JPH0710281B2 - Laser therapy equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial field of application] The present invention is used for, for example, surgery such as a laser scalpel, and irradiates a laser beam on a treated area to perform treatment such as incision on the treated area. More particularly, the present invention relates to a laser treatment apparatus capable of optimizing an irradiation constant of laser light.

[Prior Art] In general, a laser treatment apparatus irradiates a treated portion with a laser beam having a high energy density to burn out the treated portion, so that the treated portion has a hemostatic effect and can perform an operation with almost no bleeding. At the same time, it has been widely used since it has advantages such as a low risk of bacterial contamination to the treated area.

FIG. 6 is a side view showing a conventional laser treatment apparatus described in, for example, Japanese Utility Model Publication No. 61-7688. In the figure,
(23) is a therapeutic laser light (for example, carbon dioxide laser,
Argon laser, laser oscillator that emits light from neodymium yag laser), (24) is a laser beam carrier that is connected to the laser oscillator (23) and guides the laser beam, and (25) is a laser beam carrier. A laser probe provided at the tip of (24), (31) an endoscope provided between the laser beam carrier (24) and the laser probe (25), (32)
Is a laser guide channel for connecting the laser beam carrier (24) and the endoscope (31).

The conventional laser treatment apparatus is configured as described above, and the laser light output from the laser oscillator (23) passes through the laser light carrier (24), that is, the light guiding optical fiber and the endoscope (31) to generate the laser light. The probe (25) is adapted to irradiate the treated area, for example, the stomach.

When the treated area is burned off by laser light, the living cells are locally burned, but the state of the local tissue can be observed by the operator through the endoscope (31). There is.

[Problems to be Solved by the Invention] As described above, in the conventional laser treatment apparatus, since the operator observes only the surface of the treated portion with the naked eye, the circulatory dynamics and metabolic dynamics inside the tissue. However, there is a problem in that proper laser treatment is not performed, resulting in insufficient treatment due to insufficient irradiation or tissue damage due to excessive irradiation.

The present invention has been made to solve the above problems, and optimizes the irradiation constant of laser light by measuring circulatory dynamics, metabolic dynamics and morphological information of the treated area before and after treatment. The object is to obtain a laser treatment device that can be used.

[Means for Solving Problems] A laser treatment apparatus according to the present invention is a laser treatment means for irradiating a treated portion with a laser beam, and an NM from the treated portion.
An NMR signal measuring means for measuring the R signal and a feedback control means for controlling the laser treatment means based on the NMR signal are provided.

Further, the laser treatment apparatus according to the present invention measures the NMR signal from the treated area during the laser treatment period and determines the irradiation constant of the laser beam applied to the treated area based on the measurement result.

[Operation] In the present invention, the NMR signal from the treated area is monitored, and this NMR signal is fed back to the laser treatment means as a parameter for laser treatment to optimize the irradiation constant of the laser light.

[Embodiment] An embodiment of the present invention will be described below with reference to the drawings. First
FIG. 1 is a block diagram showing an embodiment of the laser treatment apparatus according to the present invention, FIG. 2 is a side view around the subject in FIG. 1, and FIG. 3 is an enlarged perspective view of the laser probe in FIG. is there.
In the figure, (23) to (25) are the same as the above-mentioned conventional device, and these constitute laser treatment means.
Although not shown in FIG. 1, the laser treatment means has a sixth
The endoscope (31) similar to the figure is also included.

(1) is a magnet as a static magnetic field generating means, and has an opening diameter of 60 to 100 cm so that a subject (13) described later can be inserted. (2) is a sequence controller for driving a high frequency transmitter (4) and a gradient magnetic field power source (8) described later at a predetermined timing. Reference numeral (3) is a computer which has a built-in memory and supplies sequence data to the sequence control device (2). The computer outputs an NMR signal obtained from a treated part of the subject (13) via a receiving coil (19) described later. It constitutes NMR signal measuring means for measurement. The sequence control device (2) and the computer (3) constitute feedback control means for controlling the laser oscillator (23) based on the measurement result of the NMR signal from the treated area.

Reference numeral (4) is a high-frequency transmitter that transmits a high-frequency wave according to the modulation signal from the sequence controller (2), and (5) is a transmission coil that is driven by the high-frequency transmitter (4) and outputs a predetermined high-frequency pulse. , These constitute high frequency transmitting means. Reference numeral (7) is a high frequency receiver for outputting an NMR signal from the receiving coil (19) to the sequence control device (2), and constitutes a high frequency receiving means together with the receiving coil (19).

(8) is a gradient magnetic field power supply, and is composed of three gradient magnetic field power supplies (8a) to (8c) corresponding to the respective orthogonal axes X, Y, and Z directions. (9) is driven by the gradient magnetic field power supply (8),
A gradient magnetic field coil for appropriately generating a gradient magnetic field in the X, Y, and Z directions, and constitutes a gradient magnetic field generating means together with the gradient magnetic field power source (8).

(10) is an operation console for inputting desired data to the computer (3). Reference numeral (11) is an impedance matching device inserted between the high frequency transmitter (4) and the transmission coil (5) and constitutes a transmission probe together with the transmission coil (5).

Reference numeral (13) is a subject such as a human body inserted into the magnet (1), the transmission coil (5) and the gradient magnetic field coil (9), and the static magnetic field is stored according to a predetermined sequence stored in the computer (3). A gradient magnetic field and a high frequency pulse are applied.

Reference numeral (15) is an irradiation optical fiber for laser light irradiation, which is provided so as to penetrate the tip of the laser light carrier (24), that is, the central portion of the laser probe (25). (16) is an illumination optical fiber for observing the treated area, and is arranged around the irradiation optical fiber (15). Reference numeral (17) is a light-receiving fiber for receiving the reflected light from the treated area and observing the treated area, and is arranged around the irradiation optical fiber (15) together with the illumination optical fiber (16). Cages and endoscopes (31)
(See FIG. 6). (18) is the subject (1
This is the tissue to be treated in 3).

Reference numeral (19) is a small loop-shaped receiving coil called a surface coil, which is configured integrally with the laser probe (25) to receive an NMR signal from the treated area. Reference numeral (20) is a resonance and impedance matching circuit connected to the receiving coil (19) and constitutes a receiving probe together with the receiving coil (19). Reference numeral (21) is a coaxial cable for signal transmission, which is connected to the resonance and impedance matching circuit (20). The coaxial cable (21) penetrates the laser beam carrier (24) from the end of the laser probe (25) and is connected to the high frequency receiver (7).

Next, the operation of the laser treatment apparatus according to the present invention configured as described above will be described with reference to the flowchart of FIG.

First, the subject (13) is placed in the magnet (1), the transmission coil (5) and the gradient magnetic field coil (9), and the laser is positioned as shown in FIG. 1 while positioning using the endoscope (31). The probe (25) and the receiving probe are inserted from the mouth of the subject (13) into the treatment site inside the body cavity (for example, stomach). Alternatively, the second
As shown in the figure, the laser probe (25) is positioned so that the surface of the subject (13) is irradiated with laser light. When only the body surface is treated as shown in FIG. 2, an endoscope is not particularly required, and as shown in FIG. 4, a laser beam carrier (2
4) can be composed of a non-metal manipulator (14) having a plurality of joints (14a) to (14c). In this case, each of the joints (14a) to (14c) is provided with a reflecting mirror for carrying laser light.

As shown in Fig. 1, the laser probe (2
The light from the tip of 5) is emitted through the optical fiber for illumination (16), and the reflected light is the optical fiber for reception (17).
The light is received via (see FIG. 3). By observing this reflected light with the endoscope (31), the operator confirms the treated area.

In this way, the laser probe (2
After performing the positioning of 5), a static magnetic field and a gradient magnetic field are applied to the subject (13) to remove the nuclear spins in the subject (13).
Apply a high-frequency pulse of 90 ° or 180 ° to tilt 90 ° or 180 ° as appropriate, and use the receiving coil (19) to
Receive NMR signals.

That is, the sequence control device (2) applies a high-frequency pulse to the subject (13) and a rectangular wave-shaped current to the gradient magnetic field coil (9) to emit the NMR emitted from the subject (13). Signal sampling, averaging, control of gradient magnetic field, etc. are performed in a programmable manner.

Normally, this measurement sequence is set up in the computer (3),
The data is sent to the sequence controller (2). The sequence control device (2) decodes this data, that is, the command, outputs the necessary signals to the high frequency transmitter (4) and the gradient magnetic field power supply (8), and at the same time, from the subject (13) through the receiving coil (19). The input NMR signal is sampled.

A high frequency transmitter (4) modulates an oscillator output oscillating at a resonance frequency according to a modulation signal from a sequence control device (2) and then power-amplifies it to obtain an impedance matching device (11).
To the transmitting coil (5). On the other hand, the NMR signal obtained from the receiving coil (19) is input to the high frequency receiver (7).

In the high frequency receiver (7), the phase sensitive detector (Phas
The NMR signal is quadrature detected by the e Sensitive Detector), two signals having a bandwidth of 10 to 30 kHz are sent to the sequence controller (2), and then converted into a digital quantity. The operation is performed through the entire console (10) including the computer (3).

The computer (3) as the NMR signal measuring means receives the received N
NMR image of protons in the treated area based on MR signals,
At least one of the proton NMR spectrum and the phosphorus NMR spectrum is measured (step S1).

This step S1 is not necessary when the treatment site is macroscopically apparent, such as in the treatment of bleeding, but for determining the treatment site when removing a tumor inside the tissue (18). Will be needed.

Incidentally, it is a known fact that blood flow can be measured by an NMR image of protons, as described in, for example, JP-A-61-119253. Further, the relaxation time of the proton NMR signal is different between the tumor tissue and the normal tissue, and that the phosphorous NMR spectrum changes depending on the tumor part, as described in, for example, JP-A-61-56154. This is a known fact.

In this way, after the treatment site is reconfirmed based on the measurement of the NMR signal, laser treatment is performed while irradiating the treated portion with laser light by the laser treatment means (step S2).

Even during or after the laser light irradiation, the metabolic state and blood circulation state of the treated area are sequentially monitored using the NMR signal as in step S1 (step S3).

That is, the irradiation of laser light is intermittently interrupted to acquire an NMR signal, and for the purpose of, for example, hemostasis, it is confirmed whether or not bleeding in the tissue (18) of the treated area has stopped. Further, in the case of treating a tumor, it is confirmed whether or not the tumor has disappeared by irradiation with laser light.

Then, it is determined whether or not the laser treatment is sufficient based on the measurement result of the NMR signal in step S3 (step S4).

If it is determined that the laser treatment (irradiation amount of laser light) is not sufficient, the computer (3) drives the laser oscillator (23) via the sequence control device (2) to perform the laser treatment again. (Step S5).

That is, feedback control is performed on the laser treatment means, and the loop of steps S3 and S4 is repeated. On the other hand, if it is determined in step S4 that the laser beam irradiation is sufficient, the laser treatment is ended.

In the above example, as feedback control of the irradiation constant of the laser light, the case of extending the irradiation time of the laser light in step S5 has been described, but based on the measured NMR signal, the wavelength of the laser light in real time. Alternatively, the irradiation intensity may be determined.

Also, as the laser treatment period, the NMR signal was measured before, during and after the irradiation of the laser beam, but the NMR signal was measured only in any period and the laser beam irradiation constant was determined based on the result. May be.

[Effects of the Invention] As described above, according to the present invention, a laser treatment means for irradiating a laser beam to a treated area and an NMR from the treated area.
An NMR signal measuring unit for measuring a signal and a feedback control unit for controlling the laser treatment unit based on the NMR signal are provided, and the NMR signal from the treated region is measured during the laser treatment period, and based on the measurement result. Since the irradiation constant of the laser light with which the treated area is irradiated is determined, there is an effect that a laser treatment apparatus capable of performing necessary and sufficient laser treatment can be obtained without causing excess or deficiency of the laser light irradiation.

[Brief description of drawings]

FIG. 1 is a block diagram showing an embodiment of the laser treatment apparatus according to the present invention, FIG. 2 is a side view showing the periphery of the subject in FIG. 1, and FIG. 3 is a laser probe in FIG. FIG. 4 is an enlarged perspective view, FIG. 4 is a side view showing another embodiment of the laser beam carrier in FIG. 2, FIG. 5 is a flow chart showing the operation of the laser treatment apparatus according to the present invention, and FIG. It is a block diagram which shows a laser therapy apparatus. (1) ...... Magnet (2) ...... Sequence control device (3) ...... Computer, (5) ...... Transmitting coil (7) ...... High frequency receiver, (9) ...... Gradient magnetic field coil (13) ...... Subject, (14) …… Manipulator (15) …… Irradiation optical fiber (16) …… Illumination optical fiber (17) …… Receiving optical fiber (19) …… Receiving coil, (23) …… Laser Oscillator (24) …… Laser beam carrier, (25) …… Laser probe S1, S3 …… Step for measuring NMR signal S2 …… Step for irradiating laser beam S4 …… Step for determining laser treatment S5 …… Step of extending irradiation time of laser light In the drawings, the same reference numerals indicate the same or corresponding portions.

Claims (11)

[Claims] 1. A laser treatment means for irradiating a treatment area of a subject with a laser beam, an NMR signal measuring means for measuring an NMR signal from the treatment area, and the laser treatment based on the NMR signal. A laser treatment device comprising feedback control means for controlling the means. 2. The laser treatment means includes a laser oscillator that emits a laser beam, and a laser beam carrier that guides the laser beam.
The laser treatment apparatus according to claim 1, further comprising: a laser probe that irradiates the treated area with the laser light. 3. The laser treatment apparatus according to claim 2, wherein the laser beam carrier is an optical fiber. 4. The laser treatment apparatus according to claim 3, wherein the laser beam carrier is provided with an endoscope for observing the treated area. 5. The laser treatment apparatus according to claim 2, wherein the laser beam carrier is a manipulator having at least one joint having a reflecting mirror. 6. The NMR signal measuring means comprises a static magnetic field generating means for accommodating a subject, a gradient magnetic field generating means and a high frequency transmitting means, and a high frequency receiving means for receiving an NMR signal from a treated region. The laser treatment apparatus according to any one of claims 1 to 5, which is characterized. 7. The high frequency receiving means comprises a receiving probe having a receiving coil composed of a surface coil, and the receiving probe is integrally formed with a laser probe for irradiating a laser beam. The laser treatment apparatus according to claim 6. 8. The NMR signal measuring means measures the NMR signal from the treated area during the laser treatment period, and the feedback control means and the laser treatment means irradiate the treated area with the laser based on the measurement result. The laser treatment apparatus according to any one of claims 1 to 7, which determines an irradiation constant of light. 9. The laser treatment apparatus according to claim 8, wherein the laser treatment period includes at least before laser treatment, during laser treatment, or after laser treatment. 10. The NMR signal measuring means measures at least a proton NMR image, a proton NMR spectrum or a phosphorus NMR spectrum of the treated area based on the NMR signal. Item 9. A laser treatment apparatus according to Item 9. 11. The laser treatment apparatus according to claim 8, wherein the irradiation constant of the laser beam includes at least wavelength, intensity or irradiation time.