JPH0822288B2 - Shock wave fragmentation treatment device and continuous wave thermotherapy device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Object of the Invention] (Field of Industrial Application) The present invention treats an object to be treated such as a cancer tissue or a stone by crushing it with a shock wave obtained by ultrasonic wave transmission or the like. The present invention relates to a shock wave fragmentation treatment device and a continuous wave thermotherapy device that treats cancer tissue by destroying cancer tissue and the like by the heat effect of focused energy of continuous waves of ultrasonic waves (continuous ultrasonic waves).

(Prior Art) As a shock wave fragmentation treatment device of this type, there is one that obtains the generation of a shock wave by ultrasonic wave transmission. Further, in this ultrasonic shock wave fragmentation treatment device, an ultrasonic oscillator as a shock wave generation source is driven at a high voltage to generate a shock wave pulse before generating a shock wave pulse for fragmenting an object to be treated in the living body by the shock wave. The ultrasonic transducer as a source is driven with a low voltage to transmit the ultrasonic pulse that obtains the received information (envelope waveform), and the ultrasonic transducer group different from the one described above is used to generate a tomographic image. There is a so-called B-mode drive that can obtain a tomographic image (B-mode image information). In such a device, the degree of coincidence between the object to be treated and the shock wave focal point position can be known from the received wave information and the tomographic image.

The above description is an example of what generates a shock wave from an ultrasonic transducer, that is, an example of a shock wave fragmentation treatment device, but if the drive circuit is replaced with one that can generate continuous ultrasonic waves, one that can perform thermal treatment, that is, continuous It is configured as a wave thermotherapy device. In the following description, the shock wave crush treatment device will be described unless otherwise specified.

FIG. 4 illustrates the relationship between the applicator, which is the main part of the conventional shock wave fragmentation therapy device, and the patient. The applicator 100 includes a container 10, a first ultrasonic transducer group 20,
And a rod-shaped probe 30. Here, the container 10 includes a concave body 11, a bellows 12, and a thin film 13. The container 10 contains water 14, which is one of the shock wave and ultrasonic wave propagating substances. The first ultrasonic transducer group 20 is provided inside the container of the concave body 11 to generate a shock wave by an ultrasonic wave and obtain an envelope waveform by an ultrasonic echo. In addition, a second ultrasonic transducer group 31 for obtaining a tomographic image by ultrasonic echo is provided at the end of the rod-shaped probe 30 inside the container.

With the applicator 100 set on the body surface of the patient 200, a shock wave can be generated when the first ultrasonic transducer group 20 is driven at a high voltage by a driving circuit (not shown), while it is driven at a low voltage. , Weak ultrasonic waves for obtaining envelope waveform information can be generated.

In this case, the focus position 40
Is fixed at a focal position determined by the curvature of the concave body 11, and an ultrasonic scanning region (image display region) 41 for obtaining a tomographic image by the second ultrasonic transducer group 31 is a rod-shaped probe. It is determined based on the end position of 30. And
The focal position 40 must be aligned with the treated region 42 by observing the tomographic image and the envelope waveform.

(Problems to be Solved by the Invention) The principle of crushing an object to be treated in a living body by a shock wave is based on, for example, physical crushing by the focused energy of an ultrasonic beam. Then, if a shock wave is applied to a cancer tissue or a stone, which is an object to be treated, it can be treated, but if a shock wave is applied to a normal tissue or the like which is not an object to be treated, it leads to biological damage. Therefore, positioning has become an important issue.

The above-described method of matching the focal position with the treated region by observing the tomographic image and the envelope waveform is performed as follows. That is, the peak value of the envelope waveform is examined while increasing / decreasing the water 14 in the container 10 in order to change the relative distance between the patient and the applicator, and when the peak value is the maximum value, the focus position and the treated site are It is assumed that a match has been made. This utilizes the fact that the echoes from the treated site, which is a stone, are larger than those from other sites.

However, for example, when a calculus, which is a treated region, is near the bone, the above-described method using echo intensity may not be able to correctly recognize the calculus and the bone. Therefore, the stones and bones are identified by observing the tomographic image, and then the degree of coincidence between the focal position and the treated site is confirmed by the echo intensity.

This will be specifically described. That is, the rod-shaped probe 30
The position within the container 10 is detected, and the focus position marker is displayed on the tomographic image based on the detected value. That is, how far the focus position fixed at the position determined by the curvature of the concave body 11 is from the end (equivalent sound source position) of the rod-shaped probe 30 that can change its position is calculated. . Then, a focus position marker is displayed at the calculated position.

In the above case, the focus position is fixed at a position determined by the curvature of the concave body 11, but this is the concave body.
It is assumed that the medium between 11 and the position of the focus position is uniform. However, the medium existing between the concave body 11 and the focal point position is actually the water 14 in the container 10 and the patient 200, which is obviously a non-uniform medium. Therefore, the position of the focus position marker displayed on the tomographic image includes an error with respect to the actual position by the difference between the refractive index of the water 14 and the refractive index of the patient 200. According to the research conducted by the present inventors, this error is greatly affected by the temperature of the water 14 and may reach 10 mm or more.

Since there is such a large error, in order to perform highly accurate positioning, it is necessary to carry out the positioning work in consideration of the error amount, which causes a problem that it takes a lot of time and labor.

SUMMARY OF THE INVENTION It is an object of the present invention to provide a shock wave fragmentation treatment device capable of easily performing highly accurate positioning between a treated region and a shock wave focal position.

Another object of the present invention is to provide a continuous wave thermotherapy device capable of easily performing highly accurate positioning between a treated region and a continuous wave focal point position.

[Structure of the Invention] The present invention has the following structure in order to solve the above problems and achieve the object. According to the invention of claim 1, in a shock wave crushing treatment device, an applicator provided with a shock wave generating source for crushing treatment of an object to be treated is provided in a container containing a shock wave and an ultrasonic wave propagating substance. A probe for performing ultrasonic tomographic imaging by abutting, means for detecting the position of the probe with respect to the shock wave source, the position of the detected probe, and the speed of sound in the propagating substance contained in the applicator. The present invention is characterized by further comprising means for obtaining a focus position of a shock wave generated from the shock wave generation source from the sound velocity in the living body, and means for displaying a marker at the obtained focus position of the shock wave.

The invention of claim 2 is a continuous wave thermotherapy apparatus comprising an applicator provided with a continuous wave generation source for performing thermotherapy of an object to be treated, in a container containing an ultrasonic wave propagating substance, in a living body. A probe that abuts for ultrasonic tomographic imaging, a means for detecting the position of the probe with respect to the continuous wave generation source, the position of the detected probe, and the speed of sound in the propagating material contained in the applicator. And a means for obtaining a focused position of the continuous wave generated from the continuous wave source from the speed of sound in the living body, and a means for displaying a marker at the obtained focused position of the continuous wave. .

(Operation) According to the invention of claim 1, the position of the focus position marker on the ultrasonic tomographic image can be made to coincide with the position of the shock wave focus on the living body by the correcting means. Highly accurate positioning can be performed without accompanying work such as taking error into consideration, and a probe for performing ultrasonic tomographic imaging is in contact with the living body, so that tomographic image resolution can be improved. it can.

According to the invention of claim 2, since the position of the focal position marker on the ultrasonic tomographic image can be matched with the position of the shock wave focal point on the living body by the correcting means, an error is taken into consideration as in the prior art. It is possible to perform highly accurate positioning without accompanying work such as performing the operation, and since the probe for performing ultrasonic tomographic image contact is in contact with the living body, it is possible to improve the tomographic image resolution.

(Embodiment) An embodiment of the shock wave fragmentation treatment device according to the present invention will be described below with reference to FIG. 1 in which the same parts as those in FIG.

As shown in FIG. 1, the applicator 100 is provided with a positioning mechanism 50 for the rod-shaped probe 30. The positioning mechanism 50 can detect the end position of the rod-shaped probe 30 at a desired position (the position in contact with the subject in FIG. 2) by the position controller 51, and also raises the rod-shaped probe 30. / Can be lowered. However, the rod-shaped probe 30 rises /
The lowering is also generally done by following a thin film 13 which rises / falls as water 14 enters and leaves the container 10.

Further, the applicator 100 has a water driver 60 including a pump, a switching pipe, a heating and cooling device, and a water controller 61 for controlling the water driver 60 as a water facility for taking in and out the water 14 in the container 10. Is attached.

Further, the first ultrasonic transducer group 20 of the container 10 included in the applicator 100 is driven by the driving circuit 70 at a high voltage for generating a shock wave or at a low voltage for obtaining an envelope waveform. The received signal driven by the low voltage is envelope-detected by the signal processing circuit 72. In addition, the second ultrasonic transducer group 31 of the rod-shaped probe 30 included in the applicator 100 has a transmitting / receiving circuit 73 for creating a tomographic image by, for example, sector scanning.
The received signal is envelope-detected by the signal processing circuit 74 and converted into, for example, a standard television scan by the signal conversion circuit 75.

Then, the envelope detection signal for obtaining the envelope waveform and the signal for obtaining the tomographic image are combined in the memory 76, and then on the display 77, as shown in the figure.
It is displayed as BI, EI, which is the temporal change of the peak amplitude of the envelope waveform image. Here, the temporal change diagram EI of the peak amplitude value of the envelope waveform image is also referred to as the focus position / treatment site coincidence graph. Further, on the tomographic image BI, for example, “▼” is displayed as the focal position marker FP indicating the focal position of the first ultrasonic transducer group 20 on the tomographic image.

The signal processing circuit 72, the signal processing circuit 74, the signal conversion circuit 75, and the memory 76 are controlled by the controller 78. The position controller 51, the water controller 61, the drive circuit 70, the receiving circuit 72, the transmitting / receiving circuit 73, and the controller 78 are controlled by the CPU 79. A console 80 is connected to the CPU 79, and various necessary operations and settings are made by the operator as desired.

The console 80 includes an operating unit 81 for creating a tomographic image, an operating unit 82 for creating an envelope waveform, and an operating unit 8 for generating a shock wave.
3, operation part 84 for taking in and out of water 14, operation part 85 for adjusting the temperature of water 14, operation part 86 for raising / lowering the rod-shaped probe 30, operation for calling data used for focus position correction A unit 87, an operation unit 88 for setting data used for focus position correction, and the like are provided.

The operation unit 87 for calling the data used for the focus position correction calls, for example, the data used for position control that is held in advance in the CPU 79, and the focus position marker on the tomographic image.
The FP “▼” and the focus position on the patient 200 can be matched on the tomographic image, and the operation unit 88 for setting the data used for the focus position correction can perform the position correction matched by the above operation. The data to be used is fixedly set.

The above-mentioned matching procedure will be described in detail. First, the focus position / treatment site coincidence degree graph is observed while changing the focus position by moving water 14 in and out. At that time, the focus position is fixed when the focus coincides with the region to be treated, that is, where the peak amplitude value indicated by the vertical axis of the graph becomes maximum, that is, the inflow and outflow of the water 14 is stopped. The coincidence here is that the treated area and the focus coincide with each other on the patient 200. Then, next, focus position correction data is selected and fixed so that the focus position marker FP “▼” appearing on the tomographic image matches the treatment site appearing on the tomographic image. To do. By executing this procedure, the focus position on the patient 200 and the position of the focus position marker FP “▼” on the tomographic image will thereafter match.

Next, a method of calculating the above-described correction data will be described. FIG. 2 is a diagram showing the focal position on the patient 200, and FIG. 3 is a diagram showing the focal position on the tomographic image.

In FIGS. 2 and 3, Z ₁ is the distance from the end surface of the rod-shaped probe 30 on the patient 200 to the focus position determined by the curvature of the concave body 11, and Z ₂ is the rod-shaped probe 30 on the patient 200.
Is the distance from the end face of the lens to the actual focus position, and R
Is the distance from the curvature reference surface of the concave body 11 on the patient 200 to the focus position determined by the curvature of the concave body 11, and M is the patient 200
The distance from the curvature reference surface of the concave body 11 to the end surface of the rod-shaped probe 30 above, θ ₁ is the ultrasonic wave incident angle (maximum view angle) from the water 14 to the patient 200, and θ ₂ is from the water 14 Patient 20
Is an ultrasonic wave emission angle to 0, C ₁ is a sound velocity in water 14, C ₂ is a sound velocity in the patient 200, and a is a curvature reference opening diameter of the concave body 11.

That is, in the matching procedure in the present embodiment, the position of the focus position marker FP “▼” on the tomographic image is Z ₁ before the correction, and is changed to Z ₂ by the correction. Z ₂
, Z ₁ , a, R are known, and C ₁ , C ₂ can be measured, so that they can be easily calculated. In other words, converting Z ₁ and Z ₂ is nothing but correcting the position of the focal point. Then, conversion data of Z ₁ and Z ₂ is prepared as correction data.

The correction data needs to be prepared in advance for each combination of C ₁ and C ₂ , but instead of this, for example, a typical combination of C ₁ and C ₂ is C ₁ = 1523m / sec (35
C), C ₂ = 1560 m / sec (36.5 ° C) may be included in the correction data (however, the correction accuracy may decrease).

Further, by operating the operation portion 85 for adjusting the temperature of the water 14, the pump of the water driver 60 and the heating / cooling device are operated,
By heating or cooling the water 14 in the applicator 100, C ₁ may be brought close to the above-described typical example.
As a result, highly accurate correction is performed.

In the above description, the focus position is actually corrected before the patient is treated, but it may be corrected using a phantom. Further, it does not specify the form of selection and setting of correction data. For example, a form in which all Z ₂ , Z ₁ conversion data is prepared (look-up table method), Z ₁ data is prepared, and Z ₂ is calculated by multiplying and dividing the corresponding Z ₁ by a correction coefficient, Various modes such as a mode in which Z ₁ data is prepared and Z ₂ is calculated by adding / subtracting the correction amount to the corresponding Z ₁ can be adopted.

Further, instead of a method of driving the first ultrasonic transducer group 20 at a low voltage and performing envelope detection by transmitting and receiving the ultrasonic waves, an ultrasonic image obtained by the probe 30 and a focus marker area of the image are obtained. It is also possible to correct the position of the focus marker by using the focus position / treatment site coincidence graph obtained from the above.

As described above, according to this embodiment, it is possible to easily perform highly accurate positioning between the treated region and the shock wave focus position.

Further, if the drive circuit 70 is replaced by a device capable of generating continuous ultrasonic waves, it is possible to easily perform highly accurate positioning between the treated region and the continuous wave focus position.

In addition, various modifications can be made without departing from the scope of the present invention.

[Effect of the Invention] As described above, the invention of claim 1 sets the position on the image of the focus position marker displayed on the ultrasonic tomographic image obtained by the probe as the living body of the shock wave generated from the shock wave generation source. Since the position of the position marker on the ultrasonic tomographic image can be matched with the position of the shock wave focus on the living body by providing the correcting means for matching the position of the focal point on the living body, As described above, it is possible to perform highly accurate positioning without any additional work such as considering an error.

Therefore, according to the present invention, it is possible to provide a shock wave crushing treatment device capable of easily performing highly accurate positioning between a treated region and a shock wave focal point position.

According to the invention of claim 2, the position on the image of the focal position marker displayed on the ultrasonic tomographic image obtained by the probe is set to the focal position on the living body of the shock wave generated from the shock wave source. Since the position of the position marker on the ultrasonic tomographic image can be matched with the position of the continuous wave focus on the living body by providing the correction means for matching, an error is taken into consideration as in the conventional case. Highly accurate positioning can be performed without accompanying work such as.

Therefore, according to the present invention, it is possible to provide a continuous wave thermotherapy device capable of easily performing highly accurate positioning between a treated region and a continuous wave focal point position. Furthermore, according to the first and second aspects of the invention, the probe for performing ultrasonic tomographic image imaging is in contact with the subject, so that the tomographic image resolution can be improved.

[Brief description of drawings]

FIG. 1 is a block diagram showing an embodiment of a shock wave fragmentation treatment device according to the present invention, FIG. 2 is a diagram showing a focal position on a patient, FIG. 3 is a diagram showing a focal position on a tomographic image, and FIG. The figure shows a conventional example. 100 ... Applicator, 10 ... Container, 11 ... Concave body 11, 12 ... Bellows, 13 ... Thin film, 14 ... Water, 20 ... First ultrasonic transducer group, 30
... rod-shaped probe, 31 ... second ultrasonic transducer group, 50 ... positioning mechanism, 51 ... position controller, 60 ... water driver, 61 ... water controller, 70 ... driver, 71 ... receiving circuit, 72 ... Signal processor, 73 ...
Transmission / reception circuit, 74 ... Signal processing circuit, 75 ... Signal conversion circuit, 76
… Memory, 77… Display, 78… Controller, 79…
CPU, 80 ... Console, 81 ... Operation section for creating tomographic image, 82
… Operating part for creating envelope waveforms, 83… Operating part for generating shock waves, 84… Operating part for putting in and out of water, 85… Operating part for adjusting temperature of water, 86… Raising / lowering of rod-shaped probe , Operation unit for calling data used for focus position correction, 88 ... operation unit for setting data used for focus position correction.

Claims (2)

[Claims] 1. A shock wave fragmentation treatment apparatus comprising an applicator provided with a shock wave generation source for performing fragmentation treatment of an object to be treated in a container containing a shock wave and an ultrasonic wave propagating substance. A probe for performing ultrasonic tomographic imaging, means for detecting the position of the probe with respect to the shock wave source, the position of the detected probe, the speed of sound in the propagating material contained in the applicator, and A shock wave fragmentation treatment device comprising: means for obtaining a focus position of a shock wave generated from the shock wave source, and means for displaying a marker at the obtained focus position of the shock wave, based on the sound velocity in the living body. 2. A container containing an ultrasonic wave propagating substance,
In a continuous wave thermotherapy device including an applicator provided with a continuous wave generation source for performing thermal treatment of an object to be treated, a probe for contacting a living body to perform ultrasonic tomographic imaging, and a continuous wave generation source A means for detecting the position of the probe, the position of the detected probe, the speed of sound in the propagating substance contained in the applicator, and the speed of sound in the living body, of the continuous wave generated from the continuous wave source. A continuous wave thermotherapy apparatus comprising: a unit for obtaining a focus position and a unit for displaying a marker at the obtained focus position of the continuous wave.