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WO2018154717A1 - Dispositif d'endoscope à ultrasons - Google Patents

Dispositif d'endoscope à ultrasons Download PDF

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Publication number
WO2018154717A1
WO2018154717A1 PCT/JP2017/007136 JP2017007136W WO2018154717A1 WO 2018154717 A1 WO2018154717 A1 WO 2018154717A1 JP 2017007136 W JP2017007136 W JP 2017007136W WO 2018154717 A1 WO2018154717 A1 WO 2018154717A1
Authority
WO
WIPO (PCT)
Prior art keywords
ultrasonic
ultrasonic element
therapeutic
insertion portion
longitudinal axis
Prior art date
Application number
PCT/JP2017/007136
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English (en)
Japanese (ja)
Inventor
伊藤　寛
Original Assignee
オリンパス株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2017/007136 priority Critical patent/WO2018154717A1/fr
Publication of WO2018154717A1 publication Critical patent/WO2018154717A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/13—Tomography
    • A61B8/14—Echo-tomography

Definitions

  • the present invention relates to an ultrasonic endoscope apparatus.
  • a HIFU (High Intensity Focused Ultrasonic) treatment device using an ultrasonic wave that converges on a focal point is known (for example, see Patent Document 1).
  • the treatment target region can be cauterized by irradiating the treatment target region with high-energy ultrasonic waves.
  • the in-body HIFU treatment apparatus is provided with a diagnostic ultrasonic element for acquiring an ultrasonic image of a treatment target region in addition to a therapeutic ultrasonic element that emits therapeutic ultrasonic waves.
  • the insertion part of the in-body HIFU treatment device has a small diameter in order to ensure good insertion into the body. Therefore, it is common that the therapeutic ultrasonic element and the diagnostic ultrasonic element are arranged side by side in the longitudinal direction of the insertion portion. When such an arrangement is adopted, the focal point of the therapeutic ultrasound and the observation region by the diagnostic ultrasound are arranged at positions shifted from each other in the longitudinal direction of the insertion portion. Therefore, after observing the treatment target region, an operation of moving the insertion portion in the longitudinal direction to make the focal point coincide with the treatment target region is required. In order to eliminate such inconvenience, in Patent Document 1, the therapeutic ultrasonic element is tilted toward the diagnostic ultrasonic element so that the focal point is located within the observation region of the diagnostic ultrasonic element.
  • the focal point of the therapeutic ultrasonic element of Patent Document 1 is formed on a perpendicular line passing through the center of the radiation surface of the therapeutic ultrasonic element. As described above, when the focal point is formed in front of the center of the therapeutic ultrasonic element, it is necessary to increase the inclination angle of the therapeutic ultrasonic element in order to place the focal point in the observation region. Therefore, there is a problem that the outer diameter of the insertion portion increases, and insertability and operability in the body of the insertion portion are deteriorated.
  • the present invention has been made in view of the above-described circumstances, and provides an ultrasonic endoscope apparatus capable of overlapping a treatment region with an observation region while suppressing an increase in the outer diameter of the insertion portion. With the goal.
  • One aspect of the present invention is an insertion portion that has a longitudinal axis and is inserted into the body, and a concave shape that is provided at the distal end of the insertion portion and that is curved in a direction intersecting the longitudinal axis and emits therapeutic ultrasound.
  • a predetermined radius on a plane that includes a normal and a radius of curvature of each concave surface includes a normal line at the center of the emission surface and bisects the emission surface in a direction intersecting the longitudinal axis. The predetermined point is equal to the distance to the normal line.
  • An ultrasonic endoscope device positioned sectional ultrasonic device side.
  • treatment ultrasonic waves generated by driving the piezoelectric body are emitted from the emission surface of the treatment ultrasonic element, thereby treating the living tissue around the distal end portion of the insertion portion disposed in the body.
  • Ultrasonic waves are irradiated.
  • an ultrasonic image signal of a living tissue around the distal end portion of the insertion portion is acquired by a diagnostic ultrasonic element provided on the distal end side or the proximal end side of the therapeutic ultrasonic element.
  • the plurality of concave surfaces constituting the emission surface have a radius of curvature equal to the distance from the predetermined point, and the therapeutic ultrasonic waves emitted from each concave surface converge to the predetermined point. Therefore, a treatment region where high-intensity ultrasonic energy is obtained is formed around a predetermined point.
  • the predetermined one point is located on the diagnostic ultrasonic element side with respect to the normal line at the center of the therapeutic ultrasonic element, the therapeutic region is located above the normal line at the center of the exit surface. It is formed at a position biased toward the sonic element side. Thereby, the treatment region can be overlapped with the observation region without greatly inclining the therapeutic ultrasonic element with respect to the longitudinal axis of the insertion portion, and an increase in the outer diameter of the insertion portion can be suppressed.
  • the therapeutic ultrasonic element can change the position of the focal point where the therapeutic ultrasonic waves emitted from the concave surfaces of the plurality of piezoelectric bodies strengthen each other within the treatment region including the predetermined point.
  • the entire treatment area may be included in the observation area of the ultrasonic image signal. In this way, even when the focal point is set at any position within the treatment region, the treatment target site can be treated with the therapeutic ultrasound while observing the treatment target site with the ultrasound image.
  • the predetermined point may be located on a center line that bisects the observation region. Furthermore, the predetermined one point may be located in the approximate center of the observation region. By doing in this way, ultrasonic energy of the maximum intensity can be irradiated to the treatment object part arranged in the approximate center of the ultrasonic image.
  • the curvature radius of the said concave surface may increase gradually toward the side far from the side near the said diagnostic ultrasonic element. By doing so, a predetermined point is formed outside the region facing the exit surface, and the treatment region is formed at a position further biased toward the diagnostic ultrasonic element side. Thereby, the increase in the outer diameter of an insertion part can further be suppressed.
  • the diagnostic ultrasonic element may be positioned on the distal end side with respect to the therapeutic ultrasonic element.
  • the treatment region can be overlapped with the observation region while suppressing an increase in the outer diameter of the insertion portion.
  • FIG. 2 is a perspective view of a therapeutic ultrasonic element in the ultrasonic endoscope apparatus of FIG. 1.
  • FIG. 3 is a cross-sectional view of the therapeutic ultrasonic element of FIG. 2 cut along a plane that passes through the concave normal at point A and is perpendicular to the plane P; It is a figure which shows the wiring of the electrode and power cable which were provided in the ultrasonic element for treatment. It is a figure which shows the modification of the GND electrode of FIG. It is a figure which shows the modification of a treatment area
  • the ultrasonic endoscope apparatus 1 is an in-vivo endoscope apparatus used by being inserted into a body, and as shown in FIG.
  • the diagnostic ultrasonic element 3 and the therapeutic ultrasonic element 4 provided at the distal end of the insertion portion 2 are provided.
  • the diagnostic ultrasonic element 3 and the therapeutic ultrasonic element 4 are arranged side by side in the direction along the longitudinal axis of the insertion portion 2, and the diagnostic ultrasonic element 3 is provided on the distal side of the therapeutic ultrasonic element 4.
  • Reference numerals 5 and 6 denote cables for connecting the ultrasonic elements 3 and 4 to devices outside the insertion portion 2, respectively.
  • the diagnostic ultrasonic element 3 has an emission surface 3 a that is arranged facing outward in the radial direction of the insertion portion 2 and emits diagnostic ultrasonic waves outward in the radial direction of the insertion portion 2.
  • the diagnostic ultrasonic element 3 irradiates diagnostic ultrasound to the observation region S in a plane facing the emission surface 3 a and parallel to the longitudinal axis of the insertion portion 2, and a reflected wave of diagnostic ultrasound from the observation region S Is received on the exit surface 3a, an ultrasonic image signal of the observation region S is acquired.
  • the ultrasonic image signal acquired by the diagnostic ultrasonic element 3 is transmitted from the diagnostic ultrasonic element 3 to an image processing apparatus (not shown) arranged outside the insertion unit 2 via the cable 5.
  • an ultrasonic image is generated based on the ultrasonic image signal, and the generated ultrasonic image is displayed on a display (not shown).
  • the therapeutic ultrasonic element 4 has a plate shape that is curved only in the radial direction perpendicular to the longitudinal axis of the insertion portion 2, and has a concave curved surface that faces the radially outward direction of the insertion portion 2. Is the exit surface 4a.
  • the therapeutic ultrasonic element 4 is diagnosed with respect to the longitudinal axis of the insertion portion 2 as shown in FIG. 1 so that the irradiation region of the therapeutic ultrasonic wave emitted from the emission surface 4a overlaps the observation region S. It inclines toward the ultrasonic element 3 side.
  • the therapeutic ultrasonic element 4 includes a plurality of columnar piezoelectric bodies 41 that are arranged in a direction substantially along the longitudinal axis of the insertion portion 2 and have a curvature in the longitudinal direction.
  • the plurality of piezoelectric bodies 41 are integrated by being bonded to each other by, for example, resin.
  • each piezoelectric body 41 is curved in an arc shape and has a concave surface 41 a on the radially inner side.
  • the exit surface 4a is composed of concave surfaces 41a of a plurality of piezoelectric bodies 41.
  • each concave surface 41a is located on a plane P that includes the normal N at the center of the emission surface 4a and bisects the emission surface 4a in the radial direction of the insertion portion 2, and is emitted radially from each concave surface 41a.
  • the ultrasonic waves converge at a position on the plane P.
  • the plane P is preferably located on the same plane as the observation region S by the diagnostic ultrasound.
  • each concave surface 41a varies depending on the distances r1, r2, r3 from the predetermined center position (predetermined point) O on the plane P to each concave surface 41a, It is equal to the distances r1, r2, r3 from the center position O to each concave surface 41a.
  • the radius of curvature of the concave surface 41a whose distance from the center position O is r3 is r3.
  • the predetermined center position O is a position that is substantially the center of a treatment region T, which will be described later, and is set on the tip side of the normal line N at the center of the exit surface 4a.
  • a power cable 6 for supplying high-frequency power is connected to the piezoelectric body 41, and high-frequency power is supplied from a power source (not shown) disposed outside the insertion portion 2 via the power cable 6. Then, it expands and contracts to generate therapeutic ultrasonic waves, and the therapeutic ultrasonic waves are emitted from the concave surface 41a.
  • One power cable 6 is connected to each piezoelectric body 41 so that each piezoelectric body 41 can be driven independently.
  • a ground (GND) electrode 9 common to all the piezoelectric bodies 41 is provided on the emission surface 4 a (concave surface 41 a), and one power cable is connected to the GND electrode 9. 61G is connected.
  • the positive electrode 10 is provided on the end surface opposite to the concave surface 41 a of each piezoelectric body 41, and one power cable 61, 62, 63 is connected to each positive electrode 10. Thereby, each piezoelectric body 41 can be individually controlled to control the phase of therapeutic ultrasonic waves.
  • therapeutic ultrasonic waves that reinforce each other at one point (focal point) due to interference can be emitted from the plurality of piezoelectric bodies 41. Furthermore, this makes it possible to change the position of the focal point.
  • the position of the focal point can be set by the operator via, for example, a power supply control device (not shown).
  • the GND electrode 9 is provided on the concave surface 41 a of each piezoelectric body 41 like the positive electrode 10, and one power cable 61 ⁇ / b> G, 62 ⁇ / b> G, 63 ⁇ / b> G is connected to each GND electrode 9. May be.
  • a piezoelectric body 41 made of a single piezoelectric body is shown.
  • Each piezoelectric body 41 is composed of a plurality of piezoelectric bodies arranged at intervals and a plurality of piezoelectric bodies. You may have the composite structure which consists of resin which fills the space
  • 4 may be formed from a single plate-like piezoelectric body curved in one direction.
  • the plurality of positive electrodes 10 are provided at intervals from each other, so that the plurality of regions of the therapeutic ultrasonic element 4 are mutually connected. It can be driven independently.
  • the plurality of piezoelectric bodies 41 are not limited to a plurality of separately manufactured piezoelectric bodies, but are a plurality of regions that are independently driven and formed in a single piezoelectric body constituting the therapeutic ultrasonic element 4. It may be.
  • the treatment region T where high-intensity ultrasonic energy necessary for treatment such as ablation is obtained at the focal point is a region having the center position O as a substantial center. Since the center position O is set to the front end side with respect to the normal line N of the exit surface 4a, the treatment region T is also formed at a position biased to the front end side with respect to the normal line N. A part overlaps the observation region S.
  • the center position O is preferably set in the observation region S so that the overlapping region of the observation region S with the treatment region T becomes larger.
  • the ultrasonic endoscope apparatus 1 configured as described above.
  • diagnostic ultrasonic waves are emitted from the diagnostic ultrasonic element 3 and an ultrasonic image of the observation region S is displayed.
  • the insertion part 2 is inserted into the body from the distal end side while acquiring a signal.
  • the operator observes the treatment target site in the body from the ultrasonic image on the display, and positions the insertion portion 2 at a position where the treatment target site is arranged in the treatment region T.
  • the diagnostic ultrasonic element 3 is provided on the distal end side with respect to the therapeutic ultrasonic element 4, the insertion amount of the insertion portion 2 into the body can be smaller.
  • the position of the focal point of the therapeutic ultrasonic wave is set as a treatment target site, and the therapeutic ultrasonic wave is emitted from the therapeutic ultrasonic element 4.
  • the treatment target site can be cauterized by irradiating the treatment target site with high-energy ultrasound for treatment while observing the treatment target site with an ultrasound image.
  • the insertion portion 2 by positioning the insertion portion 2 so that the center position O coincides with the treatment target site and setting the focal point to the center position O, it is possible to give the ultrasonic wave energy of maximum intensity to the treatment target site.
  • the radii of curvature of the plurality of concave surfaces 41a constituting the emission surface 4a are equal to the distance from the center position O, respectively, and the ultrasonic waves emitted from all the concave surfaces 41a are in one central position. Converge to O.
  • the ultrasonic energy at the central position O and its surroundings can be increased.
  • the center position O is arranged closer to the diagnostic ultrasonic element 3 than the normal line N at the center of the emission surface 4a of the therapeutic ultrasonic element 4, the treatment region T is located at the center of the emission surface 4a. It is formed at a position that is biased toward the observation region S rather than the front. Thereby, the inclination angle with respect to the longitudinal axis of the insertion portion 2 of the therapeutic ultrasonic element 4 necessary for overlapping the treatment region T with the observation region S is small, and the diameter of the insertion portion 2 can be reduced. There is an advantage that you can.
  • the center position O is set so that the entire treatment region T is included in the observation region S, as shown in FIG. In this way, even when the focus is set at any position in the treatment region T, the treatment target region is irradiated with the therapeutic ultrasonic wave while observing the treatment target portion with the ultrasonic image. It can be carried out.
  • the center position O is preferably located on a center line A that divides the observation region S into approximately two equal parts in the direction along the longitudinal axis of the insertion portion 2. More preferably, In this way, since the center position O and the treatment region T are arranged in the center of the ultrasound image, the treatment target site being treated with the treatment ultrasound can be more easily observed with the ultrasound image. Can do.
  • the center position O when the center position O is located outside the region (rectangular region surrounded by the broken line in FIG. 7) that faces the exit surface 4 a in the normal N direction, the exit surface 4 a is The curvature radius of the concave surface 41a gradually increases from the side closer to the diagnostic ultrasonic element 3 toward the side farther from it.
  • the diagnostic ultrasonic element 3 is arranged on the distal end side with respect to the therapeutic ultrasonic element 4, but instead, the diagnostic ultrasonic element 3 is replaced with the therapeutic ultrasonic element 3.
  • the sound wave element 4 may be disposed closer to the base end side.
  • the therapeutic ultrasonic element 4 is inclined to the proximal side with respect to the longitudinal axis of the insertion portion 2, and the center position O is set to the proximal side with respect to the normal line N of the emission surface 4a.
  • the treatment region T and the observation region S can be overlapped.
  • the therapeutic ultrasonic element 4 is inclined toward the diagnostic ultrasonic element 3 with respect to the longitudinal axis of the insertion portion 2, but the therapeutic ultrasonic element 4 is not necessarily inclined. It may not be necessary, and may be arranged parallel to the longitudinal axis of the insertion portion 2. Even in this case, the treatment region T can be overlapped with the observation region S by setting the center position O closer to the diagnostic ultrasonic element 3 than the normal line N.

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  • Life Sciences & Earth Sciences (AREA)
  • Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Radiology & Medical Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • General Health & Medical Sciences (AREA)
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  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

Ce dispositif d'endoscope à ultrasons comprend un élément ultrasonore de diagnostic et un élément ultrasonore thérapeutique (4) qui sont disposés à l'extrémité distale d'une partie d'insertion et adjacents l'un à l'autre dans une direction le long de l'axe longitudinal de la partie d'insertion. L'élément ultrasonore thérapeutique (4) comporte une pluralité de matériaux piézoélectriques (41) disposés sensiblement dans la direction le long de l'axe longitudinal, chacun ayant une surface concave (41a) qui forme une surface d'émission (4a) qui s'incurve dans une direction croisant l'axe longitudinal. Chaque surface concave (41a) a un rayon de courbure égal à la distance (r1, r2, r3) de cette surface concave (41a) à un point (O) sur un plan (P) qui comprend une ligne normale (N) au centre de la surface d'émission (4a) et sensiblement en coupe la surface d'émission (4a) dans la direction croisant l'axe longitudinal, et le point (O) est positionné sur le côté élément ultrasonore de diagnostic de la ligne normale (N).
PCT/JP2017/007136 2017-02-24 2017-02-24 Dispositif d'endoscope à ultrasons WO2018154717A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/007136 WO2018154717A1 (fr) 2017-02-24 2017-02-24 Dispositif d'endoscope à ultrasons

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/007136 WO2018154717A1 (fr) 2017-02-24 2017-02-24 Dispositif d'endoscope à ultrasons

Publications (1)

Publication Number Publication Date
WO2018154717A1 true WO2018154717A1 (fr) 2018-08-30

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2024540311A (ja) * 2021-11-17 2024-10-31 ヴィオル カンパニー リミテッド 皮膚処置のための高強度集束超音波プローブの製造方法

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006032059A2 (fr) * 2004-09-16 2006-03-23 University Of Washington Coupleur acoustique a coussin d'eau independent avec circulation pour le refroidissement de transducteur
JP2007152094A (ja) * 2005-11-23 2007-06-21 General Electric Co <Ge> 独立に作動されるアブレーション素子を持つアブレーション・アレイ
US20110034808A1 (en) * 2009-08-04 2011-02-10 National Health Research Institutes Dual-Curvature Phased Array High-Intensity Focused Ultrasound Transducer for Tumor Therapy
JP2014176429A (ja) * 2013-03-13 2014-09-25 Olympus Corp 経体腔式焼灼デバイス

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006032059A2 (fr) * 2004-09-16 2006-03-23 University Of Washington Coupleur acoustique a coussin d'eau independent avec circulation pour le refroidissement de transducteur
JP2007152094A (ja) * 2005-11-23 2007-06-21 General Electric Co <Ge> 独立に作動されるアブレーション素子を持つアブレーション・アレイ
US20110034808A1 (en) * 2009-08-04 2011-02-10 National Health Research Institutes Dual-Curvature Phased Array High-Intensity Focused Ultrasound Transducer for Tumor Therapy
JP2014176429A (ja) * 2013-03-13 2014-09-25 Olympus Corp 経体腔式焼灼デバイス

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2024540311A (ja) * 2021-11-17 2024-10-31 ヴィオル カンパニー リミテッド 皮膚処置のための高強度集束超音波プローブの製造方法
JP7703788B2 (ja) 2021-11-17 2025-07-07 ヴィオル カンパニー リミテッド 皮膚処置のための高強度集束超音波プローブの製造方法

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