WO2013011733A1

WO2013011733A1 - Endoscope guidance system and endoscope guidance method

Info

Publication number: WO2013011733A1
Application number: PCT/JP2012/061839
Authority: WO
Inventors: 玉野　聡
Original assignee: 株式会社日立メディコ
Priority date: 2011-07-15
Filing date: 2012-05-09
Publication date: 2013-01-24
Also published as: JPWO2013011733A1

Abstract

Provided is an endoscope guidance system whereby an endoscope can be safely guided into the body when an endoscope is to be guided into a subject while medical imaging is being used, and whereby treatment and the like can also be safely carried out for a patient when a treatment, sampling, or the like in which the endoscope is used is to be carried out. An endoscope guidance system provided with an endoscope, wherein the endoscope guidance system comprises a position sensor for detecting the position of the endoscope in space, a medical image generation unit for generating a medical image of the portion where the endoscope is being guided, and a display unit for displaying the position of the endoscope on the medical image.

Description

Endoscope guidance system and endoscope guidance method

The present invention relates to an endoscope guidance system, and more particularly to an endoscope guidance system that safely guides an endoscope to a subject.

Endoscopes used for medical image diagnosis are techniques for optically observing organs in body cavities, and are often used as gastrocameras. In addition, a cell acquisition forceps protrudes from a forceps opening at the distal end of an endoscope, collects a biological tissue, and performs a pathological examination of the collected tissue. Furthermore, by providing a needle at the distal end of the endoscope, a drug is administered to a living tissue in a body cavity via the needle.

As described above, since endoscopes can perform various treatments and examinations without performing laparotomy, they are widely used as examination techniques or surgical techniques with less subject invasion and less burden on the subject. (For example, see Patent Document 1).

JP 62-82944 JP

However, in conventional optical endoscopes, if there are optically clear findings (e.g., discoloration, dripping, bleeding, etc.), it is easy to recognize the position of the lesion, but optically obvious findings. If there was no lesion or the lesion was far from the inner surface of the organ, it was difficult to recognize the position of the lesion. In addition, although an ultrasonic endoscope in which an ultrasonic probe is combined with an optical endoscope is used, it is difficult to grasp the lesion position three-dimensionally because the internal structure of the living body is complicated. It was.

In addition, three-dimensional image diagnosis using medical images (X-ray images, CT, MRI, ultrasound images, angiography, etc.) is performed for definitive diagnosis of visceral diseases and grasping of lesion positions. However, in image diagnosis using medical images, it is easy to grasp the position of the lesion, but when combined with an endoscope, the positional relationship between the position of the endoscope and the position of the treatment target and the three-dimensional medical image It was difficult to grasp three-dimensionally.

The present invention has been made to solve the conventional problems. When the endoscope is guided to a subject while using a medical image, the endoscope is safely guided and treatment using the endoscope is performed. An object of the present invention is to provide an endoscope guidance system capable of safely performing treatment on a living body even when performing collection or collection.

An endoscope guidance system according to the present invention includes an endoscope guidance system including an endoscope, a position sensor that detects a position of the endoscope in a space, and a medical image of a portion to which the endoscope is guided. A medical image generation unit for generating, and a display unit for displaying the position of the endoscope on the medical image. Therefore, while confirming the position of the endoscope with medical images, the endoscope can be safely guided to the subject, and the subject can be safely treated even when performing treatment or collection using the endoscope. And so on.

The endoscope guidance method of the present invention is a endoscope guidance system including an endoscope, detects a position of the endoscope in a space, generates a medical image of a portion to which the endoscope is guided, The position of the endoscope is displayed on the medical image. Therefore, while confirming the position of the endoscope with medical images, the endoscope can be safely guided to the subject, and the subject can be safely treated even when performing treatment or collection using the endoscope. And so on.

According to the present invention, when guiding an endoscope to a subject while using a medical image, the endoscope is safely guided to the subject, and also when performing treatment or collection using the endoscope. The subject can be safely treated.

The figure which shows the outline | summary of the endoscope guidance system which concerns on 1st Embodiment The flowchart which shows operation | movement of the endoscope guidance system which concerns on 1st Embodiment The figure which shows the medical image and information which are displayed on the monitor of the endoscope guidance system which concerns on 1st Embodiment Diagram showing endoscopic guidance Diagram showing warning displayed on monitor The figure which shows the vector showing the distance or direction of the position of an endoscope, and a to-be-tested part position The figure which shows the medical image and information which are displayed on the monitor of the endoscope guidance system which concerns on 2nd Embodiment The figure which shows the outline | summary of the endoscope guidance system which concerns on 2nd Embodiment. The flowchart which shows operation | movement of the endoscope guidance system which concerns on 2nd Embodiment. The figure which shows the outline | summary of the endoscope guidance system which concerns on other embodiment. The flowchart which shows operation | movement of the endoscope guidance system which concerns on other embodiment. The figure which shows the optical image of the endoscope displayed on a monitor

(First embodiment)
Hereinafter, an endoscope guidance system according to an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a block diagram showing a configuration of an endoscope guidance system according to the first embodiment. In FIG. 1, an endoscope guidance system 1 includes an endoscope 2, an ultrasonic probe 11, and an ultrasonic device 10.

The endoscope 2 can optically observe the structure in the body cavity of the subject, and includes an optical camera 3, an endoscope magnetic sensor 5 (first position sensor), an ultrasonic transducer 6, and a forceps port 7. And a puncture needle 70 (protrusion). The endoscope 2 is connected to the ultrasonic apparatus 10 via the endoscope shaft 8. Further, the puncture needle 70 protrudes from the forceps port 7 of the endoscope 2, and the biological tissue can be collected or treated from the distal end of the endoscope 2.

The optical camera 3 includes a CCD image sensor and an optical fiber, and acquires an optical image. The endoscope magnetic sensor 5 detects the position and angle (including the rotation angle) of the endoscope 2 in space, and particularly detects the position of the distal end portion of the endoscope 2. The ultrasonic transducer 6 transmits ultrasonic waves and receives reflected signals from tissues in the subject in order to grasp in real time the lesion (test portion) in the body cavity of the subject. Get an image. Further, the ultrasonic transducer 6 observes the photoacoustic effect generated by the light for photoacoustic treatment. The forceps port 7 may include an optical fiber, an LED, a laser, or the like for irradiating light for photoacoustic treatment.

The ultrasonic probe 11 includes an ultrasonic transducer 30 and an ultrasonic probe magnetic sensor 16 (second position sensor). The ultrasonic probe 11 transmits an ultrasonic wave to the subject via the ultrasonic transducer 30 and receives a reflected signal from a tissue in the subject, thereby causing a lesion (in the subject's body cavity) To obtain an ultrasonic image for grasping in real time. The ultrasonic probe 11 observes the photoacoustic effect generated by the light for photoacoustic treatment. As the ultrasonic probe 11, a two-dimensional array ultrasonic probe in which transducers are arranged two-dimensionally, a mechanical scan type ultrasonic probe that mechanically swings the transducer unit, or a transducer 1 There is a one-dimensional ultrasonic probe arranged in a dimension.

The ultrasonic device 10 includes an endoscope connector 4, an optical module 9, an ultrasonic transmission / reception circuit 12, an ultrasonic image generation circuit 13 (medical image generation unit), a control circuit 14 (medical image control unit), an operation panel 15 (operation Part), monitor 17 (display part), speaker 18, position detection part 19, guidance route setting part 20, arrival position setting part 21, information providing part 22, test part position setting part 23, and attention area setting part 24 Prepare.

The endoscope connector 4 is an interface for connecting the endoscope 2 and the ultrasonic device 10. The endoscope connector 4 includes channels such as a puncture needle, forceps, light, laser, wiring, air supply, water supply, and suction. The optical module 9 includes a light emitting element and a light receiving element, and supplies light to the light source of the endoscope 2 through an optical fiber or the like.

The ultrasonic transmission / reception circuit 12 generates an ultrasonic transmission signal for the

ultrasonic transducers

6 and 30 and receives the ultrasonic signal. The ultrasonic image generation circuit 13 (medical image generation unit) is an ultrasonic signal received by the ultrasonic transmission / reception circuit 12 based on the position information of the ultrasonic probe 11 acquired by the ultrasonic probe magnetic sensor 16. An ultrasonic image (medical image) is generated from the image. The ultrasonic image generated by the ultrasonic image generation circuit 13 is displayed on the monitor 17 as a video. The control circuit 14 (medical image control unit) controls the endoscope 2, the ultrasonic probe 11, and the ultrasonic device 10. The operation panel 15 (operation unit) inputs an instruction from the operator to the ultrasonic apparatus 10.

The position detection unit 19 grasps the positions of the magnetic sensors 5 and 16 (first and second position sensors) in the space in three dimensions. The guide path setting unit 20 sets a guide path for guiding the endoscope 2 in the body cavity of the subject to an ultrasonic image (medical image). The arrival position setting unit 21 sets an arrival position at which the endoscope 2 is guided and arrives in the body cavity of the subject in an ultrasonic image (medical image). The test part position setting unit 23 sets the position of the test part in an ultrasonic image (medical image). The attention area setting unit 24 sets an attention area in the guide route through which the endoscope 2 is guided into the body cavity of the subject.

The information providing unit 22 provides information on the distance or direction between the position of the endoscope 2 in the body cavity of the subject and the arrival position or the position of the subject to be examined. The information providing unit 22 determines the position and angle of the endoscope 2 (including the rotation angle of the endoscope probe), the guidance speed of the endoscope 2, the guidance acceleration of the endoscope 2, and the guidance of the endoscope 2. Information on at least one of the direction and the pressure when the endoscope 2 abuts is provided. The information providing unit 22 provides information indicating that the attention area has been reached when the endoscope 2 reaches the attention area.

As described above, the endoscope guidance system of the present invention includes the attention area setting unit 24 that sets the attention area in the guidance route through which the endoscope 2 is guided, and when the endoscope 2 reaches the attention area. And an information providing unit 22 for providing information indicating that the region of interest has been reached. According to this configuration, an area where the endoscope is likely to be erroneously inserted, an area where the insertion path needs to be careful because the guide path is complicated or narrow, and an endoscope needs attention because it tends to bleed. Since the region and the like can be confirmed, the endoscope can be safely guided to the subject.

The monitor 17 (display unit) displays an ultrasonic image or an endoscope optical image. Here, the ultrasonic image may be an ultrasonic image generated in real time by the ultrasonic image generation circuit 13, and an ultrasonic image (preliminarily acquired as an ultrasonic three-dimensional image by the ultrasonic image generation circuit 13 ( Volume data). That is, the medical image generation unit (ultrasound image generation circuit 13) generates a medical image acquired in advance as a three-dimensional image of a portion where the endoscope 2 is guided. In addition, since the magnetic sensor 16 (position sensor) of the ultrasonic probe 11 can grasp the three-dimensional position of a living body and a lesioned part, the ultrasonic image is a normal ultrasonic B-mode image. May be.

The monitor 17 (display unit) provides the position and angle of the endoscope 2 detected by the magnetic sensor 5, the guidance route set by the guidance route setting unit 20, the arrival position set by the arrival position setting unit 21, and information provision Information on the distance or direction provided by the unit 22, the position of the test part set by the test part position setting unit 23, and the attention area set by the attention area setting unit 24 are displayed as an ultrasonic image (medical image). ) Superimposed on the screen. The speaker 18 provides information on the distance or direction provided by the information providing unit 22 by sound, and guides the endoscope 2 by sound.

As described above, the endoscope guidance system of the present invention is an endoscope guidance system including the endoscope 2, and a position sensor (endoscope magnetic sensor 5) that detects the position of the endoscope 2 in space, A medical image generation unit (ultrasonic image generation circuit 13) that generates a medical image of a portion to which the endoscope 2 is guided, and a display unit (monitor 17) that displays the position of the endoscope 2 on the medical image . Further, the endoscope guidance method of the present invention is a endoscope guidance system including the endoscope 2, and detects the position of the endoscope 2 in the space, and obtains a medical image of a portion to which the endoscope 2 is guided. The position of the endoscope 2 is generated and displayed on the medical image. Therefore, while confirming the position of the endoscope with medical images, the endoscope can be safely guided to the subject, and the subject can be safely treated even when performing treatment or collection using the endoscope. And so on.

Further, in the endoscope guidance system of the present invention, the display unit (monitor 17) includes a guidance path through which the endoscope 2 is guided, a reaching position where the endoscope 2 is guided and reached, and a position of the test part At least one of them is displayed on a medical image. Therefore, while confirming the guide route, the arrival position, and the position of the test part, the endoscope can be safely guided to the subject, and also when performing treatment or collection using the endoscope, Safe treatment can be performed.

Next, the operation of the endoscope guidance system 1 according to the present embodiment will be described. FIG. 2 is a flowchart showing the operation of the endoscope guidance system 1. FIG. 3 is a diagram showing an ultrasonic image and an endoscopic optical image displayed on the monitor 17. FIG. 4 is a diagram showing information on the arrival position of the subject in the body cavity, the position of the test portion, the guide route, and the distance or direction.

The ultrasonic probe 11 acquires ultrasonic 3D volume data (ultrasonic three-dimensional image) of the subject using the magnetic sensor 16 (second position sensor) (step S1). As shown in FIG. 3, the monitor 17 displays an ultrasonic three-dimensional image 31 acquired in advance. The monitor 17 displays an ultrasonic image 32 (B mode image), a treatment guide image 33, and an endoscope optical image 34 generated in real time.

As shown in FIG. 3 and FIG. 4 (a), using the operation panel 15, the arrival position setting unit 21 displays an ultrasonic three-dimensional image 31, an ultrasonic image 32, and a treatment guide image 33 displayed on the monitor 17. An arrival position P1 at which the distal end of the endoscope 2 is guided and reached is set for (medical image) (step S2). Further, using the operation panel 15, the subject position setting unit 23 sets the subject position P2 for the ultrasonic three-dimensional image 31, the ultrasonic image 32, and the treatment guide image 33 that are medical images. (Step S2). Here, the test portion position P2 is, for example, a lesion position, a treatment position, or a tissue acquisition position.

As shown in FIGS. 3 and 4 (b), the guide route setting unit 20 sets the guide route P3 according to the insertion plan of the endoscope 2 for the ultrasonic three-dimensional image 31 displayed on the monitor 17. (Step S3). The guidance route may be set using a touch pen or the like using the operation panel 15, or may be set using a mouse, a trackball, a joystick, or the like. Further, when setting the guide route, a line may be drawn along the insertion plan of the endoscope 2 with a touch pen, a mouse, a trackball, and a joystick, or a plurality of lines may be drawn along the insertion plan of the endoscope 2. The points may be designated and the respective points may be automatically connected by lines.

As shown in FIG. 4 (b), the attention area setting unit 24 sets the attention area P4 in the guidance path P3 for the ultrasonic image displayed on the monitor 17 (step S3). Here, the attention area P4 is an area where the endoscope 2 is likely to be erroneously inserted, an area where the insertion path needs to be careful because the guide path is complicated or narrow, and an area where the endoscope 2 is likely to bleed. This is an area that requires careful insertion. For example, as shown in FIG. 4 (b), since the endoscope 2 is likely to be erroneously inserted at the tracheal bifurcation, the attention area P4 is set.

The insertion of the endoscope 2 is started using the shaft 8 for inserting the endoscope 2 into the body cavity (step S4). As shown in FIG. 3, the monitor 17 displays an optical image acquired by the endoscope 2. The monitor 17 superimposes and displays the position P5 of the endoscope 2 detected by the magnetic sensor 5 on the ultrasonic three-dimensional image 31 (medical image). As a result, the position of the endoscope 2 is displayed on the ultrasonic three-dimensional image 31. The monitor 17 can also display an ultrasonic image acquired by the endoscope ultrasonic transducer 6 attached to the endoscope 2. Thereby, an ultrasonic image viewed from inside the body cavity is displayed.

In the endoscope guidance system according to the present invention, the endoscope 2 includes the ultrasonic transducer 6 and acquires an ultrasonic image of the portion to be examined. According to this configuration, while confirming an ultrasonic image from the endoscope, the endoscope can be safely guided to the subject, and also when performing treatment or collection using the endoscope, the subject Can be treated safely.

The information providing unit 22 provides information related to the distance and direction between the position P5 of the endoscope 2 and the arrival position P1 (or the test part position P2) based on the position information of the endoscope magnetic sensor 5. (Step S5). As shown in FIG. 4 (c), based on the information provided from the information providing unit 22, the monitor 17 displays the vector V1 on the ultrasonic image. The vector V1 indicates the distance and direction from the position P5 of the endoscope 2 to the arrival position P1. For example, when the endoscope 2 approaches the arrival position P1 along the guide path P3, the blue vector V1 may be displayed. When the endoscope 2 moves away from the arrival position P1, the red vector V1 may be displayed. . That is, the display form of the vector V1 is different depending on whether it approaches or farther from the arrival position P1. Further, the monitor 17 may display the distance to the arrival position P1 along the guidance route P3. Further, based on the information provided from the information providing unit 22, the speaker 18 may indicate the distance and direction from the position of the endoscope 2 to the arrival position P1 by sound or voice. The sound and voice may be changed depending on whether the endoscope 2 approaches or reaches the arrival position P1 along the guidance path P3. May be changed.

The information providing unit 22 also determines the position and angle of the endoscope 2, the guidance speed of the endoscope 2, the guidance acceleration of the endoscope 2, the guidance direction of the endoscope 2, and the pressure sensor. Information about at least one of the contact pressures is provided (step S5). The monitor 17 or the speaker 18 shows information provided from the information providing unit 22.

The information providing unit 22 provides information indicating that the endoscope 2 has reached the attention area P4 when the endoscope 2 reaches the attention area P4 (steps S6 and S7). The warning unit (the monitor 17 or the speaker 18) alerts the operator based on the information provided from the information providing unit 22, or automatically displays the optical image of the endoscope 2. For example, the monitor 17 may automatically enlarge the optical image that displays the attention area P4, and may change the display form such as the color of the frame of the optical image. Further, the speaker 18 may emit a sound or a sound that alerts the operator while the endoscope 2 is present in the attention area P4.

Further, as shown in FIG. 4D and FIG. 5, the warning unit (the monitor 17 or the speaker 18) is based on information provided from the information providing unit 22 (such as the position and angle of the endoscope 2). A warning is given when the position of the endoscope 2 deviates from the guidance path P3 (step S6 and step S7).

For example, based on the position and angle of the endoscope 2, when the distance between the position of the endoscope 2 and the guide path P3 exceeds a predetermined threshold, the endoscope 2 is mistaken for an organ different from the guide path P3. The monitor 17 displays a warning message 35, and the speaker 18 generates a warning sound, judging that it has been inserted. Thereby, it is possible to safely guide the endoscope 2 into the body cavity of the subject while using the medical image. Further, if the ultrasonic image from the endoscope ultrasonic transducer 6 of the endoscope 2 is used, the endoscope 2 can be guided more safely into the body cavity of the subject.

As described above, the endoscope guidance system of the present invention provides a guidance route setting unit 20 that sets a guidance route for guiding the endoscope 2, and a warning when the position of the endoscope 2 deviates from the guidance route. Warning section (monitor 17 or speaker 18). According to this configuration, it can be confirmed that the endoscope has deviated from the guidance path by a warning, and therefore the endoscope can be safely guided to the subject.

Further, as shown in FIG. 5, the monitor 17 warns the distance or direction between the position of the endoscope 2 and the guide path P3 when the position P5 of the endoscope 2 deviates from the guide path P3. The vector V2 may be displayed on an ultrasonic three-dimensional image (medical image). In this case, the monitor 17 may change the display form such as the shape and color of the vector V2 according to the distance that the endoscope 2 deviates from the guide path P3, and the speaker 18 changes the sound and sound. May be.

As described above, in the endoscope guidance system of the present invention, the warning unit (the monitor 17 or the speaker 18) is configured so that the position of the endoscope 2 and the guidance path when the position of the endoscope 2 deviates from the guidance path. Warning the distance or direction. According to this configuration, since the distance or direction of the endoscope deviating from the guidance path can be confirmed, the endoscope can be safely guided to the subject.

When the endoscope 2 has reached the arrival position P1 (step S8), the information providing unit 22 provides information on the distance or direction between the position of the endoscope 2 and the test portion position P2, and the monitor 17 Based on the information provided by the information providing unit 22, the distance and direction between the position P5 of the endoscope 2 and the test portion position P2 are displayed in an ultrasonic three-dimensional image (medical image) (step S9). As shown in FIG. 6, a vector V3 may be displayed to represent the distance or direction between the position P5 of the endoscope 2 and the test portion position P2. In this case, the monitor 17 may change the display form such as the shape and color of the vector V3 according to the distance or direction between the position P5 of the endoscope 2 and the test portion position P2, and the speaker 18 The voice may be changed. As a result, the puncture needle 70 (protruding part) protrudes from the forceps port 7 and can reach the test part position P2 while grasping the distance or direction to the test part position P2, and collected from the living body. Or treatment can be performed (step S10). The protrusion may be a medical instrument such as a forceps or a high-frequency knife. When the protruding portion is a forceps, the forceps can reach the test portion position P2 while grasping the distance or direction to the test portion position P2, and safely treat the living tissue with respect to the subject. (Step S10).

As described above, the endoscope guidance system of the present invention includes the arrival position setting unit 21 that sets the arrival position to which the endoscope 2 is guided and reached, and the distance between the position of the endoscope 2 and the arrival position, or And an information providing unit 22 that provides information on the direction. According to this configuration, since the distance or direction from the endoscope to the reaching position can be confirmed, the endoscope can be safely guided to the subject.

In addition, the endoscope guidance system of the present invention provides the information about the distance or direction between the position of the endoscope 2 and the position of the test part, and the test part position setting part 23 for setting the position of the test part And an information providing unit 22 for providing information. According to this configuration, since the distance or direction from the endoscope to the position of the test portion can be confirmed, when performing treatment or collection using the endoscope, treatment or collection is safely performed on the subject. be able to.

The puncture needle 70 (projection) includes a magnetic sensor (third position sensor) that detects the position of the puncture needle 70 (projection) in the space, and the monitor 17 exceeds the position of the puncture needle 70 (projection). You may display on the sound wave three-dimensional image 31 (medical image). Further, the information providing unit 22 may provide information on the distance or direction between the position of the puncture needle 70 (protruding part) and the test part position P2 to the warning unit (the monitor 17 or the speaker 18). In order to indicate the distance or direction between the position of the puncture needle 70 (protruding portion) and the test portion position P2, the monitor 17 may display a vector on the medical image. In this case, depending on the distance or direction between the position of the puncture needle 70 (protrusion) and the test part position P2, the monitor 17 may change the display form such as the shape and color of the vector, and the speaker 18 And the sound may be changed. Thereby, while grasping the distance or direction between the tip position of the puncture needle 70 and the test portion position P2, the puncture needle 70 (protruding portion) can surely reach the test portion position P2, and against the living body. Thus, it is possible to safely acquire a biological tissue or perform treatment. When the protruding portion is a forceps, the forceps can reach the test portion position P2 while grasping the distance or direction between the tip position of the forceps and the test portion position P2, and it is safe for the subject. Living tissue can be treated.

As described above, in the endoscope guidance system of the present invention, the endoscope includes a protrusion (puncture needle 70), the protrusion includes a position sensor (magnetic sensor) that detects the position of the protrusion in space, The display unit (monitor 17) displays the position of the protrusion on the medical image. According to this configuration, since the protruding portion can be safely guided to the position of the test portion while confirming the position of the protruding portion with the medical image, it is possible to safely treat or collect the subject.

In addition, the endoscope guidance system of the present invention relates to a test part position setting unit 23 that sets the position of the test part, and a distance or direction between the position of the protrusion (puncture needle 70) and the position of the test part. And an information providing unit 22 that provides information. According to this configuration, since the distance or direction from the protruding portion to the position of the test portion can be confirmed, when treatment or collection using a puncture needle or forceps is performed, treatment or collection is safely performed on the subject. be able to.

In addition, by directing the optical camera 3 and the ultrasonic transducer 6 of the endoscope 2 to the test part position P2, and acquiring the optical image and the ultrasonic image of the test part, the state of biological tissue collection and treatment can be checked. It can be observed in real time with ultrasound images. As a result, it is possible to acquire a biological tissue more safely with respect to the living body or to perform a treatment while confirming the effects of collecting the biological tissue and the treatment (step S11). Further, when the endoscope 2 reaches the arrival position P1 (step S8), the monitor 17 may switch from the optical image of the endoscope 2 to the ultrasonic image of the endoscope 2.

In addition, it is possible to observe the photoacoustic effect with the ultrasonic transducer 6 by directing the ultrasonic transducer 6 of the endoscope 2 toward the test portion position P2, and while confirming the photoacoustic effect, Further, it is possible to safely acquire a biological tissue or perform treatment (step S11). In the observation of the photoacoustic effect, a photoacoustic agent that specifically aggregates at a diseased site is administered to the subject, and a laser or the like is irradiated from the forceps port 7 of the endoscope 2 to the test portion position P2, thereby causing photoacoustics. The drug absorbs light energy, vibrates and evaporates, generating an ultrasonic signal. By observing the ultrasonic signals by the

ultrasonic transducers

6 and 30, the photoacoustic effect is observed. Thus, treatment using photoacoustics and observation of photoacoustic effects can be applied not only to the body surface but also to deep organs such as the esophagus, stomach, digestive tract, and intestinal tract.

As described above, in the endoscope guidance system of the present invention, the endoscope 2 includes the ultrasonic transducer 6 and the photoacoustic effect is observed by the ultrasonic transducer 6. According to this configuration, the photoacoustic effect can be observed from the inside of the subject, and effective photoacoustic treatment can be performed.

In addition, if an IVUS (intravascular ultrasound) is used from the forceps port 7 at the distal end of the endoscope 2 as an observation means in the body cavity of the subject, an ultrasonic image viewed from inside the blood vessel can be acquired by the ultrasonic transducer 6. More detailed lesion information can be obtained.

When confirming the effect of collection of biological tissue or treatment, the endoscope 2 is removed from the subject (step S12).

(Second embodiment)
Hereinafter, a medical image diagnostic apparatus according to a second embodiment of the present invention will be described with reference to the drawings. Unless otherwise specified, other configurations are the same as those of the endoscope guidance system according to the first embodiment.

In the first embodiment, as shown in FIG. 3, an ultrasonic image (volume data) acquired in advance as an ultrasonic three-dimensional image by the ultrasonic image generation circuit 13 is used for inserting the endoscope 2. A reference image is used. On the other hand, in the second embodiment, the reference image may be a CT image or an MRI image as long as it is three-dimensional volume data.

In the first embodiment, the coordinate system of the endoscope magnetic sensor 5 and the coordinate system of the ultrasonic probe magnetic sensor 16 can be handled as the same. On the other hand, in the second embodiment, it is necessary to match the CT coordinate system or MRI coordinate system with the coordinate system of the endoscope magnetic sensor 5. Here, regarding a method for converting the coordinate system of the CT or MRI three-dimensional image into the coordinate system of the magnetic sensor 5 attached to the ultrasonic probe 11, Japanese Patent No. 4300488 (`` Ultrasonic diagnosis Reference image display method and ultrasonic diagnostic apparatus ", Hitachi Medical Co., Ltd.). Japanese Patent No. 4300488 shows coordinate transformation in the case of a magnetic sensor attached to an ultrasonic probe outside the body, but in this embodiment, a magnetic attached to the ultrasonic probe outside the body. If the sensor is the magnetic sensor 5 attached to the endoscope 2, it can also be applied to mutual coordinate conversion between the CT or MRI three-dimensional coordinate system and the endoscope magnetic sensor coordinate system.

In this way, mutual coordinate transformation between the CT and MRI three-dimensional coordinate system and the endoscope magnetic sensor coordinate system can be realized, so that the monitor 17 (display unit) is detected by the magnetic sensor 5 as shown in FIG. The position P5 and angle of the endoscope 2, the guidance route P3 set by the guidance route setting unit 20, the arrival position P1 set by the arrival position setting unit 21, and the distance or direction provided by the information providing unit 22 The information, the position P2 of the test part set by the test part position setting unit 23, and the attention area P4 set by the attention area setting unit 24 can be displayed superimposed on the CT / MRI image 36. Further, the monitor 17 may display the position of the puncture needle 70 (protrusion) on the CT / MRI image 36 (medical image). The monitor 17 displays an ultrasonic image of the endoscope ultrasonic transducer 6 attached to the endoscope 2 together with the CT / MRI image 36, or superimposes it on the test part of the CT / MRI image 36. May be.

As shown in FIG. 8, the endoscope guidance system according to the present embodiment includes a CT / MRI image database 80. The CT / MRI image database 80 stores CT / MRI three-dimensional images (volume data) acquired in advance together with position information. As shown in FIG. 9, the control circuit 14 acquires a CT / MRI image using the volume data stored in the CT / MRI image database 80 (step S100). The control circuit 14 calculates the three-dimensional position of the endoscope magnetic sensor 5 provided at the distal end of the endoscope 2, and matches the CT / MRI coordinate system and the coordinate system of the endoscope magnetic sensor 5. The monitor 17 is based on the coordinate system that matches, the position P5 and angle of the endoscope 2, the guidance path P3, the arrival position P1, the information about the distance or direction, the test part position P2, the attention area P4, etc. / MRI image is superimposed and displayed (steps S2, S3, S5, S7, S9, etc.). Thus, the present invention can be applied to a three-dimensional image using various medical images (X-ray image, CT, MRI, ultrasound image, angiography, etc.).

In the second embodiment, an ultrasonic image is used. However, the present invention can be applied without using an ultrasonic image. As shown in FIG. 10, the medical image diagnostic apparatus 101 does not include the ultrasonic probe 11, the endoscope ultrasonic transducer 6, the ultrasonic transmission / reception circuit 12, and the ultrasonic image generation circuit 13. In this case, volume data of a CT / MRI three-dimensional image is used as a reference image. A CT / MRI three-dimensional image (volume data) acquired in advance is stored in the CT / MRI image database 80 together with position information. Regarding the conversion between the coordinate system of the magnetic sensor 5 attached to the ultrasonic probe 11 and the CT / MRI coordinate system, the method described in Japanese Patent No. 4300488 is used.

As shown in FIG. 11, the control circuit 14 acquires a CT / MRI image using the volume data stored in the CT / MRI image database 80 (step S200). The control circuit 14 calculates the three-dimensional position of the endoscope magnetic sensor 5 provided at the distal end of the endoscope 2, and matches the CT / MRI coordinate system and the coordinate system of the endoscope magnetic sensor 5. The monitor 17 is based on the coordinate system that matches, the position P5 and angle of the endoscope 2, the guidance path P3, the arrival position P1, the information about the distance or direction, the test part position P2, the attention area P4, etc. / MRI image is superimposed and displayed (steps S2, S3, S5, S7, S9, etc.). As described above, the present invention can also be applied to a three-dimensional image using various medical images other than the ultrasonic image.

According to the above embodiment, when guiding an endoscope to a subject while using a medical image, the endoscope is safely guided to a living body, and treatment or collection using the endoscope is performed. In addition, it is possible to safely treat the living body.

As mentioned above, although embodiment concerning this invention was described, this invention is not limited to these, It is possible to change and change within the range described in the claim.

For example, as shown in FIG. 12, the monitor 17 includes a guide path P3, a vector V1 indicating the distance and direction from the position P5 of the endoscope 2 to the arrival position P1, and the position of the endoscope 2 and the guide path P3. At least one of the vector V2 indicating the distance or direction and the vector V3 indicating the distance or direction between the position P5 of the endoscope 2 and the position P2 to be examined is used as an optical image (medical image) of the endoscope 2. It may be displayed. In addition, the monitor 17 is the arrival position P1, the test portion position P2, the position and angle of the endoscope 2, the guidance speed of the endoscope 2, the guidance acceleration of the endoscope 2, the guidance direction of the endoscope 2, and At least one of the contact pressures of the endoscope 2 by the pressure sensor may be displayed on the optical image (medical image) of the endoscope 2.

The endoscope guidance system according to the present invention safely guides an endoscope to a living body when guiding the endoscope to a subject while using a medical image, and performs treatment or collection using the endoscope. Even when it is performed, it has an effect that treatment can be safely performed on a living body, and is useful as an endoscope guidance system for safely guiding an endoscope to a subject.

1 Endoscope guidance system, 2 Endoscope, 3 Optical camera, 4 Endoscope connector, 5 Endoscope magnetic sensor, 6 Endoscope ultrasonic transducer, 7 Forceps opening, 8 Endoscope shaft, 9 Light Module, 10 ultrasonic device, 11 ultrasonic probe, 12 ultrasonic transmission / reception circuit, 13 ultrasonic image generation circuit, 14 control circuit, 15 operation panel, 16 ultrasonic probe magnetic sensor, 17 monitor, 18 speaker, 19 position detection unit, 20 guide route setting unit, 21 arrival position setting unit, 22 information providing unit, 23 test portion position setting unit, 24 attention area setting unit, 70 puncture needle

Claims

In an endoscope guidance system including an endoscope,
A position sensor for detecting the position of the endoscope in space;
A medical image generation unit that generates a medical image of a portion to which the endoscope is guided;
An endoscope guidance system comprising: a display unit that displays a position of the endoscope on the medical image.
The display unit displays at least one of a guide route through which the endoscope is guided, a reaching position at which the endoscope is guided and reached, and a position of a test unit on the medical image. The endoscope guidance system according to claim 1.
A guide route setting unit for setting a guide route for guiding the endoscope;
2. The endoscope guidance system according to claim 1, further comprising a warning unit that warns when the position of the endoscope deviates from the guidance path.
4. The warning unit according to claim 3, wherein when the position of the endoscope deviates from the guide path, the warning unit warns the distance or direction between the position of the endoscope and the guide path. Endoscope guidance system.
An arrival position setting unit for setting an arrival position at which the endoscope is guided and reached;
2. The endoscope guidance system according to claim 1, further comprising an information providing unit that provides information regarding a distance or direction between the position of the endoscope and the arrival position.
A test part position setting unit for setting the position of the test part;
2. The endoscope guidance system according to claim 1, further comprising: an information providing unit that provides information regarding a distance or direction between the position of the endoscope and the position of the test unit.
The endoscope includes a protrusion,
The protrusion includes a position sensor that detects a position of the protrusion in space.
2. The endoscope guidance system according to claim 1, wherein the display unit displays a position of the protruding portion on the medical image.
A test part position setting unit for setting the position of the test part;
8. The endoscope guidance system according to claim 7, further comprising an information providing unit that provides information regarding a distance or direction between the position of the protruding portion and the position of the test portion.
A region-of-interest setting unit for setting a region of interest in a guidance route through which the endoscope is guided;
2. The endoscope guidance system according to claim 1, further comprising: an information providing unit that provides information indicating that the endoscope has reached the attention area when the endoscope reaches the attention area.
2. The endoscope guidance system according to claim 1, wherein the endoscope includes an ultrasonic transducer and acquires an ultrasonic image of a portion to be examined.
2. The endoscope guidance system according to claim 1, wherein the endoscope includes an ultrasonic transducer, and the photoacoustic effect is observed by the ultrasonic transducer.
2. The endoscope guidance system according to claim 1, wherein the medical image generation unit generates a medical image acquired in advance as a three-dimensional image of a portion where the endoscope is guided.
In an endoscope guidance system including an endoscope,
Detecting the position of the endoscope in space;
Generating a medical image of a portion to which the endoscope is guided;
An endoscope guiding method, wherein the position of the endoscope is displayed on the medical image.