JPH02277448A - Shock wave treatment apparatus - Google Patents

Abstract

PURPOSE:To facilitate work for allowing the focus of a shock wave to coincide with an irradiation target by mounting a distance estimation means estimating the distance from the surface of a living body to the focus of the shock wave when a shock wave applicator is mounted to the surface of the living body and a display means displaying an estimation result. CONSTITUTION:The distance from the surface of a living body to the focus of a shock wave when a shock wave applicator 7 is mounted to the surface of the living body is estimated by a distance estimation means 5 and this estimation result is displayed on a display means 4. Since the depth of an object to be ground from the surface of the body as a shock wave irradiation region is known before treatment, the increase or decrease in the amount of a shock wave transmission medium after the mounting of the applicator 7 can be omitted by preliminarily increasing or decreasing the amount of the shock wave transmission medium in a bag body 8 while the indication result on the display means 4 is looked. Therefore, an operator can easily perform work for allowing the focus of the shock wave to coincide with the object to be ground after the mounting of the applicator 7.

Description

[Detailed Description of the Invention] [Objective of the Invention] (Industrial Application Field) The present invention provides shock wave therapy for treating objects to be crushed, such as cancer cells, stones, etc., in a subject by crushing them with the focused energy of shock waves. Regarding equipment.

(Prior art) In the lithotripter, which is currently widely used as a shock wave therapy device, a bag containing a shock wave transmission medium is attached to a shock wave source (transducer), and the bag is pressed against the patient to wet the patient. The treatment target is confirmed by attaching an ultrasonic probe for ultrasonic diagnosis inside the bag.

(Problem to be Solved by the Invention) However, in conventional devices, in order to ensure sufficient contact between the shock wave transmission medium, such as a bag containing water (hereinafter referred to as an ice bag), and the patient, the amount of media in the ice bag must be It is essential to adjust the shock wave source to an appropriate amount, and to align the focus of the shock wave source with the irradiation target (for example, the area where a stone is present).
Since these two tasks are related to each other,
It must be done in stages with alternating adjustments.

If this is not done properly, the following problems will occur.

If the shock wave source is moved away from the patient, there will be insufficient contact between the ice bag and the patient, and the reflection and attenuation of ultrasound at the contact area will increase. or the image quality will deteriorate.

When the shock wave source is moved closer to the patient, the ice bag compresses the patient and makes the patient feel heavy.

As a procedure for stone fragmentation, it is common to confirm the position, size, etc. of the stone using an ultrasonic diagnostic device before actually attaching the shock wave source to the patient. Therefore, at this stage, depth information from the body surface of the shock wave irradiation site has already been obtained.

By using this information to adjust the amount of media in the ice bag before placing the shock wave source on the patient, there is no need to adjust the amount of media after placing the shock wave source on the patient, so the operator can adjust the focus of the shock wave source. You will be able to concentrate on matching the stone positions.

However, with conventional equipment, there was no means to adjust the amount of media in the ice bag in advance, so the work of aligning the focus of the shock wave source with the irradiation target was troublesome and required a considerable amount of time. .

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a shock wave treatment device that can easily match the shock wave focus and the irradiation target.

[Structure of the Invention] (Means for Solving the Problems) In order to solve the above problems, the present invention provides a shock wave transducer that generates shock waves for crushing objects existing in a living body, and this shock wave transducer. A shock wave applicator is provided with a shock wave applicator having a bag body which is extendably disposed on the shock wave transmission surface side and houses a shock wave transmission medium, and an ultrasonic probe for transmitting and receiving ultrasonic waves is placed in the center of the shock wave applicator. In the shock wave treatment device, the shock wave applicator is applied to the surface of the living body based on the position information of the ultrasonic probe within the shock wave applicator and the ultrasonic A-mode image information obtained through the ultrasonic probe. Distance estimating means for estimating the distance from the surface of the living body to the focal point of the shock wave when the shock wave applicator is attached, and display means for displaying the estimation results of the distance estimating means before and after attaching the shock wave applicator to the surface of the living body are provided.

(Function) The distance from the living body surface to the shock wave focal point when the shock wave applicator is attached to the living body surface is estimated by the distance estimating means, and this estimation result is displayed on the display means. As mentioned above, since the depth of the shock wave irradiation site (object to be crushed) from the body surface is known before treatment, the amount of shock wave transmission medium in the bag can be increased or decreased in advance while checking the specified result on the display means. Therefore, it is possible to omit increasing or decreasing the amount of shock wave transmission medium after the applicator is attached. Therefore, the operator can easily align the focus of the shock wave with the object to be crushed after attaching the applicator, and the time required for this operation can be shortened.

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

FIG. 1 shows an embodiment of the invention.

7 is a shock wave applicator, and this applicator 7 includes a shock wave transducer 12 that generates a shock wave for crushing an object existing in a living body by applying a driving pulse;
The transducer 12 has a bag body 7 disposed on the shock wave transmission surface side of the transducer 12.

A telescopic bellows 9 is provided on the peripheral side of the bag 7, and a shock wave transmission medium such as water is stored inside the bag 7. And this applicator tough is tube 13
is connected to the pump 12 via the
The amount of water in the bag body 8 is adjusted by.

Further, in the center of the shock wave applicator 7, an ultrasonic probe 11 is arranged which transmits and receives ultrasonic waves toward the living body and collects image data of a region including the object to be crushed within the living body. This ultrasonic probe 11 is movable in the direction of arrow A, and the position of this ultrasonic probe 10 within the applicator 7 is determined by the probe position reading means 6 via the sensor 11.
read by.

Reference numeral 1 denotes a transmission/reception control section, and this transmission/reception control section 1 controls transmission and reception of ultrasound via the ultrasound probe 10. A B-mode processing circuit 2 and a distance estimating means 5 are arranged downstream of the transmission/reception control section 1.

The B-mode processing circuit 2 performs signal processing for forming a B-mode image of a living body based on the ultrasonic echoes from the transmission/reception control 1, and the processing outputs are S, C(
The signal is transmitted to the display unit 4 via the digital scan converter (digital scan converter) 3 and displayed.

Further, the distance estimating means 5 is configured to apply a shock wave to the surface of the living body based on the position information of the ultrasound probe 10 within the shock wave applicator 7 and the ultrasound A-mode image information obtained via the ultrasound probe 10. This is to estimate the distance from the living body surface to the shock wave focal point when the bag body position detection circuit 5a and the focal point position prediction circuit 5b are used.
It consists of

The bag position detection circuit 5a detects the distance from the tip (transmission/reception surface) of the ultrasonic probe 10 to the end surface of the bag 8 based on the A-mode image information from the transmission/reception control section 1. This distance detection is performed as follows.

As shown in FIG. 2, A-mode image information is collected in the direction of the enemy within the field of view of the probe. For example, both edges of the sector scan area 14 (this is referred to as a).

It is preferable to collect A-mode image information in three directions: (indicated by C) and the center (indicated by b). This A-mode image information collection is performed before the shock wave applicator 7 is attached to the living body. Therefore, the end surface of the bag 8 has a predetermined bulge due to the weight of the bag 8 and the weight of water, and the above-mentioned a, b,
For example, each A-mode image information of c is as shown in FIG. In each A-mode image, the peak point is due to the end face of the bag body 8, and if the times ta, tb, and tc from the time of ultrasonic transmission to this peak point are determined, the tip of the ultrasonic probe 10 can be calculated using the following calculation. The distance ga, , 9b, and Jc from to the end surface of the bag body 8 can be determined.

cw: Ultrasound in water propagation velocity (sound velocity) Further, the focus position prediction circuit 5b is configured as shown in la above.

Based on J2b, PC and the output of the probe position reading means 6, the distance from the living body surface to the shock wave focus when the shock wave applicator 7 is attached to the living body surface is determined, and the focal position is predicted. This prediction is made as follows.

Since the above la, Jlb, and J2c are the values before the shock wave applicator 7 is attached to the living body, it is first necessary to use these values to estimate the values after the shock wave applicator 7 is attached to the living body.

That is, when the shock wave applicator 7 is attached to a living body,
The end surface (rubber membrane) of the bag body 8 is attached to the living body P as shown in
deforms along the surface shape. Therefore, in consideration of this deformation, the distance from the tip of the ultrasound probe 10 to the rubber film directly under the probe (this is shown by the elephant b') is calculated as above, Qa,
, i:b, Jc. This becomes possible by setting an appropriate empirical formula. The degree of deformation depends on the surface shape of the living body,
Although it changes slightly depending on the angle of the applicator, this amount of change is within the range where the focal position can be adjusted without changing the amount of water.

In addition, the shock wave transducer 1 of the ultrasonic probe 10
The length of the protruding part from 2 (denoted by lP) is:
The probe position is read by the probe position reading means 6 based on the output of the sensor 11 (see FIG. 4). In FIG. 5, the distance R from the center of the shock wave transducer 12 to the shock wave focal point 16 is geometrically determined by the shape of the wave transmission surface of the transducer 12. Therefore, when the shock wave applicator 7 is attached to the surface of the living body P, the distance from the living body surface to the shock wave focal point (denoted by J21) is f = R-(, & P + f! b')...
- Obtained by (4). In this way, the focus position prediction circuit 5b calculates 11 and predicts the focus position.

This value of J21 (indicated by X) is displayed on the display section 4. Here, this display section 4 corresponds to display means in the present invention.

Next, stone crushing treatment using the device of this embodiment will be explained.

Before attaching the shock wave applicator 7 to the living body P (usually the patient), the operator uses an ultrasonic diagnostic device or the like to measure the depth from the body surface of the area to which shock waves should be irradiated (calculus position). do. This measurement can also be performed in the B-mode system of the apparatus of this embodiment by using a hand probe. The location of the stone may also be confirmed by X-ray photography.

Then, before attaching the shock wave applicator 7 to the living body P, ultrasonic A mode image information is obtained under the control of the transmission/reception control circuit 1, and the above jqa, J2b is obtained by the bag body position detection circuit 5a.
, find Jc (previous (11, (2), (see formula 31),
The above p1 is obtained by the focus position prediction circuit 5b (before (4)
) formula). This value X of 1 is displayed on the display unit 4 as a predicted value, so the operator must match this value with the stone position (the distance from the body surface to the stone, which is known). The amount of water in the bag body 8 is adjusted via the pump 12.

After the above adjustments are completed, the shock wave applicator 7 is attached to the living body, and the shock wave focus 16 is aligned with the stone 15 which is the irradiation target. Since the B-mode image of the living body and the focus marker indicating the shock wave focal point 16 are displayed in a superimposed manner on the display unit 4, the task of aligning the shock wave focal point 16 with the stone 15 can be performed while looking at the display screen. During this operation, the operator does not need to adjust the amount of water in the bag 8 (this is already completed before attaching it to the living body), so the above positioning operation is much easier than before. , it becomes possible to significantly shorten the time.

Note that the present invention is not limited to the above embodiments.

The amount of shock wave transmission medium within the bag body 8 may be automatically adjusted. An example in this case is shown in FIG.

In FIG. 6, the input means 18 is, for example, a keyboard, and through this input means 18, distance information from the surface of the living body to the object to be crushed in the living body (stone) can be input. As described above, this distance information is measured in advance by an ultrasonic diagnostic device or the like. 19 is a controller that controls the operation of the pump 12, and this controller 19 is configured to match the distance information input from the input means 18 with the output of the distance estimating means 5 (output of the focal position prediction circuit 5b). The pump 12 is driven and controlled to adjust the amount of medium inside the bag body 8. Therefore, the medium 1 control means in claim 2 is functionally realized by this controller 19.

This makes it possible to automatically adjust the amount of media,
This can significantly reduce the burden on the operator.

Further, in FIGS. 2 to 4, calculations of ga, , i2c may be omitted to simplify the calculations, or something other than water may be used as the shock wave transmission medium.

[Effects of the Invention] As described in detail above, according to the present invention, it is possible to provide a shock wave treatment device that can easily match the shock wave focus and the irradiation target.

[Brief explanation of drawings]

FIG. 1 is a block diagram showing an embodiment of the present invention, FIG.
3 and 4 are diagrams explaining the principle of detecting the distance from the tip of the ultrasonic probe to the end face of the bag and detecting the probe position;
FIG. 5 is a diagram explaining the principle of focus position prediction, and FIG. 6 is a block diagram showing another embodiment. 4...Display unit (display means), 5...Distance estimating means, 7...Shock wave applicator, 8...Bag body, 10...Ultrasonic probe, 12...
Shock wave transducer, 18... Input means, 19... Controller (medium amount control means) P... Living body. Agent Patent Attorney Tadashi Misawa Diagram

Claims (2)

[Claims] (1) Comprising a shock wave transducer that generates a shock wave for crushing an object existing in a living body, and a bag that is extendably arranged on the shock wave transmitting surface side of the shock wave transducer and stores a shock wave transmission medium. In a shock wave treatment device comprising a shock wave applicator and an ultrasonic probe for transmitting and receiving ultrasonic waves arranged in the center of the shock wave applicator, positional information of the ultrasonic probe within the shock wave applicator and the ultrasonic wave distance estimating means for estimating the distance from the biological surface to the focal point of the shock wave when the shock wave applicator is attached to the biological surface, based on ultrasound A-mode image information obtained through the probe; A shock wave therapy device characterized by comprising display means for displaying the estimation results of the distance estimating means before and after being attached to a surface. (2) Distance information input means for inputting distance information from the surface of the living body to the object to be shredded within the body, and shock wave transmission within the bag based on the distance information input by this means and the estimation result of the distance estimating means. 2. The shock wave therapy device according to claim 1, further comprising medium amount control means for adjusting the amount of medium to an appropriate amount.