the electrode needle, the period of energization of the electrode needle, or the above. A device for treating armpit or hyperhidrosis, characterized in that it is possible to control at least one of the strengths of energization of the electrodes.

Images