JP3369504B2 - Ultrasound therapy equipment - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus for treating a tumor in a living body using ultrasonic waves.

[0002]

2. Description of the Related Art In recent years, a stone crushing device for irradiating strong ultrasonic waves from outside the body to non-invasively crush stones has been put into practical use and is attracting attention for the treatment of stone diseases. As a powerful ultrasonic source, an underwater discharge method, an electromagnetic induction method, a micro-explosion method, a method using a piezo element, and the like are conceivable, and each has its advantages and disadvantages. The method using a piezo element has the disadvantage that the pressure of the strong ultrasonic focus is small, but there is no small focus, there is no consumable item, the strength of the strong ultrasonic wave can be arbitrarily controlled, and the drive waveform applied to multiple piezo elements is phase controlled By doing so, the focal position can be controlled, which is an excellent advantage (JP-A-60-145131, USP-452616).
8). Further, the shape of the focus can be changed by controlling the phase of the drive waveform (Japanese Patent Laid-Open No. 62-427).
73).

On the other hand, hyperthermia (hyperthermia) has been attracting attention as one of the treatment techniques for malignant neoplasm, so-called cancer. This is because the tumor tissue has a higher temperature sensitivity than that of the normal tissue and dies when it is heated to 42.5 ° C or higher, and the method of locally heating the tumor site is particularly effective. Is.

As a heating method, a method using an electromagnetic wave such as a microwave has been preceded. However, it is difficult to selectively heat a deep tumor due to the electric characteristics of the living body, and the treatment results. A good example of is limited to superficial tumors (within 5 cm in depth).

Therefore, a method utilizing acoustic energy such as ultrasonic waves has been considered for treating deep tumors. This utilizes the characteristics of focusing the ultrasonic beam and having a deep arrival depth. Further, there is also reported a treatment method in which the above-mentioned heating treatment method is advanced to heat the tumor portion to 80 ° C. or higher to burn out the tumor tissue (Japanese Patent Application No. 3-306).
106).

The method of heating by ultrasonic waves includes an ultrasonic transducer in which a plurality of ultrasonic vibrators having a spherical ultrasonic wave emitting surface are combined, or an annular device in which ring-type ultrasonic vibrators are concentrically arranged. Those using an array ultrasonic transducer have been proposed. In particular, if an annular array ultrasonic transducer is used, the depth of focus can be changed.

Further, a phased array capable of changing the focal point three-dimensionally by one step has been proposed (USP-4526168). Further, there is also proposed a structure in which a calculus crushing device and a heating / heating device are integrated (Japanese Patent Application No. 3-306106).

Regarding the heating / heating device as described above, there has been proposed a method of uniformly heating / heating the affected area by utilizing the small focal point which is a characteristic of the piezo system (Japanese Patent Laid-Open No. 61-61). -209643).

[0009]

However, the conventional ultrasonic therapy apparatus has a problem that the temperature of the tumor part cannot be known when it is heated, resulting in leakage of treatment or excessive heating.

The present invention has been made in view of the above-mentioned problems, and by detecting the temperature of the tumorous part and varying the treatment condition, it is possible to prevent the inconvenience of treatment leakage or excessive heating. The purpose of the present invention is to provide a new ultrasonic treatment device.

[0011]

The ultrasonic treatment apparatus according to the present invention is, as means for solving the above-mentioned problems, a body cavity probe inserted into a body cavity of a subject and an outer periphery of the body cavity probe. A liquid storage bag provided along with a predetermined liquid, an intensity sensor provided on the intracavity probe for detecting the intensity of ultrasonic waves emitted from outside the subject, and an intracorporeal probe provided on the intracorporeal probe. , A temperature sensor that detects the temperature of a portion irradiated with ultrasonic waves from outside the subject,
Control means for controlling the irradiation condition of the ultrasonic wave irradiated from outside the subject so that the temperature of the part irradiated with the ultrasonic wave becomes a predetermined temperature based on each detection output from the intensity sensor and the temperature sensor. Have and.

In the ultrasonic treatment apparatus according to the present invention as described above, the control means determines the location of the portion to which ultrasonic waves are applied based on the detection outputs from the intensity sensor and the temperature sensor provided in the body cavity probe. The ultrasonic irradiation conditions of the probe in the body cavity are controlled so that the temperature becomes a predetermined temperature.

With this, it is possible to prevent the treatment leakage in which the tumor tissue survives without being heated to the death temperature and the inconvenience that the excessive heating causes the normal cells to be killed. It can be performed.

[0014]

BEST MODE FOR CARRYING OUT THE INVENTION Preferred embodiments of an ultrasonic therapeutic apparatus according to the present invention will be described below with reference to the drawings.

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

The ultrasonic treatment section irradiates a strong ultrasonic wave for treatment with one or a plurality of combined spherical ultrasonic vibrators 2, a coupling liquid 4 for guiding the strong ultrasonic waves to a patient 3, and It has an ultrasonic applicator 1 consisting of a water bag 5 for sealingly holding a coupling liquid 4.

At the time of treatment, this ultrasonic applicator 1
Is placed on the body surface, and the water bag 5 is brought into contact with the skin of the patient 3 with ultrasonic jelly or the like (not shown). Then, the focus 6 is made to coincide with the tumor 7, and the drive circuit 8 drives the ultrasonic transducer 2 to irradiate strong ultrasonic waves, and the treatment site that coincides with the focus 6 is treated at high temperature.

In the ultrasonic treatment apparatus of the first embodiment, MRI is used as the CT unit for positioning. In this MRI, the patient 3 is set in a supine position on the electric table 8 and is placed in an imaging gantry (not shown) in which the static magnetic field coil 9, the gradient magnetic field coil 10 and the transmission / reception RF coil 11 are built. Sent in. At this time, the control circuit 1
By the control of 2, the table moving device 13 moves the table 8 and fixes the patient 3 at a predetermined position (A position).

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

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

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

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

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

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

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

When the initial treatment plan is completed and it is possible to judge that the treatment is sufficiently completed by the determination of the treatment effect by MRI, the operator terminates the treatment. At this time, the control circuit 12 can retrieve the history of treatment conditions from the memory and output the treatment record from the CRT 17 or the printer 20.

Further, as described in Japanese Patent Application Laid-Open No. 61-154667, it has been experimentally confirmed that a change appears on an ultrasonic image due to temperature change or thermal denaturation, and treatment using this It is also possible to judge the effect.

In this way, in the first embodiment,
While the tumor shape can be accurately recognized from the three-dimensional information, the tumor can be heated to a high temperature by the intense ultrasound focused sharply, and thus the tumor can be necrotized by the high temperature degeneration with low invasiveness and effectively. Moreover, since the treatment can be performed while recognizing the degenerated region, the entire tumor can be treated throughout, and the risk of recurrence or metastasis due to treatment omission can be reduced. Furthermore, it is possible to prevent damage caused by applying excessively strong ultrasonic waves or excessively humidifying the living body or the probe in the body cavity, and perform safe treatment.

Further, since ultrasonic treatment can be performed while recognizing the three-dimensional shape of the tumor tissue imaged by MRI, it is possible to perform the treatment easily and accurately. Moreover, if the state after treatment is imaged by MRI, the treatment effect can be immediately known. Although the MRI is used as the three-dimensional image forming apparatus in this example, an X-ray CT scanner may be used.

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

As shown in FIG. 3, the applicator 1a has a shape in which a circular flat plate ultrasonic transducer is divided into a radial direction and a circumferential direction, and an ultrasonic probe 2 for picking up an ultrasonic tomographic image is provided at the center.
01 is attached so that it can move back and forth and rotate. The drive circuit group 8a is divided into channels corresponding to the number of divided ultrasonic transducers, and is driven by an independent timing signal delayed by the phase control circuit 204 by a signal from the control circuit 12. As a result, the focus of ultrasonic waves is 6a in FIG.
As shown in 6b, it can be set in any place three-dimensionally.

The operation of moving the focal position by the delay time control is described in detail in "USP-4526168". At this time, the applicator position detection device 19 detects not only the entire position of the applicator 1a but also the relative position of the ultrasonic probe 201 and sends the data to the control circuit 12 and the ultrasonic image device 202. Further, the control circuit 12 also sends information on the set focus position by the phased array to the ultrasonic imaging apparatus 202. Therefore, it is possible to display the condition of the tumor 7 and the position of the focal point 6 which is the treatment site in real time on the ultrasonic imaging apparatus 202 during the treatment.

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

Further, in this embodiment, the static magnetic field coil 9 and the gradient magnetic field coil 10 of the MRI have a Helmholtz shape and a working hole 203 is provided at the center. The applicator 1 is made of a non-magnetic material. Therefore, the transmitting and receiving RF coil 1
Adjusting the orientation of 1 allows patient 3 from above (or below)
It is possible to directly attach the applicator 1 without changing the position of. As a result, it is not necessary to move the patient 3 in and out as in the first embodiment, and it is possible to reduce the time lag between treatment and observation and the risk of movement of the patient 3 during that time.

Furthermore, since the shape of the affected part in the body can be accurately recognized by the three-dimensional information and the treatment plan can be prepared in advance, the influence of obstacles and the like can be taken into consideration, and the treatment leakage and the shock wave irradiation to a dangerous place can be performed. In addition to being avoidable, the treatment can be advanced while monitoring whether the shock wave irradiation is performed according to the treatment plan, and the risk of erroneous irradiation can be reduced.

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

In the figure, an ultrasonic wave generation source 31 has a plurality of piezoelectric elements arranged in a spherical shell shape so as to form a concave surface, and is coupled to a patient 33 via a water bag 32.
An ultrasonic probe 36 for drawing an ultrasonic image of the tumor 34 is attached to the center of the ultrasonic wave generation source 31.
The ultrasonic probe 36 is configured to be slidable in the front-rear direction and rotatable, and is connected to an ultrasonic image diagnostic apparatus 38.

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

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

The drive circuit 40 and the drive trigger pulse generation circuit 44 are controlled by the control circuit 42. That is, during heating / heating, a burst signal of a constant voltage is continuously output. At this time, the power supply circuit 41 supplies power to the drive circuit. The configuration of the drive circuit 40 and the drive trigger pulse generation circuit 44 is described in “Japanese Patent Application No.
306106 ”.

Further, the control circuit 42 obtains the focal point 35, the sound field region and the heating / heating region placed at arbitrary positions, and outputs these information to the digital scan converter 39 (hereinafter
Output to DSC39).

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

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

FIG. 6 is an example of a screen displayed on the CRT 37 and shows a three-dimensional image of a tumor in the patient's body.
The tumor has a cross section at even intervals as shown in FIG.
The tumor 34 on the image as shown in FIG.
The image data input device 45 to read the contour information of
The three-dimensional image synthesized by the integral calculation in the control circuit 42 is again displayed on the CRT 37. This method is described in detail in Japanese Patent Laid-Open No. 61-209643. Further, the contour information of the tumor may be input from the CRT 37 using the light pen 49.

On the three-dimensional image 46, the portion 48 heated and heated by irradiation calculated by the control circuit 42 is shown.
Is specified. At this time, the color at the time of calculus crushing and the color at the time of heating and heating are different. Therefore, the erroneous operation of excessively heating and heating does not occur.

Furthermore, in order to clarify the positional relationship between the tumor and the ultrasonic probe, the XYZ axes 47 are displayed on the three-dimensional image. Further, in order to create a three-dimensional image, the maximum vertical, horizontal, and height of the tumor displayed on the CRT 37 as shown in FIG. 7 are input by the image data input device 45, and the size is approximately the same as that of the tumor. The ellipsoid of the height may be integrated by the control circuit 42 and displayed on the CRT 37 as a three-dimensional image.

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

First, as shown in FIGS. 8 (a) and 8 (b), the tumor is sectioned in the vertical and horizontal directions by thicknesses of Δd1 and Δd2, respectively. This thickness is determined by calculation considering the focal point size and the heat absorption coefficient of the living body within a range in which heating and heating can be sufficiently performed when the ultrasonic waves are focused.

Next, each area is irradiated in the order shown in FIG. 9 (c). The focusing position is controlled by the control circuit. In this case, the range of focus movement is as shown in the figure.
A rectangle consisting of eight squares smaller than the focal size,
Do not irradiate the part of the tumor that has no outline. In this way, normal tissue is less destroyed.

As described above, in the third embodiment of the present invention, by freely moving the focal position, not necessarily continuously, based on the area, a free treatment plan regarding the irradiation position becomes possible. In addition, by controlling the focus movement so that the loss of energy at the focus of strong ultrasonic waves due to the reflection of strong ultrasonic waves by the bubbles generated by cavitation, efficient use is made possible without wasting energy. It can be heated and heated, and the time required for treatment can be shortened. In addition, since the location heated and heated by irradiation is clearly indicated on the ultrasonic image,
It does not cause an erroneous operation such as excessive heating and heating.

Therefore, a free treatment plan regarding the irradiation position becomes possible, and safe and accurate treatment can be achieved. Also,
Energy loss at the focus of strong ultrasonic waves due to the effect of cavitation is reduced, heating and heating can be done efficiently without wasting energy, and the time required for treatment is shortened, so the burden on the patient can be reduced. Like Note that the focus can be moved also by mechanically moving the ultrasonic transducer.

[Fourth Embodiment] Next, a fourth embodiment of the present invention will be described. In this example, MR
An intracorporeal coil is used as the RF coil of the I device. In this example, the static magnetic field coil 9 (see FIG. 2) is a Helmholtz type,
Gradient magnetic field coil 10 Anderson (Gx, Gy) &
Maxwell (Gz) was provided, and a working hole 203 was provided in the center. Therefore, as shown in FIG.
When inserted into the patient's body, the applicator 1 can be directly mounted by only moving the applicator 1 up and down by the mechanical arm 18 (FIG. 2) without changing the position of the patient 3 from above (or below). As a result, it is not necessary to move the patient 3 in and out of the gantry, and it is possible to reduce the risk of the time difference between the treatment and the observation and the movement of the patient 3 during that time.

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

FIG. 11 is an explanatory view of the intracavity probe. In this example, a probe is inserted into the rectum for the treatment of prostate cancer. Body cavity probe 27
Is a coil 11a inside the body cavity, a plurality of strong ultrasonic wave intensity sensors 61, a temperature sensor 60 on the side surface, a water bag 64 that fills the liquid around the body of the probe 27, and information from the probe 27 is controlled. Cable 63 for transmission to circuit 12
And a water-filling hose 62 for putting the liquid in and out of the water bag 64.

First, the intracavity probe 27 is inserted into the rectum of the patient 3 in the vicinity of the tumor 7 (prostate cancer) in the patient's body so as to be in a position where strong ultrasonic waves pass. Next, the water bag 6 that covers the surface of the probe 27 and is made of a highly elastic material.
4 is filled with the liquid (water) 65 by the control of the water circuit 66,
Prevent gas from entering the position where strong ultrasonic waves pass. In the present embodiment, the plurality of strong ultrasonic wave intensity sensors 61 (for example, PVDF film) and the temperature sensor 60 (for example, thermocouple) are mounted on the surface of the water bag 64 and do not come into contact with the liquid 65. The structure is in close contact with the intestinal wall 28. Further, since the plurality of sensors 60 and 61 are evenly attached to the side surface of the probe 27, it is not necessary to consider the orientation of the probe at the time of insertion.

When the tumor 7 is irradiated with intense ultrasonic waves from the applicator, the plural intense ultrasonic wave intensity sensors 61 and the temperature sensor 60 measure the intense ultrasonic wave intensity and temperature at each position. This information is sent to the control circuit 12. The control circuit 12 calculates the difference between the optimum value stored in advance and the maximum value of the information from the plurality of sensors, and the difference is eliminated by changing the irradiation condition of the powerful ultrasonic waves.
The phase control circuit 204 is controlled.

During the treatment, the liquid 65 in the water bag 64 becomes the water circuit 6
It circulates under the control of 6 and acts as a cooling agent for preventing damage to the intestinal wall due to heating. Although the treatment of prostate cancer has been described here, the same applies to tumors such as the bladder and uterus.

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

Although the cancer treatment was explained in this example, it is clear that it can also be used for calculus crushing. Further, as shown in FIG. 4, on the CRT 17, on the freeze image 401 of the MRI before the applicator 1 is attached, the tomographic position 402 currently scanned by the ultrasonic probe 21 and the focal region 403 of the therapeutic ultrasonic wave are formed. The incident path 404 of the therapeutic ultrasonic waves can be displayed in an overlapping manner.

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

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

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

Next, the operator inputs a treatment plan from the console 16 while looking at the MRI image 71 inside the body including the tumor 7 which is the treatment site.

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

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

Since the reconstructed image 71a is displayed following the movement of the ultrasonic probe 201, the ultrasonic image currently being observed is compared with the image data used when the treatment plan was made before the surgery. It is possible to correctly grasp the positional relationship of.

On the other hand, if a large difference appears between the two screens, it is expected that the patient's body will move during the treatment, and repositioning will be performed. Also in these statues,
Not only the current focus, but also the tomographic position 73 currently scanned by the ultrasonic probe 201 and the focal region 75 of the therapeutic ultrasonic wave.
And the incident path 74 of the therapeutic ultrasonic waves, the scanning range 72a of the focal point in the treatment plan when viewed on the slice, and the irradiation intensity of the ultrasonic waves.
Time and interval can be displayed on the screen.

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

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

The treatment is automatically performed under the control of the control circuit 12 according to a predetermined treatment plan, but can be manually performed. If the treatment plan is deviated during manual treatment, a warning sound, a screen display, etc. (not shown) is provided. However, when the surgeon determines that it is necessary, the treatment plan stored in the control circuit 12 is set in the console 1
6 or by input from a light pen (not shown).

Further, in this embodiment, since the work hole 203 is provided at the center of the MRI gantry, the transmission / reception R
If the direction of the F coil 11 is adjusted, the applicator 1 can be directly moved from above (or below) without changing the position of the patient 3.
It is possible to directly mount by simply moving the mechanical arm 18 up and down. As a result, it is not necessary to move the patient 3 in and out of the gantry, and it is possible to reduce the risk of the time difference between the treatment and the observation and the movement of the patient 3 during that time. The patient may be moved by the table moving device 13 by dividing the MRI imaging unit and the treatment unit using high-intensity ultrasound.

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

When it is judged by the MRI treatment effect that the treatment is sufficiently completed, the operator finishes the treatment. At this time, the control circuit 12 can retrieve the history of treatment conditions from the memory and output the treatment record from the CRT 17.

Here, a body cavity coil may be used as the RF coil for transmission and reception. Further, although the phased array is used for the ultrasonic transducer, this may be an annular array, or the applicator may be mechanically moved to move the focus.

Further, an X-ray CT may be used instead of the MRI apparatus. Although the treatment of the tumor has been described in the present embodiment, this can be similarly applied to the device for crushing and treating the calculi in the body with high-intensity ultrasound.

[0076]

According to the ultrasonic treatment apparatus of the present invention,
In detecting the intensity of strong ultrasonic waves emitted from the outside of the body and the temperature of the treatment site due to the intensity, it is possible to prevent the adverse effect of gas entering the passage position. For this reason, it is possible to prevent leakage of treatment in which the tumor tissue survives without being heated to the death temperature, and inconvenience such as excessive heating and killing even normal tissue, which enables accurate treatment. can do.

[Brief description of drawings]

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

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

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

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

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

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

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

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

FIG. 9 is an explanatory diagram showing an ultrasonic wave irradiation sequence.

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

FIG. 11 is an explanatory diagram showing an intracavity probe and an instrument attached around the probe.

FIG. 12 is an explanatory diagram showing a positional relationship of each coil of a patient MRI apparatus.

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

[Explanation of symbols]

1 Applicator 2 Ultrasonic transducer 3 patients 4 Coupling liquid 5 water bags 6 focus 7 tumor 8 drive circuit 9 Static magnetic field coil 10 Gradient magnetic field coil 11 RF coil 12 Control circuit 13 Table moving device 14 Gradient magnetic field power supply 15 Transmitter / receiver circuit 16 consoles 17 CRT 18 mechanical arm 19 Applicator position detection device 20 printers 27 Intracavitary probe 28 Intestinal wall 31 High-power ultrasonic source 32 water bags 33 patients 34 tumor 35 focus 36 Ultrasonic probe 37 CRT 38 Ultrasound image diagnostic equipment 39 Digital Scan Converter 40 drive circuit 41 Power circuit 42 Control circuit 43 Delay circuit 44 Drive trigger pulse generation circuit 45 Image data input device 46 3D image of tumor in vivo 47 XYZ axes 48 Places that are heated or heated 49 light pen 60 temperature sensor 61 Ultrasonic intensity sensor 64 water bags 65 water 71 MRI image 72 scan range 73 Fault position 75 Focus area 201 Ultrasonic probe 202 Ultrasound Imaging System 203 Working hole 204 Phase control circuit 401 images 402 Fault position 403 Focus area 404 incident path

(72) Inventor Yoshiharu Ishibashi 1 Komukai Toshiba-cho, Sachi-ku, Kawasaki-shi, Kanagawa Toshiba Research Institute Co., Ltd. In-house (72) Inventor Kozo Sato 1 Komukai Toshiba-cho, Sachi-ku, Kawasaki-shi, Kanagawa Toshiba Research Institute Co., Ltd. (72) Inventor Akio Ito 1-1 Shibaura, Minato-ku, Tokyo Toshiba Corporation Head office (56) Reference JP-A-2-239856 (JP, A) JP-A-63-51853 (JP, A) JP-A-63-77440 (JP, A) JP-A-1-151450 (JP, A) JP-A-62-284649 (JP, A) JP-A-2-121660 (JP, A) International publication 91/3208 (WO, A1) (58) Fields investigated (Int.Cl. ⁷ , DB name) A61B 17/22 330 A61B 8/00 A61B 18/00 A61N 7/02

Claims (5)

(57) [Claims] 1. A body cavity probe to be inserted into a body cavity of a subject, and a body cavity probe provided along an outer periphery of the body cavity probe,
A liquid storage bag filled with a predetermined liquid, an intensity sensor provided in the body cavity probe for detecting the intensity of ultrasonic waves irradiated from outside the subject, and an intensity sensor provided in the body cavity probe from outside the subject A temperature sensor that detects the temperature of the part irradiated with the sound wave, and based on the detection outputs from the intensity sensor and the temperature sensor, the temperature of the part irradiated with the ultrasonic wave becomes a predetermined temperature An ultrasonic treatment device, comprising: a control unit that controls an irradiation condition of ultrasonic waves emitted from the outside. 2. The ultrasonic therapeutic apparatus according to claim 1, wherein a plurality of the intensity sensors and / or temperature sensors are provided along the outer circumference of the intracavity probe. 3. The liquid storage bag stores cooling water for cooling the probe in the body cavity, is connected to the liquid storage bag, and circulates the cooling water in the liquid storage bag. The ultrasonic treatment apparatus according to claim 1, further comprising means. 4. A static magnetic field coil, which is provided outside the subject and applies a static magnetic field to the subject, and provided outside the subject,
A gradient magnetic field coil for applying a gradient magnetic field to the subject,
An intracorporeal coil that is provided in the intracavity probe and applies a predetermined high-frequency magnetic field to the subject to which the static magnetic field and the gradient magnetic field have been applied; Resonance signal detection means for detecting a resonance signal generated by applying a predetermined high frequency magnetic field from a coil, and nuclear magnetic resonance image formation for forming a nuclear magnetic resonance image based on the detection output from the resonance signal detection means. The ultrasonic treatment apparatus according to any one of claims 1 to 3, further comprising: 5. The ultrasonic therapeutic apparatus according to claim 4, wherein the static magnetic field coil and the gradient magnetic field coil have opening holes of a predetermined size.