JPH07227395A - Ultrasonic diagnostic and curing system - Google Patents

Abstract

PURPOSE:To provide an ultrasonic diagnostic and curing system which is insertible in a celom and is suitable for ultrasonic diagnosis and high temp. curing of an organ in a deep part. CONSTITUTION:An ultrasonic probe is constituted by providing a flexible part 23 and an apex part 22 adjoining to the flexible part 23 on the apex side of a slender inserting part 21 which can be inserted into a celom and arranging two concave convergent ultrasonic oscillators 50 for curing in the long direction in the apex part 22 and storing a narrow diameter ultrasonic prove 52 in such a way that an ultrasonic oscillating part 53 for observation is positioned at the central position between the ultrasonic oscillators 50 for curing.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic diagnostic treatment system having an ultrasonic probe for performing ultrasonic diagnosis and treatment with focused ultrasonic waves in a body cavity.

[0002]

2. Description of the Related Art Generally, an ultrasonic transducer repeatedly transmits an ultrasonic pulse into a living tissue, and an echo of the ultrasonic pulse reflected from the living tissue is received by an ultrasonic transducer provided in the same body or a separate body. Then, by gradually shifting the direction of transmitting and receiving this ultrasonic pulse, various ultrasonic diagnostic apparatuses have been proposed in the past, which display information collected from a plurality of directions in the living body as an ultrasonic tomographic image of a visible image. Has been done.

These ultrasonic diagnostic apparatuses generally use an external ultrasonic probe, but they are combined with an endoscope, an ultrasonic probe having a small diameter, and an ultrasonic wave inside a body cavity to be inserted into the body cavity. In-body ultrasonic probes such as probes are also widely used.

On the other hand, various ultrasonic treatment devices such as a calculus crushing device and an ultrasonic thermotherapy device for performing various treatments with focused ultrasonic waves have been proposed. Among these ultrasonic treatment devices, there is an ultrasonic high-temperature treatment device for instantaneously cauterizing and treating living tissue such as cancer cells with focused high-intensity ultrasonic waves.

In order to obtain a focused ultrasonic wave of high intensity, this ultrasonic high-temperature therapy apparatus focuses on an objective part from an extracorporeal applicator having an ultrasonic vibrator with a large opening, and also has a relatively small ultrasonic vibration. Intracorporeal probes that contain pups and are inserted into the rectum to treat an enlarged prostate are also known.

[0006] In addition, these ultrasonic high-temperature treatment devices,
As a positioning means for positioning the deep treatment site (focal point), for example, an ultrasonic diagnostic apparatus for obtaining an ultrasonic tomographic image is combined. Therefore, some of the extracorporeal applicators and the intracorporeal probes have a diagnostic ultrasonic transducer for focus positioning built therein.

[0007]

In such a conventional ultrasonic high-temperature treatment apparatus, particularly, one in which a probe in the body cavity is inserted into the rectum to treat the prostate, since the probe is thick and hard, It has very limited application and is difficult to insert and treat in lumens other than the rectum. Therefore, there is a problem that it is very difficult to perform ultrasonic diagnosis and high-temperature treatment by inserting it into the upper digestive tract, the lower digestive tract, the abdominal cavity or the like.

The present invention has been made to solve the above-mentioned problems in the conventional ultrasonic high-temperature therapy apparatus,
An object of the present invention is to provide an ultrasonic diagnostic treatment system having an ultrasonic probe that can be easily inserted into body cavities such as the upper digestive tract, lower digestive tract, and abdominal cavity to perform ultrasonic diagnosis of deep organs and high-temperature treatment. And

[0009]

In order to solve the above problems, the present invention provides an ultrasonic diagnostic treatment system having a thin tube that can be inserted into a body cavity, wherein the thin tube includes a curved portion, and the thin tube is provided. An ultrasonic transducer for obtaining an ultrasonic diagnostic image and a focused ultrasonic transducer for ultrasonic treatment are provided at the tip of the.

In the ultrasonic diagnostic treatment system configured as described above, an ultrasonic transducer for obtaining an ultrasonic diagnostic image is provided at the tip of a thin tube that can be inserted into a body cavity and has a curved portion, and an ultrasonic transducer for ultrasonic treatment. Since the focused ultrasonic transducer for this purpose is provided, it becomes possible to insert a thin tube into the body cavity and perform ultrasonic treatment under the ultrasonic diagnostic image in the deep part of the body cavity.

[0011]

EXAMPLES Next, examples of the present invention will be specifically described. 1 to 5 relate to a first embodiment of the present invention.
(A) and (B) show the appearance of an ultrasonic probe for abdominal cavity in plan view and side view, FIG. 2 shows the overall configuration of the ultrasonic diagnostic treatment system of the first embodiment, and FIG. 3 is an ultrasonic probe. 4 shows the configuration on the distal end side of FIG. 4, FIG. 4 shows a mode of use of the first embodiment, and FIG. 5 shows a state of ultrasonic wave transmission for observation and treatment.

(First Embodiment) As shown in FIG. 2, an ultrasonic diagnostic treatment system 1 according to the first embodiment includes an ultrasonic transducer 53 for observation and a therapeutic ultrasonic transducer for performing observation and treatment by ultrasonic waves. The ultrasonic probe 20 including an ultrasonic wave observation and treatment means (comprising the ultrasonic wave oscillator 50), a signal processing means for performing signal processing on the observation ultrasonic wave oscillator 53 built in the ultrasonic probe 20, and a therapeutic ultrasonic wave. An ultrasonic diagnostic treatment apparatus 2 including a drive unit for driving the ultrasonic wave oscillator 50, a color monitor 3 as a display unit for displaying an ultrasonic image signal generated by signal processing to the observation ultrasonic wave oscillator 53, The ultrasonic probe 20 comprises a transmission medium injector 4 for supplying an ultrasonic transmission medium to a detachable balloon 40 at the tip 22 of the ultrasonic probe 20.

As shown in FIG. 1, the ultrasonic probe 20 is formed into a thin tube (that is, a thin tube) so that it can be inserted into a body cavity and a rear end of the insertion section 21. A first grip portion 32 to be gripped and a thick operation portion 3 formed adjacent to the rear of the grip portion 32 and performing a bending operation.
0 and a second portion formed adjacent to the rear of the operation portion 30.
It has a grip portion 33 and a cord 34 extending from the grip portion 33. As shown in FIG. 2, the connector 5 provided at the end of the cord 34 can be detachably connected to the ultrasonic diagnostic treatment apparatus 2.

The insertion portion 21 in this embodiment is formed adjacent to the tip end 22 containing the ultrasonic transducer for observation and the ultrasonic transducer for concave focusing treatment and the rear end of the tip 22. And a long and rigid insertion tube 24 extending from the rear end of the bending portion 23 to the front end of the first grip portion 32.

The bending portion 2 is operated by rotating the bending operation knob 31 provided on the operation portion 30.
3 can be curved in any direction up and down, left and right.

Further, a balloon 40 for enclosing the ultrasonic transmission medium 7 which performs acoustic coupling can be attached to the tip portion 22, and the ultrasonic transmission medium 7 is connected to an injection port 35 provided in the second grip portion 33. The ultrasonic transmission medium 7 can be injected from the injector 4 via the tube 6 to be injected, and the transmission medium 7 injected into the injection port 35 is supplied into the balloon 40 via the conduit 8 in the ultrasonic probe 20. It is supposed to be done.

The signal line 12 connected to the ultrasonic transducer 53 for observation is inserted into, for example, the shaft 9 in the insertion portion 21, and is extended to the outside of the shaft 9 at the rotation support portion at the rear end of the shaft 9. It is connected to the transmission pulse generation circuit 13 and the reception processing circuit 14 in the ultrasonic treatment diagnostic apparatus 2 through the code 34. The transmission pulse generation circuit 13 generates a transmission pulse for emitting (transmitting) an ultrasonic wave for observation, and the signal line 12
The ultrasonic wave for observation 53 is applied to the ultrasonic wave for observation 53 through the ultrasonic wave, and the ultrasonic wave for observation 53 is excited to radially emit the ultrasonic wave for observation.

The ultrasonic waves reflected by the parts having different acoustic impedances and received by the observation ultrasonic vibrator 53 are converted into electric signals by the observation ultrasonic vibrator 53, and the signal line 12
Then, the signal is processed by the reception processing circuit 14 and converted into a video signal. This video signal is converted into a standard video signal by a digital scan converter (abbreviated as DSC) 15, is input to the color monitor 3, and an ultrasonic tomographic image 43 is displayed on the display surface of the color monitor 3.

A focus marker generation circuit 44 for displaying a focus marker 64 at an image position corresponding to the focus position (or focus point) 62 of the therapeutic ultrasonic transducer 50 is provided in the ultrasonic diagnostic treatment apparatus 2. The marker signal is provided on the display screen of the color monitor 3 together with the ultrasonic tomographic image 43 by superimposing the marker signal on the video signal output from the DSC 15 by the mixer 45.

A rotary encoder 16 is attached to the rotary shaft of the motor 10, and the rotary encoder 16 detects the rotation amount of the rotary shaft, that is, the angle of the observation ultrasonic transducer 53 in the scanning direction. The angle signal corresponding to the rotation amount (rotation angle) detected by the rotary encoder 16 is passed through the signal line in the cord 34 and the ultrasonic treatment diagnostic apparatus 2
It is input to the controller 17 inside.

The controller 17 outputs a timing signal for controlling the timing of the transmission pulse output from the transmission pulse generation circuit 13 and the signal processing timing of the reception processing circuit 14 according to the angle signal.

The concave focusing type ultrasonic transducer for treatment 50 built in the tip portion 22 is also connected to the signal line 18 inserted through the insertion portion 21 and the like, and the signal line 18 is inside the ultrasonic treatment diagnostic apparatus 2. Is connected to the drive signal generation circuit 19 of FIG. The drive signal generation circuit 19 generates a drive signal for driving the therapeutic ultrasonic transducer 50.

This drive signal has a signal level higher than the signal level of the transmission pulse that drives the observation ultrasonic oscillator 53, and the therapeutic ultrasonic oscillator 50 is much larger than the area size of the observation ultrasonic oscillator 53. It has a large concave shape, and each part of this concave shape is formed so as to exist on a spherical surface having a radius of curvature centered on the set focal point.

Then, the therapeutic ultrasonic beam emitted from the concave therapeutic ultrasonic transducer 50 forms a concave wavefront and travels in the direction opposite to the center of the concave surface. The beam is gradually focused, and the energy of the ultrasonic beam is set to be highest at the focusing point. Therefore, by applying a drive signal to the therapeutic ultrasonic transducer 50 in a state where the focal point is set in the diseased tissue, it is possible to perform a therapeutic treatment for cauterizing the diseased tissue with the focused ultrasonic beam and necrosis. I am able to do it.

A keyboard 26 and a foot switch 27 are connected to the controller 17,
By performing a level setting key input from the keyboard 26, the level of the drive signal output from the drive signal generation circuit 19 can be variably set.

Further, by stepping on the foot switch 27 to turn the switch on or off, the controller 1
7 can output or stop the output of the drive signal from the drive signal generation circuit 19.

As shown in FIG. 2, the curved portion 23 has substantially ring-shaped pieces 28, 28, ... Connected so as to be rotatable in the longitudinal direction of the insertion portion 21. Wires 29, 29 for bending operation are fixed to the tip piece 28 by welding or the like, and these wires 29, 29 are inserted through the insertion portion 21 behind the bending portion 23.
The rear end is fixed to the rotating member 37 to which the base end of the bending operation knob 31 is attached, and a bending mechanism is configured. Then, by rotating the bending operation knob 31, the rotating member 37 rotates, and with this rotation, one of the pair of wires 29, 29 is pulled (or pulled) and the other is loosened (or extended). Pair of wires 29,
29 moves forward and backward (or back and forth), and the piece 28 of the bending portion 23 can be bent to the pulled side.

As shown in FIG. 3, in this embodiment, the tip portion 2
An ultrasonic observation means built-in portion 51 'formed substantially in the central portion of 2
Has a built-in ultrasonic transducer portion 53 'of a general observation small-diameter ultrasonic probe 52 (indicated by the internal structure of the observation small-diameter ultrasonic probe 52 in FIG. The child 53 is built in the ultrasonic transducer housing 51 for observation). The treatment ultrasonic transducers 50 are built in the treatment ultrasonic transducer accommodating portions 57 on both sides of the observation ultrasonic accommodating portion 51.

In the ultrasonic observation means built-in portion 51 ', the ultrasonic transducer portion 5 of a general small-diameter ultrasonic probe 52 for observation.
3 is built in. This small-diameter ultrasonic probe 5 for observation
Reference numeral 2 is a mechanical sector scan type or mechanical radial scan type observation probe. In addition, the ultrasonic transmission medium 7 is enclosed in the internal space of the tip end portion 22 facing the radiation surface of the concave surface focusing type oscillator 50 and the ultrasonic observation means built-in portion 51 ', and passes through the ultrasonic transmission window. The ultrasonic waves can be transmitted.

Further, in this embodiment, the ultrasonic scanning range or the ultrasonic observation range 6 by the observation ultrasonic transducer 53 is used.
0 (see FIG. 5) at a predetermined position, the therapeutic ultrasonic transducer 5
Relative positioning of the observation ultrasonic transducer 53 and the therapeutic ultrasonic transducer 50 is performed in advance as a positioning means for positioning the focus point 62 (see FIG. 5) by 0.

Specifically, as shown in FIG. 2 or FIG. 3, the concave therapeutic ultrasonic transducer 50 is equally divided into two in the longitudinal direction so that a small space is formed in the longitudinal direction (longitudinal direction). And the observation ultrasonic transducers 51 are arranged in the space between them. Then, for example, the ultrasonic scanning range 6 by the observation ultrasonic transducer 51
Focus point 6 on the radiation that emits ultrasound at a central angle of 0
Mechanical positioning is performed in advance so that 2 is positioned.

Therefore, the focus marker 64 corresponds to the ultrasonic scanning range 60 corresponding to the relative positioning states of the observation ultrasonic transducer 53 and the therapeutic ultrasonic transducer 50 which are mechanically set. A focus marker 64 (on the image corresponding to the focus point 62) is displayed so that the position of the focus point 62 can be confirmed on the acoustic tomographic image 43. The observation ultrasonic wave oscillator 53 and the therapeutic ultrasonic wave oscillator 50 can be formed with almost the same structure as the sectional structure shown in FIG.

The ultrasonic probe 2 configured as described above
As shown in FIG. 4, 0 is inserted into the abdominal cavity of the abdominal cavity via a trocar, and the distal end portion 22 is bent while performing a bending operation.
Contact the surface of the organ to be treated. Next, the transmission pulse from the transmission pulse generation circuit 13 of the ultrasonic diagnostic treatment instrument 2 is applied to the observation ultrasonic transducer 53 of the observation small-diameter ultrasonic probe 52 to emit the observation ultrasonic wave to the organ side. To do.

In this case, the ultrasonic transducer 53 for observation is reciprocally rotated by the motor 10 within a set angle, for example, so that the ultrasonic wave is intermittently discontinuous in the ultrasonic observation area range shown by reference numeral 60 in FIG. At the same time as being radiated, the reflected ultrasonic wave is received by the observation ultrasonic vibrator 53 and converted into an electric signal. The signals transmitted and received in the ultrasonic observation area range 60 are processed by the reception processing circuit 14, and as shown in FIG. 2, a tomographic image by an ultrasonic wave inside the organ, that is, an ultrasonic wave, is displayed on the display surface of the color monitor 3 via the DSC 15. The sound wave tomographic image 43 is rendered.

Then, the lesion area 6 is displayed on the ultrasonic diagnostic image 43.
The tip 22 is moved so that 3 is drawn. Then, when the lesioned part 63 is visualized on the ultrasonic diagnostic image 43, the focus marker 64 displayed by superimposing on the diagnostic image 43 is curved so as to match or overlap the position of the lesioned part. Bending of the portion 23 or the tip 2
Set the position by adjusting the position 2 and so on.

After this positioning setting, the driving signal generating circuit 19 irradiates the focused ultrasonic wave for treatment having a required intensity from the concave surface focusing type vibrator 50. This high-intensity therapeutic ultrasonic wave rapidly increases the temperature of the lesion portion 63 at the focal position, and can cauterize the lesion tissue.

While observing the state of protein degeneration of the tissue due to this cauterization on the ultrasonic diagnostic image 43, irradiation with high-intensity therapeutic ultrasonic waves is carried out until the amount of protein degeneration required for necrosis of the lesion cells progresses. . After that, the irradiation of high-intensity therapeutic ultrasonic waves is stopped, and the degree of achievement of the treatment is determined by the ultrasonic diagnostic image 43.
After confirming the above, if irradiation is insufficient, additional irradiation is continued. If irradiation to another portion is necessary, the treatment is continued in the same manner as above, and all treatments are terminated.

Although mainly described with reference to FIG. 2, this state is also shown in a simulated manner in FIG. As shown in FIG. 6, after the lesion 63 is captured in the ultrasonic observation region 60, the focus point 62 in the therapeutic focused ultrasonic beam 61 by the therapeutic ultrasonic transducer 50 is positioned at the lesion 63. , The focus marker 64 and the lesion 63 displayed on the ultrasonic diagnostic image 43
The position of the ultrasonic probe 20 is set by a bending operation or the like with reference to the ultrasonic image of 1.

After the positioning of the focal point is completed, the drive signal generating circuit 19 irradiates the focused ultrasonic wave for treatment having a necessary intensity from the concave surface focusing type transducer 50, and the ultrasonic wave for high intensity treatment causes the tissue of the lesion portion 63 to be irradiated. Cauterize.

As described above, according to the first embodiment, an ultrasonic probe having an ultrasonic observation function, an ultrasonic high-temperature treatment function, and an insertion and bending function is used to insert the ultrasonic probe into the abdominal cavity to deep organs. The ultrasonic high-temperature treatment can be performed in a state in which the ultrasonic diagnostic image can be obtained.

More specifically, since the ultrasonic probe is provided with a bendable bending portion, an observation ultrasonic transducer and a therapeutic ultrasonic transducer on the distal end side of an elongated insertion portion, the bending portion By curving, it is possible to easily set a state in which the observation ultrasonic wave and the therapeutic ultrasonic wave can be irradiated to the ablation target site side. In addition, since the focus marker can be displayed so that the focal point of the therapeutic ultrasonic wave is displayed at a predetermined position on the ultrasonic diagnostic image by the observation ultrasonic wave, a lesion part or the like is displayed at the position of the focus marker. By setting a site to be cauterized and irradiating it with therapeutic ultrasonic waves, the site can be cauterized and the state of the site can be observed on the ultrasonic diagnostic image. Therefore, it is possible to easily carry out therapeutic treatment with an appropriate amount of cauterization.

(Second Embodiment) Next, a second embodiment will be described. FIG. 6 is a diagram showing a main part of the second embodiment.
Components that are the same as or correspond to those of the first embodiment shown in FIG. In this embodiment, the ultrasonic observation means provided at the tip portion 22 of the ultrasonic probe 20 is an electronic radial array type ultrasonic transducer 54, and it is possible to obtain the same effects as those of the first embodiment. In addition, since there is no shift in image transfer peculiar to mechanical scanning, there is an effect that positioning of a focal point on a lesion image on an ultrasonic diagnostic image becomes extremely accurate.

(Third Embodiment) Next, a third embodiment will be described. FIG. 7 shows a third embodiment, and the same or corresponding components as those of the first embodiment shown in FIG. 1 are designated by the same reference numerals. In this embodiment, a distal end portion 22 of the ultrasonic probe 20 has a therapeutic concave focusing transducer (not shown) built therein, as in the first and second embodiments.
A convex ultrasonic transducer array 55 is provided as an ultrasonic transducer for observation between the tip portion 22 and the curved portion 23.

This convex type ultrasonic transducer array 5
Since the ultrasonic observation region 60 of No. 5 is offset in the direction of the tip 22 in a so-called front perspective type,
It is possible to capture the focal point 62 of the focused ultrasonic beam 61 by the therapeutic focused oscillator in the ultrasonic diagnostic image and display the marker thereof on the diagnostic image. Therefore, according to the present embodiment, it is possible to separately provide a means for performing ultrasonic treatment and a means for performing ultrasonic observation at the tip portion, which simplifies the configuration of the tip portion of the ultrasonic probe. In addition to the effect, it is also possible to obtain the effect of increasing the opening diameter of the therapeutic concave converging type vibrator to further increase the ultrasonic intensity for ultrasonic high temperature treatment and further improving the therapeutic efficiency.

(Fourth Embodiment) Next, a fourth embodiment will be described. FIG. 8 is a diagram showing a main part of the fourth embodiment, and the same or corresponding members as those of the first embodiment shown in FIG. 1 are designated by the same reference numerals. In this embodiment, an electronic linear scan ultrasonic transducer array 56 is provided on the central axis of the tip 22 of the ultrasonic probe 20, and therapeutic concave focusing transducers 50 are provided on both sides thereof. .

Even with such a configuration, the basic operation and effect are the same, and, as in the case of using the electronic radial scan type oscillator as the ultrasonic observation means in the second embodiment, the tip portion is not therapeutic. It is possible to practically combine oscillators for diagnosis.

(Fifth Embodiment) Next, a fifth embodiment will be described. FIG. 9 is a schematic diagram showing a usage state of the fifth embodiment. In this embodiment, the ultrasonic endoscope 71 is configured by combining the distal end portion 22 of the ultrasonic probe 20 shown in the first to fourth embodiments with the distal end of a flexible endoscope 70 having a front perspective optical system. Is.

For example, the distal end side of the ultrasonic endoscope 71 having the structure in which the distal end portion 22 of the ultrasonic probe 20 shown in the first embodiment is provided on the distal end side of the flexible endoscope 70 having the optical system of the front perspective. The configuration is shown in FIG. 10, and an ultrasonic diagnostic treatment system 72 using this ultrasonic endoscope 71 is shown in FIG.

The ultrasonic diagnostic treatment system 72 of FIG. 11 is different from the ultrasonic diagnostic treatment system 1 of FIG. 2 in that an ultrasonic endoscope 71 is used instead of the ultrasonic probe 20 and the light of the ultrasonic endoscope 71 is changed. This is a configuration including a light source device 73 that supplies illumination light to the guide.

The ultrasonic endoscope 71 is provided with an illumination optical system 74 and an observation optical system 75 as optical observation means at the tip of the ultrasonic probe 20.

That is, the illumination light of the lamp 76 in the light source device 73 is transmitted by the light guide 77, and the illumination optical system 74 is attached to the observation window facing the tip surface from the tip surface fixed to the tip portion 22. After that, the light is emitted obliquely forward and illuminates the object side obliquely forward.

The illuminated object is imaged on its focal plane by the observation optical system 75 attached to the observation window provided adjacent to the observation window. The tip end surface of the image guide 78 formed of a flexible fiber bundle is arranged on this focal plane. The image guide 78 is inserted through the insertion section 21 and the operation section 30, and its rear end is arranged in the vicinity of an eyepiece 79 provided at the rear end of the operation section 30 and transmits the image of the front end surface to the rear end surface. . The image transmitted to the rear end face can be observed through the eyepiece optical system 79a attached to the eyepiece window of the eyepiece unit 79.

In this embodiment, the injection port 35 is provided in the light guide connector 77a. The other structure is the same as that of the first embodiment, and the same components are given the same reference numerals and the description thereof is omitted.

According to this embodiment, there is a means for optically observing. Therefore, when ultrasonically observing or treating a target organ or a site such as an affected area, ultrasonic waves are applied to the target site. It becomes easy to set the distal end portion 22 in a state in which it can be emitted and observed and treated.

Further, even when the treatment is performed by inserting it into the abdominal cavity, for example, it is not necessary to provide a hole for inserting an endoscope for optical observation in addition to the hole for ultrasonic treatment. Therefore, the pain for the patient can be reduced.

FIGS. 9 and 10 show the case of the flexible endoscope 70 having the optical system of the front perspective in which the tip portion 22 of the ultrasonic probe 20 shown in the first embodiment is combined, but other embodiments. It can also be configured in combination with.

Concretely, as shown in FIG. 12 and FIG. 12, the distal end portions of the second, third and fourth embodiments shown in FIGS. 6, 7 and 8 are combined with the distal end of the endoscope 70, respectively. 13, shown in FIG.

According to the ultrasonic diagnostic treatment system having such a configuration, the distal end portion is inserted into the upper or lower digestive tract under the guidance of the optical image, and the deep organ inside the wall of the digestive tract is subjected to the ultrasonic diagnostic image. It becomes possible to perform ultrasonic hyperthermia treatment under the guidance of. Therefore, the application of the ultrasonic diagnostic treatment system of the present invention can be dramatically expanded.

Next, a sixth embodiment of the present invention will be described. In the embodiment shown above, an ultrasonic transducer for obtaining an ultrasonic diagnostic image by an ultrasonic probe for observation, a convex array, an electronic radial array or a linear array, and a focused ultrasonic wave for ultrasonic treatment. It was used as a separate unit from the oscillator and these were combined.

As the constitution for achieving the object of the present invention and obtaining the same effect as that of the previous embodiment, an ultrasonic transducer for obtaining an ultrasonic diagnostic image and a focused ultrasonic vibration for ultrasonic treatment are provided. It may be an ultrasonic transducer for observation and treatment that is integrated with the child.

(Sixth Embodiment) Next, a sixth embodiment of the present invention will be described. In the embodiment shown above, an ultrasonic transducer for obtaining an ultrasonic diagnostic image by an ultrasonic probe for observation, a convex array, an electronic radial array or a linear array, and a focused ultrasonic wave for ultrasonic treatment. It was used as a separate unit from the oscillator and these were combined.

As the constitution for attaining the object of the present invention and obtaining the same effect as that of the previous embodiment, an ultrasonic transducer for obtaining an ultrasonic diagnostic image and a focused ultrasonic vibration for ultrasonic treatment are used. It may be an ultrasonic transducer for observation and treatment that is integrated with the child.

FIG. 15 shows the structure of the ultrasonic probe 20 in which the ultrasonic transducer 80 for both observation and treatment is incorporated in the tip portion 22.

The ultrasonic transducer 80 for both observation and treatment is provided in the tip portion provided with an acoustic window having a high acoustic transmittance so that the tip end portion of the transducer 80 can be rotated (rotatably). , Is attached to the inner wall surface of the tip of the tip portion 22 by a pin 90. At the base end of the vibrator 80, the tip of the flexible shaft 91 inserted into the ultrasonic probe 20 is attached to the tip 22 through a bearing 92 with a packing that maintains a watertight state inside the tip 22. ing.

The flexible shaft 91 is connected to a motor (not shown) which serves as a rotation driving means, and the rotation of the motor causes the shaft 90 to reciprocate around the axes of the pin 90 and the flexible shaft 91 in a sector shape as shown by reference numeral 65a in FIG. It is rotated (or rotationally vibrated), or is rotationally driven as indicated by reference numeral 65b. When it is reciprocally rotated in a sector shape, a sector image 60a (actually displayed on the monitor screen) by a mechanical sector scan is obtained as shown by a chain double-dashed line, and when it is rotated, a thin line is drawn. As shown, a radial image 60b is obtained by mechanical radial scanning.

FIG. 16 shows an ultrasonic transducer 80 for both observation and treatment.
Shows the appearance of. Transducer radiation surface 81 formed in a concave shape
Emits a therapeutic ultrasonic wave and an observation ultrasonic wave. In this emission surface 81, for example, a small-sized square (or circular) area indicated by reference numeral 82 at the center is an observation ultrasonic wave emission area for emitting observation ultrasonic waves.
A wide area other than this is a therapeutic ultrasonic wave emitting area for emitting therapeutic ultrasonic waves.

FIG. 17A shows the structure of the ultrasonic transducer or the piezoelectric element which constitutes the ultrasonic transducer 80 for both observation and treatment. A matching layer 85 and a backing layer 86 are provided in the central region of the concave piezoelectric element 83 so that this region is in a state suitable for emitting observation ultrasonic waves. In addition, the region other than the central region is provided with a matching layer 84 suitable for emitting therapeutic ultrasonic waves with high efficiency.

Instead of the structure shown in FIG.
The structure shown in (b) may be adopted. This FIG.
In the structure (b), the matching layer 85 and the backing layer 86 are provided only in the central region of the concave piezoelectric element 83 that emits the ultrasonic waves for observation.

Instead of FIG. 17A or 17B, a concave surface type piezoelectric element 8 as shown in FIG. 17C is used.
A matching layer 87 suitable for emitting observation and therapeutic ultrasonic waves is provided on the entire emission surface of 3, and a backing 86 suitable for emitting observation ultrasonic waves is provided in the central region of the back surface of the piezoelectric element 83. A region other than this region may be provided with a backing 88 suitable for emitting therapeutic ultrasonic waves.

As shown in FIG. 18A, the observation / treatment ultrasonic transducer 80 has an ultrasonic ultrasonic transducer 97 incorporated in the center of the radiation surface 96 of the therapeutic ultrasonic transducer 95. Anything is fine.

The structure of the cross section of FIG. 18 (a) is shown in FIG. 18 (b).
Shown in. In the circular hole provided in the central portion of the concave type ultrasonic transducer for treatment 95, a disc-shaped ultrasonic transducer for observation 97 having an inner diameter of the hole as an outer diameter is inserted so as to substantially fit,
It is fixed with an adhesive or the like. Electrodes 98a and 98b to which a drive signal is applied are fixed to both surfaces of a piezoelectric element 83a that constitutes the therapeutic ultrasonic transducer 95 by sticking or the like. A matching layer 84 suitable for radiating therapeutic ultrasonic waves with high efficiency is provided on the concave surface side of the piezoelectric element 83a, that is, on the radiation surface side. A backing layer 86 is provided on the back surface side of the piezoelectric element 83a.

Further, electrodes 99a and 99b to which a driving pulse is applied are also fixed to both surfaces of the piezoelectric element 83b constituting the observation ultrasonic vibrator 97 by adhesion or the like. A matching layer 85 suitable for emitting the observation ultrasonic waves with high efficiency is provided on the concave surface side of the piezoelectric element 83b, that is, on the emitting surface side. A backing layer 86 is provided on the back surface side of the piezoelectric element 83b.

For example, the electrodes 98a and 99a on the radiation surface side are G
The signal lines 18 and 12 are connected to the ND, and the drive signals or the transmission pulses are applied to the electrodes 98b and 99b on the back surface side, respectively.

The ultrasonic transducer 80 for both observation and treatment is shown in FIG.
At the center of the back surface of the therapeutic ultrasonic transducer 95, as shown in
The ultrasonic transducer 97 for observation may be incorporated, or the ultrasonic transducer 97 may be attached by being attached to the center of the back surface.

Further, FIG. 20 shows the distal end portion 2 of the flexible endoscope 70.
2 shows the configuration of an ultrasonic endoscope 71 incorporating an ultrasonic transducer 80 for both observation and treatment, which is driven in the same manner as in the case of FIG.

Next, the operation will be described. The ultrasonic transducer 80 for both observation and treatment configured as described above is designated by reference numeral 6 in FIG. 15 or FIG.
5a is a reciprocal rotation to perform a mechanical sector scan or 65b is a mechanical radial scan to perform a mechanical radial scan, and at the same time, an ultrasonic wave for observation is emitted to form an ultrasonic diagnostic sector image 6 for ultrasonic diagnosis.
0a or the ultrasonic diagnostic radial image 60b is obtained.

At this time, the ultrasonic transducer 80 for both observation and treatment
Matching layer 85 provided in the central portion of the piezoelectric element 83 of
And the backing layer 86 intermittently radiate a broadband ultrasonic pulse, and the reflected reflected ultrasonic wave is received and used for generating an ultrasonic diagnostic image.

Then, the lesion area is visualized on the ultrasonic diagnostic image, the focus marker displayed on the diagnostic image is aligned with the lesion area, and the position is set. Then, the ultrasonic transducer for both observation and treatment is used. The focal point of 80 is directed to the set position (angle), and the reciprocating rotation or rotation of the vibrator 80 is stopped.

Then, the ultrasonic wave for treatment is radiated by driving the portion other than the observation function portion in the central region of the ultrasonic transducer 80 for both observation and treatment by continuous wave or intermittent wave. At this time, since the ultrasonic wave oscillator 80 for both observation and treatment has a structure suitable for radiating a narrow band ultrasonic wave around the central portion of the piezoelectric element as described above, it is highly efficient and high. Intense ultrasonic waves are emitted.

After irradiating the lesion with the focused ultrasonic wave for treatment, the above-mentioned ultrasonic observation is performed again to confirm the degree of high temperature ablation on the ultrasonic diagnostic image. According to the sixth embodiment, since the ultrasonic transducer 80 for both observation and treatment is used for both observation and treatment, the ultrasonic transducer 80 is incorporated in the tip portion more easily than the case where each oscillator is incorporated separately. be able to.

Further, unlike the case of a separate body, there is almost no need for an adjusting operation for setting each transducer at a relatively proper position.
That is, in the case of a separate body, it is necessary to adjust the positions of the transducers so that the focal point of the therapeutic ultrasonic waves is located at a predetermined position in the observation range of the observation ultrasonic transducers. When integrated as in the sixth embodiment, for example, the piezoelectric element 83 is composed of a concave surface having a single radius of curvature, and a part of the central portion of the piezoelectric element 83 that is substantially flat is used as an ultrasonic transducer for observation. When the remaining portion is used as the therapeutic ultrasonic transducer, the focal point of the therapeutic ultrasonic wave is automatically located at a predetermined position in the observation range of the observation ultrasonic transducer.

[Additional Notes] 1. Treatment of the target part with a bendable part at the tip of an elongated insertion part that can be inserted into a body cavity, an ultrasonic transducer for observation that transmits and receives ultrasonic waves for obtaining an ultrasonic image. Ultrasonic observation and treatment means respectively provided with a therapeutic ultrasonic transducer for focusing and irradiating ultrasonic waves for performing; and generating a signal for driving the observation ultrasonic transducer,
Signal processing means for performing signal processing for generating an image with respect to the ultrasonic waves received by the ultrasonic transducer for observation; driving for driving the ultrasonic transducer for treatment and generating ultrasonic waves for treatment An ultrasonic diagnostic treatment system comprising: a driving unit that generates a signal; and a display unit that displays the video signal generated by the signal processing unit. The ultrasonic observation and treatment means is provided with a bendable bending portion, an observation ultrasonic transducer, and a therapeutic ultrasonic transducer on the distal end side of the elongated insertion portion. It is possible to easily set the state in which the observation ultrasonic waves and the therapeutic ultrasonic waves can be applied to the site side, and it is possible to observe the state of the site irradiated with the therapeutic ultrasonic waves with the ultrasonic diagnostic image by the observation ultrasonic waves. .

2. An elongated insertion part that can be inserted into the body cavity,
A therapeutic ultrasonic transducer that is disposed on the distal end side of the insertion portion and emits so as to focus therapeutic ultrasonic waves for performing treatment on the target site, and an ultrasonic wave disposed on the distal end side of the insertion portion. An ultrasonic transducer for observation that transmits and receives ultrasonic waves for observation over a scanning range set to obtain an image, and positioning means for setting a focal point of the therapeutic ultrasonic wave at a predetermined position in the scanning range, An ultrasonic probe having. Since the positioning means for setting the focal point of the therapeutic ultrasonic wave at the predetermined position of the scanning range by the ultrasonic transducer for observation is provided, the therapeutic ultrasonic wave is set in the state where the lesion is set at the predetermined position of the scanning range. By irradiating, the tissue of the lesion can be cauterized at high temperature.

[0084]

As described above on the basis of the embodiments,
According to the present invention, since the distal end portion of the thin tube that can be inserted into the body cavity and has the curved portion is provided with the ultrasonic transducer for ultrasonic diagnosis and the focused ultrasonic transducer for ultrasonic treatment. It is possible to insert a thin tube into the body cavity and perform ultrasonic treatment under the ultrasonic diagnostic image of the deep inside of the body cavity. Further, the distal end of the thin tube can be brought into close contact with the living tissue by the bending function of the thin tube, and the operability of positioning the focal point of the therapeutic focused ultrasonic wave from the focused ultrasonic element is significantly improved. Furthermore, since it is possible to realize a soft and hard probe, the application of ultrasonic therapy can be greatly expanded.

[Brief description of drawings]

FIG. 1 is a plan view and a side view showing an appearance of an ultrasonic probe according to a first embodiment of the present invention.

FIG. 2 is an overall configuration diagram of the ultrasonic diagnostic treatment system according to the first embodiment of the present invention.

FIG. 3 is a cross-sectional view showing the configuration of the tip portion in the first embodiment shown in FIG.

FIG. 4 is a diagram showing a mode of use of the ultrasonic probe of the first embodiment.

FIG. 5 is a diagram showing a state in which ultrasonic waves are transmitted from the tip of the ultrasonic probe of the first embodiment.

FIG. 6 is a diagram showing a tip portion of an ultrasonic probe according to a second embodiment of the invention.

FIG. 7 is a side view showing a third embodiment of the present invention.

FIG. 8 is a diagram showing a tip portion in a fourth embodiment of the present invention.

FIG. 9 is a schematic diagram showing a mode of use in a fifth embodiment of the present invention.

FIG. 10 is a diagram showing a specific configuration example of the tip side of the ultrasonic probe of the fifth embodiment.

FIG. 11 is an overall configuration diagram of an ultrasonic diagnostic treatment system according to a fifth embodiment.

FIG. 12 is a diagram showing another configuration example in the fifth embodiment.

FIG. 13 is a diagram showing another configuration example of the fifth embodiment.

FIG. 14 is a diagram showing another configuration example of the fifth embodiment.

FIG. 15 is a diagram showing the configuration on the tip side of an ultrasonic probe according to a sixth embodiment of the present invention.

16 is a diagram showing an appearance of the ultrasonic transducer for both observation and treatment shown in FIG.

FIG. 17 is a sectional view of an ultrasonic transducer for both observation and treatment.

FIG. 18 is a view showing an ultrasonic transducer for both observation and treatment, which has a configuration example different from that of FIG. 16;

FIG. 19 is a diagram showing an ultrasonic transducer for both observation and treatment, which has a configuration example different from that of FIG. 16;

FIG. 20 is a diagram showing a distal end side of an ultrasonic probe having a configuration example different from that of FIG. 15;

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic treatment system 2 ... Ultrasonic diagnostic treatment apparatus 3 ... Color monitor 20 ... Ultrasonic probe 21 ... Insertion part 22 ... Tip part 23 ... Bending part 24 ... Insertion tube 30 ... Operation part 31 ... Bending operation knob 32 ... First gripping portion 33 ... Second gripping portion 40 ... Balloon 50 ... Concave focusing type transducer for treatment 51 ... Ultrasonic observation means built-in portion 52 ... Small diameter ultrasonic probe 53 for observation ... Ultrasonic transducer portion 54 ... Electronic radial array type ultrasonic transducer 55 ... Convex type ultrasonic transducer array 56 ... Electronic linear scan ultrasonic transducer 60 ... Ultrasonic observation area 61 ... Focused ultrasonic beam 62 ... Focused focus 63 ... Lesion 64 ... Focus marker

Claims (1)

[Claims] 1. An ultrasonic diagnostic treatment system having a thin tube that can be inserted into a body cavity, wherein the thin tube has a curved portion,
An ultrasonic diagnostic treatment system comprising an ultrasonic transducer for obtaining an ultrasonic diagnostic image and a focused ultrasonic transducer for ultrasonic treatment at the tip of the thin tube.