JPH01270861A - Impulse wave treatment device - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

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

(Prior Art) As a conventional shock wave treatment device, there is an ultrasonic treatment device that uses ultrasound as a shock wave. This ultrasound treatment device is
Usually, the apparatus includes an ultrasonic transducer that forms a focal point of ultrasonic waves for crushing an object to be crushed within the object, and an ultrasonic transducer that collects tomographic image data of the object.

When performing treatment, first the state of the affected area (object to be crushed) is displayed on the display section using an ultrasonic transducer that collects tomographic image data, and then, while observing this displayed image, the object to be crushed, such as a stone. Treatment is performed to crush the bones by sending ultrasonic waves for crushing. Specifically, a marker indicating the focal point of the crushing ultrasonic wave is displayed together with the tomographic image on the display section, and the crushing ultrasonic wave is transmitted with this marker aligned with the object to be crushed, and the stone is removed. We are trying to crush such things. In addition, in such a conventional device, the number of shots of ultrasonic waves for crushing is counted, and when this counted value reaches a preset number of shots, the transmission of the ultrasonic waves is stopped, and then, for example, 1/) The tomographic image of the object to be crushed is displayed on the display section using an X-ray diagnostic device or the like to confirm the crushing result.

(Problem to be Solved by the Invention) However, in the conventional device described above, the crushing ultrasonic waves are stopped and restarted based on the number of shots of the crushed ultrasonic waves to be transmitted, so that the actual object to be crushed is It has been difficult to determine whether or not the fragment has been crushed while the crushing ultrasonic wave is being transmitted.

This means that even after the crushing of the object to be crushed is completed, there is a risk of continuing to transmit powerful ultrasonic waves for crushing, and there is also a risk that the crushing ultrasonic wave will continue to be transmitted even after the crushing of the object to be crushed is There is a problem in that the transmission of ultrasonic waves is stopped. In the former case, unnecessary shock waves are transmitted, which is a problem that should be resolved as soon as possible from the viewpoint of safety, while in the latter case, there is a problem in that the time required for treatment is unnecessarily increased.

The present invention has been made in consideration of the above circumstances, and an object of the present invention is to provide a shock wave treatment device that allows the state of crushing of an object to be crushed to be confirmed even during the transmission of a crushing shock wave.

[Structure of the Invention] (Means for Solving the Problems) The structure of the present invention for achieving the above object is that, in the shock wave treatment device mentioned above, a tomographic image of the object to be crushed before the shock wave for crushing is transmitted. A first collecting means for collecting data, a second collecting means for collecting tomographic image data of the object to be crushed while the crushing shock wave is being transmitted; The apparatus further includes a display υ control means for obtaining a subtraction image of the tomographic image data of the object to be crushed obtained by the second collecting means and controlling the display of the crushed state of the object to be crushed based on the subtraction image.

(for production) The operation of the present invention having the above configuration will be explained.

First, after collecting tomographic image data of the object to be crushed before the crushing shock wave is transmitted from the first collecting means, transmission of the ultrasonic wave is started. Then, the second collecting means collects tomographic image data of the object to be crushed while the crushing shock wave is being transmitted. A subtraction image is obtained from the tomographic image data of the object to be crushed, and the display and control of the crushed state of the object to be crushed is performed based on the obtained subtraction image.

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

FIG. 1 is a block diagram of the configuration of a shock wave therapy device as an example. In this example, an example in which ultrasonic waves are used as shock waves will be described.

In the figure, the shock wave treatment device includes a shock wave transducer 1 that forms a focal point of ultrasonic waves for crushing an object to be crushed, and an ultrasonic wave that forms a sound field region including the focal point of the ultrasonic waves formed by this shock wave transducer 1. A shock wave applicator 3 includes an ultrasonic transducer 2 that transmits and receives sound waves, a balsa 4 that sends pulse signals to the shock wave transducer 1, and a controller 5 that transmits pulse signals to the ultrasonic transducers 1 and 2. A transmitter/receiver circuit 6 transmits a pulse signal to excite to perform a sector scan or the like, and receives an echo signal from the ultrasonic transducer 2 based on each sector scan, and an output signal of the transmitter/receiver circuit 6 is inputted. A signal processing circuit 7 performs amplitude detection on this signal and sends it as a video signal to a signal conversion system 8, a system controller 9 mainly composed of a CPU that controls each part of this device based on predetermined parameters, and this system The transmitter/receiver circuit 6 is controlled by a controller 9.
Signal processing circuit 7. A controller 5 that controls the pulse signal transmission/reception timing, amplitude 2 frequency, etc. in the balsa 4
and a transmitting/receiving circuit 6. controlled by the system controller 9. A signal conversion system 8 performs signal conversion processing on the output signal of the signal processing circuit 7, an image memory 20a that stores tomographic image data outputted from the signal conversion system 8, and a control signal from the system controller 9. An image processing unit 20 having a subtraction play conversion processing unit 20b that constructs a subtraction image from the tomographic image data stored in the image memory 20a and performs gray conversion processing on the subtraction image, and a control signal from the system controller 9. Based on this, a sector-shaped sound field area generated by the ultrasonic transducer 2 is generated along with a tomographic image outputted from the image processing unit 20, a subtraction image showing the state of crushing of the object to be crushed before and during the transmission of the crushing ultrasonic wave, etc. , a display unit 10 including a TV monitor and the like that display a focal point marker indicating the focal point of the crushing ultrasonic waves, and a system controller 9 for setting the generation timing of the pulse signal sent from the pulser 4 to the shock wave transducer 1. The treatment start switch 11 includes a switch (not shown) for instructing the start of pulse transmission, and a position controller 12 for adjusting the relative positional relationship of the ultrasound transducer 2 with respect to the shock wave transducer 1. It is configured.

In this embodiment, the ultrasonic transducer 2 includes a first collecting means for collecting tomographic image data of the object to be crushed before the ultrasonic wave for crushing is transmitted, and a tomographic image data of the object to be crushed while the ultrasonic wave for crushing is being transmitted. It has a function as a second collection means for collecting image data. This first. The function as the second collecting means is executed by the operator operating a W1 shadow button (not shown).

Furthermore, in this embodiment, the system controller 9
and the image processing unit 20, the first. Obtaining a subtraction image of the tomographic image data of the object to be crushed obtained by the second collecting means,
A display control means 21 is configured to display and control the crushing state of the object to be crushed based on the subtraction image.

Next, the shock wave applicator 3 will be described in detail with reference to FIG. 2.

In the same figure, the shock wave applicator 3 is connected to the shock wave transducer 1 that forms a focal point 15 of fragmentation ultrasonic waves (for example, ultrasonic pulses with strong energy) for fragmenting an object to be fragmented, such as a kidney stone 18, in the subject 14. , a water tank 16 provided on the ultrasonic wave transmission surface 1a side of the shock wave transducer 1, and an ultrasonic wave transmission head i1!17 extending from the ultrasonic wave transmission surface 1a of the shock wave transducer 1 to the focal point 15, and Ultrasonic wave transmitting/receiving surface 2 on specimen surface 14S
A sound field area 27 including the focal point 15 in contact with a
and the ultrasonic transducer 2 that collects tomographic image data of the subject 14.

The ultrasonic transducer 2 can be moved and stopped at will in the six directions of the arrows based on the control signal from the position controller 12 mentioned above. It is done as a standard.

Operation of the shock wave therapy device configured as described above.

The effect will be described with reference to the timing chart shown in FIG. 6, assuming that a renal stone 18 in the kidney shown at 19 in FIG. 2 is crushed and treated. In addition, 2 in Figure 6
7 is the treatment start switch.

28 is image storage/display before crushing, 29 is raw image memory/display of crushing.
30 is subtract image storage/display.

31 indicates the timing of each shock wave generation pulse trigger. However, the tomographic image is displayed on the display unit 10 at a rate of, for example, 30 frames/second while the apparatus is powered on.

First, the water tank 16 provided in the shock wave applicator 3 is placed on the surface 148 of the subject 14, and in this state, the transmitting/receiving circuit 6. The signal processing circuit 7 and signal conversion system 8 are controlled to drive the ultrasonic transducer 2 and display a tomographic image of the subject 14 on the display section 10.

In this case, on the display unit 10, focal point markers corresponding to the ultrasonic waves of the shock wave transducer 1 are displayed at fixed positions based on signals transmitted and received from the system controller 9 to the signal conversion system 8, and in real time. The displayed tomographic image of the subject 14 changes as the shock wave applicator 3 moves.

Then, at the stage when the kidney stone image 18 is depicted in the tomographic image, the shock wave applicator 3 is roughly adjusted so that the focal point marker (not shown) coincides with the kidney stone image 18. The shock wave applicator 3 is fixed in this state.

In this state, that is, in a state where the fragmentation ultrasonic waves are not being transmitted, the operator presses the treatment start switch 11 to start the treatment.

The tomographic image data of the kidney stone @18 is stored in the image memory 20a. In this case, the tomographic image data includes multiple tomographic images (1'Px to Pn) within one breath of the subject shown in Figure 3 (a).
The tomographic images corresponding to all the tomographic images are stored.

The operator monitors the tomographic image displayed on the display unit 10. A control signal is transmitted to the pulser 4 via the system controller 9 and the controller 5 so as to generate a shock wave pulse for the next breath.

As a result, a pulse signal is transmitted from the pulser 4 to the shock wave transducer 1, and the shock wave transducer 1 transmits a strong energy ultrasonic pulse (ultrasonic wave for crushing the object) to the kidney located at the position corresponding to the display position of the focus point marker. A wave is transmitted toward the stone 18. This ultrasonic pulse becomes a shock wave at the position of the focal point and crushes the kidney stone 18. and,
By repeating the generation of such ultrasonic pulses as many times as necessary, the entire kidney stone 18 is crushed and treated.

During the transmission of this ultrasonic wave for fragmentation, tomographic image data corresponding to all one tomographic image of the plurality of tomographic images Ql to Qn obtained during continuous breathing as shown in FIG.
Stored in 0a.

Furthermore, the image processing unit 20 converts the two tomographic image data into the data shown in FIG.
The subtraction images R1 to Rn as shown in C) are
It is created with a delay of one frame, and then gray conversion processing is performed in accordance with the gradation value of the subtraction image data.

That is, the pixel mW of the renal stone 1B before the ultrasonic wave for fragmentation is transmitted is shown by 22 in FIG. (b)
Indicated by 22' in the middle. Therefore, when subtracting these pixel densities, as shown at 23 in the same figure (C),
Some of the vixel density values become negative values. Taking advantage of this, for example, if the area 23a that has a negative value is displayed in blue, and the area that is a positive value is displayed in red, the kidney stone 18 can be detected just by observing the display. It becomes possible to clearly judge the state of crushing.

In addition, the same figure (d) shows the state before crushing of the kidney stone 18 as a profile, and the same figure (e) shows the state before crushing,
They correspond to (a) and (b) in the same figure, respectively.

Then, as shown in FIG. 5, these subtraction images 26 are displayed together with the tomographic image 24 before the fracturing ultrasound is transmitted and the tomographic image 25 during the fracturing ultrasound is being transmitted, which are stored in the image memory 20a. 10.

The operator can easily grasp the state of fragmentation of the kidney stone 18 by looking at this display, and when the operator judges that the fragmentation has been completed, the operator instructs the transmission of ultrasonic waves for fragmentation to stop, and the fragmentation is completed. If it is determined that the crushing ultrasonic waves are not being crushed, continue transmitting the crushing ultrasonic waves.

According to the present embodiment described above, the state of crushing of the object to be crushed can be easily confirmed with a simple operation even while the crushing ultrasonic waves are being transmitted. Therefore, it is possible to avoid the risk of continuing to transmit powerful ultrasonic waves for crushing even after the crushing of the object to be crushed is completed, and it is possible to avoid the risk of continuing to transmit powerful ultrasonic waves for crushing even after the crushing of the object to be crushed is completed. This prevents the problem of stopping wave transmission. That is, it is possible to ensure the safety of the subject and to shorten treatment time.

Note that the present invention is not limited to the embodiments described above, and various modifications can be made within the scope of the invention.

In the embodiment described above, the operator observes the subtraction image displayed on the display unit and transmits the ultrasonic waves.

Although the stop F is instructed, the present invention is not limited to this, and the following configuration may be used.

In advance, the value of the negative region (area) of the subtraction image in which the object to be crushed is crushed is stored in the image processing unit as a reference value based on the phantom or previous clinical experience, etc.
When the negative area of the obtained subtraction image exceeds the reference value, transmission of the ultrasound may be automatically stopped.

When configured in this way, in addition to the above-mentioned effects, it is also possible to reduce the burden on the operator.

Incidentally, in the above-described embodiment, the case of crushing kidney stones has been described, but the present invention is not limited to this and can also be applied to crushing gallstones, etc.

Advantageous Effects of the Invention 1 According to the present invention as detailed above, it is possible to provide a shock wave treatment device in which the state of crushing of an object to be crushed can be confirmed even while the crushing shock wave is being transmitted.

[Brief explanation of the drawing]

FIG. 1 is a block diagram of the configuration of a shock wave therapy device as an embodiment of the present invention, FIG. 2 is an explanatory diagram showing a cross section of an ultrasonic applicator not shown in FIG. ) to (C) are explanatory diagrams showing the transmission plane of the shock wave obtained during 11IF suction, the tomographic images of the shock wave during transmission, and the subtraction images of these, respectively. Figures 4 (a) to (C) are the images before the shock wave is transmitted. , An explanatory diagram showing changes in pixel density values during wave transmission and these subtraction images, Figures (d> and (e) are explanatory diagrams of the object to be crushed before and during shock wave transmission, Fig. 5 6 is an explanatory diagram showing a tomographic image and a subtraction image displayed on the display unit, and FIG. 6 is a timing chart diagram of the shock wave treatment device shown in FIG. Transducer), 10... Display unit 5. 14... Subject, 18... Object to be crushed, 21... Display control means. Agent: Patent attorney Noriyuki Chika Kenshu Chikazu Takeshi Fuji Figure 3

Claims (1)

[Claims] In a shock wave treatment device that sends a crushing shock wave toward a subject to perform crushing treatment on an object to be crushed within the subject, a first step is to collect tomographic image data of the object before sending the crushing shock wave. a second collecting means for collecting tomographic image data of the object to be crushed while the crushing shock wave is being transmitted;
A shock wave characterized by comprising a display control means for obtaining a subtraction image of the tomographic image data of the object to be crushed obtained by the second collecting means and displaying and controlling the crushing state of the object to be crushed based on the subtraction image. treatment equipment.