WO2015159584A1 - 超音波治療装置 - Google Patents

超音波治療装置 Download PDF

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Publication number
WO2015159584A1
WO2015159584A1 PCT/JP2015/054709 JP2015054709W WO2015159584A1 WO 2015159584 A1 WO2015159584 A1 WO 2015159584A1 JP 2015054709 W JP2015054709 W JP 2015054709W WO 2015159584 A1 WO2015159584 A1 WO 2015159584A1
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WO
WIPO (PCT)
Prior art keywords
ultrasonic
ultrasonic element
therapy apparatus
target organ
treatment target
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2015/054709
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English (en)
French (fr)
Japanese (ja)
Inventor
希依 植木
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to DE112015001369.5T priority Critical patent/DE112015001369T5/de
Priority to CN201580019399.0A priority patent/CN106163438B/zh
Publication of WO2015159584A1 publication Critical patent/WO2015159584A1/ja
Priority to US15/277,229 priority patent/US20170014650A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N7/02—Localised ultrasound hyperthermia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00154—Details of operation mode pulsed
    • A61B2017/00159—Pulse shapes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00666—Sensing and controlling the application of energy using a threshold value
    • A61B2018/00678—Sensing and controlling the application of energy using a threshold value upper
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00738—Depth, e.g. depth of ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature

Definitions

  • the present invention relates to an ultrasonic therapy apparatus.
  • the acoustic propagation medium is filled between the surface of the organ to be treated in the body and the ultrasonic element facing the surface, and the acoustic propagation medium is cooled when the therapeutic ultrasonic wave is irradiated from the ultrasonic element. Therefore, there is known an ultrasonic therapy apparatus that treats an organ to be treated while suppressing an increase in surface temperature (see, for example, Patent Document 1).
  • the present invention has been made in view of the above-described circumstances, and provides an ultrasonic treatment apparatus capable of treating an organ to be treated while suppressing an increase in surface temperature without increasing the size of the apparatus. It is aimed.
  • One aspect of the present invention is an ultrasonic element that generates an ultrasonic wave that is made to face a surface of a treatment target organ through an acoustic propagation medium and is focused on a deep portion of the treatment target organ, and the treatment from the ultrasonic element.
  • a control unit that adjusts the ultrasonic wave irradiated to the target organ, and the control unit generates heat that is generated and remains in the vicinity of the surface when the ultrasonic wave irradiated from the ultrasonic element passes below a predetermined threshold value.
  • An ultrasonic therapy apparatus that temporally changes the intensity of an ultrasonic wave incident on the same region of the surface is provided.
  • the control unit operates the ultrasonic element to generate an ultrasonic wave, and deeply enters the treatment target organ.
  • the affected part arranged in the deep part of the organ to be treated can be heated to perform treatment.
  • the ultrasonic wave emitted from the ultrasonic element passes through the acoustic propagation medium, and then enters the surface of the organ to be treated and passes through the tissue from the surface to the focal point. Is generated.
  • the heat generated when the ultrasound is not focused on the way to the focal point is sufficiently small compared to the heat generated by focusing at the focal point, but the affected part located at the focal point is treated with heat. If ultrasonic waves are continuously applied to the same area until the process is completed, the heat accumulated in the part other than the focal point also increases.
  • the control unit since the control unit temporally changes the intensity of the ultrasonic wave incident on the same region of the surface, compared to the case of continuous irradiation, the heat remaining near the surface of the treatment target organ is reduced. It can be suppressed below a predetermined threshold. Therefore, it is possible to treat the organ to be treated while suppressing an increase in the surface temperature without using a large-scale device such as a conventional method of flowing a coolant.
  • the control unit reduces the intensity of the ultrasonic wave in the first state where the ultrasonic wave is irradiated to the same region on the surface of the treatment target organ, and in the first state, You may perform alternately with the 2nd state which reduces the temperature of the said surface raised by irradiation in the said 1st state.
  • the ultrasonic wave emitted from the ultrasonic element is incident from one region of the surface of the treatment target organ and is focused on the affected part existing deep in the treatment target organ.
  • the ultrasonic wave focused on the focal position is treated by heating the affected area.
  • the said control part may control the said ultrasonic element so that the intensity
  • the first state and the second state can be easily generated, treatment by heat generation of the affected part near the focal position, and suppression of heat generation at the site from the surface where the ultrasonic wave is incident to the focal point. Can be achieved.
  • the said control part may stop irradiation of the ultrasonic wave from the said ultrasonic element in a said 2nd state. In this way, heat generation can be most effectively suppressed in the second state by stopping the irradiation of ultrasonic waves.
  • region in the surface of the said treatment target organ of the ultrasonic wave irradiated from the said ultrasonic element may be provided, and the said control part may control the said moving means.
  • the incident region of the ultrasonic wave irradiated from the ultrasonic element is moved by the moving means controlled by the control unit, so that the first state in which the ultrasonic wave is irradiated when viewed in each region And the second state in which the irradiation is not performed are performed at different times, so that treatment by heat generation of the affected part near the focal position and protection by suppression of heat generation at the site up to the focal position can be achieved.
  • the said moving means may move the said ultrasonic element along the surface of the said treatment target organ.
  • the said moving means may move the said ultrasonic element so that the focus of the ultrasonic wave irradiated from the said ultrasonic element may not be moved.
  • the focal point does not move even if the incident area of the ultrasonic wave is moved by the moving means.
  • heat generation in the affected area near the focal position is maintained even in the second state seen in each region, and more efficient treatment by heat generation in the affected area near the focal position and protection by suppressing heat generation in the area up to the focal position. Can be planned.
  • a plurality of the ultrasonic elements are arranged so that ultrasonic waves can be incident on different regions of the surface of the treatment target organ, and the moving means switches the ultrasonic elements that generate ultrasonic waves.
  • region of the treatment target organ into which an ultrasonic wave injects is switched, when a moving means switches an ultrasonic element.
  • the said some ultrasonic element may be arrange
  • the senor includes a sensor that measures a temperature of an ultrasonic incident region on the surface of the treatment target organ, and the control unit removes the treatment from the ultrasonic element based on the temperature measured by the sensor. You may adjust the ultrasonic wave irradiated to a target organ. By doing in this way, based on the temperature measured by the sensor, it is possible to more accurately carry out heat generation at the focal point and suppression of heat generation at a portion between the surface and the focal point.
  • the said sensor is a non-contact sensor which measures temperature non-contactingly
  • the moving means moves the ultrasonic element to x / t. It may be moved at a speed greater than [mm / s]. By doing in this way, it can continue irradiating with an ultrasonic wave, without making each part reach a temperature threshold.
  • FIG. 1 is an overall configuration diagram showing an ultrasonic therapy apparatus according to a first embodiment of the present invention. It is a figure which shows an example of the waveform of the ultrasonic wave irradiated by the ultrasonic therapy apparatus of FIG. (A)-(c) is a figure which shows the heat_generation
  • FIG. 1 It is the other modification of the ultrasonic therapy apparatus of FIG. 1, Comprising: (a) The state in which one ultrasonic element was act
  • FIGS. 8A to 8E are views showing the position of the ultrasonic element by the ultrasonic therapy apparatus of FIG. 7 and the heat generation of each part in the depth direction at the start position when the ultrasonic wave is arranged at that position. It is a whole block diagram which shows the modification of the ultrasonic therapy apparatus of FIG.
  • FIGS. 8A to 8E are views showing the position of an ultrasonic element by the ultrasonic apparatus of FIG. 7 and how heat is generated when an ultrasonic wave is placed at that position. It is a whole block diagram which shows the other modification of the ultrasonic therapy apparatus of FIG.
  • the ultrasonic therapy apparatus 1 controls an ultrasonic element 2 that generates ultrasonic waves, a drive circuit 3 that drives the ultrasonic element 2, and the drive circuit 3.
  • the control part 4 which performs and the memory
  • a balloon 7 enclosing an acoustic propagation medium 6 is disposed between the ultrasonic element 2 and the surface of the treatment target organ A, and fills a space between the ultrasonic element 2 and the surface of the treatment target organ A. ing.
  • the ultrasonic element 2 is a HIFU (High Intensity Focused Ultrasound) element, has a concave ultrasonic transducer, and generates ultrasonic waves that are focused on the focal point F of the concave surface.
  • the drive circuit 3 includes an impedance matching unit 8 in the vicinity of the ultrasonic element 2 for the purpose of suppressing electrical loss due to an increase in the length of the cable connected to the ultrasonic element 2.
  • the control unit 4 drives the ultrasonic element 2 to irradiate ultrasonic waves, and the control unit 4 stops driving the ultrasonic element 2 and does not irradiate ultrasonic waves.
  • a drive command signal is output to the drive circuit 3 of the ultrasonic element 2 so as to alternately repeat the state.
  • the control unit 4 is configured by a computer, for example.
  • the intensity of the ultrasonic wave irradiated from the ultrasonic element 2 in the first state and the duration of the first state and the second state are stored in the storage unit 5 as the ultrasonic irradiation condition by the control unit 4. Yes.
  • the intensity of the ultrasonic wave and the duration of irradiation in the first state are set to such an intensity and time that the temperature of the surface of the treatment target organ A reaches the upper limit temperature at which heat denaturation does not occur.
  • the duration of the second state is set to a time until the temperature of the incident surface falls below a predetermined value.
  • the ultrasonic intensity and irradiation time in the first state and the ultrasonic stop time in the second state are constant.
  • the ultrasonic therapy apparatus 1 configured as described above will be described below.
  • a balloon 7 in which an acoustic propagation medium 6 is enclosed is sandwiched between the surface of the treatment target organ A.
  • the ultrasonic element 2 is placed opposite to the affected part arranged in the deep part of the treatment target organ A.
  • the focal point F of the ultrasonic wave from the ultrasonic element 2 coincides with the affected part inside the treatment target organ A.
  • the control unit 4 outputs a drive command signal to the drive circuit 3 in accordance with the ultrasonic irradiation conditions stored in the storage unit 5, and the drive circuit 3 operates the ultrasonic element 2 as shown in FIG.
  • the 1st state which irradiates an ultrasonic wave, and the 2nd state which stops an ultrasonic wave are repeated alternately.
  • the ultrasonic wave emitted from the ultrasonic element 2 in the first state the ultrasonic wave emitted from the ultrasonic element 2 propagates in the acoustic propagation medium 6 in the balloon 7 in close contact with the ultrasonic element 2. Then, the light is incident from the surface of the treatment target organ A to the inside, and is focused at a focal point F position that is arranged to coincide with the affected part.
  • the control unit 4 alternately activates and stops the ultrasonic element 2 to enter the same region on the surface of the treatment target organ A.
  • the control unit 4 By changing the intensity of the sound wave over time, the heat generated and remaining in the vicinity of the surface of the treatment target organ A when the ultrasonic wave irradiated from the ultrasonic element 2 passes can be reduced below a predetermined threshold value. it can.
  • This has an advantage that it is possible to achieve both effective treatment of the affected area where the focal point F is disposed and protection of a site other than the affected area.
  • the driving of the ultrasonic element 2 is stopped as the second state.
  • ultrasonic waves may be irradiated with sufficiently low intensity that the residual heat decreases.
  • the ultrasonic intensity and irradiation time in the first state may be changed, or the ultrasonic pause time in the second state may be changed.
  • a moving mechanism (moving means) 9 for moving the ultrasonic element 2 may be provided.
  • the moving mechanism 9 include a mechanism in which a slider 11 that moves along an arcuate groove 10 is driven by a link 12. By making the center position of the groove 10 coincide with the focal point F position of the ultrasonic element 2, the ultrasonic element 2 can be swung around the focal point F position.
  • the ultrasonic wave is moved to the focal point F position of the ultrasonic element 2 by operating the moving mechanism 9 and swinging the ultrasonic element 2 while always irradiating the ultrasonic wave from the ultrasonic element 2.
  • the focused area can be continuously focused to treat the affected area.
  • the incident area of the ultrasonic wave to the surface of the treatment target organ A is changed every moment, heat generation near the surface becomes intermittent, and an excessive temperature rise can be prevented in the same manner as described above.
  • the moving mechanism 9 that physically moves the ultrasonic element 2 is exemplified as the moving means, but instead of this, as shown in FIGS. 6A and 6B, the moving mechanism 9 has the same focal point F position.
  • a plurality of ultrasonic elements 2a and 2b are arranged, and moving means for changing the ultrasonic incident area on the surface of the treatment target organ A by switching the ultrasonic elements 2a and 2b operated by the control unit 4 is configured. May be. Thereby, it is possible to effectively treat the affected part arranged at the focal point F position by continuously irradiating the ultrasonic wave while suppressing an excessive temperature rise on the surface of the treatment target organ A.
  • the number of ultrasonic elements 2a and 2b may be three or more.
  • an ultrasonic therapy apparatus 20 according to a second embodiment of the present invention will be described below with reference to the drawings.
  • portions having the same configuration as those of the ultrasonic therapy apparatus 1 according to the first embodiment described above are denoted by the same reference numerals and description thereof is omitted.
  • the ultrasonic therapy apparatus 20 is an apparatus used when the affected area to be treated is not a single point but covers a relatively wide range. As shown in FIG. 7, the focal point F of the ultrasonic element 2 is used. Is provided.
  • the moving mechanism 21 is a linear motion mechanism such as a ball screw 23 driven by a motor 22 and moves the ultrasonic element 2 linearly.
  • Reference numeral 24 denotes a nut that is driven by the motor 22 and meshes with the ball screw 23, and reference numeral 25 denotes a motor drive unit that drives the motor 22 based on a command signal from the control unit 4.
  • the moving direction of the ultrasonic element 2 is set in a direction parallel to the surface of the treatment target organ A.
  • the ultrasonic element 2 is reciprocated in a direction along the surface of the treatment target organ A while aligning and continuously operating the ultrasonic element 2 to irradiate ultrasonic waves.
  • the ball screw 23 is exemplified as the linear motion mechanism, but a rack and pinion mechanism or a linear motor may be employed instead.
  • a linear motion mechanism has been exemplified as the moving mechanism 21, but instead, as shown in FIG. 9, the ultrasonic element 2 crosses a predetermined axis, for example, the longitudinal axis or the longitudinal axis of the insertion portion 26.
  • a rotation mechanism for example, a motor 22 that swings or rotates around the axis may be employed.
  • the ultrasonic element 2 When rotating the ultrasonic element 2 around the longitudinal axis of the insertion portion 26, as shown in FIG. 10, the ultrasonic element 2 is continuously rotated in the same direction, and the ultrasonic element 2 is operated over a desired angle range. You may decide to make it.
  • the moving mechanism 21 may be provided with a detector (not shown) such as an encoder, and the position and angle of the ultrasonic element 2 may be accurately adjusted by feedback control. Further, instead of continuously driving the ultrasonic element 2 and the moving mechanism 21, they may be driven intermittently.
  • the ultrasonic wave of a constant intensity is irradiated while increasing the moving speed, or the ultrasonic element 2 is moved at a constant speed while decreasing the intensity of the ultrasonic wave. Can be treated.
  • the ultrasonic element 2 is moved intermittently, ultrasonic waves with a certain intensity are irradiated while sequentially reducing the irradiation time of the ultrasonic waves in the first state or increasing the interval between irradiation positions.
  • a plurality of ultrasonic elements 2a, 2b having different focal point F positions are arranged and operated. You may employ
  • the number of ultrasonic elements 2a and 2b may be three or more.
  • a temperature sensor 27 that measures the temperature of the incident region on the surface of the organ A to be treated with ultrasonic waves from the ultrasonic element 2 is arranged, and the ultrasonic wave is detected according to the measured temperature.
  • the intensity, irradiation time, and stop time may be adjusted. Thereby, the excessive temperature rise in the surface vicinity of the treatment target organ A can be prevented more reliably.
  • the temperature sensor 27 is preferably a non-contact sensor, but may be a contact type sensor.
  • a balloon 7 enclosing the acoustic propagation medium 6 is a relatively hard one that can maintain a constant distance between the ultrasonic element 2 and the surface of the treatment target organ A, and a temperature sensor. It is preferable to improve the measurement accuracy by keeping the measurement position by 27 constant.
  • the relatively hard balloon 7 include a film made of a film having low stretchability, a balloon 7 having a skeleton such as a stent, and the like.
  • the temperature sensor 27 is arranged in the center of the ultrasonic element 2, regardless of the change in distance.
  • the temperature of the central portion of the ultrasonic incident region can be measured.
  • the temperature sensor 27 measures the temperature of the central portion of the ultrasonic incident region from an oblique direction, and therefore the distance changes. Then, the measurement position changes.
  • the focal position of the ultrasonic element 2 can be matched with the affected area by changing the thickness of the balloon 7 enclosing the acoustic propagation medium 6, and the incident area It is possible to accurately control the ultrasonic wave by measuring the temperature at the same position.
  • the temperature measurement position is not necessarily the center of the incident area, and the temperature of the edge of the incident area may be measured.
  • the moving speed of the element is x / t. It is preferably larger than [mm / s].
  • the ultrasonic irradiation conditions are stored in the storage unit 5.
  • an input unit (not shown) for inputting by the operator is provided, and the ultrasonic irradiation conditions are input or selected. You may decide to make it. Moreover, you may decide to set a treatment part and a treatment area

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Thermotherapy And Cooling Therapy Devices (AREA)
PCT/JP2015/054709 2014-04-17 2015-02-20 超音波治療装置 Ceased WO2015159584A1 (ja)

Priority Applications (3)

Application Number Priority Date Filing Date Title
DE112015001369.5T DE112015001369T5 (de) 2014-04-17 2015-02-20 Ultraschall-Behandlungsvorrichtung
CN201580019399.0A CN106163438B (zh) 2014-04-17 2015-02-20 超声波治疗装置
US15/277,229 US20170014650A1 (en) 2014-04-17 2016-09-27 Ultrasonic treatment apparatus

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2014085458A JP2015204894A (ja) 2014-04-17 2014-04-17 超音波治療装置
JP2014-085458 2014-04-17

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US15/277,229 Continuation US20170014650A1 (en) 2014-04-17 2016-09-27 Ultrasonic treatment apparatus

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WO2015159584A1 true WO2015159584A1 (ja) 2015-10-22

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PCT/JP2015/054709 Ceased WO2015159584A1 (ja) 2014-04-17 2015-02-20 超音波治療装置

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US (1) US20170014650A1 (enExample)
JP (1) JP2015204894A (enExample)
CN (1) CN106163438B (enExample)
DE (1) DE112015001369T5 (enExample)
WO (1) WO2015159584A1 (enExample)

Cited By (1)

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Publication number Priority date Publication date Assignee Title
JP2020505116A (ja) * 2017-01-31 2020-02-20 ジョンチョル パク 超音波施術装置

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WO2018182018A1 (ja) * 2017-03-30 2018-10-04 京セラ株式会社 超音波照射装置
CN107261344B (zh) * 2017-06-29 2019-10-08 哈尔滨医科大学 一种用于声动力治疗的超声自适应聚焦方法

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JP2013503653A (ja) * 2008-09-09 2013-02-04 コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ エネルギーを投与する治療システム
JP2013223728A (ja) * 2012-04-19 2013-10-31 Siemens Medical Solutions Usa Inc 医用超音波治療における皮膚温度制御

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JP2020505116A (ja) * 2017-01-31 2020-02-20 ジョンチョル パク 超音波施術装置

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