JPH11313832A - Ultrasound therapy equipment - Google Patents

Abstract

(57) [Summary] [PROBLEMS] In ultrasonic heating treatment, the inconvenience that tumor tissue survives without being heated to the killing temperature or that even normal cells are killed by excessive heating. To prevent SOLUTION: A plurality of temperature sensors 60 and intensity sensors 61 are provided along the outer circumference of an intracavity probe 27 inserted into a body cavity of a subject. Then, based on the respective detection outputs from the temperature sensor 60 and the intensity sensor 61, the ultrasonic irradiation conditions of the intracavity probe 27 are controlled so that the temperature of the part to which the ultrasonic waves are irradiated becomes a predetermined temperature. Thereby, the temperature of the site to be irradiated with the ultrasonic wave can be always kept constant at the temperature at which the tumor tissue is killed, and the above-mentioned omission of treatment and overheating can be prevented.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus for treating a tumor or the like in a living body using ultrasonic waves.

[0002]

2. Description of the Related Art In recent years, a calculus crushing device for crushing calculus non-invasively by irradiating a powerful ultrasonic wave from outside the body for the treatment of calculus disease has been put into practical use and attracted attention. As a powerful ultrasonic source, an underwater discharge method, an electromagnetic induction method, a micro explosion method, a method using a piezo element, and the like are conceivable, and each has a disadvantage and an advantage. The method using a piezo element has the disadvantage that the pressure of the strong ultrasonic focus is small, but there is no small focus, no consumables, it is possible to arbitrarily control the strong ultrasonic intensity, and the phase control of the drive waveform applied to multiple piezo elements And the focus position can be controlled by performing such operations (JP-A-60-145131, USP-452616).
8). Further, the shape of the focal point can be changed by controlling the phase of the driving waveform (Japanese Patent Laid-Open No. 62-427).
73).

On the other hand, as one of the treatment techniques for malignant neoplasms, so-called cancer, hyperthermia has been attracting attention. This is based on the fact that tumor tissues have higher temperature sensitivity than normal tissues and die when heated to 42.5 ° C. or higher, and a method of locally heating a tumor site is particularly effective. It is.

As a method of heating, a method using electromagnetic waves such as microwaves has been preceded. However, it is difficult to selectively heat deep tumors due to electrical characteristics of a living body. Are limited to superficial (within 5 cm deep) tumors.

[0005] Therefore, a method using acoustic energy such as ultrasonic waves has been considered for treating deep tumors. This utilizes the characteristics of the convergence of the ultrasonic beam and the deep arrival depth. In addition, there has been reported a treatment method in which the above-mentioned heating treatment is advanced to heat the tumor portion to 80 ° C. or more, thereby burning out the tumor tissue (Japanese Patent Application No. 3-306).
No. 106).

[0006] The ultrasonic heating method includes an ultrasonic transducer in which a plurality of ultrasonic transducers having a spherical ultrasonic radiation surface are combined, or an annular transducer in which ring-shaped ultrasonic transducers are concentrically arranged. Those using an array ultrasonic transducer have been proposed. In particular, when an annular array ultrasonic transducer is used, the depth of focus can be changed.

Further, a phased array capable of changing the focus three-dimensionally by taking a step further has been proposed (US Pat. No. 4,526,168). In addition, a device in which a calculus crushing device and a heating / heating device are integrated has been proposed (Japanese Patent Application No. 3-306106).

As for the heating / heating device as described above, there has been proposed a method of uniformly heating / heating an affected part by utilizing a small focus which is a feature of the piezo method (Japanese Patent Application Laid-Open No. Sho 61). -209643).

[0009]

However, the conventional ultrasonic therapy apparatus has a problem in that the temperature of the tumor cannot be known when the tumor is heated, and thus the treatment is leaked or overheated.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and it is possible to prevent a treatment omission or an inconvenience of excessive heating by detecting a temperature of a tumor and changing a treatment condition. The purpose of the present invention is to provide a simple ultrasonic therapy apparatus.

[0011]

An ultrasonic therapy apparatus according to the present invention is, as a means for solving the above-mentioned problems, inserted into a body cavity of a subject and irradiates a predetermined portion of the subject with ultrasonic waves. An intracavity probe to be provided, an intensity sensor provided on the intracavity probe, for detecting the intensity of the ultrasonic wave emitted from the intracavity probe, and an intensity sensor provided on the intracavity probe, A temperature sensor for detecting the temperature of the irradiated part, and an ultrasonic sensor for detecting the temperature of the part to be irradiated with the ultrasonic wave based on each detection output from the intensity sensor and the temperature sensor. Control means for controlling the irradiation conditions of the acoustic wave.

[0012] In the ultrasonic therapy apparatus according to the present invention, the control means determines a portion to be irradiated with the ultrasonic wave based on each detection output from the intensity sensor and the temperature sensor provided in the intracavity probe. The ultrasonic irradiation conditions of the intra-cavity probe are controlled so that the temperature becomes a predetermined temperature.

[0013] Thereby, it is possible to prevent the omission of treatment in which the tumor tissue survives without being heated to the killing temperature, and the inconvenience of overheating to kill even the normal cells, thereby enabling accurate treatment. It can be performed.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of an ultrasonic therapy apparatus according to the present invention will be described below with reference to the drawings.

[First Embodiment] FIG. 1 is a block diagram of an ultrasonic therapy apparatus according to a first embodiment of the present invention. In FIG. 1, the ultrasonic therapy device is
It has an “ultrasonic treatment section” and a “CT section for positioning”.

The ultrasonic treatment section comprises a spherical ultrasonic transducer 2 for irradiating one or more powerful ultrasonic waves for treatment, a coupling liquid 4 for guiding the powerful ultrasonic waves to a patient 3, It has an ultrasonic applicator 1 consisting of a water bag 5 for holding the coupling liquid 4 in a sealed state.

During treatment, the ultrasonic applicator 1
Is placed on the body surface, and the water bag 5 is brought into contact with the skin of the patient 3 using an ultrasonic jelly or the like (not shown). Then, after the focal point 6 coincides with the tumor 7, the ultrasonic vibrator 2 is driven by the drive circuit 8 to irradiate high-intensity ultrasonic waves.

In the ultrasonic therapy apparatus according to the first embodiment, an MRI is used as a positioning CT unit. In this MRI, a patient 3 is set on a motorized table 8 in a supine position, and is placed in an imaging gantry (not shown) in which a static magnetic field coil 9, a gradient magnetic field coil 10, and a transmitting / receiving RF coil 11 are incorporated. Sent in. At this time, the control circuit 1
The table moving device 13 moves the table 8 by the control of 2 to fix the patient 3 at a predetermined position (A position).

Next, the control circuit 12 activates the gradient magnetic field power supply 14 and the transmission / reception circuit 15 in accordance with a predetermined sequence (for example, T2-weighted imaging method) instructed from the console 16, and the patient 3
The image information of the multi-plane in the body is stored in a memory (not shown). This three-dimensional information is stored in C by the control circuit 12.
An arbitrary form such as a pseudo three-dimensional display using a wire frame is displayed on the RT 17 and is frozen.

Here, the operator inputs a treatment plan from the console 16 while viewing the image of the inside of the body including the tumor 7 which is the treatment site. Here, the treatment plan refers to the method of scanning the focal point 6, the irradiation intensity of ultrasonic waves, the time, the interval, and the like.

When the start of treatment is instructed from the console 16, the control circuit 12 moves the table 8 to move the patient 3 to the treatment position (B position). When the movement is completed, the control circuit 12 controls the mechanical arm 18 to move the applicator 1 to the treatment position.

At this time, the position of the focal point 6 of the strong ultrasonic wave in the body is determined in advance by a signal from an applicator position detecting device 19 composed of a potentiometer (not shown) or the like attached to each part of the mechanical arm 18 and The control circuit 12 calculates from the measured information on the mounting position of the MRI apparatus and the mechanical arm 18 and displays it on the MRI image of the CRT 17.

Further, not only the focal point but also the incident path of the ultrasonic wave can be displayed together, which is considered to be useful in making a treatment plan in consideration of the influence of bones and the like in the middle.
The state of coincidence between the position of the focal point 6 and the initially determined focal position of the treatment plan is checked, the control circuit 12 instructs the drive circuit 8 to start ultrasonic irradiation, and the treatment is started.

Next, the irradiation of the ultrasonic wave is stopped at the time when the treatment is considered to be intermediate or completed, the applicator 1 is removed from the patient 3, the patient is moved to the A position, and the progress of the treatment is observed. This is performed in the same manner as in the above-described operation, and an MRI image around the tumor 7 is taken to examine a change in a living body.

Here, when the data of the T2-weighted image stored in the memory before the treatment and the current data are subtracted, the thermally degenerated region can be clearly confirmed, and whether the treatment has been sufficiently performed or has been insufficiently performed. Can be used to determine if re-treatment is necessary. Also, this was included in the treatment plan from the beginning,
It is also possible to automatically take an image every predetermined treatment time.

When the initial treatment plan has been completed and the situation is such that it is possible to determine that the treatment has been sufficiently completed by judging the treatment effect by MRI, the operator terminates the treatment. At this time, the control circuit 12 can retrieve the history of the treatment condition from the memory and output the treatment record from the CRT 17 or the printer 20.

Further, as described in Japanese Patent Application Laid-Open No. 61-154667, it has been experimentally confirmed that a change in an ultrasonic image appears due to a temperature change or thermal denaturation. Effect determination is also possible.

Thus, in the first embodiment,
Since the tumor can be heated to a high temperature by sharply focused high-intensity ultrasound while accurately recognizing the tumor shape from the three-dimensional information, the tumor can be necrotized by high-temperature degeneration with low invasiveness to the patient and effectively. Further, since the treatment can be performed while recognizing the degenerated area, the entire tumor can be treated, and the risk of recurrence or metastasis due to omission of treatment can be reduced. Further, it is possible to prevent damage caused by applying excessively strong ultrasonic waves to a living body or a probe in a body cavity or by excessively humidifying, and to perform safe treatment.

Further, since the ultrasonic treatment can be performed while recognizing the three-dimensional shape of the tumor tissue imaged by MRI, the treatment can be performed easily and accurately. In addition, if the state after treatment is photographed on MRI, the effect of treatment can be immediately known. In this example, the MRI is used as the three-dimensional image forming apparatus, but an X-ray CT scanner may be used.

[Second Embodiment] FIG. 2 shows a second embodiment of the present invention.
FIG. 3 is a block diagram showing a configuration of the embodiment. In the present embodiment, a phased array is used as a source of high-intensity ultrasonic waves for treatment.

As shown in FIG. 3, the applicator 1a has a shape in which a circular flat ultrasonic transducer is divided in a radial direction and a circumferential direction, and an ultrasonic probe 2 for imaging an ultrasonic tomographic image is provided at the center.
01 is attached so as to be able to move back and forth and rotate. The drive circuit group 8a is divided into channels corresponding to the number of divided ultrasonic transducers, and is driven by independent timing signals delayed by the phase control circuit 204 by a signal from the control circuit 12. Thereby, the focal point of the ultrasonic wave is 6a in FIG.
As shown in FIG. 6b, it can be set at an arbitrary location three-dimensionally.

The operation of moving the focal position by the delay time control is described in detail in US Pat. No. 4,526,168. At this time, the applicator position detecting device 19 detects not only the entire position of the applicator 1a but also the relative position of the ultrasonic probe 201, and sends the data to the control circuit 12 and the ultrasonic imaging device 202. The control circuit 12 also sends information on the set focal position by the phased array to the ultrasonic imaging apparatus 202. For this reason, it is possible to display the status of the tumor 7 as the treatment site and the position of the focal point 6 on the ultrasonic imaging device 202 in real time even during the treatment.

On the CRT 17, as shown in FIG.
MRI freeze image 4 before applicator 1a installation
A tomographic position 402 currently being scanned by the ultrasonic probe 201, a focal region 403 of the therapeutic ultrasonic wave, and an incident path 404 of the therapeutic ultrasonic wave can be displayed on 01 in a superimposed manner.

In this embodiment, the MRI static magnetic field coil 9 and the gradient magnetic field coil 10 are Helmholtz shaped, and a work hole 203 is provided at the center. The applicator 1 is made of a non-magnetic material. Therefore, the transmitting and receiving RF coil 1
If the direction of the patient 1 is adjusted, the patient 3 can be seen from above (or below).
Can be mounted directly without changing the position of the applicator 1. Thus, it is not necessary to take the patient 3 in and out as in the first embodiment, and it is possible to reduce the time lag between the treatment and the observation and the risk of movement of the patient 3 during the time.

Furthermore, since the shape of the affected part in the body can be accurately recognized based on the three-dimensional information and a treatment plan can be made in advance, the influence of an obstacle can be taken into consideration, and the omission of treatment and the irradiation of a shock wave to a dangerous place can be considered. In addition, the treatment can be performed while monitoring whether or not the shock wave irradiation is performed according to the treatment plan, and the risk of erroneous irradiation and the like can be reduced.

[Third Embodiment] FIG. 5 is a block diagram showing a configuration of a third embodiment of the present invention.

In the figure, the ultrasonic source 31 has a plurality of piezo elements arranged in a spherical shell shape so as to form a concave surface, and is coupled to a patient 33 via a water bag 32.
An ultrasonic probe 36 for drawing an ultrasonic image of the tumor 34 is provided at the center of the ultrasonic source 31.
The ultrasonic probe 36 is configured to be slidable and rotationally movable in the front-rear direction, and is connected to an ultrasonic diagnostic imaging device 38.

The drive circuit 40 drives the piezo element to irradiate the tumor 34 in the body of the patient 33 with ultrasonic waves.

In this example, a desired portion is irradiated with ultrasonic waves by using a phased array type piezo element as in the second embodiment. Therefore, by controlling the drive timing of the plurality of drive circuits 40 by the plurality of delay circuits 43, it is possible to operate the focal position, the sound field, and the heating / heating area without moving the applicator.

The drive circuit 40 and the drive trigger pulse generation circuit 44 are controlled by a control circuit 42. That is, at the time of heating and heating, a burst signal of a constant voltage is continuously output. At this time, power is supplied to the drive circuit by the power supply circuit 41. The configurations of the driving circuit 40 and the driving trigger pulse generating circuit 44 are described in Japanese Patent Application No. Hei.
306106 ".

The control circuit 42 obtains a focal point 35, a sound field area and a heating / heating area located at arbitrary positions, and converts these information into a digital scan converter 39 (hereinafter, referred to as a digital scan converter 39).
DSC39).

The DSC 39 superimposes the treatment mode information, the virtual focus 35 in the phased array, the sound field area, and the heating / heating area on the ultrasonic image generated by the ultrasonic image diagnostic apparatus 38. Image is CR
It is displayed at T37. In the heating region and the heating region, the focal position, the shape, and the like can be approximately calculated by a fluid equation, a heat absorption coefficient of a living body, and the like.

On the CRT 37, a three-dimensional image 46 of the tumor in the body of the patient may be synthesized and displayed based on information from the ultrasonic image. These calculations are performed by the control circuit 42. In addition, three-dimensional images of tumors in the body
Alternatively, imaging may be performed using an X-ray CT scanner.

FIG. 6 is an example of a screen displayed on the CRT 37, and shows a three-dimensional image of a tumor in the body of a patient.
As for the tumor, for example, an equally-spaced cross section as shown in FIG.
As shown in FIG. 6 (b), the tumor 34
Is read into the image data input device 45,
The three-dimensional image synthesized by the integral calculation in the control circuit 42 is displayed on the CRT 37 again. This method is described in detail in JP-A-61-209643. The information on the outline of the tumor may be input from the CRT 37 using the light pen 49.

On the three-dimensional image 46, a location 48 heated and heated by irradiation calculated by the control circuit 42.
Is specified. At this time, the colors at the time of calculus crushing, at the time of heating and at the time of heating are different from each other. Therefore, an erroneous operation of excessively heating and heating does not occur.

Further, in order to clarify the positional relationship between the tumor and the ultrasonic probe, XYZ axes 47 are displayed on the three-dimensional image. Further, in order to create a three-dimensional image, the maximum diameter of each of the length, width and height of the tumor displayed on the CRT 37 as shown in FIG. The ellipsoid may be integrated by the control circuit 42 and displayed on the CRT 37 as a three-dimensional image.

FIGS. 8 and 9 show the order of irradiation positions when the focal positions in continuous irradiation at the time of heating and heating are separated as much as possible so that energy loss due to cavitation is reduced. .

First, as shown in FIGS. 8 (a) and 8 (b), the tumor is divided in the vertical direction and the horizontal direction by Δd1 and Δd2, respectively. This thickness is determined by calculation in consideration of the focal spot size and the heat absorption coefficient of the living body within a range where heating and heating can be sufficiently performed when the ultrasonic waves are focused.

Next, each area is irradiated in the order shown in FIG. The focusing position is controlled by a control circuit. In this case, the range of focus movement is
A rectangle consisting of eight squares smaller than the focal size,
Do not irradiate the area where the tumor outline is not visible at all. In this way, destruction of normal tissue is reduced.

As described above, in the third embodiment of the present invention, the treatment position can be freely planned with respect to the irradiation position by moving the focal position based on the area and not necessarily continuously but freely. Also, by controlling the movement of the focal point so that the energy loss at the focal point of the strong ultrasonic waves due to the reflection of the strong ultrasonic waves by the bubbles generated by cavitation, without using wasteful energy, efficiently It can be heated and heated, and the time required for treatment can be shortened. In addition, since the location heated and heated by irradiation on the ultrasonic image is clearly indicated,
It does not cause erroneous operation such as excessive heating and heating.

Therefore, a free treatment plan concerning the irradiation position can be made, so that safe and accurate treatment can be achieved. Also,
The loss of energy at the focal point of strong ultrasonic waves due to the effects of cavitation is reduced, heating and heating can be efficiently performed without wasting energy, and the time required for treatment is shortened, so that the burden on the patient can be reduced. Become like The focal point can be moved by mechanically moving the ultrasonic transducer.

[Fourth Embodiment] Next, a fourth embodiment according to the present invention will be described. In this example, MR
A coil in the body cavity is used as the RF coil of the I device. In this example, the static magnetic field coil 9 (see FIG. 2) is a Helmholtz type,
The gradient coil 10 is connected to Anderson (Gx, Gy) &
Maxwell (Gz) was provided with a work hole 203 at the center. Therefore, as shown in FIG.
By inserting the applicator 1 into the patient's body, the applicator 1 can be directly mounted by simply moving the applicator 1 up and down by the mechanical arm 18 (FIG. 2) without changing the position of the patient 3 from above (or below). This eliminates the need to move the patient 3 in and out of the gantry, thereby reducing the time lag between treatment and observation and the risk of movement of the patient 3 during that time.

When the initial treatment plan is completed, and the situation is such that it is possible to determine that the treatment has been sufficiently completed based on the judgment of the treatment effect by MRI, the operator ends the treatment. At this time, the control circuit 12 (FIG. 2) can retrieve the history of the treatment condition from the memory and output the treatment record from the CRT 17 or the printer 20.

FIG. 11 is an explanatory view of the intracavity probe. In this example, a case where a probe is inserted into the rectum for treating prostate cancer is shown. Body cavity probe 27
Controls information from the internal body coil 11a, a plurality of strong ultrasonic intensity sensors 61 and temperature sensors 60 on the side surface, a water bag 64 that fills a liquid around the body of the probe 27, and the information from the probe 27. Cable 63 for transmitting to circuit 12
And a water injection hose 62 for taking liquid in and out of the water bag 64.

First, the intracavity probe 27 is inserted into the rectum of the patient 3 so as to be located near the tumor 7 (prostate cancer) in the patient and at a position where strong ultrasonic waves pass. Next, a water bag 6 made of a highly elastic material covering the surface of the probe 27 is used.
4 is filled with liquid (water) 65 by controlling the water circuit 66,
Make sure that no gas enters the position where high-intensity ultrasonic waves pass. In the present embodiment, a plurality of high-intensity ultrasonic intensity sensors 61 (for example, PVDF film) and temperature sensors 60 (for example, thermocouples) are mounted on the surface of the water bag 64 and do not come into contact with the liquid 65. , And is in contact with the intestinal wall 28. Further, since the plurality of sensors 60 and 61 are evenly mounted on the side surface of the probe 27, it is not necessary to particularly consider the direction of the probe at the time of insertion.

When the tumor 7 is irradiated with strong ultrasonic waves from the applicator, a plurality of strong ultrasonic intensity sensors 61 and temperature sensors 60 measure the intensity and temperature of the strong ultrasonic waves at the respective positions. This information is sent to the control circuit 12. The control circuit 12 calculates the difference between the optimum value stored in advance and the maximum value of the information from the plurality of sensors, and changes the irradiation condition of the strong ultrasonic wave so that the difference disappears.
The phase control circuit 204 is controlled.

During treatment, the liquid 65 in the water bag 64 is
It circulates under the control of 6, and acts as a coolant for preventing damage to the intestinal wall due to heating. Here, the treatment of prostate cancer has been described, but the present invention can be similarly applied to tumors such as bladder and uterus.

In the fourth embodiment, an example in which an intracavity probe is used has been described with reference to the embodiment shown in FIG. 2, but this is applied to the embodiment shown in FIG. It is also possible. In addition, the static magnetic field coil 9 and the gradient magnetic field coil 10 shown in FIGS. 1 and 2 may be arranged like the static magnetic field coil 9a and the gradient magnetic field coil 10a shown in FIG.

Although the treatment for cancer has been described in this example, it is apparent that the present invention can be used for calculus crushing. As shown in FIG. 4, on the CRT 17, a tomographic position 402 currently scanned by the ultrasonic probe 21 and a focal region 403 of the therapeutic ultrasonic wave are displayed on an MRI freeze image 401 before the applicator 1 is mounted. The incident path 404 of the therapeutic ultrasonic wave can be superimposed and displayed.

[Fifth Embodiment] Next, a fifth embodiment of the present invention will be described.
An embodiment will be described. In this embodiment, M
A three-dimensional image of the subject is obtained by the RI device, a tomographic image of the treatment site is obtained as an ultrasonic image, and an MR two-dimensional image is reconstructed from the three-dimensional image. The images are referred to for diagnosis. Since the device is the same as that shown in FIG. 2, the description will be made with reference to FIG.

In FIG. 2, a patient 3 is set on a motorized table in a supine position, and is placed in an imaging gantry (not shown) in which a static magnetic field coil 9, a gradient magnetic field coil 10, and an RF coil 11 are incorporated. It is sent by the table moving device 13 controlled by the control circuit 12.

Next, the control circuit 12 activates the gradient magnetic field power supply 14 and the transmission / reception circuit 15 according to a predetermined sequence (for example, T2-weighted imaging method) instructed from the console 16, and the patient 3
The three-dimensional image information of the body is stored in a memory (not shown). This three-dimensional information is transmitted to the
As shown in (a), the image can be displayed on the CRT 17 in an arbitrary form such as a pseudo three-dimensional display using a wire frame.

Next, the operator inputs a treatment plan from the console 16 while viewing the MRI image 71 of the body including the tumor 7 as the treatment site.

Here, the treatment plan refers to the method of scanning the focus, the scanning range, the irradiation intensity of ultrasonic waves, the time, the interval, and the like. Also, on the CRT 17, not only the focus,
The tomographic position 73 currently scanned by the ultrasonic probe 201
In addition, the focal region 75 of the therapeutic ultrasonic wave and the incident path 74 of the therapeutic ultrasonic wave can be displayed, which is considered to be useful for making a treatment plan in consideration of the influence of bones and the like in the middle. Further, the scanning range 72 of the focal point on the treatment plan can be shown, and the irradiation intensity, time, interval, etc. of the ultrasonic wave can be displayed on the screen. During the treatment, the color of the portion irradiated with the ultrasound changes so that the progress of the treatment can be seen at a glance.

FIG. 13B shows an ultrasonic tomographic image and an image 71a obtained by reconstructing the same tomographic image as the current ultrasonic wave from the three-dimensional image data of MRI.

Here, even if the ultrasonic probe 201 is moved, the reconstructed image 71a is displayed so as to be followed, so that the image data used when making the treatment plan before the operation is compared with the ultrasonic image currently observed. Can be correctly grasped.

Conversely, if a large difference appears between the two screens, repositioning will be performed because movement of the patient's body during treatment is expected. These statues also
Not only the current focal point, but also the tomographic position 73 currently being scanned by the ultrasonic probe 201 and the focal region 75 of the therapeutic ultrasonic wave
And the incident path 74 of the therapeutic ultrasonic wave, the scanning scanning range 72a of the focal point on the treatment plan when viewed on the tomography, the irradiation intensity of the ultrasonic wave,
Time, interval, etc. can be displayed on the screen.

The reconstructed image has the same scale as the ultrasonic tomographic image, but can be enlarged or reduced. FIG.
The images (a) and (b) can be displayed simultaneously.
The ultrasound image and the MRI image can be colored or changed in color as needed. These operations are
The calculation is performed by the control circuit 12.

The applicator position detecting device 19 and the control circuit 12 check the coincidence between the position of the focal point 6 and the focal position of the initially determined treatment plan, and the control circuit 12 instructs the drive circuit 8a to start ultrasonic irradiation. Then, treatment is started.

The treatment is automatically performed under the control of the control circuit 12 in accordance with a predetermined treatment plan, but can be performed manually. If the patient is out of the treatment plan during manual treatment, the user is notified by a warning sound, a screen display, or the like (not shown). However, when the surgeon determines that it is necessary, the treatment plan stored in the control circuit 12 is displayed on the console 1.
6 or can be changed by input from a light pen (not shown).

In this embodiment, since the working hole 203 is provided at the center of the MRI gantry, the transmitting and receiving R
If the orientation of the F coil 11 is adjusted, the applicator 1 can be directly moved without changing the position of the patient 3 from above (or below).
Can be directly mounted simply by raising and lowering with the mechanical arm 18. This eliminates the need to move the patient 3 in and out of the gantry, thereby reducing the time lag between treatment and observation and the risk of movement of the patient 3 during that time. Further, the MRI imaging unit and the high-intensity ultrasonic treatment unit may be separated, and the patient may be moved by the table moving device 13.

At the point in time when the treatment is considered to be in the middle or at the end of the initial treatment plan, the ultrasonic irradiation is stopped, the applicator 1 is removed from the patient 3, and the progress of the treatment is observed. This is performed in the same manner as the above-described operation, and an MRI image around the tumor 7 is taken to check a change in a living body. Here, as described in the “action”, the T stored in the memory before the treatment is used.
By subtracting the data of the 2-weighted image and the current data, the heat-denatured region can be clearly confirmed, and it can be determined whether the treatment has been sufficiently performed or whether the treatment is insufficient and re-treatment is necessary. It is also possible to incorporate this into the treatment plan from the beginning and automatically take an image at predetermined treatment times.

When it becomes possible to determine that the treatment has been completed sufficiently by the treatment effect judgment by MRI, the operator ends the treatment. At this time, the control circuit 12 can retrieve the history of the treatment condition from the memory and output the treatment record from the CRT 17.

Here, a coil in the body cavity may be used as the RF coil for transmission / reception. Although the phased array is used for the ultrasonic transducer, it may be an annular array, or the focal point may be moved by mechanically moving the applicator.

Further, an X-ray CT may be used instead of the MRI apparatus. Although the present embodiment has described the treatment of a tumor, the present invention can be similarly applied to a device for crushing and treating a calculus in a body with powerful ultrasonic waves.

[0076]

The ultrasonic therapy apparatus according to the present invention can control the ultrasonic irradiation conditions of the intracavity probe so that the temperature of the part to which the ultrasonic waves are irradiated becomes a predetermined temperature. For this reason, it is possible to prevent the omission of treatment in which the tumor tissue survives without being heated to the death temperature, and the inconvenience of overheating and killing even the normal cells, thereby enabling accurate treatment. can do.

[Brief description of the drawings]

FIG. 1 is a block diagram of an ultrasonic therapy apparatus according to a first embodiment of the present invention.

FIG. 2 is a block diagram showing a configuration of a second exemplary embodiment of the present invention.

FIG. 3 is a schematic diagram of an applicator according to a second embodiment.

FIG. 4 is a diagram illustrating a display example of a CRT.

FIG. 5 is a block diagram showing a configuration of a third exemplary embodiment of the present invention.

FIG. 6 is an explanatory diagram showing a three-dimensional image of a tumor in a living body created by calculation.

FIG. 7 is an explanatory diagram showing an example of a method for creating a three-dimensional image of a tumor in a living body.

FIG. 8 is an explanatory diagram showing a method for dividing a tumor image.

FIG. 9 is an explanatory diagram showing an irradiation order of ultrasonic waves.

FIG. 10 is an explanatory diagram showing a tumor part and its periphery according to a fourth embodiment of the present invention.

FIG. 11 is an explanatory view showing an intracavity probe and instruments provided around the probe.

FIG. 12 is an explanatory diagram showing a positional relationship between respective coils of a patient's MRI apparatus.

FIG. 13 is an explanatory diagram schematically showing imaging regions of an MRI image and an ultrasonic image.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Applicator 2 Ultrasonic transducer 3 Patient 4 Coupling liquid 5 Water bag 6 Focus 7 Tumor 8 Drive circuit 9 Static magnetic field coil 10 Gradient magnetic field coil 11 RF coil 12 Control circuit 13 Table moving device 14 Gradient magnetic field power supply 15 Transmission / reception circuit 16 Console 17 CRT 18 Mechanical arm 19 Applicator position detecting device 20 Printer 27 Intracavitary probe 28 Intestinal wall 31 Powerful ultrasonic source 32 Water bag 33 Patient 34 Tumor 35 Focus 36 Ultrasonic probe 37 CRT 38 Ultrasonic diagnostic imaging device 39 Digital Scan converter 40 Drive circuit 41 Power supply circuit 42 Control circuit 43 Delay circuit 44 Drive trigger pulse generation circuit 45 Image data input device 46 Three-dimensional image of tumor in living body 47 XYZ axis 48 Heated / heated part 49 Light pen Reference Signs List 60 temperature sensor 61 ultrasonic intensity sensor 64 water bag 65 water 71 MRI image 72 scanning range 73 tomographic position 75 focal region 201 ultrasonic probe 202 ultrasonic imaging device 203 working hole 204 phase control circuit 401 image 402 tomographic position 403 focal region 404 Incident path

Continuing from the front page (72) Inventor Yoshiharu Ishibashi 1 Toshiba-cho, Komukai-shi, Kawasaki-shi, Kanagawa Prefecture Inside the Toshiba Research Institute (72) Inventor Takuji Suzuki 1 Toshiba-cho, Komukai-shi, Kochi-ku, Kawasaki-shi, Kanagawa Inside Toshiba Research Institute (72) Inventor Kozo Sato 1 Komukai Toshiba-cho, Sachi-ku, Kawasaki City, Kanagawa Prefecture Inside Toshiba Research Institute (72) Inventor Aya Ito 1-1-1 Shibaura, Minato-ku, Tokyo Shares Company Toshiba head office

Claims (6)

[Claims] An intracavity probe inserted into a body cavity of a subject and irradiating a predetermined portion of the subject with ultrasonic waves, and an ultrasonic probe provided on the intracavity probe and radiated from the intracavity probe. An intensity sensor for detecting intensity, a temperature sensor provided in the intracavity probe, and a temperature sensor for detecting a temperature of a portion irradiated with ultrasonic waves from the intracavity probe; and a detection output from the intensity sensor and the temperature sensor. Control means for controlling the ultrasonic irradiation conditions of the intracavity probe so that the temperature of the part to be irradiated with the ultrasonic wave becomes a predetermined temperature based on the ultrasonic treatment apparatus. 2. The ultrasonic therapy apparatus according to claim 1, wherein a plurality of said intensity sensors and / or temperature sensors are provided along the outer circumference of said intracavity probe. 3. The ultrasonic treatment apparatus according to claim 1, further comprising a liquid storage bag filled with a predetermined liquid and provided along an outer periphery of the intra-body cavity probe. 4. A cooling water circulation for storing the cooling water for cooling the intracavity probe in the liquid storage bag, connected to the liquid storage bag and circulating the cooling water in the liquid storage bag. The ultrasonic therapy apparatus according to any one of claims 1 to 3, further comprising means. 5. A static magnetic field coil provided outside the subject and applying a static magnetic field to the subject; a gradient magnetic field coil provided outside the subject and applying a gradient magnetic field to the subject; An intra-cavity coil provided on the intra-cavity probe and applying a predetermined high-frequency magnetic field to the subject to which the static magnetic field and the gradient magnetic field are applied; and Signal detection means for detecting a resonance signal generated when a predetermined high-frequency magnetic field is applied from the apparatus, and nuclear magnetic resonance image forming means for forming a nuclear magnetic resonance image based on a detection output from the resonance signal detection means The ultrasonic treatment apparatus according to any one of claims 1 to 4, comprising: 6. The ultrasonic therapy apparatus according to claim 5, wherein the static magnetic field coil and the gradient magnetic field coil have an opening having a predetermined size.