JPH07178111A - Ultrasonic therapy equipment - Google Patents

Abstract

(57) [Abstract] [Purpose] To facilitate diagnosis of a treatment site by X-rays during positioning and treatment, improve positioning accuracy, and reduce the installation area of the entire apparatus. [Structure] The support column 2 as a moving means is rotated so that the X-ray system 1 is located at the center of the treatment bed as the first position where the treatment region of the patient can be imaged, and X-ray fluoroscopy is performed from the vertical direction. . Then, the column 2 is horizontally rotated so that the stone image as the treatment site is located at the center of the image, the X-ray U arm 1c is seen through with an inclination of 30 °, and the stone image is located at the center of the image. 1c is moved up and down. Then, the height of the X-ray U arm 1c as position data is stored in the storage means 5, and the support column 2 is rotated by 90 °. Then, the therapeutic applicator 3 is placed on the patient as the subject, the X-ray system 1 is moved to the position as the second position, and the therapeutic applicator 3 is stored in the storage means 5. Moved to height.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic therapeutic apparatus with high positioning accuracy.

[0002]

2. Description of the Related Art Conventionally, continuous wave heat for transmitting an ultrasonic wave to a treatment object such as a cancer tissue or a stone so as to focus the ultrasonic wave on the treatment object and treating the treatment object by a thermal effect or a shock wave effect. There are ultrasonic treatment devices such as treatment devices or shock wave lithotripters. Ultrasonic waves and X-rays have been used to position the treatment site of the treatment object. Focusing on the positioning by X-rays, X as a medical image capturing apparatus
There are several types according to the arrangement of the line system. Of these, the X-ray system spatially separated from the therapeutic treatment applicator makes it easy to take an optimal passage path for both the therapeutic treatment applicator and the positioning X-ray, and a general-purpose X-ray system can be used. It has the feature.

FIG. 17 is a front view showing an example of a conventional ultrasonic therapeutic apparatus, FIG. 18 is a side view thereof, and FIG. 19 is a constitutional view showing a therapeutic applicator. In each of these drawings, the therapeutic applicator 3 has a water bag 3b on the side that is in close contact with a patient as a subject (not shown), and inside the water bag 3b, an ultrasonic wave is generated at the center of an oscillator 3c for observation. The ultrasonic probe 3a is installed. The vibrator 3c is connected to the drive circuit 192, receives an electric signal, and converts it into an ultrasonic wave. The ultrasonic probe 3a is the ultrasonic diagnostic apparatus 1
Through 91, positioning of a treatment site and observation during treatment are performed, and an ultrasonic image thereof is displayed on a monitor (not shown). The therapeutic applicator 3 is supported by a pedestal 71 having 7 axes, and the ultrasonic therapeutic focus can be moved to an arbitrary position on the therapeutic bed 4 having a moving function in up, down, left and right directions. There is. In the X-ray system 1 as a medical image capturing apparatus, the relative position of the therapeutic applicator 3 with respect to the gantry 71 is fixed, and the storage means 5 is used.
According to the above memory, the moving mechanism of the therapeutic bed 4 is located at a position where the treatment site in the subject on the therapeutic bed 4 can be moved into the irradiation field. C-shaped C-shaped arm 1i
The X-ray generation source 1b and the image intensifier (II) 1a attached to both ends of the C-arm 1i are rotatable in the direction of the arrow with the base of the C-arm 1i as the axis 1j.
The X-ray image received by the image intensifier 1a is displayed on a monitor (not shown) as shown in FIG. Figure 20
In, the marker M indicates the central axis of the X-ray system 1 and is displayed on the screen.

A procedure for matching an arbitrary target with the treatment site (positioning of the treatment site) by the X-ray system 1 will be described below. FIG. 21 is an explanatory diagram of the operation. (I)
The C-shaped arm 1i is made vertical and the treatment bed 4 is moved to bring the treatment site into the X-ray irradiation field (the treatment site is brought to the point A). (B) By moving the treatment bed 4 forward, backward, leftward, and rightward (in the long axis direction of the bed), the treatment site is brought on the marker M indicating the central axis of the X-ray system 1 (the treatment site is brought to the point B). . (C) Set the C-shaped arm 1i to θ
[Rad] Tilt. (D) Bring the treatment site on the marker M indicating the central axis of the X-ray system 1 by moving the treatment bed 4 in the longitudinal direction of the bed by an arbitrary value y (hold the treatment site at the point P). come). The position data, that is, the point P where the treatment site is installed by the operations of (A) to (D) is on the central axis straight line OP of the X-ray system 1. This central axis and C
The intersection point O of the shaped arm 1i with the base axis 1j is known, and with this as a reference, the coordinates of the point P are (y, yco
tθ). The coordinates are stored by the storage means 5. Since the gantry 71 of the therapeutic applicator 3 and the X-ray system 1 are spatially fixed, the X-ray system 1
The coordinates of the treatment site recognized by are also recognized in the gantry 71 by the storage unit 5. Therefore, (e) By moving the treatment bed 4 back and forth, the treatment site is brought to the treatment position.
(F) The treatment applicator 3 is moved to match the treatment site with the treatment focus. Thus, when the positioning of the treatment site is completed, the treatment is started. Then, in the treatment stage, the treatment is observed by the ultrasonic probe 3a in place of the X-ray system 1 which is away from the treatment position.
The deviation between the treatment site and the treatment focus is adjusted at any time.

FIG. 22 is an operation explanatory view showing a current ultrasonic treatment apparatus of ESL-500A. In the figure, the X-ray system 1 as a medical image capturing apparatus and the treatment applicator 3 are spatially separated. A treatment site exists inside the patient 51 as the subject, and the patient 51 is placed on the treatment bed 4. In these configurations, the treatment bed 4 is slid during positioning and treatment.

As a device different from the above-mentioned device,
Although not shown, there is a device having an ultrasonic probe 3a and an X-ray system 1 on the therapeutic applicator 3 offset from its axis, as in US Pat. In the case of this apparatus, when the X-ray system 1 is used, a gas balloon is inflated in the water bag 3b to create a path where X-rays are not attenuated.

[0007]

In the conventional system, X
Since the line system 1 is located away from the treatment position, the patient 51 may move while the treatment bed 4 is being slid, so that the final positioning confirmation must rely on the in-line probe. In terms of patient psychology, it is difficult to stay still on the moving therapeutic bed 4. For this reason, there is a limit to the accuracy of positioning using only X-rays. Moreover, in order to slide the therapeutic bed 4, a large area corresponding to the movable part range is required. Moreover, the appearance of stones during treatment cannot be observed. As a method for realizing monitoring during treatment with X-rays, there is a method of arranging the X-ray system with an angular offset centered on the shock wave focus.
However, since the size of the treatment applicator 3 is larger than other methods, a large shadow of the treatment applicator 3 appears in the X-ray image, and it is difficult to diagnose the treatment site by X-rays during positioning and treatment. Therefore, a method of incorporating the X-ray generation source 1b into the treatment applicator 3 must be adopted. At this time, since the shock wave uses water as a medium, the treatment applicator 3 is filled with water, but the X-rays are attenuated by the water, so that the X-ray passing region is secured by the treatment wave. In addition to the complicated structure of the applicator 3, the applicator is further increased in size in order to maintain the output of the shock wave.

The present invention has been made in view of such a situation, and an object thereof is to show the following. (A) It is possible to shift from positioning to treatment without moving the treatment bed 4 on which the patient is placed. (B) During treatment, the state of the treatment site can be observed by X-ray without lowering the treatment efficiency, and positioning by X-ray can be facilitated without interrupting the treatment. (D) The treatment applicator 3 and the X-ray system 1 can be positioned from above or below the patient. (E) To improve the positioning accuracy. (F) The installation area of the entire device is reduced. (G) The shadow of the therapeutic applicator 3 does not largely appear in the X-ray image, so that the treatment site can be easily diagnosed by X-rays during positioning and treatment. (H) X
The line source 1b is provided outside the treatment applicator 3 to simplify and miniaturize the structure of the treatment applicator 3. (Re) X
The combined use of X-rays and ultrasonic waves makes it possible to reduce the required dose of X-rays.

[0009]

An ultrasonic therapeutic apparatus according to claim 1 is a medical image capturing apparatus (X-ray system 1) placed at a first position capable of capturing an image of a treated region of a subject, and the same. Means for obtaining and storing position data of the treatment site imaged by the medical image capturing apparatus (X-ray system 1), treatment applicator 3 for performing treatment by irradiating the treatment site with ultrasonic waves, and After the position data is stored, the medical image capturing apparatus (X-ray system 1) is moved to a second position different from the first position, and the therapeutic applicator 3 is located near the first position. It is characterized in that it is provided with a moving means (support 2) for moving to.

The ultrasonic therapy apparatus according to the second aspect is arranged so as to sandwich the subject (patient 51), and the X-ray tube (X-ray source 1b) and the image intensifier 1a are mounted so as to face each other. A first C-shaped arm 31 and a second C-shaped arm 32 which is arranged so as to sandwich the subject (patient 51) and to which the therapeutic applicator 3 is attached,
The first C-arm 31 and the second C-arm 32 are supported on the same axis.

In the ultrasonic treatment apparatus according to the third aspect, the treatment applicator 3 and the X-ray imaging apparatus (X-ray system 1) are supported by the same arm (C-shaped arm 1d), and the subject (patient 51). ) Within the range that can be detected by the image intensifier 1a,
The treatment applicator 3 is arranged so that the treatment focus F is located.

An ultrasonic therapy apparatus according to a fourth aspect is an X-ray imaging apparatus (X-ray system 1) and a therapeutic applicator 3.
Is characterized by the following. (A) X-ray tube (X-ray generation source 1b) and image intensifier 1a have different arcuate arms (C-shaped arms 1g and 1h).
Be supported by. (B) The therapeutic applicator 3 is supported by either of the two arms (C-shaped arms 1g, 1h). (C) Both arms (C-shaped arms 1g and 1h) have the same shafts 71a and 71b.
To rotate independently and in synchronization with each other.
(D) At least one of the two arms (C-shaped arms 1g and 1h) should rotate along the arc of the arm. (E) The shafts 71a and 71b should pass through the therapeutic focus. (F) X irradiated on the subject (patient 51)
The therapeutic applicator 3 is arranged such that the therapeutic focus F is located within a range in which a line can be detected by the image intensifier 1a.

[0013]

In the present invention configured as described above, the moving means is arranged so that the medical image radiographing apparatus (X-ray system 1) is located at the center of the therapeutic bed as the first position capable of radiographing the treatment site of the subject. It is rotated by (post 2). X from vertical
Fluoroscopic is performed so that the treatment site is located in the center of the image.
Move the arm horizontally. Next, move the U arm 30 °
Fluoroscopy is performed in the rotated state, and the U arm is moved in the vertical direction so that the treatment site is located in the center of the image. The height of the X-ray U arm 1c is stored in the storage means 5. Next, the medical image capturing apparatus (X-ray system 1) is rotated by 90 °, the therapeutic applicator 3 is placed on the subject, and the medical image capturing apparatus (X-ray system 1) is moved to the first position. Is moved to a second position different from. Next, the therapeutic applicator 3 is moved to the height stored in the storage means 5.
Further, in order to change the irradiation direction of the shock wave from the therapeutic applicator 3, two axes intersecting at a certain point O (axis α and axis β)
The therapeutic applicator 3 is rotated about the center axis.
Further, the treatment applicator 3 is moved along the central axis of the shock wave (axis γ passing through a certain point O), and the treatment focus F and the point O are aligned with each other or separated from each other. And X
X-ray system (X-ray system 1) and therapeutic applicator 3
And are rotated independently of each other. An X-ray tube (X-ray generation source 1b) of an X-ray imaging apparatus (X-ray system 1) is fixed to the side of the water bag 3b of the therapeutic applicator 3.
Further, both arms (C-shaped arms 1g and 1h) are rotated in opposite directions about the shaft 71a and are respectively replaced below or above the therapeutic bed 4.

Therefore, it is possible to shift from positioning to treatment without moving the treatment bed on which the patient is placed. In addition, the treatment site can be observed during treatment. Further, it is possible to switch the treatment direction up and down. As a result, the positioning accuracy can be improved. In addition, the installation area of the entire device can be reduced. It is also possible to facilitate X-ray positioning without interrupting the treatment. In addition, the shadow of the therapeutic applicator 3 does not largely appear on the X-ray image, and the diagnosis of the treatment site by the X-ray during positioning and treatment can be easily performed. Moreover, the structure is simplified.

[0015]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT A preferred embodiment of the present invention will be described below with reference to the drawings.

Example 1. FIG. 1 is a perspective view showing the ultrasonic therapeutic apparatus of the first embodiment. In this description, a shock wave calculus breaking device will be described as an example of the ultrasonic treatment device. In the figure, an X-ray U arm 1c supporting an X-ray system 1 placed at a first position in a direction different from the therapeutic applicator 3 by 90 ° is attached to a column 2 supporting the therapeutic applicator 3. ing. At this time, the central axis of the therapeutic applicator and the central axis of the X-ray system are arranged so as to be present on a concentric cylindrical surface with the column 2 as the central axis. Then, the therapeutic bed is arranged beside the column.
The X-ray system 1 is composed of an X-ray generation source 1b that emits X-rays and an image intensifier 1a that faces the X-ray generation source 1b. A treatment bed 4 on which a subject (not shown) is placed is installed directly below the treatment applicator 3, and the treatment bed 4 is supported by a support 4a.
Further, the storage means 5 stores the position data of the treatment site.

Next, the operation will be described. 2A and 2B are explanatory views of the operation of FIG. 1, where FIG. 2A shows the positioning and FIG. 2B shows the treatment. In FIG. 7A, the same symbols as those shown in FIG. 1 are the same elements, and their explanations are omitted. X
The line system 1 ′ shows the position when the X-ray system 1 is tilted by 30 °. At that time, the X-ray source 1b ′ and the image intensifier 1a ′ are respectively tilted by 30 ° together with the X-ray system 1 ′. In the same figure (B), the therapeutic applicator 3 and the image intensifier 1a are at positions rotated by 90 ° with respect to (A). As shown in the figure, when the X-ray positioning is performed, the position of the X-ray system 1 and the X-ray U are aligned so that the center of rotation of the X-ray system 1 coincides with the calculus position as the treatment site of the subject (not shown).
Match the height of the arm 1c. The positioning procedure is shown below. (A) The support 2 as a moving unit is rotated so that the X-ray system 1 is located at the center of the treatment bed which is the first position where the treatment region of the patient can be imaged. (B) X from the vertical direction
Fluoroscopic observation is performed, and the column 2 is horizontally rotated so that the stone image as the treatment site is located at the center of the image. (C) The X-ray U arm 1c is seen through with an inclination of 30 °, and the X-ray U arm 1c is moved up and down so that the stone image is located at the center of the image. (At this time, the height of the X-ray U arm 1c as position data is stored in the storage means 5) (d) The support column 2 is rotated by 90 °,
The therapeutic applicator 3 is brought onto the subject, and the X-ray system 1 is moved to the position shown in FIG. 2B as the second position. (E) The therapeutic applicator 3 is moved to the height stored in the storage means 5. The positioning is completed by the above procedure.

As can be seen from the above description, according to the first embodiment, it is possible to shift from positioning to treatment without moving the treatment bed on which the patient is placed. Therefore, the positioning accuracy can be improved. In addition, the installation area of the entire device can be reduced. At this time, if an ultrasonic probe (not shown) is installed in the medical treatment applicator 3, positioning can be performed with higher accuracy.

In the first embodiment, the position of the X-ray system 1 is moved, but conversely, the treatment bed 4 may be moved vertically and horizontally for alignment. Even in this case, the treatment bed 4
Since the slide amount is smaller than the conventional one, it does not affect the increase of the installation area of the device.

In the first embodiment, one column 2 supports the X-ray system 1 and the treatment applicator 3, and the rotation of the column 2 switches between positioning and treatment. Positioning and treatment may be switched by rotating the line system 1 separately and rotating the line system 1. Moreover, it is not switching by rotation, but the applicator 3 for treatment.
Positioning and treatment may be switched by translating the X-ray system 1 and the X-ray system 1.

Example 2. FIG. 3 is a perspective view showing a second embodiment,
4 is a conceptual diagram showing the therapeutic applicator of FIG. 3, and FIG. 5 is an explanatory diagram of the operation of FIG. In each of these figures, the axis α, the axis β, and the axis γ pass through a point O. Further, the X-ray system 1 as an X-ray imaging apparatus is supported by a C-shaped arm 31 as a first C-shaped arm, and the therapeutic applicator 3 is supported by a C-shaped arm 32 as a second C-shaped arm. ing. Then, the therapeutic applicator 3 can be rotated about the axis α and the axis β. Further, the therapeutic applicator 3 can be slid along the axis γ. The X-ray system 1 can also be rotated about the axes α and β. Further, the therapeutic bed 4 can be slid along the axes X, Y and Z which are orthogonal to each other. The axis γ coincides with the shock wave axis and passes through the therapeutic focus F. The therapeutic applicator 3 is composed of a water bag 3b and an ultrasonic probe 3a. X as an X-ray tube
The line source 1b and the image intensifier 1a are X
They are facing each other on the line axis δ. A patient 51 as a subject is placed on the treatment bed 4. The same reference numerals as those in the first embodiment are the same elements, and the description thereof will be omitted.

Next, the operation will be described. After the treatment site is positioned at the point O, the treatment applicator 3 is moved along the axis γ to make the treatment focus F coincide with the point O and perform the treatment. When locating the treatment site at the point O while observing the treatment site of the patient 51 with the X-ray system 1, after moving the treatment applicator 3 along the axis γ to move the treatment focus F away from the point O, By rotating the X-ray axis δ of the X-ray system 1 around the treatment site, the treatment applicator 3 does not enter the X-ray passage region, and a wide X-ray field can be obtained. This improves operability. In order to change the irradiation direction of the shock wave from the therapeutic applicator 3, the therapeutic applicator 3 can be rotated about two axes (axis α and axis β) intersecting at a certain point O as a central axis. Furthermore, the central axis of the shock wave (at a certain point O
The treatment applicator 3 can be moved along the axis γ) passing through to make the treatment focus F and the point O coincide with each other or move away from each other. By doing so, the treatment site can be observed while the treatment is being performed. The X-ray generation source 1b can be rotated about the axis α so that the X-ray axis δ passes through the point O and the perspective direction of the X-ray can be changed. In addition,
The X-ray system 1 and the therapeutic applicator 3 rotate independently of each other. Further, the operation will be described in detail with reference to FIG. In (A), the therapeutic applicator 3 is retracted upward and tilted toward the foot side (−30 °). The X-ray is seen through vertically and positioned in the horizontal direction. In (B), the X-ray generation source 1b is tilted toward the head side (30 °), is seen through obliquely, and is positioned in the vertical direction. In (C), after the therapeutic applicator 3 is brought into close contact with the body surface of the patient 51 from above, fine adjustment and angling are performed while observing an in-line US image (not shown).

FIG. 6 is an explanatory view of the follow-up observation with X-ray.
In the same figure, (A) shows the case where the angle formed by the X-ray axis δ and the shock wave axis (axis γ) can be 50 ° or more, and although the X-ray image has a shadow of the therapeutic applicator 3, the therapeutic applicator 3 It is possible to observe the treatment site at the treatment focus F while keeping 3 in close contact with the body surface of the patient 51. That is,
Observation while irradiating with shock waves is possible. (B) is X
The case where the angle formed by the line axis δ and the shock wave axis (axis γ) is 50 ° or less (not more than 50 °) is shown, and the treatment applicator 3 ′ is retracted to the position of the treatment applicator 3 above. Make an X-ray path. That is, in this case, treatment must be interrupted in order to observe with X-rays.

As is clear from the above description, according to the second embodiment, the state of the treatment site can be observed by X-ray during the treatment without lowering the treatment efficiency and without interrupting the treatment. It is possible to facilitate positioning with X-rays. Moreover, the positioning accuracy can be improved, and the treatment site can be easily diagnosed by X-rays during positioning and treatment without the shadow of the treatment applicator 3 appearing largely on the X-ray image.

Example 3. FIG. 7 is a front view showing the third embodiment,
FIG. 8 is a side view thereof. In each of these drawings, the configuration of the therapeutic applicator 3 is the same as that of the conventional example, and the description thereof is omitted. The X-ray generation source 1b of the X-ray system 1 is fixed to the side of the water bag 3b of the therapeutic applicator 3. In the case of the present embodiment, the therapeutic applicator 3 has a pedestal 71.
Is attached to one end of a C-shaped arm 1d supported by
An image intensifier (II) 1a of the X-ray system 1 is attached to the other end of the shaped arm 1d. As for the positional relationship between the treatment applicator 3 and the C-shaped arm 1d, the treatment focus F of the treatment applicator 3 is located on the rotation shaft 71a of the C-shaped arm 1d, as shown in FIGS. It is like this. The therapeutic bed 4 has a function of moving up, down, left and right. The X-ray image received by the image intensifier 1a is displayed on a monitor (not shown).

FIG. 9 is a block diagram of the essential parts of this embodiment. As shown in FIG. 9, the positional relationship between the therapeutic applicator 3 and the image intensifier 1a is such that the X-rays emitted from the X-ray generation source 1b on the therapeutic applicator 3 are received by the image intensifier 1a. The surface 1e has such a positional relationship as to be received. Then, a straight extension line 91 passing through the X-ray point source 1f and the therapeutic focus F of the therapeutic applicator 3 reaches the light receiving surface 1e of the image intensifier 1a. The extension line 91 and the X-ray axis δ coincide with each other.

Next, the operation will be described. Figure 10
Is an explanatory diagram of the operation. A procedure for positioning a treatment site by the X-ray system 1 will be described below.
(A) The C-shaped arm 1d is made vertical, and the treatment bed 4 is moved back and forth and left and right to bring the treatment site on the marker indicating the central axis of the X-ray system 1 (hold the treatment site at the point B ′). come). (B) The C-shaped arm 1d is tilted by an appropriate angle θ. (C) By moving the treatment bed 4 up and down, the treatment site is brought on the marker indicating the central axis of the X-ray system 1 (the treatment site is brought to the point O ′).

In this way, the point O'where the treatment site is installed is the treatment focus F of the treatment applicator 3, so positioning is completed and treatment is started. At the treatment stage, the treatment region is observed by the X-ray system 1 and the ultrasonic probe 3a, and the displacement between the treatment region and the treatment focus F is adjusted as needed.

By moving the treatment bed 4 and rotating the C-shaped arm 1d by 180 degrees, the treatment direction can be switched up and down.

As is clear from the above description, according to the third embodiment, the same effects as those of the first and second embodiments can be obtained and the structure is simplified.

FIG. 11 is a block diagram of the essential parts showing a modification of the third embodiment, and FIG. 12 is its monitor screen. In FIG. 8, an extension line 91 of a straight line connecting the X-ray point source 1f and the treatment focus F of the treatment applicator 3 reaches the center on the light receiving surface 1e of the image intensifier 1a. If it reaches the light receiving surface of the image intensifier 1a, it may reach other than the center (X-ray axis δ) on the light receiving surface 1e as shown in FIG. In this case, the image on the light receiving surface 1e of the image intensifier 1a is displayed at a position where the marker M indicating the therapeutic focus F of the therapeutic applicator 3 is deviated from the center, as shown in FIG. .

FIG. 13 is a main part configurational view showing still another modified embodiment. As shown in FIG. 13, by fixing the image intensifier 1a at a position deviated from the front (X-ray axis δ) of the X-ray generation source 1b, the extension line 91 is centered on the light receiving surface 1e of the image intensifier 1a. It is also possible to receive it. However, in order to prevent excessive leakage of X-rays, it is necessary to adjust the diaphragm so that the X-rays are irradiated only onto the light receiving surface 1e of the image intensifier 1a.

In this embodiment, the X-ray source 1b of the X-ray system 1 is provided beside the water bag 3b of the therapeutic applicator 3.
Was fixed and the image intensifier 1a was present at the opposite position, but conversely, the image intensifier 1 was provided beside the water bag 3b of the therapeutic applicator 3.
Alternatively, a may be fixed, and the X-ray generation source 1b may be located at the opposite position.

Example 4. 14 is a front view showing the fourth embodiment, and FIG. 15 is a side view thereof. In each of these figures,
The same symbols as the symbols shown in the third embodiment are the same elements, and their explanations are omitted. An X-ray generation source 1b as an X-ray tube of an X-ray system 1 as an X-ray imaging apparatus is fixed beside the water bag 3b of the treatment applicator 3 and
Is attached to one end of the C-shaped arm 1g supported by the mount 71. However, in the case of the present embodiment, the C-shaped arm 1g has only an arc length of about 2/3 of the normal length. There is another C-shaped arm 1h attached to the same supporting position (corresponding to the therapeutic focus F) as the C-shaped arm 1g on the gantry 71, and the C-shaped arm 1h also has only an arc length of about 2/3 of the usual one. . The image intensifier 1a of the X-ray system 1 is attached to one end of the C-arm 1h. These two C-shaped arms 1g and 1h rotate independently of each other or in synchronization with two axes, that is, a shaft 71a extending horizontally from the supporting position and a long axis 71b of the therapeutic bed 4 as rotation axes. It is possible.
The positional relationship between the therapeutic applicator 3 and the image intensifier 1a during the synchronous rotation is the same as that in the third embodiment, and the X-rays emitted from the X-ray generation source 1b on the therapeutic applicator 3 are image intensifiers. 1a has a positional relationship that it receives. A straight extension line 91 connecting the X-ray point source 1f and the therapeutic focus F of the therapeutic applicator 3 reaches the light receiving surface 1e of the image intensifier 1a. Further, the positional relationship between the therapeutic applicator 3 and the C-shaped arm 1g is such that the therapeutic focus F of the therapeutic applicator 3 is located on the rotation shafts 71a and 71b of the C-shaped arm 1g. The therapeutic bed 4 has a function of moving up, down, left and right. The X-ray image received by the image intensifier 1a is displayed on a monitor (not shown). The procedure from the positioning of the treatment site to the treatment by the X-ray system 1 is the same as that of the third embodiment except that the both C-shaped arms 1g and 1h are kept in the synchronous rotation state.

In this embodiment, the up / down switching of the treatment direction is performed by the following procedure. FIG. 16 is an explanatory diagram showing up / down switching. (A) shows a state in which the therapeutic applicator 3 is located below the therapeutic bed 4,
(B) shows a state in which the therapeutic applicator 3 is located above the therapeutic bed 4. (A) Both C-shaped arms 1 above
Each of g and 1h has a support base 4a centered on the shaft 71a.
The therapeutic bed 4 is slid on the support table 4a to a position where the therapeutic bed 4 does not come into contact with the support table 4a so as to be rotated on the opposite side. (B) Rotate the both C-shaped arms 1g and 1h independently of each other about the axis 71b along the arc of the arm,
The X-ray generation source 1b and the image intensifier 1a are prevented from interfering with each other during rotational movement about the axis 71a. (C) The both C-shaped arms 1g and 1h are rotated about the shaft 71a to the positions where they are exchanged below or above the therapeutic bed 4, respectively.
(D) The X-ray source 1b and the image intensifier 1a are opposed to each other by rotating the C-shaped arms 1g and 1h around the axis 71b along the arc of each arm. (E) Both C-shaped arms 1g, 1h
Synchronize the rotation of each other.

As is clear from the above description, according to this embodiment, the same effect as that of the third embodiment can be obtained, and the installation area of the entire apparatus can be reduced.

[0037]

As described above, according to the present invention,
A first medical image capturing apparatus capable of capturing an image of a treatment region of a subject
, The X-ray fluoroscopy is performed from the vertical direction, and then the medical image capturing apparatus is rotated by 90 °.
While the therapeutic applicator is placed on the subject,
The medical image capturing apparatus is moved to a second position different from the first position. Further, the X-ray imaging apparatus and the therapeutic applicator are independently rotated about the same axis. Further, the treatment applicator and the X-ray imaging apparatus are fixed to the same arm. Further, since the X-ray tube and the image intensifier are respectively supported by different arms, it is possible to shift from positioning to treatment without moving the treatment bed on which the patient is placed. In addition, the treatment site can be observed during treatment. Further, it is possible to switch the treatment direction up and down.

As a result, the following effects can be obtained. (I)
It is possible to shift from positioning to treatment without moving the treatment bed on which the patient is placed. (B) During treatment, the state of the treatment site can be observed by X-ray without lowering the treatment efficiency, and positioning by X-ray can be facilitated without interrupting the treatment. (C) The therapeutic applicator and the X-ray imaging apparatus can be positioned from above or below the patient. (D) The positioning accuracy can be improved. (F) The installation area of the entire device can be reduced. (G) The shadow of the therapeutic applicator does not appear on the X-ray image,
It is possible to easily diagnose the treatment site by X-rays during positioning and treatment. (H) The structure of the medical treatment applicator can be simplified and miniaturized by providing the X-ray tube outside the medical treatment applicator. (I) The combined use of X-rays and ultrasonic waves can reduce the required X-ray irradiation dose.

[Brief description of drawings]

FIG. 1 is a perspective view showing a first embodiment of an ultrasonic therapeutic apparatus of the present invention.

2A and 2B are explanatory views of the operation of FIG. 1, in which FIG.
(B) shows the time of treatment.

FIG. 3 is a perspective view showing a second embodiment of the ultrasonic therapeutic apparatus of the present invention.

FIG. 4 is a conceptual diagram showing the therapeutic applicator of FIG.

5 is an explanatory diagram of the operation of FIG.

6 is an explanatory diagram of follow-up observation with X-rays in FIG.

FIG. 7 is a front view showing an embodiment 3 of the ultrasonic therapeutic apparatus of the present invention.

FIG. 8 is a side view of FIG. 7.

9 is a main part configuration diagram of FIG. 7. FIG.

10 is an explanatory diagram of the operation of FIG.

11 is a main part configuration diagram showing a modified example of FIG. 9. FIG.

12 is a monitor screen of FIG.

FIG. 13 is a main part configuration diagram showing still another modified example of FIG. 9;

FIG. 14 is a front view showing an embodiment 4 of the ultrasonic therapeutic apparatus of the present invention.

FIG. 15 is a side view of FIG.

FIG. 16 is an explanatory view showing switching between up and down in FIG. 14, (A) shows a state in which the treatment applicator 3 is positioned below the treatment bed 4, and (B) shows the treatment applicator 3; The state where it is located above the treatment bed 4 is shown.

FIG. 17 is a front view showing an example of a conventional ultrasonic therapy apparatus.

FIG. 18 is a side view of FIG.

FIG. 19 is a configuration diagram showing the therapeutic applicator of FIG. 17.

20 is a monitor screen in FIG.

21 is an explanatory diagram of the operation of FIG.

FIG. 22 is an operation explanatory view showing a conventional ultrasonic therapy apparatus of ESL-500A.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 X-ray system 1a Image intensifier 1b X-ray tube 1c X-ray U arm 2 Strut 3 Treatment applicator 4 Treatment bed 5 Storage means F Treatment focus α (β, γ, 71a, 71b, 1j) Axis 31 (32, 1g, 1h, 1i) C-shaped arm δ X-ray axis 51 Patient 191 Ultrasonic diagnostic device

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Yuji Yanagida 1385-1 Shimoishigami, Otawara-shi, Tochigi Stock company Toshiba Nasu factory (72) Inventor Hideki Kosaku 1385-1, Shimoishigami, Otawara-shi, Tochigi Company Toshiba Nasu Factory

Claims (4)

[Claims] 1. A medical image capturing apparatus placed at a first position capable of capturing an image of a treated region of a subject, and means for obtaining and storing position data of the treated region captured by the medical image capturing apparatus. , A therapeutic applicator for irradiating the treatment site with ultrasonic waves for treatment, and moving the medical image capturing apparatus to a second position different from the first position after the position data is stored. The ultrasonic treatment apparatus, further comprising: a moving unit that moves the treatment applicator to the vicinity of the first position. 2. A treatment area of a subject placed on a treatment bed is photographed by an X-ray photographing apparatus composed of an X-ray tube and an image intensifier, and the photographed image is used as a basis. In the ultrasonic treatment apparatus for performing ultrasonic treatment after setting the treatment focus of the treatment applicator to the treatment site, the X-ray tube and the image intensifier are arranged so as to sandwich the subject. First mounted relative to each other
C-shaped arm and a second C-shaped arm which is arranged so as to sandwich the subject and to which the therapeutic applicator is attached, wherein the first C-shaped arm and the second C-shaped arm are An ultrasonic therapy device characterized by being supported on the same axis. 3. An X-ray tube of an X-ray imaging apparatus is used to X-ray a subject.
Irradiating the subject with X-rays and detecting the X-rays transmitted through the subject by the image intensifier of the X-ray imaging device to detect the position of the treatment site in the subject and to treat the treatment site. In an ultrasonic therapy apparatus for performing therapeutic treatment by focusing on an applicator, the X-ray is applied to the subject by supporting the treatment applicator and the X-ray imaging apparatus by the same arm.
An ultrasonic therapeutic apparatus, wherein the therapeutic applicator is arranged so that the therapeutic focus is located within a range in which a line can be detected by the image intensifier. 4. An X-ray tube of an X-ray imaging apparatus is used to X-ray a subject.
Irradiates the subject with X-rays, detects the X-rays transmitted through the subject with an image intensifier, detects the position of the treatment site in the subject, and treats the treatment site with a therapeutic applicator. An ultrasonic treatment apparatus for performing a focused treatment, wherein the X-ray imaging apparatus and the treatment applicator are as follows. (A) The X-ray tube and the image intensifier are supported by different arcuate arms. (B) The therapeutic applicator is supported by either of the arms. (C) Both arms should rotate independently and in synchronization with each other about the same axis. (D) At least one of the two arms should rotate along the arc of the arm. (E) The axis should pass through the therapeutic focus. (F) The therapeutic applicator is arranged such that the therapeutic focus is located within a range in which the X-rays applied to the subject can be detected by the image intensifier. .