JPH0824268A - Shock wave treatment device and hyperthermia treatment device - Google Patents

Abstract

(57) [Abstract] [Purpose] Shock wave treatment device and hyperthermia treatment device capable of easily locating the focus of the shock wave (or intense ultrasonic wave) and the treatment object and irradiating the shock wave (or intense ultrasonic wave) based on the positioning To provide. A means 2 for obtaining a tomographic image of a subject based on a signal transmitted / received by an ultrasonic imaging probe, and a shock wave generating means 3 formed from at least two sets of transducer units for generating a shock wave at a predetermined focus. Display means 1 for displaying the tomographic image and a marker indicating the position of the focal point
4, marker moving means 1 for moving the marker displayed on the display means to a desired position, and changing delay information given to the transducer unit based on position information of the marker moved by the marker moving means. By virtue of this, the vibrator driving means 6 for electron-moving the focal point of the shock wave to a desired position is provided.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a shock wave treatment device for crushing and treating a treatment object such as a stone in the kidney or ureter, a cancer tissue, etc. by shock wave energy of an ultrasonic pulse, and a treatment object by a focused energy of strong ultrasonic waves. The present invention relates to a thermotherapy device for destructive treatment of objects.

[0002]

2. Description of the Related Art Some shock wave treatment devices use an ultrasonic vibrator as a shock wave generation source. Compared to underwater discharge type and electromagnetic induction type devices, this ultrasonic shock wave treatment device has no consumable elements in the shock wave source,
It has the feature that the device can be maintained at low running cost. In such a shock wave treatment apparatus using shock waves, the treatment object such as a calculus is located at a different position from the body surface of the human body, and therefore the focus of the shock wave is made to match the position of the treatment object (hereinafter, simply referred to as “positioning”). (Sometimes referred to)
There is a need. In addition to a method by a holding device that moves an applicator composed of a shock wave source, an imaging probe, and water propagating the shock wave for positioning the shock wave focus and an object to be treated, between the vibrator and the body surface. The following methods are used to adjust the distance and. One method is to increase or decrease the water in the applicator to adjust it, and the other method is to move it mechanically using an acoustic lens. However, in these methods, it takes time to focus the shock wave on the position of the treatment target.

In order to solve the above-mentioned problems, a shock wave treatment device for electronic scanning of a shock wave focus is known (Japanese Patent Laid-Open No. 1-136649). This shock wave treatment device electronically two-dimensionally changes the focus of the shock wave by delaying the ultrasonic wave transducer constituted by a ring-shaped concave transducer on the shock wave transmission surface of the applicator. However, the positioning method using this shock wave treatment device is described only to match the treatment object with the focus marker, and a specific means for matching the positions of the focus marker and the treatment object is described. Is not disclosed.

In addition, there is known a shock wave treatment device intended to enlarge the size of the focal area according to the size of the object to be treated (Japanese Patent Laid-Open No. 2-121647). here,
The “focal region” is a region where the pressure of the transmitted shock wave is equal to or more than half the peak pressure. In this shock wave treatment device, the shock wave transmitting surface of the applicator is formed in a concave shape by a plurality of groups of vibrators, and a delay circuit for controlling the generation timing of shock waves is used for each vibrator group. However, in this shock wave treatment device as well, as in the shock wave treatment device described above, no specific means for matching the positions of the focus marker and the treatment object is disclosed. The above problems have been described with respect to the shock wave treatment device, but the same applies to the thermotherapy device.

[0005]

As described above, in the conventional shock wave therapy device or hyperthermia therapy device, the focus point (hereinafter referred to as "focus point") of shock wave or intense ultrasonic wave (hereinafter simply referred to as "shock wave or the like"). , Which is referred to as “)”, is not specifically disclosed for a marker such as a shock wave, a marker for indicating the position of the focal point of the shock wave, a means for moving the marker, and a means for determining the position. . Therefore, it takes time to handle the shock wave therapy device or the hyperthermia therapy device,
As a result, there is a problem that it takes time to treat the subject.

The present invention has been made in view of the above circumstances, and provides a shock wave treatment apparatus and a thermotherapy apparatus which can easily position a focal point of a shock wave or the like and an object to be treated and irradiate the shock wave or the like based on the positioning. The purpose is to provide.

[0007]

The present invention has taken the following means in order to solve the above problems. The shock wave treatment apparatus or the thermotherapy apparatus of the present invention is formed by at least two sets of transducer units and means for obtaining a tomographic image of a subject based on a signal transmitted and received by an ultrasonic imaging probe, and a shock wave at a predetermined focus. Shock wave generating means or heat generating means (hereinafter simply referred to as "shock wave generating means")
And) display means for displaying the tomographic image and a marker indicating the position of the focal point, and marker moving means for moving the marker displayed on the display means to a desired position,
An oscillator driving unit that electronically moves the focus of the shock wave or the like to a desired position by changing delay information given to the oscillator unit based on position information of the marker moved by the marker moving unit.

Another shock wave treatment apparatus or hyperthermia treatment apparatus of the present invention comprises means for obtaining a first image of a subject from a first direction,
A means for obtaining a second image of the subject from a second direction different from the first direction; a shock wave etc. generating means for generating a shock wave etc. at a focus, the shock wave etc. being formed of at least two sets of transducer units; And a marker moving means for moving a marker indicating a focus such as a shock wave displayed on the second image to a desired position, and a delay given to the transducer unit based on position information of the marker moved by the marker moving means. A vibrator driving means for electronically moving the focal point of the shock wave or the like to a desired position by changing information is provided. In the shock wave treatment apparatus or the thermotherapy apparatus, at least one of the first image and the second image is X-rayed.
The image is a fluoroscopic image.

[0009]

As a result of taking the above-mentioned means, the following effects occur. According to the present invention, after attaching an applicator or a positioning device using an X-ray transmission image incorporating a shock wave generating means and an ultrasonic imaging probe to a subject, a focus marker is used as a treatment target without changing the amount of water inside. Match and
Since the position information of the focus marker is given to the shock wave etc. generating means as delay information to the vibrator driving means for driving the vibrator, positioning is simplified, and as a result, efficient treatment can be performed. Further, even if the focus and the treatment target are displaced from each other, repositioning can be easily performed.

Therefore, the shock wave treatment apparatus and the like of the present invention can be easily performed by changing the excitation timing of the vibrator, which is the shock wave generation means, and the focus of the shock waves generated from a plurality of vibrator groups can be obtained. Since the marker corresponding to the focus is displayed on the tomographic image or the X-ray transmission image, it can be electronically changed, and thus the positioning can be easily performed. In addition, since the marker position can be changed to a desired position, it is not necessary to mechanically move the applicator, and it is not necessary to increase or decrease water. Therefore, the treatment can be efficiently performed.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the shock wave treatment apparatus and the thermotherapy apparatus of the present invention will be described below with reference to the drawings. In the following examples, the thermotherapy device has the same configuration as the shock wave treatment device, and therefore the shock wave treatment device will be described.

FIG. 1 is a layout diagram showing a schematic configuration of a shock wave treatment apparatus according to an embodiment of the present invention. In this example, a concave shock wave treatment device will be described. The shock wave treatment apparatus of the present invention includes a system controller 1 that performs coordinated control of each unit, and an ultrasonic diagnostic apparatus 2 that displays an ultrasonic tomographic image of a subject P (not shown) together with a marker indicating a focal position of a shock wave on a display device. , An applicator 5 in which a shock wave source 3 and an ultrasonic imaging probe 4 are arranged in a water container
A vibrator drive device 6 for controlling the voltage applied to the piezoelectric element of the shock wave source 3, and a bed 7 on which the subject P is laid.

The applicator 5 comprises an ultrasonic imaging probe 4 arranged in the central portion of the water container and six sets of ring-shaped vibrators 3a to 3f as shown in FIG. Formed shock wave source 3. Further, the ring-shaped vibrators 3a to 3f have a structure in which piezoelectric elements are appropriately attached in a ring shape, for example, and each of the ring-shaped vibrators receives a voltage applied by the vibrator driving device 6 and is independent. Can be driven.

The ring-shaped vibrators 3a to 3f can change the focus position and the size of the focus by changing the excitation timing as shown in FIG. In FIG. 3, the arrow Z indicates the movable range of the focus of the shock wave in the depth direction. The control for changing the excitation timing of the ring-shaped vibrators 3a to 3f is performed by the vibrator drive device 6 under the system controller 1, and the focus position is
It changes from Z _{a to} Z _b .

FIG. 4 is a block diagram showing the circuit configuration of the shock wave therapy apparatus of the present invention. In addition to the configuration of FIG. 1, the shock wave treatment device has an operation console 8 for inputting / outputting from / to the outside (for example, an operator), and a focus marker controller 9 which is a feature of the present invention. This focus marker controller 9
It has a memory for storing the focal position, and outputs a signal for adjusting the position of the ultrasonic imaging probe 4 for positioning.

The vibrator driving device 6 includes the first to sixth pulsers 1
1a to 11f and first to sixth delay circuits 12a to 12f
A drive voltage control unit 13, a delay control unit 14, a pulser control unit 15, and a delay data storage system 16.

The first to sixth pulsers 11a to 11f apply pulse voltages to the piezoelectric elements (not shown) that excite the corresponding ring-shaped vibrators 3a to 3f, respectively. The first to sixth delay circuits 12a to 12f receive the control signal sent from the delay control unit 14 and adjust the drive timings of the first to sixth pulsers 11a to 11f, respectively.

The drive voltage control section 13 is based on the control data sent from the system controller 1 and is based on the first to sixth values.
It controls the pulse voltage of the pulsers 11a to 11f. The delay control unit 14 controls the first to sixth delay circuits 12a to 12f based on the command signal sent from the pulser control unit 15.

The pulsar controller 15 is based on signals from the system controller 1 and the delay data storage system 16
Control signals are output to the drive voltage control unit 13 and the delay control unit 14, respectively.

The delay data storage system 16 includes first to sixth pulsers 11a to 11f for switching the focal position of the shock wave.
A delay program for delaying the drive timing of is stored. The ultrasonic diagnostic apparatus 2 includes an applicator position controller 17, a probe position controller 18, an imaging pulser 19, a transmission circuit 20, and a multiplexer 2.
1, a receiving circuit 22, a signal processing circuit 23, an image memory 24, an image processing unit 25, and a display unit 26.

The applicator position controller 17 adjusts the position of the applicator on the subject P. The probe position controller 18 adjusts the probe position based on the signal from the focus marker controller.

The imaging pulser 19 generates an imaging pulse for obtaining an ultrasonic image. Transmission circuit 2
0 outputs the imaging pulse output from the imaging pulser 19 to the ultrasonic imaging probe 4.

The multiplexer 21 performs processing such as signal switching between transmission and reception. The receiving circuit 22 receives the signal output from the ultrasonic imaging probe 4.

The signal processing circuit 23 subjects the signal from the ultrasonic imaging probe 4 received by the receiving circuit 22 to predetermined processing to convert it into an image signal. The image memory 24
The image of the subject obtained by the ultrasonic imaging probe 4 is stored, and the focus position on the image is stored based on the signal from the focus marker controller 9.

The image processing unit 25 calls the image of the subject and the image showing the focus position stored in the image memory, performs a predetermined process, and outputs the image to the display unit 26. The display unit 26 displays the image of the subject and the image indicating the focus position output from the image processing unit 25.

The operation of the above-mentioned shock wave treatment device when performing fracture treatment will be described with reference to FIG. FIG. 5A is a diagram showing changes in the ultrasonic image when the applicator is rotated, and FIG. 5B is a diagram showing how the focus position moves.

First, after the subject P is laid on the bed 7, as shown in FIG. 5A, the ultrasonic diagnostic apparatus 2 causes a B-mode tomographic image around the treatment object S and a shock wave source. The first marker M ₁ indicating the focusing position movable range of the shock wave generated from 3 is displayed on the screen of the display unit 26. In this case, the second marker M indicating the actual focal area
₂ may be simultaneously displayed on the display device. Where the first
Since the marker M _{1 of} and the treatment target S do not match,
When the ultrasonic imaging probe 4 is tilted in the direction of arrow A5 in order to match the first marker M ₁ and the treatment object S, the screen of the display unit 26 is changed to the display shown by the broken line, and the first marker M ₁ is displayed. M ₁ moves to the position of M ₁ ′ shown by the broken line and coincides with the treatment object S.

Next, as shown in FIG. 5 (b), the second marker M ₂ is displayed, and it is confirmed whether the second marker M ₂ and the treatment object S are coincident with each other. 2 marker M ₂
If they do not match as shown, the second marker is M
It moves from the position _{2 to} the position M ₂ ′ so as to match the treatment object S.

As described above, the first and second markers M
The positions of ₁ and M ₂ can be adjusted to easily match the treatment target S, and if the focus of the shock wave and the treatment target S match in this way, a treatment start switch (not shown) is used. Treatment can begin.

In this case, the ultrasonic imaging probe 4 may be moved at the same time when the first marker M ₁ is moved, or the ultrasonic imaging probe 4 is moved when the movement of the first marker M ₁ is completed. You may let me. Alternatively, the first marker M ₁ and the second marker M ₂ may be displayed at the same time so that they can be moved simultaneously.

As described above, when the focus position of the shock wave displayed on the display unit 26 is moved by the first and second markers M ₁ and M ₂ according to the position of the treatment object S, the second A delay program corresponding to the display position of the marker M ₂ is loaded into the system controller 1 from a storage system (not shown), and the delay controller 14 is loaded from the system controller 1.
A command signal is sent to. When the delay controller 14 receives this command signal, it sends the control signal to the first to sixth delay circuits 12a to 12f. First to sixth delay circuits 12a
12 f are the corresponding 1st-6th pulsers 11a-
By delaying the timing of the pulse voltage output from 11f, the shock wave can be irradiated while focusing on the treatment target S that is aligned with the second marker M ₂ .

As described above, according to the present invention, the shock wave can be easily focused on the object to be treated. In the apparatus of this embodiment, the focus position is 2 cm to 15 cm.
Can be electronically changed, and the size of the focus is also variable, so that the treatment target S can be irradiated with a focus of an appropriate size.

Incidentally, in order to irradiate a shock wave to the treatment object S such as a calculus and to carry out crush treatment, it is usually 3000 to 500.
Although 0 shock waves are emitted, if a shock wave having a high peak pressure is emitted from the beginning, the subject will suffer pain. Therefore, when the peak pressure control unit 13 receives a treatment start command signal from the system controller 1. , The peak pressure is gradually increased to an appropriate height, and then the output voltage of the pulsar is controlled so that the crushing treatment can be performed at the optimum peak pressure.

In the above shock wave treatment device, the shock wave treatment device can be made to function as a hyperthermia treatment device by changing the pulsar of the vibrator drive device to a device for generating intense ultrasonic waves. In this case, the peak pressure control unit 13 of the shock wave treatment device functions as a peak temperature controller that variably adjusts the peak temperature rise during the thermal treatment.

The present invention is not limited to the above embodiment. In the above embodiment, the display of the moving range of the focus movement of the first marker is shown by a straight line, and the second marker is moved along the straight line. However, as shown in FIG. )
At the time of positioning, (b) When the focus position is moving, (c)
The display of the marker may be changed in time series during irradiation.

In FIG. 6, when positioning (a),
As in the above embodiment, the first marker M ₁ is displayed to display the first marker M ₁ .
The marker M ₁ and the treatment object S are matched. During the movement of the focus position in (b), the focus shallowest position marker M _a and the focus deepest position marker M _b are displayed, and the second marker M ₂ indicates the focus shallowest and deepest position marker M _a. And M _b , the second marker M ₂ and the treatment target S are made to coincide with each other. And (c)
During irradiation, the focus area marker M ₃ is displayed, and it can be visually confirmed that the shock wave is applied to the position of the focus area marker M ₃ . Therefore, as shown in FIG. 6, the current operation can be visually confirmed by changing the display in chronological order. Therefore, in addition to the above-described embodiment, operability is improved and erroneous operation can be prevented.

Further, in the above embodiment, the tomographic image of the subject P is obtained by ultrasonic waves and the marker is displayed on the display of the tomographic image. However, the present invention is not limited to this, and the X-ray fluoroscopic image from two directions is used. ,
Alternatively, the treatment object may be displayed by the ultrasonic image and the X-ray fluoroscopic image from different directions, and the marker may be displayed by being superimposed on the X-ray fluoroscopic image or the ultrasonic image.

Further, the shape of the ultrasonic transducer is not limited to the concave ring shape, but may be the shape shown in FIGS. 7 to 9. FIG. 7 shows a polyhedral oscillator in which one ring of the oscillator of the above embodiment is divided into a plurality of rings. FIG.
Shows a planar type arrangement example in which the vibrators are arranged on a plane. FIG. 9 is a diagram showing an example in which, in a planar arrangement example of the vibrators, the vibrators are arranged so as to be inclined by a predetermined angle in the focal direction. Also with each of the above-mentioned configurations, it is possible to make the movement of the focus and the size of the focus variable by giving an appropriate delay to the vibrator. 8 and 9, the vibrator may have a ring shape as shown in the embodiment, or may have a polyhedral shape which is divided like the ring shape in FIG. 7 instead of the ring shape.

In the above embodiment, an example of performing positioning by the ultrasonic diagnostic apparatus 2 has been described, but the ultrasonic diagnostic apparatus cannot perform positioning when gas is present in the subject. As a method for solving this, there is a method of positioning using not only ultrasonic waves but also X-ray transmission images when positioning is performed.

FIG. 10 shows a schematic block diagram when positioning is performed using both the X-ray transmission image and the ultrasonic diagnostic apparatus. In FIG. 10, the configurations of the ultrasonic diagnostic apparatus 2 and the transducer driving device 6 are the same as those in FIG. 4, so the details thereof are omitted and only the positioning device based on the X-ray transmission image is shown.

The X-ray positioning device includes an X-ray drive unit 27,
Position controller 28, X-ray trigger generator 29, X
X-ray generation unit 30, X-ray tube 31, image intensifier 32, image acquisition unit 33, and X-ray image processing unit 34.
And an X-ray image memory 35 and an X-ray image display unit 36.

The X-ray drive unit 27 is equipped with an X-ray tube 31 and an image intensifier 32, and relatively rotates and moves around a subject (not shown). Position controller 2
Reference numeral 8 controls the movement of the X-ray drive unit 27.

The X-ray trigger generator 29 outputs an X-ray pulse signal for collecting an X-ray transmission image. The X-ray generation circuit 30 generates an X-ray based on the signal from the X-ray trigger generation unit 29.
A high voltage is applied to the wire tube 31.

The X-ray tube 31 irradiates an object (not shown) with X-rays based on the output from the X-ray generation circuit 30. The image intensifier 32 detects the X-ray transmitted through the subject, converts it into an optical image, and outputs it.

The image acquisition unit 33 includes an X-ray trigger generation unit 29.
The optical image from the image intensifier 32 is collected on an image-by-image basis in synchronization with the signal from the. The image processing circuit 34 converts the optical image into an image signal.

The X-ray image memory 35 stores the image of the subject and the focus position on the image based on the signal from the focus marker controller 9. The X-ray image display unit 36 calls the image of the subject and the image showing the focus position stored in the image memory, and displays the image of the subject and the image showing the focus position.

The operation of the apparatus of this embodiment having the above structure will be described with reference to FIGS. 11 and 12. FIG.
The schematic diagram in the case of collecting the image of the subject P from different directions (for example, the angle formed by the first direction D1 and the second direction D2 is θ = 30 degrees) is shown. 12A to 12
(D) shows a drawing from the first direction before positioning, a drawing from the second direction before positioning, a drawing from the first direction after positioning, and a drawing from the second direction after positioning.

As shown in FIGS. 11 and 12, in order to perform positioning, X-ray transmission images from at least two different directions are collected to stereoscopically grasp the positional relationship between the focal position and the treatment object. As a result, the correct treatment target position is focused.

Therefore, according to this embodiment, accurate positioning can be performed regardless of the presence of gas or the like in the subject. With the above-described configuration, the position of the treatment object can be obtained from the X-ray transmission images in the two directions, similarly to the ultrasonic diagnostic apparatus, and the shock wave focus may be moved to that position. Furthermore, not only the X-ray transmission image is used to determine the focal position, but, for example, one X-ray transmission image and one ultrasonic tomographic image are combined in an arbitrary combination,
Positioning is possible. Of course, various modifications can be made without departing from the scope of the present invention.

[0050]

According to the present invention, the following effects can be obtained. According to the present invention, after attaching an applicator or a positioning device using an X-ray transmission image incorporating a shock wave generating means and an ultrasonic imaging probe to a subject, a focus marker is used as a treatment target without changing the amount of water inside. Match and
Since the position information of the focus marker is given to the shock wave etc. generating means as delay information to the vibrator driving means for driving the vibrator, positioning is simplified, and as a result, efficient treatment can be performed. Further, even if the focus and the treatment target are displaced from each other, repositioning can be easily performed.

Therefore, the shock wave treatment device and the like of the present invention can be easily performed by changing the excitation timing of the vibrator which is a shock wave etc. generating means, and the focus of the shock wave generated from a plurality of vibrator groups can be focused. Since the marker corresponding to the focal point is displayed on the tomographic image or the X-ray transmission image while being electronically changeable, positioning can be performed easily. In addition, since the marker position can be changed to a desired position, it is not necessary to mechanically move the applicator, and it is not necessary to increase or decrease water.
Therefore, the treatment can be efficiently performed.

[Brief description of drawings]

FIG. 1 is a block diagram showing the configuration of a shock wave therapy device according to an embodiment of the present invention.

FIG. 2 is a diagram showing a ring-shaped oscillator of a shock wave generation source.

FIG. 3 is a diagram schematically showing a movement range of a focus of a shock wave in relation to an applicator and a diagram showing a positioning method.

FIG. 4 is a block diagram showing a schematic configuration of a vibrator driving device.

FIG. 5 is a diagram specifically showing a moving range of a vibrator driving device on an ultrasonic image of a display device.

FIG. 6 is a diagram specifically showing a moving range of a vibrator driving device on an ultrasonic image of a display device.

FIG. 7 is a diagram showing a polyhedral oscillator in which one ring of the oscillator is divided into a plurality of rings.

FIG. 8 is a diagram showing a planar type arrangement example in which transducers are arranged on a plane.

FIG. 9 is a diagram showing an example in which, in a planar arrangement example of the vibrators, the vibrators are arranged so as to be inclined at a predetermined angle in a focal direction.

FIG. 10 is a schematic block diagram when positioning is performed using both an X-ray transmission image and an ultrasonic diagnostic apparatus.

FIG. 11 is a diagram showing an example of positioning by an X-ray transmission image.

FIG. 12 is a view showing a display example by an X-ray transmission image.

[Explanation of symbols]

1 ... System controller, 2 ... Ultrasonic diagnostic device, 3 ...
Shock wave source, 4 ... Ultrasonic imaging probe, 5 ...
Applicator, 6 ... Transducer drive device, 7 ... Bed, 8 ... Operation console, 9 ... Focus marker controller, 11a to 11f ...
1st-6th pulser, 12a-12f ... 1st-6th delay circuit, 13 ... Drive voltage control part, 14 ... Delay control part, 15 ...
Pulser control unit, 16 ... Delayed data storage system, 17 ... Applicator position controller, 18 ... Probe position controller, 19 ... Imaging pulser, 20 ... Transmission circuit, 2
DESCRIPTION OF SYMBOLS 1 ... Multiplexer, 22 ... Receiving circuit, 23 ... Signal processing circuit, 24 ... Image memory, 25 ... Image processing part, 26 ... Display part, 27 ... X-ray drive part, 28 ... Position controller, 2
9 ... X-ray trigger generation unit, 30 ... X-ray generation unit, 31 ... X-ray tube, 32 ... Image intensifier, 33 ... Image acquisition unit, 34 ... X-ray image processing unit, 35 ... X-ray image memory,
36 ... X-ray image display unit, P ... Subject, S ... Treatment object,
M ... Marker.

Claims (6)

[Claims] 1. A means for obtaining a tomographic image of a subject based on a signal transmitted and received by an ultrasonic imaging probe, and a shock wave generating means formed of at least two sets of transducer units for generating a shock wave at a predetermined focus. A display unit that displays the tomographic image and a marker that indicates the position of the focus; a marker moving unit that moves the marker displayed on the display unit to a desired position; and a marker that is moved by the marker moving unit. A shock wave treatment device comprising: a vibrator driving unit that electronically moves a focus of the shock wave to a desired position by changing delay information given to the vibrator unit based on position information. 2. A means for obtaining a tomographic image of a subject on the basis of a signal transmitted and received by an ultrasonic imaging probe, and at least two sets of transducer units, which generate heat and generate intense ultrasonic waves at a predetermined focus. Means, display means for displaying the tomographic image, and a marker indicating the position of the focal point, marker moving means for moving the marker displayed on the display means to a desired position, and moving by the marker moving means And a vibrator driving means for electronically moving the focal point of the strong ultrasonic wave to a desired position by changing delay information given to the vibrator unit based on position information of the marker. apparatus. 3. A means for obtaining a first image of a subject from a first direction, a means for obtaining a second image of the subject from a second direction different from the first direction, and at least two sets of transducer units. A shock wave generating unit that is formed and generates a shock wave at the focus; a marker moving unit that moves the marker indicating the focus of the shock wave displayed on the first image and the second image to a desired position; and the marker moving unit. A shock wave driving unit that electronically moves the focus of the shock wave to a desired position by changing delay information given to the vibrator unit based on position information of the marker moved by the shock wave. Treatment device. 4. The shock wave treatment apparatus according to claim 3, wherein at least one of the first image and the second image is an X-ray fluoroscopic image. 5. A means for obtaining a first image of a subject from a first direction, a means for obtaining a second image of the subject from a second direction different from the first direction, and at least two sets of transducer units. A heat generating unit that is formed and generates a strong ultrasonic wave at the focus; and a marker moving unit that moves a marker indicating the focus of the strong ultrasonic wave displayed on the first image and the second image to a desired position, Vibrator driving means for electronically moving the focal point of the strong ultrasonic wave to a desired position by changing delay information given to the vibrator unit based on position information of the marker moved by the marker moving means. A thermotherapy device characterized by the above. 6. The hyperthermia treatment apparatus according to claim 5, wherein at least one of the first image and the second image is an X-ray fluoroscopic image.