JPH02268752A - Medical treatment apparatus - Google Patents

Abstract

PURPOSE:To facilitate the positioning of a focus region by supporting a shock wave generation part in a state movable in the focus region forming direction due to the convergence of a shock wave and the direction reverse thereto. CONSTITUTION:The positioning of a focus region 33 is performed by rotating a shock wave generation part 12 by an applicator moving mechanism 38 to move the same in the direction shown by an arrow A. This movement is controlled by a position controller 25. Since the position of the focus region 33 is geometrically determined according to the shape of a vibrator 12a, the forming position of the focus region 33 within a living body P can be changed in the direction shown by the arrow A by the movement of the shock wave generation part 12 in the direction shown by the arrow A. Therefore, the B- mode image of the living body and the focus region marker showing the position of the focus region 33 are displayed on a monitor 22 in a superposed state and the positioning of the focus region can be easily performed by moving the shock wave generation part 12 so that a calculus 13 coincides with the focus region marker. Since the taking in and out work of water 15 is not required, the positioning of the focus region can be easily performed.

Description

Detailed Description of the Invention [Purpose of the Invention (Industrial Field of Application) The present invention aims to destroy objects to be treated (objects to be crushed) existing in living bodies, such as cancerous tissue, with the convergent energy of shock waves, or This invention relates to a treatment device that destroys and treats using the thermal effect of focused energy of ultrasonic waves.

(Conventional technology) Figures 6(a), (b) and Figure 7(a).

(b) shows a shock wave applicator in a conventional device.

In FIGS. 6(a) and 6(b), 1 is an imaging probe that collects B-mode information of a living body P, and 2 is a spherical crushing vibrator. 3 is an ice bag,
This water bag 3 is filled with water as a shock wave transmission medium. A bellows is formed on the circumferential side of the water bag 3, and the distance between the crushing vibrator 2 and the living body P can be changed by adjusting the amount of water in the water bag 3. That is, the positioning of the convergence point (focal area) of the shock wave 5 transmitted from the crushing vibrator 2 can be performed by adjusting the amount of water in the water bag 3, adjusting the bellows length, etc.

In the above configuration, the imaging probe 1 is located at the lowest position when positioning the convergence point, and the tip of the probe 1 (
The sending/receiving surface) and the living body P are in almost close contact with each other. After this positioning is completed, the imaging probe is moved upward (the state shown in FIG. 6(a)), and a predetermined standoff S is formed between it and the living body P.

However, in the apparatus shown in FIGS. 6(a) and 6(b), the image quality of the B-mode image is degraded due to the standoff S, and it is difficult to confirm the crushing effect on the B-mode image.

On the other hand, in the apparatus shown in FIGS. 7(a) and (b), the sending and receiving surface of the imaging probe 1 is always located at the tip of the applicator, and the device shown in FIGS.
Since there is no standoff S as in the apparatus shown in 1)), the image quality of the B-mode image is good (and it is relatively easy to confirm the crushing effect on the B-mode image).

However, since the standoff S is not provided, the external dimensions of the crushing vibrator 2 must be increased by 2 (>1+), and the entire applicator inevitably becomes larger.

(Problems to be Solved by the Invention) The conventional device described above has a disadvantage in that the amount of water in the water bag 3 must be adjusted when positioning the focal region, which takes time.

SUMMARY OF THE INVENTION The present invention aims to eliminate the above-mentioned drawbacks, and an object of the present invention is to provide a treatment device that facilitates focal area positioning.

[Structure of the Invention] (Means for Solving the Problems) In order to solve the above problems, the present invention includes a shock wave generation section that generates shock waves that converge in the living body, and a shock wave generation section that transmits the shock waves from the shock wave generation section to the living body. In a treatment device that has a shock wave applicator that includes a shock wave transmission medium and a shock wave transmission medium housed in a case body, and is configured to crush an object to be crushed existing in a living body with the convergent energy of the shock wave, the focus area formation direction and The shock wave generating section is supported movably in the opposite direction.

In addition, a continuous ultrasonic wave generator is constructed by housing a continuous ultrasonic wave generator that generates continuous ultrasonic waves that converge in a living body and an ultrasonic transmission medium that transmits the ultrasonic waves from the continuous ultrasonic wave generator to the living body in a case body. In a treatment device that has a sonic wave applicator and is configured to treat an object to be treated in a living body with heat generated by converging energy of continuous ultrasonic waves, the direction in which a focal region is formed by converging continuous ultrasonic waves and the direction opposite to this are provided. The continuous ultrasonic wave generator is supported movably in the direction.

(Function) According to the above configuration, the shock wave focal region can be positioned by moving the shock wave generation part, and it is not necessary to take out and take out the shock wave transmission medium in the applicator during this positioning. area positioning can be performed easily.

Furthermore, if a shock wave applicator is provided with a notch into which an imaging probe can be attached, and the shock wave applicator is made detachable from the imaging probe while the ultrasound transmitting/receiving surface of the imaging probe is in contact with the living body,
First, only the imaging probe is brought into contact with the living body and positioned, and shock wave therapy is performed by integrating the imaging probe and applicator while maintaining the angular position of the imaging probe at that time.Then, the applicator is removed. B-mode information for determining treatment effectiveness can be collected using only the imaging probe. In this way, the imaging probe can be operated with the imaging probe and applicator separated, and positioning and treatment effects can be easily determined.

Furthermore, by transmitting continuous ultrasonic waves instead of the above-mentioned shock waves, the object to be treated, such as cancerous tissue, can be destroyed and treated by the thermal effect of the focused energy of the continuous ultrasonic waves. In this case as well, by movably supporting the continuous ultrasound generator as described above, it is possible to facilitate focal area positioning, and by making the continuous ultrasound applicator detachable from the imaging probe, positioning and treatment effects can be achieved. can be easily determined.

(Example) Hereinafter, the present invention will be specifically explained with reference to Examples.

FIG. 1 shows an embodiment of the invention.

10 is a shock wave applicator, and 11 is an imaging probe. The imaging probe 11 is a living body P.
B-mode information is collected and is placed in the center of the shock wave applicator 10. The shock wave applicator 10 includes a shock wave generator 12 that generates a shock wave 14 that converges within the living body P, and a shock wave transmission medium such as water 1 that transmits the shock wave 14 from the shock wave generator 12 to the living body P.
5 is housed in a case body 16. Note that details of this shock wave applicator 10 will be explained later.

17 is a transmitting/receiving circuit, and this transmitting/receiving circuit 17 transmits and receives ultrasonic waves via the imaging probe 11.
B-mode information of the living body P is collected. This transmitter/receiver circuit 1
A signal processing circuit 19 and a scan conversion system 20 are arranged after 7, and the B mode information is processed by the signal processing circuit 19, then scan converted by the scan conversion system 20, and transmitted to the display 22 for visualization. be done.

Further, 18 is a pulser, and this pulser 18 drives the shock wave generating section 12. The pulser 18 and the transmitting/receiving circuit 17 are under the control of the controller 24.

25 is a position controller, and this position controller 25 controls the positions of the imaging probe 11 and the shock wave generator 12 under the control of the controller 24.

21 is a CPU (central processing unit), and this CPU2
1 controls the operation of the entire apparatus of this embodiment.

Reference numeral 23 denotes a switch provided on the operation panel, and with this switch 23, the timing at which the shock wave is generated can be set.

Next, based on FIGS. 2 and 3, the shock wave applicator 10 is
The detailed configuration will be explained below.

FIG. 2 shows an enlarged view of the shock wave applicator 10 in FIG. 1, and FIG. 3 is a plan view of the shock wave applicator.

The shock wave generating section 12 includes a vibrator 12a formed in a spherical shape.
and a support body 12b that supports the vibrator 12a. The imaging probe 11 is inserted through the center of the support 12b. The imaging probe 11 is slidable in the direction of arrow B with respect to the support 12b, and is provided with a ring-shaped backing material 30 to prevent water 15 from leaking. Furthermore, the support body 12b is slidable in the six directions of the arrows with respect to the case body 16, and ring-shaped backing materials 31 and 32 are also provided at the contact points between the support body 12b and the case body. The shock wave 14 from the spherical vibrator 12a converges within the living body P, forming a focal region 33. Therefore, the shock wave generating section 12 is supported by the case body 16 so as to be movable in the shock wave focal region forming direction and in the opposite direction. In order to smoothly move the shock wave generating section 12 in the direction of arrow A, through holes 26a and 2.6b are provided in the support body 12b.

26c and 26d are provided. That is, when the shock wave generating section 12 is moved in the focal region forming direction, the water 15 is moved from the wave transmission surface side of the vibrator 12a to the back side through the through holes 26a to 26d, and in the opposite direction. When the shock wave generating section 12 is moved, the water 15 is moved from the back side of the vibrator 12a to the wave transmission surface side via the through holes 26a to 26d. In this way, by adjusting the water pressure between the wave transmitting surface side and the back side of the vibrator as the shock wave generating section 12 moves, smooth movement of the shock wave generating section 12 is achieved. Further, a rubber film 28 is provided at the tip of the shock wave applicator 10 to enable close contact between the body surface of the living body P and the applicator 107.

In the above configuration, the focal region 33 is positioned by rotating and moving the shock wave generating section 12 by the applicator moving mechanism 38 and by moving it in the six directions of the arrows. This movement is controlled by position controller 25. Since the position of the focal region 33 is geometrically determined by the shape of the vibrator 12a, etc., by moving the shock wave generating section 12 in the six directions of arrows, the formation position of the focal region 33 within the living body P can be moved in the direction of arrow A. It can change. Therefore, a B-mode image of the living body and a focal region marker indicating the position of the focal region 33 are superimposed and displayed on the monitor 22, and a shock wave is generated so that the calculus 13 and the focal region marker coincide with each other on this displayed image. Positioning can be easily performed by moving the portion 12. Moreover, in this positioning, the conventional device (FIGS. 6(a), (b) and FIG. 7(a)) is used.

Since there is no need to adjust the amount of water in the water bag 3, that is, to take in and out the water as in (b)), the focal area positioning can be performed more easily than in the past.

Next, other embodiments will be described.

4 and 5 are a plan view and a side view of a shock wave applicator in another embodiment of the device.

What is different from the above embodiment is that this shock wave applicator IO
This is because a fan-shaped notch 37 is provided at A.

This notch 37 allows the imaging probe 11 to be attached to the center of the applicator IOA from the lateral direction of the applicator IOA.

35 is a probe support, which has a hinge mechanism so that the arrow 3
It can be rotated as shown at 6. The imaging probe 11 attached to the center of the applicator 10A is supported by the probe support 35 and integrated with the applicator IOA.

Note that 38 is a U-shaped or C-shaped arm that supports the shock wave applicator IOA.

In the above configuration, first, the imaging probe 11
B-mode information of the living body is collected by contacting only the living body P, and a B-mode image is displayed on the monitor 22. Then, the probe 11 is operated so that the calculus 13 appears at the center of the displayed image on the monitor 22. At this time, since the imaging probe 11 is separated from the shock wave applicator IOA, the probe operation is extremely easy. Thereafter, the probe operation is stopped, and in this stopped state, the applicator IOA is attached to the probe 11. If the angle of the probe 11 is not changed during this installation, the shock wave transmission direction of the applicator 10A will almost match the direction in which the calculus 13 is present. Therefore, after that, by moving the shock wave generating section 12 in the direction of arrow A, the focal region 33 and the calculus 13 can be brought into alignment, and the shock wave can be transmitted or irradiated toward the calculus 13.

When checking in detail whether or not the stone 13 has been fragmented by this shock wave (determining the therapeutic effect), it can be easily done by operating only the imaging probe 11 by removing it from the applicator IOA. .

In the case of this embodiment, the applicator IOA is attached to the imaging probe 11 using the notch 37, so it is particularly difficult to see the image shown in FIG. 7(a).

There is an advantage that the applicator IOA itself can be made smaller than the case (b). In addition, a rubber film 2 is provided between the tip of the imaging probe 11 (ultrasonic wave transmitting/receiving surface) and the body surface.
8 is not present, a good mode image can be obtained. Furthermore, the imaging probe 11 and the applicator IOA
Since it is easy to integrate and separate from the probe, treatment time can be shortened, and it is also possible to change to other probes with different characteristics as necessary.

Although the embodiments of the present invention have been described above, it goes without saying that the present invention is not limited to the above embodiments, and that various modifications can be made.

In the above embodiment, a device capable of shock wave treatment has been described, but if an oscillator capable of generating continuous ultrasonic waves is used in place of the pulser 18 in FIG. 1, this device can be used to perform thermal treatment of cancerous tissue, etc. It can be used as a treatment device. In other words, the object to be treated can be thermally treated using the focused energy of continuous ultrasound waves. In this thermotherapy device, the shock wave applicator 10 shown in FIG. is referred to as a continuous ultrasonic wave generator, and the shock wave transmission medium (for example, water) is referred to as a continuous ultrasonic wave transmission medium.

[Effects of the Invention] As described in detail above, according to the present invention, it is possible to provide a treatment device that facilitates focal area positioning.

[Brief explanation of drawings]

Fig. 1 is a block diagram of an apparatus according to an embodiment of the present invention, Fig. 2 is an enlarged view of the shock wave applicator in Fig. 1, Fig. 3 is a plan view of the shock wave applicator, and Figs. 4 and 5 are other figures. Fig. 4 is a side view of the shock wave applicator, Fig. 5 is a plan view thereof, Figs. 6(a), (b), and Fig. 7(a). (b) is a side view and a plan view of a shock wave applicator in a conventional device. 10, IOA... Shock wave applicator (Unread super Mtl
Application illusion 11... Imaging probe, 12... Shock wave generation part (continuous ultrasound generation part), 13.
... Stone (object to be crushed, object to be treated), 15 ... Water (i
i Shockwave transmission medium, continuous ultrasonic transmission medium) 16... Case body, 37... Notch, P... Living body. Agent Patent Attorney Noriyuki Kondo Takeshi Kondo +OA +6A Figure (bl)

Claims (4)

[Claims] (1) A shock wave applicator that has a shock wave generator that generates shock waves that converge in the living body and a shock wave transmission medium that transmits the shock waves from the shock wave generator to the living body is housed in a case body; A treatment device configured to crush objects to be crushed existing in the area using the convergent energy of shock waves, characterized in that the shock wave generation section is supported so as to be movable in the direction of formation of a focal region by shock wave convergence and in the opposite direction. Device. (2) The shock wave applicator is configured to generate ultrasonic wave B of the living body.
Claim 1: The shock wave applicator has a notch into which an imaging probe for collecting mode information can be attached, and the shock wave applicator is detachable from the imaging probe while the ultrasound transmitting/receiving surface of the imaging probe is in contact with the living body.
The treatment device described. (3) A series consisting of a continuous ultrasound generator that generates continuous ultrasound that converges within a living body, and an ultrasound transmission medium that transmits the ultrasound from this continuous ultrasound generator to the living body, housed within a case body. In a treatment device that has an ultrasonic applicator and is configured to treat an object to be treated in a living body with heat generated by convergent energy of continuous ultrasonic waves, the direction of focal region formation by converging continuous ultrasonic waves and the direction thereof are determined. A treatment device characterized in that the continuous ultrasound generating section is supported so as to be movable in opposite directions. (4) The continuous ultrasound applicator has a notch into which an imaging probe for collecting ultrasonic B-mode information of the living body can be attached, and the ultrasound transmitting/receiving surface of the image probe is brought into contact with the living body. 4. The treatment device according to claim 3, wherein the continuous ultrasound applicator is detachably attached to the imaging probe.