JPH0341941A - Impulse wave crushing medical treatment device and continuous wave warming medical treatment device - Google Patents

Abstract

PURPOSE:To easily execute positioning of the part to be brought to medical treatment and an impulse wave focal position with high accuracy by providing a correcting means for allowing a position of a focal position marker displayed on an ultrasonic tomography to coincide with a focal position on a living body of an impulse wave generated from a shock wave generation source. CONSTITUTION:A first ultrasonic vibrator group 20 of an applicator 100 executes high voltage driving for generating an impulse wave by a driving circuit 70, or low voltage driving for obtaining an envelope waveform. A receiving signal by low voltage driving is brought to envelope detection by a signal processing circuit 72. Also, a second ultrasonic vibrator group 31 of a bar-like probe 30 provided on the applicator 100 is driven by a transmitting circuit 73 for generating a tomographic image by a sector scan, and its receiving signal is brought to envelope detection by a signal processing circuit 74, and converted into a standard television scan by a signal converting circuit 75. Subsequently, an envelope detecting signal for obtaining an envelope waveform, and a signal for obtaining a tomographic image are synthesized by a memory 76, and thereafter, displaying as a tomographic image BI, and a time variation diagram EI of a peak a amplitude value of an envelope waveform image by a display 77.

Description

[Detailed Description of the Invention] [Object of the Invention] (Industrial Application Field) The present invention treats objects to be treated, such as cancer tissues and stones, by crushing them with shock waves obtained by ultrasonic transmission, etc. The present invention relates to a shock wave fragmentation therapy device and a continuous wave thermotherapy device that treats cancerous tissue by destroying cancer tissue and the like with the thermal action of the focused energy of continuous ultrasound waves (continuous ultrasound).

(Prior Art) As this type of shock wave fragmentation therapy device, there is one that generates shock waves by transmitting ultrasonic waves. In addition, in this ultrasonic shock wave fragmentation treatment device, an ultrasonic vibrator as a shock wave generation source is driven at high voltage to generate a shock wave before generating a shock wave pulse that crushes the object to be treated in the living body by the shock wave. The ultrasonic transducer as a source is driven at low voltage to transmit ultrasonic pulses to obtain reception information (envelope waveform), and a group of ultrasonic transducers different from those mentioned above is used to generate tomographic images. Some devices are capable of obtaining tomographic images (B-mode image information) by driving in B mode. In such an apparatus, the degree of coincidence between the object to be treated and the shock wave focal position can be known from the received wave information and the tomographic image.

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

FIG. 4 illustrates the relationship between an applicator, which is a main part of a conventional shock wave fragmentation therapy device, and a patient. First ultrasonic transducer group 2
0, and a rod-shaped probe 30. Here, container 10
is a concave body 11. Bellows 12. and a thin film 13. Water 14, which is one of the shock wave and ultrasonic wave propagation substances, is contained in the container 10. The first ultrasonic transducer group 20 is provided inside the container of the concave body 11, and is for generating shock waves by ultrasonic waves and obtaining an envelope waveform by ultrasonic echoes. Furthermore, a second ultrasonic transducer group 31 for obtaining a tomographic image by ultrasonic echoes is provided at the end of the rod-shaped probe 30 inside the container.

When the first ultrasonic transducer group 20 is driven at a high voltage by a drive circuit (not shown) with such an applicator 100 set on the body surface of the patient 200, a shock wave can be generated, whereas when driven at a low voltage, a shock wave can be generated. , can generate weak ultrasound waves to obtain envelope waveform information.

In this case, the focal position 40 of any wave is fixed at the focal position determined by the curvature of the concave body 11, and the ultrasound transducer group 31 is used to obtain a tomographic image. The acoustic wave scanning area (image display area) 41 is determined based on the end position of the rod-shaped probe 30. Then, the tomographic image and the envelope line waveform must be observed to align the focal point 40 with the treated area 42 .

(Problem 8 to be Solved by the Invention) The principle of crushing a treated object in a living body using shock waves is based on physical crushing using, for example, the focused energy of an ultrasonic beam. If the shock waves are applied to cancer tissue, stones, etc., which are the objects to be treated, it can provide treatment, but if the shock waves are applied to normal tissues, etc., which are not the objects to be treated, it will lead to damage to the living body. Therefore, positioning has become an important issue.

The above-described method of aligning the focal point with the treated area by observing the tomographic image and the envelope waveform is performed as follows. That is, the container l to vary the relative distance between the patient and the applicator.

Check the peak value of the envelope line waveform while increasing or decreasing the water 14 in the
When the peak value is the maximum value, it is assumed that the focal position and the treated region are matched.

This takes advantage of the fact that echoes from the site to be treated, which is a stone, are louder than echoes from other sites.

However, for example, if a stone to be treated is located near a bone, the above-mentioned method using echo intensity may not be able to correctly identify the stone and the bone. Therefore, stones and bones are distinguished by observing tomographic images, and then the degree of coincidence between the focal position and the treated area is confirmed by checking the echo intensity.

This will be explained specifically. That is, the rod-shaped probe 30
The position within the container 10 is detected, and a focal position marker is displayed on the tomographic image based on the detected value.

In other words, it is calculated how far the focal point position, which is fixed at a position determined by the curvature of the concave body 11, is from the end of the rod-shaped probe 30 (equivalent sound source position), which can change its position. . Then, a focus position marker is displayed at the calculated position.

In the above case, it is assumed that the focal point position is fixed at a position determined by the curvature of the concave body 11, but this is because the medium existing between the concave body 11 and the focal point position is uniform. I am assuming a certain case.

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;
It is clearly a non-uniform medium. Therefore, the position of the focal position marker displayed on the tomographic image includes an error from the actual position by the difference between the refractive index of the water 14 and the refractive index of the patient 200. According to research conducted by the present inventors, this error is greatly affected by the temperature of the water 14, and can reach 10 mm or more.

Due to such a large error, in order to perform highly accurate positioning, the positioning operation must be performed while taking the error into consideration, which poses the problem of being very time-consuming.

SUMMARY OF THE INVENTION Accordingly, it is an object of the present invention to provide a shock wave fragmentation treatment device that can easily perform highly accurate positioning of the treated region and the shock wave focal position.

Another object of the present invention is to provide a continuous wave thermal treatment device that can easily perform highly accurate positioning of the treated region and the continuous wave focal position. In order to achieve the purpose, the following structure is adopted. The invention according to claim 1 provides a shock wave generating source provided in a container containing a shock wave and ultrasonic propagation substance, and an applicator provided with a probe for ultrasonic tomographic imaging placed in the container; In the shock wave fragmentation treatment device, the position of the focal position marker displayed on the ultrasonic tomogram obtained by the probe on the image is set to the position of the focal point on the living body of the shock wave generated from the shock wave generation source. The invention according to claim 2 is characterized in that it is provided with a correction means for matching, and a continuous wave generation source is provided in a container containing a continuous wave and an ultrasonic propagating substance, and a container for ultrasonic tomographic image imaging is provided. A continuous wave thermotherapy device comprising an applicator with a probe placed in the container,
Correction for making the position of the focal position marker displayed on the ultrasonic tomographic image obtained by the probe match the position of the focal point on the living body of the continuous wave generated from the continuous wave generation source. It is characterized by being equipped with means.

(Function) According to the invention of claim 1, 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 correction means, so that it is possible to Highly accurate positioning can be performed without the need for additional work such as considering errors.

According to the second aspect of the invention, the correction means can match the position of the focal position marker on the ultrasonic tomographic image with the position of the continuous wave focal point on the living body. Highly accurate positioning can be performed without the need for additional work such as consideration.

(Example) An example of the shock wave fragmentation treatment device according to the present invention will be described below.
The description will be made with reference to FIG. 1, in which the same parts as in FIG. 4 are given the same reference numerals.

As shown in FIG. 1, the applicator 100 is provided with a positioning mechanism 50 for the rod-shaped probe 30. As shown in FIG. This positioning mechanism 50 can detect the end position of the rod-shaped probe 3o at a desired position by the position controller 51, and can also raise/lower the rod-shaped probe 30. However, the raising/lowering of the rod-shaped probe 30 is generally performed within the container l.

This is also achieved by following the thin film 13 which rises/falls as the water 14 flows in and out.

The applicator 100 also includes a pump as water equipment for taking in and out the water 14 in the container lo.

A water driver 60 consisting of a switching pipe, a heating/cooling device, etc. A water controller 61 for controlling this water driver 60 is attached.

Further, the first ultrasonic fjL transducer group 2o in the container 1° provided in the applicator 100 is driven by a drive circuit 7o at a high voltage for generating shock waves or at a low voltage for obtaining an envelope waveform. . The received signal due to low voltage drive is
The signal processing circuit 72 performs envelope detection. Further, the second ultrasonic transducer group 31 of the rod-shaped probe 30 provided in the applicator 100 is driven by a transmitting/receiving circuit 73 to create a tomographic image by, for example, sector scanning, and the received signal is wrapped by a signal processing circuit 74. Route detection and signal conversion circuit 7
5, the image is converted into, for example, a standard television scan.

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 the tomographic image Bl and the envelope waveform are displayed on the display 77 as shown in the figure. It is displayed as a time change diagram El of the peak amplitude value of the image. Here, the temporal change diagram El of the peak amplitude value of the envelope waveform image is also referred to as a focal position/treated region coincidence degree graph. Further, on the tomographic image BI, for example, "Ma2" is displayed as a focal position marker FP indicating the focal position of the first ultrasound transducer group 20 on the tomographic image.

Then, the signal processing circuit 72. The signal processing circuit 74, signal conversion circuit 75, and memory 76 are controlled by a controller 78. Also, a position controller 51, a water controller 61, a drive circuit 70. Receiving circuit 72. The transmitting/receiving circuit 73 and the controller 78 are controlled by a CPU 79. CPU7
An operator console 80 is connected to 9, and various necessary operations and settings can be performed as desired by the operator.

The console 80 includes an operation section 81 for creating a tomographic image, an operation section 82 for creating an envelope waveform. Operation unit 83 for generating shock waves. Operation unit 84 for putting in and taking out water 14. water 1
4. Operation section 85.4 for temperature adjustment. Operation unit 86 for raising/lowering the rod-shaped probe 30. It is provided with an operation section 87 for calling up data used for focus position correction, an operation section 88 for setting data used for focus position correction, and the like.

Note that the operation unit 87 for calling data used for focal position correction calls data used for positional correction held in advance in the CPU 79, for example, and adjusts the focal position marker FP "ma" on the tomographic image and the patient 200. The operation unit 88 for setting data used for focal position correction is used to fix and set the data used for position correction that has been made coincident with the above-mentioned operation. be.

The above matching procedure will be explained in detail. First, while changing the focal point position by putting in and taking out the water 14, the focal position/treated area matching graph is observed.

At this time, when the focus matches the treated area, that is, when the peak amplitude value shown on the vertical axis of the graph becomes maximum, the focus position is fixed, that is, the introduction and withdrawal of the water 14 is stopped. The match here means that the treated area and the focus on the patient 200 match. Next, the focal position marker FP'ma'' appearing on the tomographic image is
Data for focal position correction is selected and fixed so as to match the treated region appearing on the tomographic image.

By executing this procedure, from now on, the focal position on the patient 200 and the focal position marker F on the tomographic image will be determined.
The position of P "ma" matches.

Next, a method of calculating the above-mentioned correction data will be explained. 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 is the distance from the end surface of the rod-shaped probe 30 on the patient 200 to the focal point determined by the curvature of the concave body 11, and Z2 is the distance from the end surface of the rod-shaped probe 30 on the patient 200. Z is the distance from the end surface of the rod-shaped probe 30 to the focal position on the tomographic image, and R is the distance from the curvature reference plane of the concave body 11 on the patient 200. It is the distance to the focal point determined by the curvature of the concave body 11, M is the distance from the curvature reference plane of the concave body 11 on the patient 200 to the end surface of the rod-shaped probe 30, and θ1 is the distance from the water 14 to the patient 200. Ultrasonic incident angle (maximum viewing angle), θ2 is the angle of incidence from water 14 to patient 2.
C7 is the sound velocity in the water 14, C2 is the sound velocity in the patient 200, and a is the curvature reference aperture diameter of the concave body 11.

Z, -R-M θ1㘗5in-" - R In other words, the matching procedure in this embodiment is that the position of the focal position marker FP "ma" on the tomographic image was Z before correction, The correction is made to z2, where z2 is Z, , a, and R are known, and C1,
Since C2 can be measured, it can be easily calculated. In other words, 2
．． Converting between and 22 is nothing but correcting the focal point position. Conversion data between Zl and 22 is then prepared as correction data.

Note that it is necessary to prepare correction data for each combination of CI and C2 in advance, but instead of this,
A typical combination of CI and C2 is, for example, C, -152
3m/see <35@C).

C, ml 560 m/see (36,5'' C) may be provided with correction data only (however, this will result in a decrease in correction accuracy).

In addition, by operating the operation unit 85 to adjust the temperature of the water 14, the pump and heating/cooling device of the water driver 60 are operated, and the water 14 in the applicator 100 is heated or cooled, thereby controlling the CI as described above. It may be possible to make it closer to the typical example. This allows highly accurate correction.

Although it has been explained above that the focus position is corrected prior to actually treating the patient, the correction may be performed using a phantom. Furthermore, it does not specify the form of selection and setting of correction data. For example, in a format where all 22.21 conversion data is prepared (lookup table method), z1 data is prepared and the corresponding Z
It is possible to adopt various modes such as a mode in which z2 is calculated by multiplying and dividing l by a correction coefficient, a mode in which zl data is prepared and Z2 is calculated by adding a correction amount to the corresponding Zl. can.

In addition, instead of driving the first ultrasonic transducer group 20 at a low voltage and performing envelope detection using the ultrasonic wave transmission/reception, an ultrasonic image obtained by the probe 30 and a focus marker area of the image may be used. It is also possible to correct the position of the focus marker using the focus position/treated area matching graph obtained from .

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

Furthermore, by replacing the drive circuit 70 with one capable of generating continuous ultrasonic waves, highly accurate positioning of the treated region and the focal position of the continuous waves can be easily performed.

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

[Effects of the Invention] As described above, the invention of claim 1 allows the position of the focal position marker displayed on the ultrasonic tomographic image obtained by the probe to be determined by adjusting the position of the focal point marker displayed on the ultrasonic tomographic image obtained by the probe. By providing a correction means for matching the position of the focal point on the ultrasound tomogram, the position of the position marker on the ultrasonic tomographic image can be matched with the position of the shock wave focal point on the living body. Thus, highly accurate positioning can be performed without the need for incidental work such as taking into account errors.

Therefore, according to the present invention, it is possible to provide a shock wave fragmentation treatment device that can easily perform highly accurate positioning of the treated region and the shock wave focal position.

In addition, the invention of claim 2 is a method for determining the position of the focal position marker displayed on the ultrasound tomographic image obtained by the probe on the image of the focal point on the living body of the continuous wave generated from the continuous wave generation source. By providing a correction means for matching the position, it is possible to match the position of the position marker on the ultrasonic tomographic image with the position of the continuous wave focal point on the living body, making it possible to eliminate errors as in the conventional method. Highly accurate positioning can be performed without the need for additional work such as consideration.

Therefore, according to the present invention, it is possible to provide a continuous wave thermal treatment device that can easily perform highly accurate positioning of the treated region and the continuous wave focal position.

[Brief explanation of drawings]

FIG. 1 is a block diagram showing an embodiment of the shock wave fragmentation treatment device according to the present invention, FIG. 2 is a diagram showing the focal point position on a patient, FIG. 3 is a diagram showing the 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, 5
0... 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, 8
0... Operation console, 81... Operating unit for creating tomographic images, 82... Operating unit for creating envelope waveforms, 83...
- Operation unit for generating shock waves, 84... Operation unit for putting in and taking out water, 85... Operation unit for adjusting the temperature of water,
86...Operation unit for raising/lowering the rod-shaped probe;
87... Operating unit for calling data used for sunspot position correction, 88... Operating unit for setting data used for focus position extraction.

Claims (2)

[Claims] (1) A shock wave fragmentation therapy device comprising an applicator in which a shock wave generation source is provided in a container containing a shock wave and ultrasound propagating substance, and a probe for ultrasonic tomographic imaging is placed in the container, a correction means for matching the position of the focal position marker displayed on the ultrasonic tomographic image obtained by the probe with the position of the focal point on the living body of the shock wave generated from the shock wave generation source; A shock wave fragmentation treatment device characterized by comprising: (2) Continuous wave thermotherapy comprising a continuous wave generation source in a container containing a continuous wave and ultrasound propagation substance and an applicator in which a probe for ultrasonic tomographic imaging is placed in the container. In the apparatus, the position of the focal position marker displayed on the ultrasonic tomographic image obtained by the probe is matched with the position of the focal point on the living body of the continuous wave generated from the continuous wave generation source. A continuous wave thermal treatment device characterized by comprising a correction means for.