JP2659790B2 - Tumor treatment device - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to a tumor treatment apparatus for irradiating an affected part with ultrasonic waves for treatment.

[Conventional technology]

Recently, it has been found that irradiating ultrasound to a photosensitizer such as HPD accumulated in the affected area enhances the cell killing effect, and that the same effect as PDT, which treats cancer by irradiating a laser to the photosensitizer, can be obtained. ing.

The treatment method of irradiating a laser is performed by guiding a laser beam using an optical fiber or the like, and the PDT generally performed is as follows. First, a photosensitizer is intravenously administered to accumulate the photosensitizer in the tumor. When λ = 430nm laser is irradiated on the tumor, λ = 615,670 from the tumor
Fluorescence of nm is generated. When the laser of λ = 630 nm is irradiated to this fluorescence generating part, the cells are destroyed and healed.

However, the laser irradiation method is not sufficient in terms of irradiation angle and irradiation depth, and the irradiation efficiency for a wide range of tumors is poor. Therefore, the ultrasonic irradiation method is more effective for tumor treatment. In this method, a photosensitizer is intravenously administered to accumulate the photosensitizer in the tumor, and then the ultrasound (1 MHz, 1 W
) To emit a spectrum of about 400 nm by acoustic luminescence. This light emission is absorbed by a photosensitizer and excited to generate fluorescence. And a cell killing effect occurs and heals.

[Problems to be solved by the invention]

However, the method of irradiating the affected part with ultrasonic waves for treatment has the following problems. First, it is difficult to detect an affected part easily and reliably, and it is difficult to irradiate an ultrasonic wave only to a target tumor part after detecting the affected part, and to prevent an adverse effect on a normal part.

The present invention is proposed to solve such a problem, and an object of the present invention is to provide a tumor treatment apparatus that can irradiate an ultrasonic wave only to a required place.

[Means and actions for solving the problem]

In order to achieve the above object, the present invention provides a tumor treatment apparatus having an ultrasonic irradiation unit and an observation unit, wherein the ultrasonic irradiation unit has a fluorescence detection unit for detecting fluorescence generated from the tumor, and an ultrasonic wave directed toward the tumor. Is provided with an ultrasonic wave generating means for irradiating light.

In this way, it is possible to accurately detect the treatment site and irradiate the ultrasonic wave only to the treatment site to perform appropriate tumor treatment.

〔Example〕

When using a tumor treatment device, it is necessary to easily and surely detect and treat an affected part. FIG. 1 shows a first embodiment for this purpose, in which a transducer unit 3 having an ultrasonic transducer 2 is provided in a distal end component 1 of a probe, and the transducer unit 3 performs radial scanning. The flexible cable 4 is connected to a hollow flexible shaft 4 for transmitting the driving force, and a signal cable 5 for transmitting and receiving signals to and from the ultrasonic vibrator 2 is provided in the hollow of the flexible shaft 4. The distal end component 1 has a main body 6 made of a flexible material such as Teflon or silicon, and a window 7 through which ultrasonic waves can pass is formed in a portion of the main body 6 facing the ultrasonic transducer 2. ing. Window 7
Behind the main body 6, that is, at a position near the operator near the main body 6.
A cloth-like fiber 8 divided into four in the outer circumferential direction of
The fibers 8a are bundled on the back side of each cloth-like fiber 8, and are drawn in the extending direction of the main body 6 as a light guide 8b. Further, a water supply passage 9 is provided in the main body 6, and the balloon 10 is inflated through a water supply port 10a provided to supply water into a transparent balloon 10 provided so as to cover the distal end component 1.

The probe has a length sufficient to be inserted into a body cavity, and a water pipe 11 connected to a water channel 9 is connected to an end of the main body 6 close to the operator, which is continuous with the distal end component 1. It is drawn out and connected to the water supply pump 12. Further, from the end of the main body 6, the end 13 of the signal cable 5 is pulled out and connected to the radial drive and ultrasonic drive unit 14, and the end 15 of the flexible shaft 4 is drawn out and connected to the spectroscope 17. It is. The emission detection / display unit 16 is provided with a SIT camera 18 and a monitor unit 19 in addition to the spectroscope 17. Reference numeral 20 denotes an ultrasonic image processing unit.

In order to operate the apparatus of the first embodiment configured as described above, first, a photosensitizer such as HPD is administered to a patient to accumulate on a diseased part, and then a probe is inserted into a lumen. This insertion may be performed transendoscopically or by inserting the probe alone under X-ray fluoroscopy.

Then, after the tip of the probe is positioned in the vicinity of the area expected to be the affected part, water is injected by the water supply pump 12 through the water supply channel 9, the balloon 10 is inflated and tightly fixed to the lumen wall, and the tip of the probe is fixed. When the ultrasonic transducer 2 is excited to irradiate the target with an ultrasonic wave while performing a radial scan, the photosensitizer accumulated in the target is excited to emit fluorescence. The fluorescent light is received by the cloth-like fiber 8 and guided to the light emission detection / display unit 16 via the light guide 8b to monitor the amount of the fluorescent light. Thus, the position of the affected part can be accurately grasped by detecting the amount of fluorescence. Therefore, by irradiating the photosensitizing substance accumulation portion with ultrasonic waves, the cell killing effect is enhanced and accurate treatment is performed. In this case, by making it possible to observe an ultrasonic image via the ultrasonic image processing unit 20, more appropriate treatment can be realized.

FIGS. 2 and 3 show a second embodiment of the present invention and are schematic views of a probe to be inserted into a body cavity. The shaft 21 is made of a flexible material having a small diameter and has a curved surface so as not to damage the inner wall of the body cavity, the affected part, and the like when the tip is inserted into the body cavity. An ultrasonic transducer 22 such as PVDF is provided outside the vicinity of the tip of the shaft 21, and a first balloon 23 is provided outside the vicinity of the tip of the shaft 21.
Is provided. Inside the shaft 21, an air supply channel 25 for supplying air to the first balloon 23 in a direction in which the shaft extends and a signal cable 22a for supplying electricity to the ultrasonic transducer 22 are provided.

The ultrasonic vibrator 22 extends in the extending direction of the shaft 21 and outside the shaft 21, and is provided so as to cover the sheath 26 from the rear portion of the ultrasonic vibrator 22 to the outside of the shaft 21. This sheath 26
A second balloon 24 having an air supply tube 27 is provided at the distal end of the second balloon 24. The shaft 21 extends to the operator's hand side,
A sheath 26 extending continuously to near the hand is connected to a slide device 28 provided outside the shaft 21, and the sheath 26
The slide 26 and the slide 28 slide integrally along the shaft 21.

The slide member 28 is provided with a water supply port 29 for injecting water into a gap between the sheath 26 and the shaft 21 and is provided with an O-ring 30 for preventing water leakage from the hand side. Reference numeral 31 denotes a current-carrying connector connected to the signal cable 26;
This is an air supply mouthpiece for supplying air to the balloon 23 of FIG.

In order to operate the probe of the second embodiment configured as described above, first, the entire probe is connected to the lumen in which the tumor site exists.
34 and the like, and air is supplied to the first balloon 23 via the air supply mouthpiece 32 and the air supply channel 25. Then, as shown in FIG. 2, the probe is positioned in front of the tumor portion 33 and is fixed so that the whole probe does not further proceed in the insertion direction. The ultrasonic transducer 22 is located behind the first balloon 23 so as to face the tumor 33, but the ultrasonic transducer 22 is exposed in accordance with the length of the tumor 33 in the luminal direction. The sheath 26 is slid along the axis 21 via the slide member 28 to determine the exposed length of the ultrasonic transducer 22 in order to face the tumor portion 33 by a necessary length. Thereafter, the second balloon 24 is inflated by inflation through an air supply tube 27 so that the sheath 26 does not move and the entire probe is fixed in the lumen 34. Next slide
Water is supplied through a gap between the outside of the shaft 21 and the inside of the sheath 26 from a water supply port 29 provided in the first balloon 23 and the first balloon 23 and the second balloon 23.
Fill the space with 24 with water. In this way, the ultrasound is easily transmitted to the tumor 33, and the ultrasound transducer 22
Is excited and irradiated.

According to the present embodiment, the ultrasonic transducer 22 that does not face the tumor portion 33 is covered with the sheath 26 and the second balloon 24
As a result, ultrasonic waves are not irradiated to unnecessary portions.

At the site in the body cavity where the tumor treatment apparatus such as the first embodiment is difficult to use, the apparatus of the third embodiment shown in FIG. 4A may be used. In this device, an operation section 37 is provided continuously to the insertion section 36 of the endoscope 35, and the operation section 37 is provided with an eyepiece 38 connected to an observation optical system provided at the tip of the insertion section. A communicating forceps port 39 is provided, and a probe 40 having an ultrasonic vibrator at the tip is inserted through the forceps port 39.
A probe driving unit 41 is provided on the operator's side of the probe 40 so as to perform linear or radial scan. The ultrasonic image is projected on the monitor of the ultrasonic observation device 42.

FIG. 4B is a sectional view of the distal end portion of the probe 40. An ultrasonic vibrator 43 is fixed to a vibrator fixing portion 44, and the vibrator fixing portion 44 is connected to a flexible shaft 45, and rotates around the axis of a sheath 47 forming the outside of the probe 40 by rotation of the flexible shaft 45. I do. Flexible shaft
Fluorescent plastic optical fiber between 45 and sheath 47
46 is provided, and is excited by absorbing the fluorescent light to generate the fluorescent light, which is transmitted to the operator's hand side of the probe 40 and transmitted to the fluorescent light detecting unit 48 shown in FIG. 4A. The insertion section 36
The distal end is remotely bent via an operation knob of the operation unit 37. Reference numeral 49 denotes a signal cable for transmitting and receiving signals to and from the ultrasonic transducer 43.

FIG. 4C shows a tip component of the laser probe 50 inserted into the forceps port 39 instead of the probe having the ultrasonic transducer. Fluorescent plastic optical fiber 51
It is provided between a laser light guide fiber 52 provided substantially at the axis of the laser probe 50 and a tube 54 forming the outside of the laser probe 50 having a tip 53 at the tip.

FIG. 4D is an external ultrasonic generator used independently of the apparatus shown in FIG. 4A. This device is provided with a main unit 56 having an ultrasonic vibrator 56a, and the ultrasonic vibrator 56a is connected to an ultrasonic driving device 57. The moving device 58 connected to the main body 56 is the ultrasonic observation device 42 shown in FIG.
The position is adjusted so that the focal point of the ultrasonic wave coincides with the position of the tumor 55b based on the ultrasonic image according to the above. When this device is used, an ultrasonic transmission body 59 such as water is provided between the ultrasonic transducer 56a and the human body by a film made of a soft resin or the like.
Do it by filling within 60.

In order to perform treatment using the apparatus of this embodiment, first, a photosensitizer is administered to a patient. Then, the endoscope 35 is inserted into the body cavity 55, and the distal end thereof is inserted into the peripheral portion 55a of the body cavity 55 while the probe 40 or the laser probe 50 is inserted through the forceps port 39 for endoscopic observation. Here, when the tumor part 55b is superficial to the body cavity wall, it is generated by observing an image with the ultrasonic observation device 42 or irradiating the photosensitive substance accumulated in the tumor part 55b with ultrasonic waves or laser. The fluorescence is detected by the fluorescent plastic optical fibers 46 and 51, and the size, direction, depth of penetration, and the like of the tumor are grasped.

When the position of the tumor 55b is grasped, the tumor 55b is irradiated with a laser, ultrasonic waves, or ultrasonic waves from an extracorporeal ultrasonic generator, or a combination thereof.
A cell killing effect is obtained while emitting light. Deep tumor 56
If fluorescence observation or laser irradiation cannot be performed due to b,
The cell killing effect may be obtained by irradiating an ultrasonic wave from an extracorporeal ultrasonic generator to the tumor portion 56B on which the photosensitizer is accumulated based on the ultrasonic image obtained by the ultrasonic probe 40.

FIG. 5 shows a modification of the probe (FIG. 4B).
The sheath 62 is formed of a tube through which fluorescence does not pass, and an opening 63 is formed in a part of the sheath 62. Other configurations are the same as those in FIG. 4B. In this embodiment, the fluorescence generated in the tumor part by the ultrasonic wave from the ultrasonic transducer is:
Since it is taken in from the opening 63, if the amount of fluorescence is detected, it means that there is a tumor in the direction of the opening 63 where the amount of fluorescence becomes maximum, so that it is possible to effectively grasp.

FIG. 6 shows another modification of the probe (FIG. 4B) in which a second sheath 66 that does not transmit fluorescence is provided outside the sheath 65 of the probe 64, and an opening 67 is formed in a part thereof. is there. Other configurations are the same as those in FIG. 4B. In the present embodiment, since the second sheath 66 can be freely moved in the advance / retreat direction and the rotation direction with respect to the sheath 65, the opening 67 is moved so that the amount of fluorescence generated in the tumor is maximized. Thus, the direction and position of the tumor can be grasped more correctly. 5 and 6 can be applied to a laser probe.

FIG. 7 is a modification of the embodiment shown in FIGS. 4A and 4D. In the above embodiment, the operator manually operates the moving device based on the position of the tumor portion grasped by the ultrasonic observation device and the fluorescence detection unit. Although the configuration was such that the extracorporeal ultrasonic generator was moved by operation, in this modified example, the fluorescence detector 48a and the ultrasonic observation device 4
A position detection unit 68 is connected to 2a and connected to a moving device so that the extracorporeal ultrasonic generator is automatically operated in accordance with the detection of the tumor position. Specifically, where the endoscope end is located in the body cavity is recorded, and then the position of the tumor portion with respect to the probe is detected by ultrasonic scanning and fluorescence detection, and the position in the body cavity is calculated. Then, the positioning of the extracorporeal ultrasonic generator is performed.

FIG. 8 shows a seventh embodiment, in which an ultrasonic vibrator 70 is provided at the inner end of an ultrasonic probe 69 via a vibrator unit 72 and connected to a transparent cylindrical rotation transmitting member 71. To enable radial scanning. The rotation transmitting member 71 is connected to a coil sheath 73 extending in the direction in which the ultrasonic probe 69 extends, and a signal cable 74 for transmitting and receiving signals to and from the ultrasonic vibrator 70 is connected to the rotation transmitting member 71 and the coil sheath.
It is connected to an ultrasonic imaging device 76 through a relay unit 75 through the inside of the unit 73.

An optical system 77 having an optical axis in the same direction as the ultrasonic wave emitting direction is provided near the ultrasonic vibrator 70, and optical information from the optical system 77 is transmitted through the rotation transmitting member 71 and the coil sheath 73 to an optical fiber. Transmitted via 78, relay unit 75, fluorescence intensity detection unit
79, connected to the ultrasonic imaging device 76 via the arithmetic unit 80. The coil sheath 73 is connected to a radial drive unit 81, and the direction in the rotational direction of the ultrasonic vibrator 70 is detected by a rotational direction detecting unit 82 such as an encoder, and the position information is transmitted through an arithmetic unit 80 to an ultrasonic image. It is transmitted to the device 76. A portion extending from the radial drive section 81 to the tip of the ultrasonic probe 69 is covered with a sheath 83 made of Teflon or the like, and a transmission window 84 made of transparent polyethylene is formed at a portion facing the ultrasonic transducer 70 and the optical system 77. .

In the treatment using this embodiment, first, a photosensitizer is administered to a patient, and the vicinity of the tumor is radially scanned with an ultrasonic probe 69 to perform ultrasonic image diagnosis. Then the tumor
The photosensitizer integrated in 55b absorbs and excites fluorescence near 400 nm generated by acoustic luminescence of ultrasonic waves, and emits fluorescence near 600 nm when returning to the ground state. The fluorescence intensity detection unit 79 detects fluorescence near 600 nm via the optical system 77, and responds to the signal from the ultrasonic transducer 70 and the calculation unit 80 from which direction (tumor direction) the fluorescence is generated. The detected image is displayed on the ultrasonic imaging device 76. On the screen of the illustrated ultrasonic imaging device 76, a fluorescent display band 85 is formed outside the ultrasonic image 86, and the direction and intensity of the fluorescent light are displayed as luminance. In this manner, the direction and size of the tumor can be easily and reliably detected, and appropriate treatment can be realized.

FIG. 9 shows a modification of the seventh embodiment, in which a linear scan type ultrasonic probe 87 is used. In this embodiment, a coil sheath is formed by the vibrator unit 88, the optical system 89, and the like.
The linear drive section 91 is fixed so as to move integrally with the sheath 90 so that the linear drive section 91 can move forward and backward (for example, about 30 mm). The display method in the ultrasonic imaging device 93 is such that a fluorescent display band 95 is formed above the ultrasonic image 94 so as to correspond to the image, and the position and intensity at which fluorescence is generated are displayed as luminance. The other configuration is the same as that of the third embodiment, and is the same as that of the third embodiment except that the actual treatment is performed by linear scanning using an ultrasonic probe. As a result, fluorescence at around 600 nm from the tumor is detected and displayed, and the position and size of the tumor can be easily and reliably grasped.

FIGS. 10A and 10B show another modified example of only the ultrasonic image display device. A is for radial scan and B is for linear scan.
Are formed as equally divided cells 96a and 97a. According to the detected direction or position of the fluorescent light, the corresponding cells 96a and 97a are blinked and displayed, and the intensity of the fluorescent light is converted into a blinking frequency. The same effect can be obtained by changing the colors of the cells 96a and 97a.

FIG. 11 shows another modification of the seventh embodiment. The ultrasonic probe 98 is of a radial scan type, and the transducer unit 99 includes the diagnostic ultrasonic transducer 100 and the therapeutic ultrasonic transducer 101 in opposite directions in a direction orthogonal to the axis of the ultrasonic probe 98. Provided. Then, the therapeutic ultrasonic transducer 101 is connected to the powerful ultrasonic generator 102 via a signal cable for transmission. Other configurations are the same as in the seventh embodiment.

The treatment using this device is the same as that of the seventh embodiment, but in this embodiment, in particular, a high-intensity ultrasonic wave of about 1 MHz and 1 W is applied to the affected part from the high-intensity ultrasonic generator 102 via the ultrasonic ultrasonic transducer 101 for treatment. Thereby, the cell killing effect can be improved. in this case,
As shown in FIG. 12, the calculation unit 103 is configured to irradiate high-intensity ultrasonic waves only in a range where the fluorescence intensity is strong (in the direction where the tumor is located).
May be transmitted to the powerful ultrasonic generator 102. It goes without saying that this treatment method can be applied to other scanning methods such as linear scanning.

 FIG. 13 and FIG. 14 show examples of actual use.

FIG. 15 shows an eleventh embodiment, in which ultrasonic generating means such as a PVDF and a piezoelectric element divided in the extending direction are arranged at the tip of a hollow tube (catheter) 104, and each ultrasonic generating means is provided. A signal cable is connected to 105, an amplifier 107 and a transmitter 108 are connected via a changeover switch 106 arranged on the operator's hand side, and a foot switch 109 is connected to drive any ultrasonic generating means. I have. A balloon 110 is provided so as to cover the ultrasonic wave generating means 105, and the catheter 104
The ultrasonic transmission medium liquid can be injected into the balloon 110 via the recirculation device 111 provided near the hand.

To perform treatment using this device, first, a photosensitizer is intravenously administered to a patient, and when the patient accumulates at the tumor site, a catheter 104 is inserted into a body cavity, and all of the ultrasonic wave generating means 105 are driven to drive the entire circumference. Is irradiated with ultrasonic waves. Since an endoscope can be inserted into the inside of the catheter 104, a tumor portion that has been irradiated with ultrasonic waves by the endoscope and reacted with a photosensitizer to emit light is visually recognized. Therefore, the surgeon drives only the ultrasonic wave generating means 105 facing the direction of the emitting tumor through the foot switch 109 to irradiate ultrasonic waves to perform treatment. If strong ultrasound is required during treatment, the individual ultrasound generating means 105
Since the output can be controlled independently, the output can be selectively increased. In this way, in this embodiment, efficient diagnosis and treatment can be performed, and the time required for diagnosis and treatment can be reduced. In this embodiment, the identification means corresponding to the ultrasonic wave generating means is formed inside the catheter by numbers, symbols, etc. so that the ultrasonic wave generating means opposing the affected part can be selected in the present embodiment. Can be selectively driven by the corresponding switches of the external control means.

FIGS. 16A and 16B show modified examples of the catheter, in which A is obtained by dividing the ultrasonic generating means in the catheter length direction so that the ultrasonic generating means 105a and 105b can be used according to the treatment target. Yes, B is divided into the length direction of the catheter and the direction orthogonal thereto.

FIG. 17A shows a twelfth embodiment of the present invention, in which a focusing lens 114 having a mirror 113 at the tip is disposed at the tip of the ultrasound probe 112, and the ultrasound probe 112 is provided at the focusing lens 114. 112
The optical fiber 115 is connected in the extending direction of the optical fiber 115, and the other end of the optical fiber 115 is connected to the spectroscope 116. At the rear of the condenser lens 114, an ultrasonic transducer 118 having a matching layer lens 117 is provided,
The signal cable 118a connected thereto is connected to the ultrasonic transducer driving circuit 119. The ultrasonic transducer 118 is a rotating member 12
0, and the rotating member 120 is
It is rotatably supported by a connection member 121 provided on the main body via a locking portion 122. The rotating member 120 is connected to a coil sheath 123 extending to the operator's hand side, and the other end is connected to the drive shaft of the motor 124, and the rotating member 1
The torque is transmitted to 20. The motor 124 is connected to the operation unit 126 via a motor control circuit 125, and the ultrasonic transducer driving circuit 119 is also connected to the operation unit 126.

The other end of the optical fiber 115 is connected to a spectroscope 116. The spectroscope 116 is further connected to a monitor 128 through a SIT camera 126 and an analyzer 127.

A cylinder 130 made of polyethylene having a tip cap 129 is provided around the condenser lens 114 and the ultrasonic transducer 118, and the inside of the cylinder is filled with an ultrasonic wave transmission 131 such as water. The cylinder 130 is fixed to a Teflon sheath 132 forming an ultrasonic probe main body via a connecting member 121.

In the treatment using the apparatus of this embodiment, first, a photosensitizer is intravenously administered to a patient to accumulate in a tumor. Next, the ultrasonic probe 112 is inserted endoscopically into the body cavity, and the operation unit 1
26 is operated to drive the motor 124 via the motor control circuit 125. Then, the rotating member 120 rotates via the coil sheath 123, and the ultrasonic transducer 118 rotates. Next, the operation unit 126 is operated to drive the ultrasonic vibrator 118 via the ultrasonic vibrator driving circuit 119 to emit ultrasonic waves. Ultrasound emits a 400 nm spectrum by acoustic luminescence, and when absorbed by a photosensitizer accumulated in the tumor,
615,670 nm fluorescence is generated. This fluorescent light is collected by a condenser lens 114
And is reflected by the mirror 113 to be transmitted to the optical fiber 115. The fluorescence passing through the optical fiber 115 is separated by the spectroscope 116,
The information is displayed on the monitor 128 via the T camera 126 and the analyzer 127. FIG. 17B shows an image displayed on the monitor 128. Referring to FIG.
Stop 4 Then, the rotation of the ultrasonic transducer 118 stops, and the tumor part is irradiated with a spectrum of 400 nm. This spectrum is absorbed by the photosensitizer accumulated in the tumor, and a cell-killing effect can be exhibited for treatment.

In this manner, in this embodiment, appropriate treatment can be performed while confirming whether or not ultrasonic waves have been applied to the tumor site.

FIG. 18 shows a modification of the thirteenth embodiment,
4a, 134b and 134c are arranged in a row on the outer periphery of the tip of the probe 133, and these ultrasonic transducers are connected to an ultrasonic transducer control device 136 via an ultrasonic transducer drive circuit 135. The device 136 is connected so that a command is input from the operation unit 137. At the tip of the probe 133, a cylindrical condenser lens 139 having a mirror 138 is provided. A cylindrical member 141 made of polyethylene and having a tip cap 140 and a Teflon sheath 143 are attached to the fixing member 14 so as to cover the outside of the tip of the probe 133.
2 and is fixed to the probe 133. Other configurations are the same as those of the above-described embodiment, and 14
4 is optical fiber, 145 is spectroscope, 146 is SIT camera, 147
Is an analyzer and 148 is a monitor.

To treat with this device, a photosensitizer is first administered intravenously to a patient, and then the device is inserted endoscopically into a body cavity. By operating the operation unit 137, the ultrasonic transducer control device 1
With a delay at 35, the ultrasonic vibrators 134a to 134c are sequentially driven through the ultrasonic vibrator driving circuit 135, and the 615,670 nm fluorescent light generated by irradiating the ultrasonic wave to the tumor portion is collected by the condenser lens 139. Collect and project it on monitor 148 to find out the tumor. After grasping the tumor part, the ultrasonic transducers 134a to 134c are selectively driven to irradiate the tumor part with ultrasonic waves to perform treatment by a cell killing effect.

This embodiment does not employ a method of driving the ultrasonic transducers 134a to 134c while rotating them, so that the configuration can be simplified and the probe diameter can be reduced without the need for a rotating mechanism or device. Further, efficient treatment can be performed by selectively driving a plurality of ultrasonic transducers. Needless to say, the number of ultrasonic transducers is not limited to three.

FIG. 19 shows the fourteenth embodiment, and is a partial cross-sectional view of the probe 149. The cone mirror 150 is fixed to a fixing member 151, and the fixing member 151 is fixed to a fixing plate 152 provided behind the cone mirror 150. These are covered with a cover 154 having a tip member 153.
4 is a window 154a for irradiating laser light or receiving fluorescence.
Is formed. The tip member 153 is water-tightly joined so that the cover 154 can slide.
3 is fixing the fixing member 151. A hole is formed in the center of the fixing plate 152 to fix the end of the light shielding tube 156 containing the optical fiber 155. The cover 154 is fixed to the shaft 157. A flexible shaft 158 is connected to the shaft 157 so that the cover 154 can rotate. 159 is an encoder. A sheath 160 is provided on the outer periphery of the shaft 157 and the flexible shaft 158 in a watertight manner so that they can slide.

FIG. 20 is a block diagram showing the entire apparatus. motor
161 is connected to the flexible shaft 158 of the probe 149, and is connected to the CPU 163 via the controller 162. The position detection circuit 164 is connected to the encoder 15 of the probe 149.
9 and to CPU 163. Optical fiber 1
55 is connected to a spectroscope 165 and a laser device 166, and these are connected to a CPU 163. Further, an operation panel 167 and a CRT 168 are connected to the CPU 163.

In order to perform treatment using the present apparatus, first, a photosensitizer is administered to a patient, and then the probe 149 is inserted into a body cavity and positioned near the tumor site 169. Next, a signal is transmitted to the CPU 163 to operate the operation panel 167 to drive the motor. The controller 162 transmits a motor drive signal to the motor based on this signal. The cover 154 is rotated by the drive of the motor 161 via the flexible shaft 158 and the shaft 157.

On the other hand, a signal for driving the position detection circuit 164 by operating the operation panel 167 is transmitted to the CPU 163. The rotation angle of the shaft 157 is detected by the encoder 159 and processed by the position detection circuit 164. Therefore, the detection value of the encoder 159 and the window of the cover 154
By associating the position of the window 154a with the position of the window 154a in advance, the position of the window 154a can be grasped by processing the detection value of the encoder 159. The position data of the window 154a is transmitted to the CPU 163, and the position can be imaged.

First, the operation panel 167 is operated to transmit the signal for driving the spectroscope 165 and the laser device 166 to the CPU 163 for the irradiation of the laser beam and the reception of the fluorescence from the tumor. When the laser device 166 is driven by a signal from the CPU 163, the laser beam reaches the cone mirror 150 through the optical fiber 155, where the laser beam is scattered in a 360 ° direction, and a part of the laser beam is scattered in the window 154a of the cover 154.
From the probe 149. In this case, cover 1
Since 54 is rotating, laser light is emitted in any direction of 360 °. The wavelength of the laser light is preferably 430 nm, but when a tumor on which a photosensitizer is accumulated is irradiated with the laser light, fluorescence having a wavelength of 615,670 nm is generated therefrom. This fluorescence is transmitted through window 154
Light is received from a, but enters the optical fiber 155 via the cone mirror 150. Further, the light is split by the spectroscope 165, and the wavelength is 615,
Only 670 nm fluorescence is detected. After detection, the signal is
3 and the CPU 163 processes and stores the signal,
The processed signal is transmitted to the CRT 168 to image the position of the tumor. In this way, the position of the tumor part can be accurately grasped by associating the position data of the window 154a with the fluorescence.
Note that a switching device for switching between the laser device 166 and the spectroscope 165 is not shown. By irradiating the grasped tumor part with a laser beam having a wavelength of 630 nm through a series of operations, the tumor cells are destroyed and the treatment is performed. According to the present embodiment, accurate position detection and treatment for a tumor can be performed.

FIGS. 21 and 22 show still another modification of the fifteenth embodiment, which differs from the above-described modification in that an ultrasonic transducer 171 is provided at the probe tip and an ultrasonic emission window 154b is formed in the cover 154. That is the point. The treatment with laser light is the same as in the above-described modification. To treat with ultrasound, the motor 16
1 is driven to rotate the cover 154, and the ultrasonic vibrator driving circuit 164 is driven to emit ultrasonic waves from the ultrasonic vibrator 171. A 400 nm spectrum is emitted from the tumor site where photosensitizers are accumulated by acoustic luminescence. By detecting the emission position of the spectrum through the window 3a and irradiating an ultrasonic wave thereto, the spectrum is absorbed and excited by the photosensitizer, thereby producing a cell killing effect. The treatment may be performed by detecting the position of the spectrum emitted by irradiation with ultrasonic waves and irradiating the position with laser light having a wavelength of 630 nm.

〔The invention's effect〕

As described above, according to the present invention, the ultrasonic transducer is exposed only in a necessary range so that the ultrasonic wave can be irradiated to a required affected part, so that a proper treatment can be performed by preventing the adverse effect on a normal part.

[Brief description of the drawings]

FIG. 1 is a schematic view showing a first embodiment of the present invention, FIG. 2, FIG. 3 is a schematic cross-sectional view of a probe according to a second embodiment and a schematic view showing a use state, FIG. , C and D show the third embodiment, FIG. 5 shows the fourth embodiment, FIG. 6 shows the fifth embodiment, FIG. 7 shows the sixth embodiment, FIG. 8 shows the seventh embodiment, FIG. FIG. 9 shows an eighth embodiment,
FIG. 9 shows the eighth embodiment, and FIGS. 10A and 10B show the ninth embodiment and FIGS.
Figure 10 is a tenth embodiment, Figs. 13 and 14 are actual use examples, Fig. 15 is an eleventh embodiment, Figs. 16A and B are catheter embodiments, Fig. 17
A and B show the twelfth embodiment, FIG. 18 shows the thirteenth embodiment, and FIGS.
Fourteenth Embodiment FIGS. 21 and 22 show the fifteenth embodiment. DESCRIPTION OF SYMBOLS 1 ... Top end component part 2 ... Ultrasonic vibrator 3 ... Vibrator unit, 7 ... Window 8 ... Cloth-like fiber, 10 ... Balloon 14 ... Ultrasonic drive device, 16 ... Issuance detection Display unit 19 Monitor unit 20 Ultrasonic image processing unit

Continuation of the front page (72) Inventor Seiji Iwasaki 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-Limpus Optics Kogyo Co., Ltd. (72) Inventor Naoki Sekino 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-Limpus Optics Within the Industrial Co., Ltd. (72) Naoki Uchiyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-Linpus Optical Industrial Co., Ltd. (72) Nobuhiko Watanabe 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-Rinpus Optical (56) References JP-A-2-126848 (JP, A)

Claims (5)

(57) [Claims] 1. A tumor treatment apparatus having an ultrasonic irradiation section and an observation section, wherein: a fluorescence detecting means for detecting fluorescence generated from the tumor at the tip of an insertion section into a body cavity constituting the ultrasonic irradiation section; An ultrasonic wave generating means for irradiating ultrasonic waves toward the object is provided. 2. The tumor treatment apparatus according to claim 1, wherein an ultrasonic element for diagnosis and an ultrasonic element for treatment are provided as ultrasonic wave generating means. 3. The tumor treatment apparatus according to claim 1, wherein said fluorescence detecting means is provided with means for detecting fluorescence from all directions orthogonal to the insertion axis of said insertion portion. 4. The tumor treatment apparatus according to claim 1, wherein a fluorescence intensity display means is provided on a monitor of the observation unit. 5. A tumor treatment apparatus having an ultrasonic irradiation section and an observation section, wherein the fluorescence detecting means of the ultrasonic irradiation section is provided at the tip of the insertion section into the body cavity, and the ultrasonic generation means is provided outside the body cavity. A tumor treatment device characterized by the above-mentioned.