JPH03131278A - Probe for thermotherapy - Google Patents

Abstract

PURPOSE:To enable a clear ultrasonic image to be observed with an ultrasonic element for ultrasonic diagnosis arranged inside a probe so as to guide a heating electrode to an optimum position easily and accurately be forming a heating electrode fitted to the tip of a prove with a material of low ultrasonic attenuation. CONSTITUTION:An inner conductor 3 of a coaxial cable 5 is arranged concentrically inside an outer electrode (b) to form an inner electrode (a) and constitute an antenna part (c) serving as a heating electrode. An outer conductor 4, which is divided into a plurality of parts, is formed by an electrically conductive material of low ultrasonic attenuation and an insulation film 6 over the antenna part (c) is also made of a material of low ultrasonic attenuation. An ultrasonic probe 8 is equipped with an ultrasonic element 9 for ultrasonic diagnosis at its tip and oscillates an ultrasonic wave and receives its reflected one. It is possible to obtain an ultrasonic diagnostic image of living tissue around the heating electrode (c) fitted to an internal probe 1 through this electrode and to guide the probe to an optimum position by the aforementioned devices.

Description

[Detailed description of the invention]

[Industrial Application Field] The present invention provides local heating of a lesion occurring in a living body. The present invention relates to a thermotherapy probe for therapeutic treatment. [Prior Art] A thermotherapy probe for locally applying FA to treat a lesion formed in a living body is disclosed in, for example, USP 4. No. 700.716. This is a device in which a microwave irradiation antenna section consisting of an external electrode and an internal electrode is provided at the tip of the probe, and microwaves are irradiated from this antenna section toward the lesioned part of the living body. The external electrode constituting the microwave irradiation antenna section of this probe is made of metal abrasive material. Diagnosis using ultrasonic tomographic images has often been used to diagnose lesions for which heating treatment is performed using this probe. On the other hand, as a heating means, a method is also known in which a high frequency current is applied between an internal electrode and an external electrode to heat a lesion located between the electrodes (see Japanese Patent Publication No. 62-48505). In this case, the in-vivo electrode is installed on a probe for in-vivo illumination inserted into a living body's lumen organ. This internal electrode is composed of a tubular braided body, a bellows, or a spiral body formed of metal wire such as stainless steel wire or tin-plated wire. When this intracorporeal electrode probe is introduced into the body and high-frequency current is applied to the lesion to perform heat treatment, a diagnostic device using ultrasound tomographic images is used to diagnose the lesion to be treated with heat treatment. . [Problems to be Solved by the Invention] By the way, in each of the above-mentioned probes, the electrode of the microwave irradiation antenna part or the internal electrode for high frequency is made of a metal material, so it is difficult to use the probe to heat the area to be treated. When diagnosing with ultrasonic tomographic images using an ultrasonic diagnostic probe, the electrodes tend to get in the way and create blind spots. Furthermore, since the thermotherapy probe and the ultrasonic diagnostic probe are separate bodies, it is difficult to accurately match the treatment area with the thermotherapy probe and the diagnosis area with the ultrasonic diagnostic device. For this reason, it has been difficult to accurately diagnose the treated area during or before and after treatment. Furthermore, with a single conventional thermotherapy probe, it is difficult to accurately locate the affected area within a living body and guide the probe to the optimal position for treating that area. The present invention has been made in view of the above-mentioned problems (2), and its purpose is to easily place a heating probe at the most suitable position for heating and treating a lesion that has occurred in a living body. The object of the present invention is to provide a probe for thermotherapy that can clearly diagnose the condition of a lesioned area and surrounding living tissue parts during or before and after the thermotherapy treatment using ultrasound. [Means and effects for solving the above problems] In order to solve the above problems, the present invention provides a heating electrode in an intracorporeal probe introduced into a body cavity, and uses the heating electrode to measure a lesion occurring in a living body. In the thermotherapy probe for locally heating and treating the body, an ultrasound element for ultrasonic diagnosis is built into the in-vivo probe close to the heating electrode, and the heating electrode includes at least the ultrasound element. The part located on the viewing field side for observation is made of an ultrasound-transparent material. With this configuration, ultrasound diagnostic images of living tissue around the electrode can be seen through the heating electrode provided on the intracorporeal probe. Therefore, reliable and clear ultrasonic diagnosis can be performed simultaneously with thermotherapy using a single probe. [Example] Figures 1 and 2 show a first embodiment of the present invention. Fig. 1 shows the intracorporeal probe 1 for thermotherapy, and the probe body 2 of the intracorporeal probe is constructed using a flexible two-hole tube made of silicone rubber. A coaxial cable 5 consisting of an inner conductor 3 and an outer conductor 4 is inserted through the center hole formed in the center hole. The outer periphery of the tip of the probe body 2, including each external conductor 4, is covered with an insulating coating 6. The internal conductor 3 drawn out to the side is arranged concentrically inside the external electrode a to form an internal electrode, thereby forming an antenna section C as a heating electrode. The plurality of external conductors 4 that are divided into a plurality of parts constituting the antenna part C are made of a conductive material with low attenuation of ultrasonic waves, such as conductive silicone rubber. It is made of a material such as Teflon, which has a low dielectric constant when exposed to microwaves.At the same time, the insulating coating 6 is made of a material that is less susceptible to ultrasonic waves.On the other hand, from the other hole of the probe body 2, insertion hole 7
An ultrasonic probe 8 is inserted through the hole. The ultrasonic probe 8 is equipped with an ultrasonic element (ultrasonic vibration element unit) 9 for ultrasonic diagnosis at its tip, and oscillates ultrasonic waves outward (downward in FIG. 1) from this element. It is designed to receive the reflected waves. A connector 11 is attached to the end of the coaxial cable 4 in the intracorporeal probe 1 configured as described above, and
Another connector 12 is provided at the end of the ultrasound probe 8. So

[As shown in FIG. 2, the connector 1 of the in-body probe] is connected to the microwave generator 13, and the connector ] 2 of the ultrasound probe 8 is connected to the probe drive device 14 and the ultrasound generator. Connected to 1.5. Furthermore, an observation monitor 16 is connected to the ultrasonic generator 15 . Next, an example of using the intracorporeal probe 1 configured and connected in this manner for thermotherapy will be described with reference to FIG. 2. FIG. 2 shows a situation in which the intracorporeal probe 1 is inserted into a living body lumen 20, the antenna portion C is positioned near a tumor 22 that has arisen within a living tissue 21, and thermotherapy is performed. In other words, this intracorporeal probe] is inserted orally or percutaneously into the living body lumen 20, such as the bile duct. At this time, insert it into the internal probe 1.

[Also, the ultrasonic element T-9 portion of the ultrasonic probe 8 is located inside corresponding to the antenna portion C. Then, the ultrasonic probe 8 is moved with the longitudinal axis of the ultrasonic probe 8 as the center by the probe driving device]-4. While rotating and driving 12, the ultrasonic diagnostic ultrasonic element 9 is caused to perform oscillation and reception operations. This received signal is subjected to image signal processing;
Observe with. In this case, since the external electrode is made of a material with low attenuation of ultrasonic waves, the external electrode does not interfere with ultrasonic diagnosis. In other words, 1. An ultrasonic image of the tissue around the outer periphery of the antenna portion C can be observed. In this way, while observing, the intracorporeal probe 1 is introduced so that the antenna part C of the intracorporeal probe is placed directly below the tumor 22. Then, as shown in FIG. 2, with the antenna part C in contact with the wall surface of the biological lumen 20 directly below the tumor 22, microwaves are transmitted from the microwave generator 13 through the coaxial cable 5, and the antenna Microwaves are emitted from part C to perform thermotherapy on the tumor 22. At the same time, the ultrasound probe 8 is linearly driven in the axial direction of the probe 1 by the probe driving device 14 by the axial length of the antenna portion C, and scans the tumor 22 being heated and the tumor 22 near the Observe the ultrasound image of biological tissue 2]. Due to the above-mentioned ↑ and ψ actions and actions, a tomographic image of the living tissue 21 on the outer periphery of the antenna portion C can be observed from inside the thermotherapy probe 1 using the ultrasound probe 8.
Tumors 22 that occur inside tissues that are difficult to judge with direct vision can be easily detected L, and the intracorporeal probe 1 accurately targets the area to be heated.
can lead to. Further, even during the heating treatment, changes in the tumor 22 and the surrounding normal tissues can be observed from a blind spot using ultrasonic tomographic images, so that safer treatment can be performed. FIG. 3 shows an intracorporeal probe 41 for thermotherapy in a second embodiment of the present invention. This in-body probe 41 is composed of a flexible silicone tube as a probe body 42,
A coaxial cable 43 is inserted into the probe body 42 . An internal conductor 44 drawn out from this coaxial cable 43 constitutes an internal electrode a. Also, for example, a spiral-shaped groove provided on the outer periphery of the tip of the probe body 42 may be provided on the outside. 1s pole 1) is configured l-. Note that the outer conductor 45 is not spiral-shaped and may be divided into a plurality of parts in the front and rear. An antenna section C is constituted by this internal electrode a and the second electrode. A plurality of ultrasonic elements 47 are located inside the tip of the probe body 42.
a and 47b are fixedly installed. For example, one ultrasonic element 47a is located relatively forward at position j7.
It is installed facing downward. The other ultrasonic element 47
b is located relatively backward and is installed facing three directions. Cables 48a and 48b for transmitting ultrasonic waves are separately connected to each of these ultrasonic elements 47a and 47b. Further, the external conductor 45 forming the external electrode
As in the embodiment, it is made of a material that has extremely low attenuation of ultrasonic waves. Further, the outer periphery of the antenna portion C including the outer conductor 45 is covered with an insulating coating 49. The intracorporeal probe 41 configured in this manner has a connector 50 attached to the end of the coaxial cable 43 and a connector 50 attached to the ends of the ultrasonic transmission cables 48a and 48b, respectively, as in the first embodiment. Connector 518.51
The connector 50 is connected to a microwave oscillator, and the connectors 51a and 51b are connected to a probe drive device and an ultrasonic wave generator through the connector b. The in-vivo probe 41 for thermotherapy configured and connected in this way is inserted into the living body lumen and heat-treated the affected area using microwaves, as in the case of the first embodiment. During the heating treatment, the affected area around the electrodes in each direction is observed using the ultrasonic elements 47a and 47b. The intracorporeal probe 41 of this second embodiment also provides the same effects as those of the first embodiment. 4 and 5 show a fourth embodiment of the present invention. In this embodiment, high frequency is used to perform thermotherapy. FIG. 1 shows the intracorporeal probe 50. The intracorporeal probe 50 has a flexible 4-hole silicone tube attached to the probe body 51.
A tubular internal electrode 52 is fixedly provided on the outer periphery of the tip of the probe body 51. In-body electrode 52
is made of conductive silicone rubber or the like that has extremely low attenuation of ultrasonic waves. The inside where the in-body electrode 52 is provided is hollow except for the front and rear end portions, forming a sealed space 53. A cable 54 is connected to the intracorporeal electrode 52, and this cable 54 is inserted through one hole 55 in the probe body 51. The other hole 56 has a diagnostic ultrasonic probe 57.
is inserted. This diagnostic ultrasound probe 57 consists of a flexible shaft 58 and an ultrasound vibration element unit 59 provided at the tip thereof.
3. The inside of the sealed space 53 is filled with an ultrasonic transmission liquid 61 such as liquid paraffin. Further, on the outer periphery of the tip of the probe body 51, a balloon 6 is provided which surrounds the internal electrode 52 so as to take it inside.
2 is installed. The balloon 62 is made of a soft thin film such as latex. Inside the balloon 62, a water supply pipe 63 and a drainage pipe (64) are formed using the remaining two holes of the probe body 51.
). Further, a water supply tube 65 and a drain tube 66 are connected to the water supply pipe 63 and the drain pipe (64). The intracorporeal probe 50 also includes a first connector 67 attached to the end of the cable 54, a second connector 68 attached to the end of the flexible shaft 58 of the diagnostic ultrasound probe 57, a water supply tube 65, and a drainage tube 66. There are third and fourth connectors 71, 72 respectively attached to each end of the connector. And the fifth
As shown in the figure, the first connector 67 connects to the high frequency generator 7.
3. The second connector 68 is an ultrasonic probe drive device fl
! 74, third and fourth connectors 71 and 72 are connected to a coolant circulation device 75, respectively. Further, an ultrasonic signal transmission cable (not shown) connected to the ultrasonic vibration element unit 59 of the diagnostic ultrasonic probe 57 is connected to an external ultrasonic generation/observation device 76 through the flexible shaft 58 . Furthermore, as shown in FIG.
It is connected to the high frequency generator 73 through. Although liquid is supplied to and discharged from the porous 77 of the extracorporeal electrode 78, the coolant may be circulated by a coolant circulation device through a water supply tube or a drainage tube similar to the above. Next, an example of how this embodiment is used will be explained. As shown in FIG. 5, the intracorporeal probe 50 is inserted into a living body lumen 81, such as a dining room. At this time, in order to facilitate insertion, the balloon 62 is kept in a completely deflated state without being supplied with cooling liquid. Further, during this insertion, the diagnostic ultrasound probe 57 inserted into the probe body 51 is rotated around its axis by the drive device 74, and further, the ultrasound generation/observation device 76 is driven. As a result, the ultrasonic transducer unit 59 emits ultrasonic waves while rotating and receives the reflected waves. With this received signal, the ultrasonic generation/observation device 7
Observe the ultrasound image in step 6. By the way, the intracorporeal electrodes 52 located around the five ultrasonic transducer units described in 2.1. 1. Since the ultrasound is not attenuated as described above, the internal electrode 52 is not attenuated. The part of the living tissue 82 can be observed. In this way, the intracorporeal probe 50 with the intracorporeal electrode 52 at 15
The tip of the intracorporeal probe 50 is positioned directly below the lesion (tumor) 83 while observing an ultrasonic image of the living tissue around the outside of the tip. Next, a cooling liquid is supplied 17 into the balloon 62 by the cooling liquid circulation device 75, and the balloon 62 is inflated. This brings the balloon 62 into close contact with the interior surface of the living body lumen 81. In addition, the circulation flow rate of the coolant is adjusted so that this close contact state is maintained. Note that it is preferable to use degassed water or the like with low attenuation of ultrasonic waves as the coolant (7).On the other hand, an extracorporeal electrode 78 is installed on the extracorporeal surface opposite the tip of the intracorporeal probe 5o where the intracorporeal electrode 52 is located. The lesion 83 is located between the internal electrode 52 and the external electrode 78. Therefore, the high frequency generator 73 applies high frequency between the internal electrode 52 and the external electrode 78, and the lesion located between the internal electrode 52 and the external electrode 78 is The area 83 is heated and treated.During this treatment, normal tissues near the internal electrode 52 and the external electrode 78 are likely to be heated.
circulating a cooling liquid within the balloon 62 and the porous 77;
Prevent overheating of normal tissues. Furthermore, if the ultrasonic transducer unit 59 is moved by linearly driving the diagnostic ultrasound probe 57 in the axial direction within the intracorporeal probe 50, the lesion 83 between the intracorporeal electrode 52 and the extracorporeal electrode 78 can be moved. Ultrasonic tomographic images can be observed. However, the intracorporeal probe 50 has a diagnostic ultrasound probe 57 built therein, and the intracorporeal electrodes 52 around the ultrasonic vibration element unit 59 are made of materials that do not attenuate ultrasonic waves. Ultrasonic tomographic images of the living tissue 82 and the lesion 83 can be observed through the electrode 52. Therefore, the intracorporeal probe 50 can be easily and accurately introduced into a desired position of the living body lumen 81 (a position suitable for treating the lesion 83). Moreover, since the ultrasonic tomographic image of the heating section can be observed even during treatment, safe and accurate thermal treatment can be performed. 6 to 8 show a fourth embodiment of the present invention. FIG. 6 shows an intracorporeal probe 90 for performing thermotherapy using high frequency waves, similar to the third embodiment. This intracorporeal probe 90 has a flexible three-hole silicon tube as a probe body 91, and a tubular intracorporeal electrode 92 is fixedly provided on the outer periphery of the distal end of the probe body 91. This internal electrode 92 is made of a material such as conductive silicone rubber, which has extremely low attenuation of ultrasonic waves. Further, the internal electrode 92 is covered with an electrically insulating thin film 93. Furthermore, the inner probe main body 91 on which the internal electrode 52 is provided has both front and rear end portions remaining. It is cut out to form a window 94. Further, the thickest hole of the probe body 91 forms an insertion hole 95 17, which penetrates to the tip of the probe body 9]. However, 17, the diameter of the most extreme hole portion 96 is particularly narrow. The most advanced hole portion 96 is the tapered portion 9
7 to the distal end portion of the insertion hole 95. A cable 98 connected to the internal electrode 92 is led to the proximal end ω through another hole 99 of the probe body 9, and is connected to a high frequency generator as in the above embodiment. Further, the remaining holes 101 of the probe body 9] communicate with the spaces ], 02 within the window portion 94. From this point, an ultrasonic transmission fluid 103 such as liquid paraffin is injected. On the other hand, a guide wire 104 and an ultrasonic diagnostic probe 105 can be selectively inserted into the insertion hole 95, as shown in FIG. The guide wire 104 can be inserted distally through the most distal hole portion 96 until it passes through. The guide wire 104 is guided by the tapered portion 97 and tightly inserted into the most distal hole portion 96 .
It is designed to block the In addition, the ultrasonic diagnostic probe] 05 is the Taber section 97
It is inserted up to a point just before the hole 96, and is stopped at a position where it does not reach the most extreme hole portion 96, thereby determining the final insertion position. In the ultrasonic diagnostic probe 105, an ultrasonic transducer unit 106 is incorporated in a portion corresponding to the window 94 where the internal electrode 92 is located. An ultrasonic signal transmission cable (not shown) is connected to the ultrasonic transducer unit 106. The ultrasonic signal transmission cable connects the ultrasonic diagnostic probe 10
As in the case of the above embodiment, it is connected to an external ultrasonic generation/observation device (not shown) through the flexible shaft 106 of No. 5. Next, the operation when using this embodiment will be explained. First, the intracorporeal probe 90 is introduced into the living body lumen in the same manner as in the third embodiment. In this case, the guide wire 104 is introduced into the living body lumen using an endoscope or the like in advance. Then, as shown in FIG. 6, the guide wire 104 is inserted into the insertion hole 95 of the probe body 91 from the hole portion 96 on the distal end side thereof. Then, the intracorporeal probe 90 is introduced into a narrow biological lumen such as a bile duct using the guide wire 104 as a guide. Then, only the guide wire 104 is pulled out from the proximal side, and instead of this, the ultrasonic diagnostic probe 105 is inserted into the insertion hole 95 to the final position as shown in FIG. At this time, the tip of the ultrasonic diagnostic probe 105 comes into close contact with the inner wall of the tapered portion 97 and hits the most distal hole portion 96.
occlude. Further, the ultrasonic vibration element unit 106 is connected to the internal electrode 9
It is located at a location corresponding to the window portion 94 with 2. In this state, an ultrasonic transmission fluid 103 such as liquid paraffin is injected into the space 102 inside the window 94 through the hole 101. Therefore, as in the third embodiment, the ultrasonic transducer unit 106 is driven and the diagnostic ultrasonic probe 105 is rotated around its axis by a drive device (not shown), while the ultrasonic generation/observation device Observe by. That is, as a result, the ultrasonic transducer unit 106 emits ultrasonic waves while rotating and receives the reflected waves. Using this received signal, an ultrasound image is observed using the ultrasound generation/observation device. By the way, since the intracorporeal electrodes 92 located around the ultrasonic transducer unit 106 do not attenuate the ultrasonic waves as described above, the part of the living tissue can be clearly observed through the intracorporeal electrodes 92. In this way, while observing the ultrasound image of the living tissue around the outside of the tip of the intracorporeal probe 90 where the intracorporeal electrode 92 is located, the insertion position is adjusted such that the tip of the intracorporeal probe 90 is located directly below the lesion (tumor). Correct. Then, as in the third embodiment, a high frequency is applied between the internal electrode 92 and the external electrode (not shown) by a high frequency generator to heat and treat the lesion located between them. Furthermore, if the ultrasonic transducer unit 106 is moved within the intracorporeal probe 90 by linearly driving the diagnostic ultrasonic probe 105 in its axial direction, the intracorporeal electrode 9
2 and the extracorporeal electrode can be observed. According to the in-body probe 90, the same effects as in the third embodiment can be obtained. Furthermore, the intracorporeal probe 90 can be inserted into the living body lumen using the guide wire 104. Therefore, it can be easily inserted into a narrow living body lumen. In addition, in the present invention, the number of ultrasonic elements installed inside the thermotherapy probe is not limited to one or two, and a larger number of ultrasonic elements may be incorporated. Further, the structure of the heating electrode of the antenna section and the like is not limited to that of the above embodiment. [Effects of the Invention] As explained above, in the thermotherapy probe of the present invention, the i'R electrode formed at the tip of the probe is made of a material with extremely low attenuation of ultrasonic waves. Clear ultrasound images can be observed through the heating electrode using the ultrasonic diagnostic ultrasonic element provided, and therefore, the heating electrode is most suitable for heating treatment for tumors, etc. in living tissue. , can be easily and accurately guided to the desired position. Furthermore, since ultrasonic tomographic images of the affected area, etc. can be observed during heating treatment, safe and accurate heating treatment can be performed.

[Brief explanation of the drawing]

FIG. 1 is a sectional view showing the configuration of a thermotherapy probe according to a first embodiment of the present invention, FIG. 2 is an explanatory diagram of the state in which the thermotherapy probe of the first embodiment is used, and FIG. The figure is a cross-sectional view showing the structure of a thermotherapy probe according to the second embodiment of the present invention, FIG. 4 is a cross-sectional view showing the structure of a thermotherapy probe according to the third embodiment of the present invention, and FIG. Similarly, the third
FIG. 6 is a sectional view showing the structure of the thermotherapy probe according to the fourth embodiment of the present invention, and FIG. FIG. 8 is a cross-sectional view taken along the line A-A, and is a cross-sectional view showing the configuration of a thermotherapy probe according to the fourth embodiment. 1... Probe for thermotherapy, 2... Probe body,
3... Internal conductor, 5... Outer conductor, 8... Ultrasonic probe, 9... Ultrasonic element, a... Internal electrode, b
... External electrode, C... Antenna, 41... In-body probe, 47 a. 47b... Ultrasonic element, 50... In-body probe, 5
2... In-body electrode, 59... Ultrasonic vibration element unit, 90... In-body probe, 92... In-body electrode, 10
6... Ultrasonic vibration element unit.

Claims (1)

[Claims] A heating electrode is provided on an internal probe introduced into a body cavity, and the heating electrode is used to locally heat and treat a lesion that has occurred in the living body. , an ultrasonic element for ultrasonic diagnosis is incorporated close to the heating electrode, and at least a portion of the heating electrode located on the observation side observed by the ultrasonic element is formed of an ultrasound-transparent material. A thermotherapy probe featuring: