WO2018154717A1 - Ultrasonic endoscope device - Google Patents

Ultrasonic endoscope device Download PDF

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Publication number
WO2018154717A1
WO2018154717A1 PCT/JP2017/007136 JP2017007136W WO2018154717A1 WO 2018154717 A1 WO2018154717 A1 WO 2018154717A1 JP 2017007136 W JP2017007136 W JP 2017007136W WO 2018154717 A1 WO2018154717 A1 WO 2018154717A1
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ultrasonic
ultrasonic element
therapeutic
insertion portion
longitudinal axis
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PCT/JP2017/007136
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French (fr)
Japanese (ja)
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伊藤　寛
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オリンパス株式会社
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Priority to PCT/JP2017/007136 priority Critical patent/WO2018154717A1/en
Publication of WO2018154717A1 publication Critical patent/WO2018154717A1/en

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

Definitions

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

Abstract

This ultrasonic endoscope device includes a diagnostic ultrasonic element and a therapeutic ultrasonic element (4) which are arranged on the distal end of an insertion portion and adjacent to each in a direction along the longitudinal axis of the insertion portion. The therapeutic ultrasonic element (4) has a plurality of piezoelectric materials (41) arranged substantially in the direction along the longitudinal axis, each having a concave surface (41a) that forms an emission surface (4a) which curves in a direction intersecting the longitudinal axis. Each concave surface (41a) has a radius of curvature equal to the distance (r1, r2, r3) from that concave surface (41a) to a point (O) on a plane (P) that includes a normal line (N) to the center of the emission surface (4a) and substantially bisects the emission surface (4a) in the direction intersecting the longitudinal axis, and the point (O) is positioned on the diagnostic ultrasonic element side of the normal line (N).

Description

超音波内視鏡装置Ultrasound endoscope device
　本発明は、超音波内視鏡装置に関するものである。 The present invention relates to an ultrasonic endoscope apparatus.
　従来、焦点に収束する超音波を利用したＨＩＦＵ（Ｈｉｇｈ　Ｉｎｔｅｎｓｉｔｙ　Ｆｏｃｕｓｅｄ　Ｕｌｔｒａｓｏｎｉｃ）治療装置が知られている（例えば、特許文献１参照。）。超音波の焦点を治療対象部位に一致させることで、治療対象部位に高エネルギの超音波を照射して治療対象部位を焼灼することができる。ＨＩＦＵ治療装置の使用時には、治療対象部位の位置や大きさ等をモニタリングする必要がある。そのため、体内式のＨＩＦＵ治療装置には、治療用の超音波を射出する治療用超音波素子に加えて、治療対象部位の超音波画像を取得するための診断用超音波素子が設けられる。 Conventionally, a HIFU (High Intensity Focused Ultrasonic) treatment device using an ultrasonic wave that converges on a focal point is known (for example, see Patent Document 1). By matching the focal point of the ultrasonic wave to the treatment target region, the treatment target region can be cauterized by irradiating the treatment target region with high-energy ultrasonic waves. When using the HIFU treatment apparatus, it is necessary to monitor the position and size of the treatment target site. For this reason, the in-body HIFU treatment apparatus is provided with a diagnostic ultrasonic element for acquiring an ultrasonic image of a treatment target region in addition to a therapeutic ultrasonic element that emits therapeutic ultrasonic waves.
　体内式のＨＩＦＵ治療装置の挿入部は、体内への良好な挿入性を確保するために細径であることが望ましい。そのため、治療用超音波素子と診断用超音波素子は、挿入部の長手方向に並んで配置されることが一般的である。このような配列を採用した場合、治療用の超音波の焦点と診断用の超音波による観察領域とが、挿入部の長手方向に互いにずれた位置に配置される。したがって、治療対象部位の観察後に、挿入部を長手方向に移動させて焦点を治療対象部位に一致させる操作が必要となる。このような不都合を解消するために、特許文献１では、診断用超音波素子による観察領域内に焦点が位置するように治療用超音波素子を診断用超音波素子側に傾斜させている。 It is desirable that the insertion part of the in-body HIFU treatment device has a small diameter in order to ensure good insertion into the body. Therefore, it is common that the therapeutic ultrasonic element and the diagnostic ultrasonic element are arranged side by side in the longitudinal direction of the insertion portion. When such an arrangement is adopted, the focal point of the therapeutic ultrasound and the observation region by the diagnostic ultrasound are arranged at positions shifted from each other in the longitudinal direction of the insertion portion. Therefore, after observing the treatment target region, an operation of moving the insertion portion in the longitudinal direction to make the focal point coincide with the treatment target region is required. In order to eliminate such inconvenience, in Patent Document 1, the therapeutic ultrasonic element is tilted toward the diagnostic ultrasonic element so that the focal point is located within the observation region of the diagnostic ultrasonic element.
特開２０００－０９３４２９号公報JP 2000-093429 A
　特許文献１の治療用超音波素子の焦点は、該治療用超音波素子の放射面の中心を通る垂線上に形成される。このように、治療用超音波素子の中心の正面に焦点が形成されている場合、焦点を観察領域内に配置するためには治療用超音波素子の傾斜角度を大きくする必要がある。そのため、挿入部の外径が増大し、挿入部の体内での挿入性および操作性が低下するという問題がある。 The focal point of the therapeutic ultrasonic element of Patent Document 1 is formed on a perpendicular line passing through the center of the radiation surface of the therapeutic ultrasonic element. As described above, when the focal point is formed in front of the center of the therapeutic ultrasonic element, it is necessary to increase the inclination angle of the therapeutic ultrasonic element in order to place the focal point in the observation region. Therefore, there is a problem that the outer diameter of the insertion portion increases, and insertability and operability in the body of the insertion portion are deteriorated.
　本発明は、上述した事情に鑑みてなされたものであって、挿入部の外径の増大を抑制しながら、治療領域を観察領域と重複させることができる超音波内視鏡装置を提供することを目的とする。 The present invention has been made in view of the above-described circumstances, and provides an ultrasonic endoscope apparatus capable of overlapping a treatment region with an observation region while suppressing an increase in the outer diameter of the insertion portion. With the goal.
　上記目的を達成するため、本発明は以下の手段を提供する。
　本発明の一態様は、長手軸を有し体内に挿入される挿入部と、該挿入部の先端部に設けられ、前記長手軸に交差する方向に湾曲し治療用超音波を射出する凹状の射出面を有する治療用超音波素子と、前記挿入部の先端部に前記治療用超音波素子と前記長手軸に沿う方向に並んで設けられ、前記体内の超音波画像信号を取得する診断用超音波素子とを備え、前記治療用超音波素子は、前記挿入部の前記長手軸に略沿う方向に配列され、前記射出面を構成する凹面をそれぞれ有し、互いに独立に駆動可能な複数の圧電体を備え、各前記凹面の曲率半径が、各前記凹面から、前記射出面の中心における法線を含み該射出面を前記長手軸に交差する方向に略２等分する平面上の所定の一点までの距離と等しく、前記所定の一点が、前記法線よりも前記診断用超音波素子側に位置する超音波内視鏡装置である。 In order to achieve the above object, the present invention provides the following means.
One aspect of the present invention is an insertion portion that has a longitudinal axis and is inserted into the body, and a concave shape that is provided at the distal end of the insertion portion and that is curved in a direction intersecting the longitudinal axis and emits therapeutic ultrasound. A therapeutic ultrasonic element having an exit surface, and a diagnostic ultrasonic element that is provided at a distal end portion of the insertion portion in a direction along the longitudinal axis with the therapeutic ultrasonic element to acquire an ultrasonic image signal in the body A plurality of piezoelectric elements that are arranged in a direction substantially along the longitudinal axis of the insertion portion and each have a concave surface that constitutes the emission surface and can be driven independently of each other. A predetermined radius on a plane that includes a normal and a radius of curvature of each concave surface includes a normal line at the center of the emission surface and bisects the emission surface in a direction intersecting the longitudinal axis. The predetermined point is equal to the distance to the normal line. An ultrasonic endoscope device positioned sectional ultrasonic device side.
　上記態様によれば、圧電体の駆動によって発生した治療用超音波が治療用超音波素子の射出面から射出されることにより、体内に配置された挿入部の先端部の周囲の生体組織に治療用超音波が照射される。このときに、複数の圧電体の凹面から射出される複数の治療用超音波が焦点で互いに強め合うように複数の圧電体を駆動するタイミングを適切に制御することで、焦点およびその近傍の生体組織を効率的に治療することができる。一方、治療用超音波素子の先端側または基端側に設けられた診断用超音波素子によって挿入部の先端部の周囲の生体組織の超音波画像信号が取得される。 According to the above aspect, treatment ultrasonic waves generated by driving the piezoelectric body are emitted from the emission surface of the treatment ultrasonic element, thereby treating the living tissue around the distal end portion of the insertion portion disposed in the body. Ultrasonic waves are irradiated. At this time, by appropriately controlling the timing of driving the plurality of piezoelectric bodies so that the plurality of therapeutic ultrasonic waves emitted from the concave surfaces of the plurality of piezoelectric bodies strengthen each other at the focus, Tissues can be treated efficiently. On the other hand, an ultrasonic image signal of a living tissue around the distal end portion of the insertion portion is acquired by a diagnostic ultrasonic element provided on the distal end side or the proximal end side of the therapeutic ultrasonic element.
　この場合に、射出面を構成する複数の凹面は、所定の一点からの距離と等しい曲率半径を有し、各凹面から射出された治療用超音波は所定の一点に収束する。したがって、所定の一点を中心に、高強度の超音波エネルギが得られる治療領域が形成される。ここで、所定の一点が、治療用超音波素子の中心における法線よりも診断用超音波素子側に位置にしているので、治療領域は、射出面の中心における法線に対して診断用超音波素子側に偏った位置に形成される。これにより、治療用超音波素子を挿入部の長手軸に対して大きく傾けずとも治療領域を観察領域に重複させることができ、挿入部の外径の増大を抑制することができる。 In this case, the plurality of concave surfaces constituting the emission surface have a radius of curvature equal to the distance from the predetermined point, and the therapeutic ultrasonic waves emitted from each concave surface converge to the predetermined point. Therefore, a treatment region where high-intensity ultrasonic energy is obtained is formed around a predetermined point. Here, since the predetermined one point is located on the diagnostic ultrasonic element side with respect to the normal line at the center of the therapeutic ultrasonic element, the therapeutic region is located above the normal line at the center of the exit surface. It is formed at a position biased toward the sonic element side. Thereby, the treatment region can be overlapped with the observation region without greatly inclining the therapeutic ultrasonic element with respect to the longitudinal axis of the insertion portion, and an increase in the outer diameter of the insertion portion can be suppressed.
　上記態様においては、前記治療用超音波素子は、前記複数の圧電体の凹面から射出された治療用超音波が互いに強め合う焦点の位置を前記所定の一点を含む治療領域内で変更可能であり、前記治療領域の全体が、前記超音波画像信号の観察領域に含まれていてもよい。
　このようにすることで、焦点を治療領域内のいずれの位置に設定した場合でも、超音波画像によって治療対象部位を観察しながら治療用超音波による治療対象部位の治療を行うことができる。 In the above aspect, the therapeutic ultrasonic element can change the position of the focal point where the therapeutic ultrasonic waves emitted from the concave surfaces of the plurality of piezoelectric bodies strengthen each other within the treatment region including the predetermined point. The entire treatment area may be included in the observation area of the ultrasonic image signal.
In this way, even when the focal point is set at any position within the treatment region, the treatment target site can be treated with the therapeutic ultrasound while observing the treatment target site with the ultrasound image.
　上記態様においては、前記所定の一点が、前記観察領域を略２等分する中心線上に位置していてもよい。さらに、前記所定の一点が、前記観察領域の略中央に位置していてもよい。
　このようにすることで、超音波画像の略中央に配置された治療対象部位に対して最大強度の超音波エネルギを照射することができる。 In the above aspect, the predetermined point may be located on a center line that bisects the observation region. Furthermore, the predetermined one point may be located in the approximate center of the observation region.
By doing in this way, ultrasonic energy of the maximum intensity can be irradiated to the treatment object part arranged in the approximate center of the ultrasonic image.
　上記態様においては、前記凹面の曲率半径が、前記診断用超音波素子に近い側から遠い側に向かって漸次増大していてもよい。
　このようにすることで、所定の一点が射出面と正対する領域の外側に形成され、治療領域が診断用超音波素子側にさらに偏った位置に形成される。これにより、挿入部の外径の増大をさらに抑制することができる。 In the said aspect, the curvature radius of the said concave surface may increase gradually toward the side far from the side near the said diagnostic ultrasonic element.
By doing so, a predetermined point is formed outside the region facing the exit surface, and the treatment region is formed at a position further biased toward the diagnostic ultrasonic element side. Thereby, the increase in the outer diameter of an insertion part can further be suppressed.
　上記態様においては、前記診断用超音波素子が、前記治療用超音波素子よりも先端側に位置していてもよい。
　このようにすることで、診断用超音波素子による観察領域が治療対象部位に到達するまでの挿入部の挿入量が、より少なくて済む。 In the above aspect, the diagnostic ultrasonic element may be positioned on the distal end side with respect to the therapeutic ultrasonic element.
By doing in this way, the insertion amount of the insertion part until the observation region by the diagnostic ultrasonic element reaches the treatment target site can be reduced.
　本発明によれば、挿入部の外径の増大を抑制しながら、治療領域を観察領域と重複させることができるという効果を奏する。 According to the present invention, there is an effect that the treatment region can be overlapped with the observation region while suppressing an increase in the outer diameter of the insertion portion.
本発明の一実施形態に係る超音波内視鏡装置の先端部の構成を模式的に示す図である。It is a figure which shows typically the structure of the front-end | tip part of the ultrasonic endoscope apparatus which concerns on one Embodiment of this invention. 図１の超音波内視鏡装置における治療用超音波素子の斜視図である。FIG. 2 is a perspective view of a therapeutic ultrasonic element in the ultrasonic endoscope apparatus of FIG. 1. 図２の治療用超音波素子を点Ａにおける凹面の法線を通り平面Ｐに垂直な平面で切断した断面図である。FIG. 3 is a cross-sectional view of the therapeutic ultrasonic element of FIG. 2 cut along a plane that passes through the concave normal at point A and is perpendicular to the plane P; 治療用超音波素子に設けられた電極および電力ケーブルの配線を示す図である。It is a figure which shows the wiring of the electrode and power cable which were provided in the ultrasonic element for treatment. 図４のＧＮＤ電極の変形例を示す図である。It is a figure which shows the modification of the GND electrode of FIG. 治療領域およびその中心位置の変形例を示す図である。It is a figure which shows the modification of a treatment area | region and its center position. 治療領域およびその中心位置の他の変形例を示す図である。It is a figure which shows the other modification of a treatment area | region and its center position.
　以下に、本発明の一実施形態に係る超音波内視鏡装置について図面を参照して説明する。
　本実施形態に係る超音波内視鏡装置１は、体内に挿入して使用される体内式の内視鏡装置であり、図１に示されるように、体内に挿入される細長い挿入部２と、該挿入部２の先端部に設けられた診断用超音波素子３および治療用超音波素子４とを備えている。診断用超音波素子３および治療用超音波素子４は、挿入部２の長手軸に沿う方向に並んで配置され、診断用超音波素子３が治療用超音波素子４よりも先端側に設けられている。符号５，６は、超音波素子３，４を挿入部２の外部の装置とそれぞれ接続するケーブルである。 Hereinafter, an ultrasonic endoscope apparatus according to an embodiment of the present invention will be described with reference to the drawings.
The ultrasonic endoscope apparatus 1 according to the present embodiment is an in-vivo endoscope apparatus used by being inserted into a body, and as shown in FIG. The diagnostic ultrasonic element 3 and the therapeutic ultrasonic element 4 provided at the distal end of the insertion portion 2 are provided. The diagnostic ultrasonic element 3 and the therapeutic ultrasonic element 4 are arranged side by side in the direction along the longitudinal axis of the insertion portion 2, and the diagnostic ultrasonic element 3 is provided on the distal side of the therapeutic ultrasonic element 4. ing. Reference numerals 5 and 6 denote cables for connecting the ultrasonic elements 3 and 4 to devices outside the insertion portion 2, respectively.
　診断用超音波素子３は、挿入部２の径方向外方を向いて配置され、挿入部２の径方向外方へ向けて診断用超音波を射出する射出面３ａを有している。診断用超音波素子３は、射出面３ａと対向し挿入部２の長手軸に平行な平面内の観察領域Ｓに診断用超音波を照射し、観察領域Ｓからの診断用超音波の反射波を射出面３ａにおいて受信することで、観察領域Ｓの超音波画像信号を取得する。 The diagnostic ultrasonic element 3 has an emission surface 3 a that is arranged facing outward in the radial direction of the insertion portion 2 and emits diagnostic ultrasonic waves outward in the radial direction of the insertion portion 2. The diagnostic ultrasonic element 3 irradiates diagnostic ultrasound to the observation region S in a plane facing the emission surface 3 a and parallel to the longitudinal axis of the insertion portion 2, and a reflected wave of diagnostic ultrasound from the observation region S Is received on the exit surface 3a, an ultrasonic image signal of the observation region S is acquired.
　診断用超音波素子３によって取得された超音波画像信号は、診断用超音波素子３から、挿入部２の外部に配置された画像処理装置（図示略）にケーブル５を介して送信される。画像処理装置では、超音波画像信号に基づいて超音波画像が生成され、生成された超音波画像がディスプレイ（図示略）に表示されるようになっている。 The ultrasonic image signal acquired by the diagnostic ultrasonic element 3 is transmitted from the diagnostic ultrasonic element 3 to an image processing apparatus (not shown) arranged outside the insertion unit 2 via the cable 5. In the image processing apparatus, an ultrasonic image is generated based on the ultrasonic image signal, and the generated ultrasonic image is displayed on a display (not shown).
　治療用超音波素子４は、図２に示されるように、挿入部２の長手軸に直交する径方向にのみ湾曲した板状であり、挿入部２の径方向外方を向く凹状の湾曲面が射出面４ａとなっている。治療用超音波素子４は、射出面４ａから射出される治療用超音波の照射領域が観察領域Ｓと重複するように、図１に示されるように、挿入部２の長手軸に対して診断用超音波素子３側に傾斜している。 As shown in FIG. 2, the therapeutic ultrasonic element 4 has a plate shape that is curved only in the radial direction perpendicular to the longitudinal axis of the insertion portion 2, and has a concave curved surface that faces the radially outward direction of the insertion portion 2. Is the exit surface 4a. The therapeutic ultrasonic element 4 is diagnosed with respect to the longitudinal axis of the insertion portion 2 as shown in FIG. 1 so that the irradiation region of the therapeutic ultrasonic wave emitted from the emission surface 4a overlaps the observation region S. It inclines toward the ultrasonic element 3 side.
　治療用超音波素子４は、挿入部２の長手軸に略沿う方向に配列され、長手方向に曲率を有する複数の柱状の圧電体４１を備えている。複数の圧電体４１は、例えば樹脂等によって互いに接着されることで一体化されている。各圧電体４１は、図３に示されるように、円弧状に湾曲しており、径方向内側に凹面４１ａを有している。射出面４ａは、複数の圧電体４１の凹面４１ａから構成されている。各凹面４１ａの曲率中心は、射出面４ａの中心における法線Ｎを含み射出面４ａを挿入部２の径方向に２等分する平面Ｐ上に位置し、各凹面４１ａから放射状に射出された超音波は、平面Ｐ上の位置に収束する。平面Ｐは、診断用超音波による観察領域Ｓと同一平面上に位置することが好ましい。 The therapeutic ultrasonic element 4 includes a plurality of columnar piezoelectric bodies 41 that are arranged in a direction substantially along the longitudinal axis of the insertion portion 2 and have a curvature in the longitudinal direction. The plurality of piezoelectric bodies 41 are integrated by being bonded to each other by, for example, resin. As shown in FIG. 3, each piezoelectric body 41 is curved in an arc shape and has a concave surface 41 a on the radially inner side. The exit surface 4a is composed of concave surfaces 41a of a plurality of piezoelectric bodies 41. The center of curvature of each concave surface 41a is located on a plane P that includes the normal N at the center of the emission surface 4a and bisects the emission surface 4a in the radial direction of the insertion portion 2, and is emitted radially from each concave surface 41a. The ultrasonic waves converge at a position on the plane P. The plane P is preferably located on the same plane as the observation region S by the diagnostic ultrasound.
　ここで、各凹面４１ａの曲率半径は、図２に示されるように、平面Ｐ上の所定の中心位置（所定の一点）Ｏから各凹面４１ａまでの距離ｒ１，ｒ２，ｒ３に応じて異なり、中心位置Ｏから各凹面４１ａまでの距離ｒ１，ｒ２，ｒ３と等しくなっている。例えば、図３に示されるように、中心位置Ｏからの距離がｒ３である凹面４１ａの曲率半径は、ｒ３である。所定の中心位置Ｏは、後述する治療領域Ｔの略中心となる位置であり、射出面４ａの中心における法線Ｎよりも先端側に設定されている。 Here, as shown in FIG. 2, the radius of curvature of each concave surface 41a varies depending on the distances r1, r2, r3 from the predetermined center position (predetermined point) O on the plane P to each concave surface 41a, It is equal to the distances r1, r2, r3 from the center position O to each concave surface 41a. For example, as shown in FIG. 3, the radius of curvature of the concave surface 41a whose distance from the center position O is r3 is r3. The predetermined center position O is a position that is substantially the center of a treatment region T, which will be described later, and is set on the tip side of the normal line N at the center of the exit surface 4a.
　圧電体４１には、高周波電力の供給用の電力ケーブル６が接続されており、電力ケーブル６を介して、挿入部２の外部に配置された電源（図示略）から高周波電力が供給されることで、伸縮して治療用超音波を発生し、凹面４１ａから治療用超音波を射出する。 A power cable 6 for supplying high-frequency power is connected to the piezoelectric body 41, and high-frequency power is supplied from a power source (not shown) disposed outside the insertion portion 2 via the power cable 6. Then, it expands and contracts to generate therapeutic ultrasonic waves, and the therapeutic ultrasonic waves are emitted from the concave surface 41a.
　電力ケーブル６は、各圧電体４１を独立に駆動することができるように、各圧電体４１に１本ずつ接続されている。具体的には、図４に示されるように、射出面４ａ（凹面４１ａ）には全ての圧電体４１に共通のグランド（ＧＮＤ）電極９が設けられ、該ＧＮＤ電極９に１本の電力ケーブル６１Ｇが接続されている。また、各圧電体４１の凹面４１ａとは反対側の端面には正極電極１０が設けられ、各正極電極１０に１本の電力ケーブル６１，６２，６３が接続されている。これにより、各圧電体４１を個別に制御して治療用超音波の位相を制御することができる。また、干渉により１点（焦点）で互いに強め合うような治療用超音波を複数の圧電体４１から射出させることができる。さらに、これによって、焦点の位置を変更することができる。焦点の位置は、例えば、電源用の制御装置（図示略）を介して操作者が設定可能となっている。 One power cable 6 is connected to each piezoelectric body 41 so that each piezoelectric body 41 can be driven independently. Specifically, as shown in FIG. 4, a ground (GND) electrode 9 common to all the piezoelectric bodies 41 is provided on the emission surface 4 a (concave surface 41 a), and one power cable is connected to the GND electrode 9. 61G is connected. Further, the positive electrode 10 is provided on the end surface opposite to the concave surface 41 a of each piezoelectric body 41, and one power cable 61, 62, 63 is connected to each positive electrode 10. Thereby, each piezoelectric body 41 can be individually controlled to control the phase of therapeutic ultrasonic waves. Also, therapeutic ultrasonic waves that reinforce each other at one point (focal point) due to interference can be emitted from the plurality of piezoelectric bodies 41. Furthermore, this makes it possible to change the position of the focal point. The position of the focal point can be set by the operator via, for example, a power supply control device (not shown).
　ＧＮＤ電極９は、図５に示されるように、正極電極１０と同様に、各圧電体４１の凹面４１ａに設けられ、各ＧＮＤ電極９に１本ずつ電力ケーブル６１Ｇ，６２Ｇ，６３Ｇが接続されていてもよい。
　また、添付の図面には、単一の圧電体からなる圧電体４１が示されているが、各圧電体４１は、互いに間隔を空けて配列された複数の圧電体と該複数の圧電体の間の間隙を埋める樹脂とからなるコンポジット構造を有していてもよい。 As shown in FIG. 5, the GND electrode 9 is provided on the concave surface 41 a of each piezoelectric body 41 like the positive electrode 10, and one power cable 61 </ b> G, 62 </ b> G, 63 </ b> G is connected to each GND electrode 9. May be.
In the attached drawings, a piezoelectric body 41 made of a single piezoelectric body is shown. Each piezoelectric body 41 is composed of a plurality of piezoelectric bodies arranged at intervals and a plurality of piezoelectric bodies. You may have the composite structure which consists of resin which fills the space | gap between them.
　また、添付の図面には、別個に形成された複数の圧電体４１を互いに接着することで形成された治療用超音波素子４が示されているが、これに代えて、治療用超音波素子４は、一方向に湾曲した単一の板状の圧電体から形成されていてもよい。このように単一の部材から治療用超音波素子４が形成されている場合においても、複数の正極電極１０を互いに間隔をあけて設けることで、治療用超音波素子４の複数の領域を互いに独立に駆動させることができる。すなわち、複数の圧電体４１とは、別個に製造された複数の圧電体に限らず、治療用超音波素子４を構成する単一の圧電体内に形成された互いに独立に駆動可能な複数の領域であってもよい。 In the attached drawings, there is shown a therapeutic ultrasonic element 4 formed by bonding a plurality of separately formed piezoelectric bodies 41 to each other. 4 may be formed from a single plate-like piezoelectric body curved in one direction. Thus, even when the therapeutic ultrasonic element 4 is formed from a single member, the plurality of positive electrodes 10 are provided at intervals from each other, so that the plurality of regions of the therapeutic ultrasonic element 4 are mutually connected. It can be driven independently. That is, the plurality of piezoelectric bodies 41 are not limited to a plurality of separately manufactured piezoelectric bodies, but are a plurality of regions that are independently driven and formed in a single piezoelectric body constituting the therapeutic ultrasonic element 4. It may be.
　ここで、各凹面４１ａから射出される超音波は中心位置Ｏに収束するので、焦点が中心位置Ｏに設定されたときに、焦点での超音波エネルギが最大となる。また、焦点を移動させたときに、中心位置Ｏの周囲においても、治療用超音波の高い収束性により高強度の超音波エネルギが得られる。したがって、焼灼のような治療に必要な高強度の超音波エネルギが焦点において得られる治療領域Ｔは、中心位置Ｏを略中心とする領域となる。中心位置Ｏは、射出面４ａの法線Ｎよりも先端側に設定されているので、治療領域Ｔも法線Ｎに対して先端側に偏った位置に形成され、これにより治療領域Ｔの少なくとも一部が観察領域Ｓと重複している。観察領域Ｓの治療領域Ｔとの重複領域がより大きくなるように、中心位置Ｏは、観察領域Ｓ内に設定されていることが好ましい。 Here, since the ultrasonic waves emitted from the respective concave surfaces 41a converge at the center position O, when the focus is set at the center position O, the ultrasonic energy at the focus becomes the maximum. Further, when the focal point is moved, high-intensity ultrasonic energy can be obtained around the center position O due to the high convergence of the therapeutic ultrasonic waves. Therefore, the treatment region T where high-intensity ultrasonic energy necessary for treatment such as ablation is obtained at the focal point is a region having the center position O as a substantial center. Since the center position O is set to the front end side with respect to the normal line N of the exit surface 4a, the treatment region T is also formed at a position biased to the front end side with respect to the normal line N. A part overlaps the observation region S. The center position O is preferably set in the observation region S so that the overlapping region of the observation region S with the treatment region T becomes larger.
　次に、このように構成された超音波内視鏡装置１の作用について説明する。
　本実施形態に係る超音波内視鏡装置１によって体内の治療対象部位の観察および治療を行うためには、診断用超音波素子３から診断用超音波を射出して観察領域Ｓの超音波画像信号を取得しながら、挿入部２を先端側から体内に挿入する。操作者は、ディスプレイ上の超音波画像によって体内の治療対象部位を観察し、治療領域Ｔ内に治療対象部位が配置される位置に挿入部２を位置決めする。このときに、診断用超音波素子３が治療用超音波素子４よりも先端側に設けられているので、挿入部２の体内への挿入量がより少なくて済む。 Next, the operation of the ultrasonic endoscope apparatus 1 configured as described above will be described.
In order to observe and treat a treatment target site in the body by the ultrasonic endoscope apparatus 1 according to the present embodiment, diagnostic ultrasonic waves are emitted from the diagnostic ultrasonic element 3 and an ultrasonic image of the observation region S is displayed. The insertion part 2 is inserted into the body from the distal end side while acquiring a signal. The operator observes the treatment target site in the body from the ultrasonic image on the display, and positions the insertion portion 2 at a position where the treatment target site is arranged in the treatment region T. At this time, since the diagnostic ultrasonic element 3 is provided on the distal end side with respect to the therapeutic ultrasonic element 4, the insertion amount of the insertion portion 2 into the body can be smaller.
　続いて、治療用超音波の焦点の位置を治療対象部位に設定し、治療用超音波素子４から治療用超音波を射出する。これにより、治療対象部位を超音波画像で観察しながら治療対象部位に高エネルギの治療用超音波を照射して治療対象部位を焼灼することができる。また、中心位置Ｏが治療対象部位に一致するように挿入部２を位置決めし、焦点を中心位置Ｏに設定することにより、治療対象部位に最大強度の超音波エネルギを与えることができる。 Subsequently, the position of the focal point of the therapeutic ultrasonic wave is set as a treatment target site, and the therapeutic ultrasonic wave is emitted from the therapeutic ultrasonic element 4. As a result, the treatment target site can be cauterized by irradiating the treatment target site with high-energy ultrasound for treatment while observing the treatment target site with an ultrasound image. Further, by positioning the insertion portion 2 so that the center position O coincides with the treatment target site and setting the focal point to the center position O, it is possible to give the ultrasonic wave energy of maximum intensity to the treatment target site.
　このように、本実施形態によれば、射出面４ａを構成する複数の凹面４１ａの曲率半径が中心位置Ｏからの距離とそれぞれ等しく、全ての凹面４１ａから射出された超音波が１つの中心位置Ｏに収束する。このように中心位置Ｏにおける治療用超音波の収束性を向上することで、中心位置Ｏおよびその周囲における超音波エネルギを高めることができるという利点がある。 Thus, according to the present embodiment, the radii of curvature of the plurality of concave surfaces 41a constituting the emission surface 4a are equal to the distance from the center position O, respectively, and the ultrasonic waves emitted from all the concave surfaces 41a are in one central position. Converge to O. Thus, by improving the convergence of the therapeutic ultrasonic wave at the central position O, there is an advantage that the ultrasonic energy at the central position O and its surroundings can be increased.
　また、中心位置Ｏが、治療用超音波素子４の射出面４ａの中心における法線Ｎよりも診断用超音波素子３側に配されているので、治療領域Ｔが、射出面４ａの中心の正面よりも観察領域Ｓ側に偏った位置に形成される。これにより、治療領域Ｔを観察領域Ｓと重複させるために必要な、治療用超音波素子４の挿入部２の長手軸に対する傾斜角度が小さくて済み、挿入部２の細径化を図ることができるという利点がある。 Further, since the center position O is arranged closer to the diagnostic ultrasonic element 3 than the normal line N at the center of the emission surface 4a of the therapeutic ultrasonic element 4, the treatment region T is located at the center of the emission surface 4a. It is formed at a position that is biased toward the observation region S rather than the front. Thereby, the inclination angle with respect to the longitudinal axis of the insertion portion 2 of the therapeutic ultrasonic element 4 necessary for overlapping the treatment region T with the observation region S is small, and the diameter of the insertion portion 2 can be reduced. There is an advantage that you can.
　本実施形態においては、図６に示されるように、治療領域Ｔの全体が観察領域Ｓに含まれるように、中心位置Ｏが設定されていることが好ましい。
　このようにすることで、治療領域Ｔ内のいずれの位置に焦点を設定した場合であっても、治療対象部位を超音波画像で観察しながら当該治療対象部位への治療用超音波の照射を行うことができる。 In the present embodiment, it is preferable that the center position O is set so that the entire treatment region T is included in the observation region S, as shown in FIG.
In this way, even when the focus is set at any position in the treatment region T, the treatment target region is irradiated with the therapeutic ultrasonic wave while observing the treatment target portion with the ultrasonic image. It can be carried out.
　中心位置Ｏは、図７に示されるように、観察領域Ｓを挿入部２の長手軸に沿う方向に略２等分する中心線Ａ上に位置することが好ましく、観察領域Ｓの中心と一致していることがさらに好ましい。このようにすることで、超音波画像の中央に中心位置Ｏおよび治療領域Ｔが配置されるので、治療用超音波による治療中の治療対象部位を超音波画像でより観察し易い構成とすることができる。
　図７に示されるように、中心位置Ｏが、射出面４ａと法線Ｎ方向に正対する領域（図７において破線で囲まれる矩形の領域）の外側に位置する場合には、射出面４ａは、円錐台面の一部からなる形状を有し、凹面４１ａの曲率半径は、診断用超音波素子３に近い側から遠い側に向かって漸次増大する。 As shown in FIG. 7, the center position O is preferably located on a center line A that divides the observation region S into approximately two equal parts in the direction along the longitudinal axis of the insertion portion 2. More preferably, In this way, since the center position O and the treatment region T are arranged in the center of the ultrasound image, the treatment target site being treated with the treatment ultrasound can be more easily observed with the ultrasound image. Can do.
As shown in FIG. 7, when the center position O is located outside the region (rectangular region surrounded by the broken line in FIG. 7) that faces the exit surface 4 a in the normal N direction, the exit surface 4 a is The curvature radius of the concave surface 41a gradually increases from the side closer to the diagnostic ultrasonic element 3 toward the side farther from it.
　本実施形態においては、診断用超音波素子３が、治療用超音波素子４よりも先端側に配置されていることとしたが、これに代えて、診断用超音波素子３が、治療用超音波素子４よりも基端側に配置されていてもよい。
　この場合には、治療用超音波素子４を挿入部２の長手軸に対して基端側に傾斜させ、中心位置Ｏを射出面４ａの法線Ｎよりも基端側に設定することで、治療領域Ｔと観察領域Ｓとを重複させることができる。 In the present embodiment, the diagnostic ultrasonic element 3 is arranged on the distal end side with respect to the therapeutic ultrasonic element 4, but instead, the diagnostic ultrasonic element 3 is replaced with the therapeutic ultrasonic element 3. The sound wave element 4 may be disposed closer to the base end side.
In this case, the therapeutic ultrasonic element 4 is inclined to the proximal side with respect to the longitudinal axis of the insertion portion 2, and the center position O is set to the proximal side with respect to the normal line N of the emission surface 4a. The treatment region T and the observation region S can be overlapped.
　本実施形態においては、治療用超音波素子４が挿入部２の長手軸に対して診断用超音波素子３側に傾斜していることとしたが、治療用超音波素子４は、必ずしも傾斜している必要はなく、挿入部２の長手軸に平行に配置されていてもよい。
　このようにしても、中心位置Ｏを法線Ｎよりも診断用超音波素子３側に設定することで、治療領域Ｔを観察領域Ｓと重複させることができる。 In the present embodiment, the therapeutic ultrasonic element 4 is inclined toward the diagnostic ultrasonic element 3 with respect to the longitudinal axis of the insertion portion 2, but the therapeutic ultrasonic element 4 is not necessarily inclined. It may not be necessary, and may be arranged parallel to the longitudinal axis of the insertion portion 2.
Even in this case, the treatment region T can be overlapped with the observation region S by setting the center position O closer to the diagnostic ultrasonic element 3 than the normal line N.
１　超音波内視鏡装置
２　挿入部
３　診断用超音波素子
３ａ　射出面
４　治療用超音波素子
４ａ　射出面
４１　圧電体
４１ａ　凹面
Ｎ　法線
Ｏ　中心位置（所定の一点）
Ｓ　観察領域
Ｔ　治療領域 DESCRIPTION OF SYMBOLS 1 Ultrasonic endoscope apparatus 2 Insertion part 3 Diagnosis ultrasonic element 3a Ejection surface 4 Therapeutic ultrasonic element 4a Ejection surface 41 Piezoelectric body 41a Concave surface N Normal line O Center position (predetermined one point)
S Observation area T Treatment area

Claims (6)

  1. 　長手軸を有し体内に挿入される挿入部と、
    　該挿入部の先端部に設けられ、前記長手軸に交差する方向に湾曲し治療用超音波を射出する凹状の射出面を有する治療用超音波素子と、
    　前記挿入部の先端部に前記治療用超音波素子と前記長手軸に沿う方向に並んで設けられ、前記体内の超音波画像信号を取得する診断用超音波素子とを備え、
    　前記治療用超音波素子は、前記挿入部の前記長手軸に略沿う方向に配列され、前記射出面を構成する凹面をそれぞれ有し、互いに独立に駆動可能な複数の圧電体を備え、
    　各前記凹面の曲率半径が、各前記凹面から、前記射出面の中心における法線を含み該射出面を前記長手軸に交差する方向に略２等分する平面上の所定の一点までの距離と等しく、
    　前記所定の一点が、前記法線よりも前記診断用超音波素子側に位置する超音波内視鏡装置。     An insertion portion having a longitudinal axis and inserted into the body;
    A therapeutic ultrasonic element provided at the distal end of the insertion portion and having a concave exit surface that is curved in a direction intersecting the longitudinal axis and emits therapeutic ultrasonic waves;
    A diagnostic ultrasonic element for obtaining an ultrasonic image signal in the body, provided at the distal end portion of the insertion portion and arranged in a direction along the longitudinal axis with the therapeutic ultrasonic element;
    The therapeutic ultrasonic element includes a plurality of piezoelectric bodies that are arranged in a direction substantially along the longitudinal axis of the insertion portion, each have a concave surface that constitutes the emission surface, and can be driven independently of each other,
    The radius of curvature of each concave surface is a distance from each concave surface to a predetermined point on a plane that includes a normal at the center of the exit surface and bisects the exit surface in a direction that intersects the longitudinal axis. equally,
    The ultrasonic endoscope apparatus in which the predetermined one point is located closer to the diagnostic ultrasonic element than the normal line.
  2. 　前記治療用超音波素子は、前記複数の圧電体の凹面から射出された治療用超音波が互いに強め合う焦点の位置を前記所定の一点を含む治療領域内で変更可能であり、
    　前記治療領域の全体が、前記超音波画像信号の観察領域に含まれる請求項１に記載の超音波内視鏡装置。     The therapeutic ultrasonic element can change the position of the focal point where the therapeutic ultrasonic waves emitted from the concave surfaces of the plurality of piezoelectric bodies strengthen each other within the treatment region including the predetermined point,
    The ultrasonic endoscope apparatus according to claim 1, wherein the entire treatment area is included in an observation area of the ultrasonic image signal.
  3. 　前記所定の一点が、前記観察領域を略２等分する中心線上に位置する請求項２に記載の超音波内視鏡装置。 3. The ultrasonic endoscope apparatus according to claim 2, wherein the predetermined point is located on a center line that bisects the observation region.
  4. 　前記所定の一点が、前記観察領域の略中央に位置する請求項３に記載の超音波内視鏡装置。 4. The ultrasonic endoscope apparatus according to claim 3, wherein the predetermined one point is located substantially in the center of the observation region.
  5. 　前記凹面の曲率半径が、前記診断用超音波素子に近い側から遠い側に向かって漸次増大する請求項１から請求項４のいずれかに記載の超音波内視鏡装置。 The ultrasonic endoscope apparatus according to any one of claims 1 to 4, wherein a radius of curvature of the concave surface gradually increases from a side closer to the diagnostic ultrasonic element toward a side farther from the diagnostic ultrasonic element.
  6. 　前記診断用超音波素子が、前記治療用超音波素子よりも先端側に位置する請求項１から請求項５のいずれかに記載の超音波内視鏡装置。 The ultrasonic endoscope apparatus according to any one of claims 1 to 5, wherein the diagnostic ultrasonic element is located on a distal end side with respect to the therapeutic ultrasonic element.
PCT/JP2017/007136 2017-02-24 2017-02-24 Ultrasonic endoscope device WO2018154717A1 (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006032059A2 (en) * 2004-09-16 2006-03-23 University Of Washington Acoustic coupler using an independent water pillow with circulation for cooling a transducer
JP2007152094A (en) * 2005-11-23 2007-06-21 General Electric Co <Ge> Ablation array with independently operated ablation element
US20110034808A1 (en) * 2009-08-04 2011-02-10 National Health Research Institutes Dual-Curvature Phased Array High-Intensity Focused Ultrasound Transducer for Tumor Therapy
JP2014176429A (en) * 2013-03-13 2014-09-25 Olympus Corp Trans-body cavity cauterization device

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006032059A2 (en) * 2004-09-16 2006-03-23 University Of Washington Acoustic coupler using an independent water pillow with circulation for cooling a transducer
JP2007152094A (en) * 2005-11-23 2007-06-21 General Electric Co <Ge> Ablation array with independently operated ablation element
US20110034808A1 (en) * 2009-08-04 2011-02-10 National Health Research Institutes Dual-Curvature Phased Array High-Intensity Focused Ultrasound Transducer for Tumor Therapy
JP2014176429A (en) * 2013-03-13 2014-09-25 Olympus Corp Trans-body cavity cauterization device

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