CN103079488A - Cryotherapy element and cryotherapy device - Google Patents
Cryotherapy element and cryotherapy device Download PDFInfo
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- CN103079488A CN103079488A CN2011800387216A CN201180038721A CN103079488A CN 103079488 A CN103079488 A CN 103079488A CN 2011800387216 A CN2011800387216 A CN 2011800387216A CN 201180038721 A CN201180038721 A CN 201180038721A CN 103079488 A CN103079488 A CN 103079488A
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00106—Sensing or detecting at the treatment site ultrasonic
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00041—Heating, e.g. defrosting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0293—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument interstitially inserted into the body, e.g. needle
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Abstract
A cryotherapy element is an element for carrying out treatment on a diseased area by repeatedly freezing and defrosting said area, thus making the area necrotize. A frozen diseased area reaches a frozen state and an MRI or an x-ray CT device is used in the observation thereof. However, there is a desire for the frozen state to be detected more easily, reliably and accurately. This cryotherapy element is configured from a metal cylinder (1) and a freezing terminal (3) which is inserted inside the cylinder. A diseased area is frozen by the flow of freezing gas in the freezing terminal (3), and is defrosted by the flow of defrosting gas. An ultrasonic vibrator (4) is mounted to the circumferential outer-peripheral surface of the cylinder (1) in an attachable and detachable manner. Ultrasound waves are emitted from the ultrasonic vibrator (4) and reflected waves are received from the boundary between the frozen region of the diseased area and normal tissue. The transmission and reception is carried out by means of a transmitting and receiving unit (5). The time and amplitude of the reflected wave signals received by the transmitting and receiving unit (5) are stored in a memory (22). A processing unit (23) determines the envelope curve surface area of the amplitude from the data, and calculates the size of the frozen area from the surface area.
Description
Technical field
The present invention relates to by affected part being carried out repeatedly freezing and thawing to carry out cold therapy element and the cold-therapy device of the disposal of affected part.
Background technology
It is freezing and thaw several times that the cold therapy element utilizes Joule-Thomson effect (Joule-Thomson effect) etc. that affected part is carried out repeatedly, makes thus affected part downright bad.This therapy is called the cold therapy method.
Affected part is by freezing and freeze with the scope of regulation, and makes it by thawing to melt.By will this freezing and thaw repeatedly carry out once (circulation) above, for example cause certain necrosis twice or three times.
For chilled affected part, this position is in icing state.The size of freezing is decided by kind (tissue), the cryogenic temperature of internal organs.Repeatedly carrying out existing icing volume ratio first circulation time of the second circulation time to become large tendency in two situations with cocycle.
About the relation of this freezing and icing size, carried out following patent application and open by this case applicant.
Technical literature formerly
Patent documentation 1: TOHKEMY 2010-42231 communique
When cold therapy, on the basis of carrying out adequate preparation, formulate size and the freezing and treatment plans such as sequential (time sequence) that thaw for the treatment of element according to tissue and the pathological changes state of affected part in advance.Treat based on this treatment plan.Although icing being of a size of under the freezing state when understanding is freezing in treatment, the state that freezes, because affected part self is positioned at the cause of the bodies such as lung, can't visualization.Therefore expect synchronously carrying out the image of being realized by MRI device or CT device and the practice of judging the size of freezing from this image with treatment.
In the image of being realized by MRI device or CT device, synchronously carry out online MRI measurement, CT measurement while carry out cold therapy.But, installs that self is larger, and must make up with image processing apparatus, so system also has to become extensive.
Therefore, wish not utilize MRI device and CT device just can measure easy and online the size of freezing.
Summary of the invention
The object of the invention is to, a kind of cold therapy element and cold-therapy device that can satisfy above-mentioned requirements is provided.
And, the present invention also aims to, a kind of cold therapy element and cold-therapy device that can utilize ultrasound wave to detect easily icing size is provided.
The invention discloses a kind of cold-therapy device, it is characterized in that, have: the freezing terminal of the freezing and usefulness of thawing; Obtain the size detection mechanism of the size of freezing with measuring the freezing position of affected part.
And, the invention discloses a kind of cold therapy element, have metal urceolus and the freezing terminal that is inserted in this urceolus, freezing and the usefulness of thawing, the disposal that described cold therapy element can carry out the freezing of affected part and thaw is characterized in that,
Have ultrasonic oscillator, described ultrasonic oscillator is installed on the described urceolus, and sends ultrasound wave to the freezing position of affected part, and receives the ultrasonic reflections ripple from the freezing position of affected part that the size detection at the freezing position of affected part is used.
And, the invention discloses a kind of cold therapy element, described ultrasonic oscillator can disassembled and assembled freely with respect to the cylinder peripheral part of described urceolus.
And, the invention discloses a kind of cold therapy element, be provided with the material of ultrasound wave transport properties a little less than than this metal in the leading end side inner of described urceolus.
And, the invention discloses a kind of cold-therapy device, it is characterized in that having:
The cold therapy element, have metal urceolus and the freezing terminal that is inserted in this urceolus, freezing and the usefulness of thawing, the disposal that described cold therapy element can carry out the freezing of affected part and thaw, and described cold therapy element has the ultrasonic oscillator that is installed on the described urceolus;
Be installed in the ultrasonic oscillator on the described urceolus;
Transmitting mechanism encourages described ultrasonic oscillator and sends ultrasound wave to the affected part frozen part;
Receiving mechanism is from having received the described oscillator reception reflected signal from the ultrasonic reflections ripple at the freezing position of affected part; With
Size detection mechanism obtains the size at the freezing position of affected part based on this reflected signal.
And, the invention discloses a kind of cold-therapy device, it is characterized in that,
Described ultrasonic unit has:
Ultrasonic oscillator;
Transmitting mechanism encourages described ultrasonic oscillator and sends ultrasound wave to the freezing position of affected part;
Receiving mechanism is from having received the described oscillator reception reflected signal from the ultrasonic reflections ripple at the freezing position of affected part; With
Size detection mechanism obtains the size at the freezing position of affected part based on this reflected signal.
And, the invention discloses a kind of cold-therapy device, wherein, the area of the envelope that described size detection mechanism changed based on the amplitude of reflected signal and time and obtain icing size.
And, the invention discloses a kind of cold-therapy device, wherein, described size detection mechanism is based on the peak value of the amplitude of reflected signal and obtain icing size.
And, the invention discloses a kind of cold-therapy device, wherein, described size detection mechanism carries out size detection based on reflected signal except the reflected signal suitable with distance from the ultrasonic oscillator setting position to the urceolus position, that receive after this reflected signal.
And, the invention discloses a kind of cold-therapy device, it is characterized in that having:
The cold therapy element, have metal urceolus and the freezing terminal that is inserted in this urceolus, freezing and the usefulness of thawing, described metal urceolus is provided with the material material of ultrasound wave transport properties a little less than than described metal, the disposal that described cold therapy element can carry out the freezing of affected part and thaw in leading end side inner;
Be installed in the ultrasonic oscillator on the described urceolus;
In order to send ultrasound wave and to encourage described oscillator to send hyperacoustic transmitting mechanism to the freezing position of affected part to the freezing position of affected part;
Send the transmitting mechanism of pumping signal to the affected part frozen part;
Receiving mechanism is from having received the described oscillator reception reflected signal from the ultrasonic reflections ripple at the freezing position of affected part; With
Size detection mechanism obtains the size at the freezing position of affected part based on this reflected signal, and,
Size detection mechanism service time poor will be via the echo of described material material and do not distinguish via the echo of described material material, and obtain icing size or diameter based on area or the peak value via the envelope of the echo of described material material not.
The effect of invention
According to cold therapy element of the present invention and cold-therapy device, according to from the reflected signal of affected part and can detect icing size.
And, according to cold therapy element of the present invention and cold-therapy device, can detect exactly icing size according to the amplitude envelope line area of reflected signal.
Ultrasonic oscillator of the present invention can be installed on the circumference of metal urceolus freely in dismounting, therefore has the effect that can install when needed to detect icing size.
Description of drawings
Fig. 1 is the exploded view of expression cold therapy element of the present invention.
Fig. 2 is the figure that can dismounting be installed in freely the embodiment of the ultrasonic vibration apparatus on the cold therapy element.
Fig. 3 is the sketch map that affected part is carried out cold therapy.
Fig. 4 is that expression is based on the figure of freezing icing state.
Fig. 5 is the equivalent circuit figure that is used for the ultrasonic propagation reflection when the ultrasonic oscillator of cold therapy element of the present invention is installed.
Fig. 6 is the key diagram of hyperacoustic propagation of the present invention and its reflection.
Fig. 7 is the figure that echo is measured example.
Fig. 8 is that expression is from the freezing variation diagram that begins the icing state till thaw.
Fig. 9 is the sequential chart of the reflection under the icing state of presentation graphs 8.
Figure 10 is the figure of other embodiment of cylinder 1.
Figure 11 is the sequential chart of the reflected signal that produces by cylinder 1 shown in Figure 10 of expression.
Figure 12 is that expression is corresponding to the figure of the signal identification of the sequential chart of Figure 11.
Figure 13 is the figure of the embodiment of size detecting device.
Figure 14 is the figure that sends and receives the concrete configuration example of section 5 of the present invention.
Figure 15 is the figure for the circuit example of ultrasonic exciting of the present invention.
Figure 16 is the figure of other embodiment of size detecting device.
Figure 17 is basic comprising figure of the present invention.
Figure 18 is the figure of tables of data example of the present invention.
The specific embodiment
Figure 17 is the whole pie graph of cold-therapy device of the present invention.Cold-therapy device is made of cold therapy element 100 and icing size detecting device 200.Cold therapy element 100 has two types.The first is, freezing element (cryoprobe, lower with) is inserted in the metallic that becomes urceolus or the plastics cylinder and with the integrated example of cylinder.The second is, do not use urceolus and only uses the example of freezing element.At this, so-called freezing element has and makes frozen gas alternately enter inside with the gas that thaws and the detected body affected part that contacts with urceolus or freezing element is carried out freezing and thaw so that the function of affected part necrosis.
The first type is multiplex from the external use that detected body is punctured, about the second type, have the affected part of detected body is performed the operation and made it local or become all sidedly open state and make use-case and offer aperture and make use-case from this hole insertion to what affected part punctured at detected body as laparoscopic surgery what this affected part punctured.
The first type be can't be visual example make use-case, the second type is can be with the use-case that makes under the visual state that pierces through state to a certain degree.
In addition, because the first type is that freezing element is inserted into the example that uses in the urceolus, so for freezing element in use leak the outside of damaged, frozen gas or the gas that thaws, the first type is to the detected safer element of body.Therefore, even can also can use under the state with visual puncture state to a certain degree.
The size detecting device 200 that freezes is devices that the icing size to the freezing position of affected part of detected body detects.The size detecting device 200 that freezes has the example of the image diagnosing systems such as X ray CT device, MRI device, diagnostic ultrasound equipment, also has to be installed in ultrasonic oscillator on the cold therapy element 100 described later and the size detecting device that will freeze is connected to detect the example of the ultrasonic unit of icing size with this oscillator.At this, the so-called size of freezing comprises icing diameter, icing area and icing volume.
In the former example of use image diagnosing system, detect in real time the size of freezing along with freezing carrying out.For example, when using X ray CT device, in freezing (also comprise thaw in) on one side X-ray irradiation on one side affected part is had an X-rayed or tomography.From the fluoro data by this shooting gained or faultage image data, obtain icing size.When using the MRI device, in freezing, carry out the MRI shooting and obtain faultage image data, and obtain thus icing size.When using diagnostic ultrasound equipment, in freezing, carry out ultrasonic irradiation and obtain fluoro data or faultage image data.From this fluoro data or faultage image data, obtain icing size.
About the above-mentioned shooting in freezing (X ray, MRI, ultrasound wave), example and the discontinuous example that (intermittently) carries out taken are continuously arranged in freezing.In addition, the example for the size detection of only once freezing in freezing only carries out above-mentioned shooting in this moment once.But, be that advancing of the freezing element in freezing monitored if take purpose, or the configuration relation of adjacent internal organs with other is monitored, then can in freezing, continue shooting.And, when needs detect icing size, as long as the date processing of the size detection of freezing.
Icing size detection based on fluoro data or faultage image data has such practice: fluoroscopy images or faultage image to display frame carry out visualization, and use mouse etc. to carry out with half manual operation (human-machine operation).As additive method, the method for automatically obtaining in addition.For example, only the position that freezes is automatically detected, and detected icing size from the icing position that this detects.Varying in size of the pixel data at icing position and non-icing position.The pixel data at icing position is compared with the pixel data at non-icing position, and pixel value is larger.Therefore, setting can be identified the threshold value of the two, and selects to belong to the pixel data at icing position.This pixel data group represents the position that freezes.Icing size can be obtained from this icing position.
About freezing the size detection method, the example of being obtained by fluoro data or faultage image data has been described, still, utilizing in hyperacoustic situation, also have the method that the envelope according to reflection wave signal detects.This utilizes the detection method of envelope to be, only identifies the reflected signal from the position that freezes, and obtains icing size according to the envelope of this reflected signal that recognizes.
The following describes the icing size detection method of having utilized envelope.
The energy that icing size can send ripple by ultrasound wave is determined with the ratio that the ultrasonic reflections from the position that freezes receives the energy of ripple.
Ultrasonic energy is determined by the long-pending of its waveform and its time width.It is the trigonometric functions such as erupting wave, impulse wave, sine wave etc. that ultrasound wave sends ripple, and its time width and waveform are known in advance.On the other hand, decided by tissue and condition of illness (sick body), the size of freezing as the therapentic part of object from the ultrasonic reflections ripple at the position that freezes, it obtains by mensuration.
When the energy that makes ultrasound wave send ripple is E
1, the energy that ultrasound wave receives ripple is E
2The time, the icing size S that should obtain is
(numerical expression 1)
S＝k(E
2/E
1)
At this, be V when making the transmission ripple
1(t), its time width is t
i～t
j, making and receiving ripple is V
2(t), its time width is t
m～t
nThe time, E
1, E
2For as described below.Wherein, k is correction coefficient, common k=1, but its numerical value is decided by lesions position (internal organs such as breast, kidney, liver) and condition of illness.
(numerical expression 2)
(numerical expression 3)
Above-mentioned E
1, E
2The envelope function that sends ripple, receives ripple at mathematics.
The size of freezing changes according to freezing the carrying out of freeze cycle, thaw cycles and each circulation, the carrying out of thawing.The various moment that are determined at that are used for icing size detection carry out.
(1) in the situation of the icing size of just hoping the final moment that to obtain each freeze cycle, after each freeze cycle just finishes, measures reflection wave signal and detect the size of freezing.
(2) when wanting situation of change to the icing size that forms along with freezing the carrying out of each freeze cycle to monitor, a plurality of moment in each freeze cycle are measured reflection wave signals and the detection of the size of freezing.For example, in each circulation, carry out for the first time ultrasonic wave radiation and carry out the reception of its echo and obtain the size of freezing for the first time.The moment in the complete obiteration of first reflection ripple is carried out the ultrasonic wave radiation second time, and carries out the reception of its echo and obtain the size of freezing for the second time.Below, then carry out same mensuration and detect icing size in the same moment for the third time if need.
(3) when wanting by the size of freezing the thawing condition in the thaw cycles to be monitored, the freeze detection of size of a plurality of moment in each thaw cycles.
Above-mentioned detection method is directly to obtain the size S that freezes, and with Figure 18 other detection methods is described, described other detection methods are used for reply value of calculation S
0With the coefficient k of the inconsistent example of icing size and numerical expression 1 be the situation of various values.In advance with the kind of internal organs, the kind of tumor etc. as parameter, utilize detected body Model etc. to obtain value of calculation S
0With the relation of icing dimension D, and it is stored in the tables of data 300 as benchmark data.Then, the value of calculation S that obtains for the detected body from reality
0, from this tables of data, read corresponding icing dimension D.
Actual icing dimension D exists with ... the kind a (lesions positions of lung or kidney, liver etc.) of internal organs, condition of illness b and the value of calculation S such as kind of tumor
0(being referred to as parameter c) these three parameters.At this, value of calculation S
0The meaning of the parameter c that consists of is, measures and the value of calculation S of the reality that obtains based on this mensuration because exist according to the progress of freezing
0With the icing size of reality of this moment may not be consistent situation, so with c as parameter.Certainly, for both consistent situations, do not need parameter c.
The following describes reading of data in the tables of data of having considered parameter c.
In tables of data 300, make value of calculation data S
0With based on the data D (a, b, c) of three parameters corresponding storage.For example, as for certain internal organs a
1, certain tumor b
1The freezing processing situation.Make the value of calculation S of certain reality constantly
0Be S
01(itself and parameter c
1Corresponding).Therefore, comparable data table 300.At first, reference and internal organs a
1With tumor b
1The field that the two is corresponding then reads and value of calculation data S from this field
01Corresponding icing sized data D
1, be data D (a
1, b
1, c
1).With these data D (a
1, b
1, c
1) specific be the icing size of the reality in this moment, and export control device and display frame to and use.
Further, for the value of calculation S of next reality constantly
02(itself and parameter c
2Corresponding), read similarly corresponding icing sized data D
2, be data D (a
1, b
1, c
2), with its specific be the icing size in this moment, and export control device and display frame to and use.
As the ultrasonic unit in the above detection method of utilizing envelope, the example that adopts above-mentioned diagnostic ultrasound equipment is arranged and ultrasonic oscillator is installed in the example of measuring and detecting on the cold therapy element 100.The former diagnostic ultrasound equipment be with 100 splits of cold therapy element independently, with can electronically controlled multichannel ultrasonic oscillator group, switch and can carry out ultrasonic wave radiation to a plurality of directions by passage.Measure ultrasonic reflections ripple from all directions by all directions, and carry out mensuration based on envelope for all useful directions.From the measurement result of useful directive envelope, detect the size of freezing.Except multichannel, also has the example that a passage is only arranged.
In the example on ultrasonic oscillator being installed in freezing element 100, ultrasonic detection device is connected with this ultrasonic oscillator.Ultrasonic detection device detects the echo from the ultrasonic oscillator of installing, with the detection of the size of freezing.In this case, ultrasonic oscillator and ultrasonic detection device become the icing size detecting device of Figure 17.In the example on ultrasonic oscillator being installed in freezing element 100, be essentially single channel type.The example that a plurality of passages of dual pathways etc. are also arranged certainly.Each passage is had can all cover such directional property by all passages position that will freeze, the ultrasound wave that carries out each passage sends, receives and determines the data of whole icing section, and obtains the size S that freezes.
Because above-mentioned to utilize the detection method of envelope be not to be obtained by the data of fault plane, but utilized reflection wave signal from the sequential at the position that freezes, so, compare the advantage of answering the deal with data measurer to have data capacity significantly to reduce with the example that utilizes the fault plane data.
Fig. 1, Fig. 2 are the figure of the embodiment of exploded representation cold therapy element that ultrasonic oscillator of the present invention is installed.This element consists of by the metallic cylinder 1 as urceolus shown in Figure 1, guide needle 2, freezing element (cryoprobe) 3 and ultrasonic oscillator 4.The front end 1A opening of cylinder 1.This front end 1A is the position with the affected part butt.Front end 1A for example is sharp keen bladed, can pierce through affected part.It is the example of needle-like that the front that makes cylinder 1 is also arranged.The internal diameter of cylinder 1 is to make guide needle 2 and the freezing size that can intert separately with probe 3.
As shown in Figure 2, ultrasonic oscillator 4 has the support 4A and two 4B of ultrasonic vibration section, 4C being installed in support 4A front end of clamp shape.Support 4A with spring 4D is the holding mechanism of operator etc.The 4B of ultrasonic vibration section, 4C have the cylinder sheet 40,41 that also can be fixed on the outside cylindrical face that is clipped in cylinder 1 on the cylinder 1.In cylinder sheet 40,41 the bonding oscillator main body 42,43 that is equipped with of inner surface.
For ultrasonic oscillator 4 is installed on the inner core 1, the gripping support 4A such as operator and make it crooked to the inside, on this basis cylinder sheet 40,41 is connected to the periphery of cylinder 1, then hands unclamps and effect by spring 4D is installed on the cylinder 1 from support 4A.Thus, make oscillator main body 42,43 and the periphery close contact of cylinder 1.
Can dismantle freely by the effect of spring 4D, but example beyond the spring is also arranged, be fixedly installed in addition the example on the periphery of cylinder 1.
Be connected with ultrasound wave in the oscillator main body 42,43 of ultrasonic oscillator 4 and send and receive section 5.Ultrasound wave sends and receives section 5 to have: transmitting mechanism is used for to ultrasonic oscillator main body 42,43 signals that send for the vibration usefulness of ultrasonic exciting; And receiving mechanism, receive reflection wave signal from the ultrasonic oscillator main body 42,43 that receives echo.Vibrating reed 42,43 is connected section 5 and connects by the wire 44 of establishing along the clamp shape parts of support 4A with ultrasound wave.
In the situation of the ultrasonic oscillator in the freezing element of above-mentioned the second type, ultrasonic oscillator shown in Figure 2 directly is installed on the freezing element 3 uses.
Below, illustrate with the example of the freezing element of the first type, but the freezing element of the second type also is same.
Next, the using method of cold therapy element is described.Guide needle 2 is inserted in the cylinder 1, and the cylinder 1 that operator etc. will be inserted with guide needle 2 is against on the bio-tissue such as skin, and/or cylinder advanced and makes guide needle 2 pierce through the operation of puncturing.Then, be advanced into affected part.If arriving affected part then extracts guide needle 2 from cylinder 1.Next, replace this guide needle 2, cryoprobe 3 is interted to cylinder 1.Between cylinder 1 and cryoprobe 3, have a little gap, make thus normal saline flow into this gap.
Then, carry frozen gas to cryoprobe 3, to comprise the position that contact with cylinder 1 and/or cryoprobe 3 around affected part around its of position carry out freezing (freezing), next, conveying is thawed gas and is carried out the thawing of icing position of affected part.This is freezing and thaw and carry out at least a circulation, and passable words are carried out about 2～4 circulations repeatedly.
Below, use Fig. 3 that the idea of the icing dimension measurement when the cold therapy of reality is described.Fig. 3 represents to make cryoprobe 3 to be through to the state of affected part 7 from skin-piercing.Ultrasonic oscillator 4 has been installed in the cylinder 1.
At first, carry out the freezing disposal of affected part 7.This disposal is by being injected into the cryoprobe 3 and carrying out through pipe 8 from the outside with freezing (freezing) gas (for example argon).Based on the injection control of pipe 8 frozen gas by being located at outside gas and flowing into and output mechanism (not shown) carrying out.By freezing disposal, make the affected part 7 on every side of probe 3 and cylinder 1 become icing state.
After just carrying out freezing disposal, the disposal of thawing.This disposal of thawing flows in the cryoprobe 3 via pipe 8 by the gas that will thaw to be carried out, and this gas that thaws flows into by gas and output mechanism (not shown) carries out.
In addition, frozen gas, the gas that thaws are all carried to probe 3 suitably from gas inflow and output mechanism (not shown).
Inject at frozen gas, send and receive at ultrasound wave under the effect of section 5, send ultrasound wave from the vibrating reed 42,43 of oscillator 4 with suitable sequential.Sequential can be for continuous, also can be for intermittently.The ultrasound wave that sends from vibrating reed 42,43 is in cylinder 1 interior propagation, and sends to its outside.Externally have and comprise affected part 7 at interior bio-tissue, receive by vibrating reed 42,43 and comprise this affected part 7 at the echo of interior bio-tissue.Vibrating reed 42,43 can only have any one party, but relatively arranges by two, has the advantage that ultrasound wave is propagated in cylinder 1 equably.
Comprise affected part and have icing position and non-icing position at interior bio-tissue, icing position is same with water, and its hyperacoustic decay is little, because non-icing position is bio-tissue, so decay becomes greatly.Owing to change at icing position and non-icing portion boundary place medium, so the ultrasound wave that sends produces special reflection on this border.Receive these echos and as reflected signal by vibrating reed 42,43, and send and receive the signal that section 5 is identified as other echo by ultrasound wave.Identify, reflected icing size (area or diameter) from the signal of the echo on border, obtain icing size (area or diameter) by the conversion of regulation.
The mensuration that more than is based on ultrasound wave of the present invention and carries out and detection principle.Below, concrete mensuration example is described.
Fig. 4 represents the schematic relation of icing position 10, cryoprobe 3 and cylinder 1.P
1Point is the setting position (in order simply to process as point) of ultrasonic oscillator, P
2Point is the cylinder front position in the affected part 7.The existing icing section situation consistent with affected part also has inconsistent situation, but the objective of the invention is, and measures the size of the section 10 of freezing.
Fig. 5 represents the equivalent circuit of ultrasonic propagation, and ultrasonic propagation is expressed as the transmission lines net of equal valuely.P
1Oscillator setting position shown in Figure 4, P
2It is the front position of cylinder 1 or cryoprobe 3.(be the front position of cylinder in the drawings, but the front end that probe also arranged is from this front position outstanding example forwards.Be the front end P of this outstanding probe this moment
3).P
3The position that mostly is equivalent to the maximum diameter that freezes.Show as: not producing under the state that freezes, do not have r
1, r
2Deng the impedance composition, along with the progress of freezing, it is large that the size of freezing becomes, the impedance composition little by little with P
2Compare nearby side (from P
2To P
1Side) and at P
2→ P
3Scope in produce.
When the ultrasound wave that such equivalent circuit is sent burst shape shown in Figure 7 sends information S
1The time, the ultrasonic reflections ripple appears, it is transformed to the signal of telecommunication and that obtain is exactly reflected signal S
2Reflected signal S
2The signal corresponding with icing size, by its identification is detected icing size.
Fig. 6 is be used to hyperacoustic figure that sends with its reflection is described.P
1 Ultrasonic wave plate 42,43 setting position, the 10th, the section of freezing, Q
1It is echo.From position P
1The ultrasound wave that sends is in cylinder 1 interior propagation.For the ultrasound wave of propagating, because cylinder 1 is metal, so return the earliest from the echo of this cylinder.And its attenuation is few.It becomes initial echo.
A large amount of ice (and the water when thawing) is contained in section 10 owing to freeze, thus ultrasound wave from the periphery of cylinder 1 in the 10 interior propagation of icing section, attenuation ratio is propagated many in cylinder.Then, produce reflection and become echo Q at the boundary with organism 15
2On the other hand, compare with icing section 10, in organism 15, the decay of propagation is large, its echo Q
3Little.These echos Q
2, Q
3And the echo formation echo Q that comprises cylinder
1By only identifying the Q in this echo
2And obtain the reflection wave signal of the section of freezing.For example, although larger from the direct reflection wave amplitude of cylinder self, owing to be the echo that after sending, returns at once, so consider cylinder and P
1The physical property condition such as distance and can from receive ripple, remove on electric property ground.Because echo Q
3The echo that after the echo of section 10 that freezes, returns later on, so it also can be identified on time shaft, the perhaps appearance of the decaying wave by monitoring little amplitude and with the method for its removal, it being removed from the processing object.
The following describes actual mensuration example.
In Fig. 7, interval t
1The reflection wave signal from cylinder self, this interval t
1By a P
1And P
3Distance and obtain in advance.Therefore, be present in interval t
1In reflected signal all by except, to moment T thereafter
1Reflected signal is afterwards obtained the envelope that is accompanied by amplitude and time variation, and obtains the area V of this envelope.Area V is the value of the icing size of reflection, calculates icing size by the conversion of regulation.
For moment T
1Afterwards be zero interval t to reflected signal
2, icing size is larger, this interval t
2Larger, icing size is less should interval t
2Less.
This a series of processing, namely be issued to the processing of calculating the size of freezing from ultrasound wave and undertaken by the size detection section of freezing.Its details is in rear explanation.
Fig. 8 represents to comprise the example of the icing dimension measurement under freezing a plurality of time phases with thawing in an interior circulation entire scope.Before Fig. 8 (a) is freezing beginning, when Fig. 8 (b)～(d) is freezing, (e), (f) be when thawing.The sequential chart of the ultrasonic reflections signal that Fig. 9 (a)～(d) is corresponding with Fig. 8 (b)～(e) is the reflected signal corresponding with icing size under each time phase, obtains thus the icing size under each time phase.
The detection of the icing size under a plurality of time phases of Fig. 8, Fig. 9 has the advantage that can grasp the growth situation of freezing in the refrigerating process.
Replace the method that obtaining icing size among Fig. 7～Fig. 9, also have the method for obtaining the diameter that freezes by obtaining amplitude peak.Carry out by the following method in this case: the size to adjacent amplitude compares, and amplitude that will be larger is as midway peak value, with finally remaining peak value as peak swing.Such method is also arranged: detected amplitude value and obtain so-called envelope only, obtain thus peak value.The peak value that should carry out based on envelope detects when peak value self is difficult to obtain clearly, is not for example having outstanding peak value and is not having in amplitude self in the situation of larger difference, and the very suitable peak value that carries out based on statistical disposition detects.Obtain the method for meansigma methods for certain value more than the threshold value that in envelope, is considered to peak value in addition, and obtain standard deviation and obtain the method etc. of the meansigma methods of the above value of setting.
In fact, in order to obtain icing size, icing diameter, except the method for value transform for freeze size and diameter that will detect or calculate according to conversion formula, also has following method: obtain in advance according to freezing size or diameter and fixed reference value and be stored in the memorizer, find the reference value consistent or approaching with measured value or the value of calculating, and obtain corresponding with it icing size or diameter.
The embodiment that is used for the discrimination of raising reflected signal by Figure 10, Figure 11, Figure 12 explanation.This embodiment is example from delay to the ultrasonic reflections signal that forcibly pay.Figure 10 (a) is the example that the interior forward end towards cylinder 1 is equipped with the material sheet 20 of (slowly) a little less than the metal material of Ultrasonic Wave Propagation Character than cylinder.Cylinder interior with cylindric cutting, is installed material sheet cylindraceous, for example plastic components 20 at this cutting portion.Figure 10 (b) does not cut just with plastic components 20 built-in examples.
Figure 11 represents the sequential chart of the ultrasonic reflections signal among the embodiment of Figure 10.Figure 12 represents its test example.Diminish because compare amplitude from the reflected signal n of plastic components 20 and reflected signal m from the position that plastic components 20 is not installed, so both can be distinguished.As practical significance, because the moment that becomes the peak amplitude value among the reflected signal m is corresponding with the minor axis of icing section, reflected signal m is constantly corresponding with the major diameter of icing section with the border of n, so by these are detected constantly, can obtain minor axis and the major diameter of the section of freezing.
Icing section has various shapes.Have the example of subglobular, just as the example of the shape of rugby, just as example of the shape of the Allium chinense in the vegetable etc.These shapes are subject to the impact of the shape of lesions position.Lesions position is subject to the impact of the internal organs on every side at its place.For example, if be adjacent to produce with blood vessel, then according to the existence of blood vessel and shape is affected, for example, even the original sphere that is shaped as also can become different with sphere at the position from the blood vessel contact.
In addition, although the center of preferred focus section is consistent with the center of cryoprobe, inconsistent situation is arranged also.In inconsistent situation, in the situation of cryoprobe, exist from distance and the short shape on the border of focus section, icing section also becomes the shape of this shape of reflection.
In addition, also has other the impact example that causes because of blood vessel.Warm blood flow is arranged in blood vessel, and close to blood vessel or in the lesions position of with it contact, this blood heat meeting produces harmful effect to freezing.That is, for example the part of sphere can be out of shape.
In so all situations, minor axis and major diameter can appear, and Fig. 8, Fig. 9 are for the effective technology of the detection of such minor axis and major diameter.
Figure 13 is the figure of embodiment of processing side of size detection section of freezing.This embodiment has ultrasound wave and sends and receives section 5, memorizer 22, handling part 23 and display part 24.Ultrasound wave sends and receives section 5 and sends the ultrasonic exciting signal to ultrasound portion oscillator 4, and receives the reflected signal that is detected by oscillator 4.The ultrasonic exciting signal sends when freezing dimension measurement.This mensuration is predetermined constantly, for example according to carrying out each time phase (a)～(f) shown in Figure 8.
Handling part 23 is obtained the envelope area of the amplitude that becomes peak value by each time phase in the useful a plurality of amplitudes from be stored in memorizer 22, and utilizes conversion formula or by obtaining icing size with the comparison of reference value by this area.Display part 24 shows this result.In addition, in the example that peak value detects, handling part 23 is obtained the peak swing value, and it is calculated icing diameter as peak value.
Figure 14 represents the figure for the circuit example of ultrasonic vibration sheet 42,43 excitation.This circuit is the object lesson that ultrasound wave sends and receives section 5, and it has sending part 51, acceptance division 50 and directivity circuit part 52, and directivity circuit part 52 carries out the switching of sending part 51 and acceptance division 50.And cylinder 1 is (E) electrical ground.This ground connection (E) is for vibrating reed 40,41 is encouraged evenly.
Figure 15 is the sketch map for vibrating reed 42,43 excitation.Make driving source 54 and vibrating reed 42,43 couplings by transformator 53.Vibrating reed 42,43 is connected to the both sides of the second siding ring of transformator 53, and the mid point of this second siding ring is connected with drum surface and is grounded (E).
Figure 16 will detect the size of freezing and utilize energetically the figure of the embodiment in frozen gas control.Freeze-thaw sequencing contro section 25 is devices of setting freezing sequential, and this sequential is predetermined, but can revise it according to the detected value of the size of freezing.Namely, whether carry out such as such control: detecting the icing size of obtaining by handling part 23 becomes the icing size of preplanned target, then make it become large if this icing size of obtaining is less, if reached the target size of freezing, then constantly stop freezing and be transferred to the disposal of thawing at this.Therefore, the detected value control sequencing contro section 25 by handling part 23 carries out actual gas control by gas control part 26.
Description of reference numerals
1 metal urceolus
2 guide needle
3 freezing terminals
4 ultrasonic oscillators
5 ultrasound wave send and receive section
100 cold therapy elements
200 icing size detecting devices
Claims (13)
1. cold-therapy device is characterized in that having: the freezing terminal of the freezing and usefulness of thawing; Obtain the size detection mechanism of the size of freezing with measuring the freezing position of affected part.
2. cold-therapy device is characterized in that having:
The cold therapy element has metal urceolus and is inserted in freezing terminal in this urceolus, that be detected the freezing and usefulness of thawing of body affected part, the disposal that described cold therapy element can carry out the freezing of affected part and thaw; With
Ultrasonic unit sends ultrasound wave and reception from the ultrasonic reflections ripple at the freezing position of affected part, and detects the size of freezing to the freezing position of affected part.
3. cold-therapy device according to claim 2 is characterized in that,
Described ultrasonic unit has:
Ultrasonic oscillator;
Transmitting mechanism encourages described ultrasonic oscillator and sends ultrasound wave to the freezing position of affected part;
Receiving mechanism is from having received the described oscillator reception reflected signal from the ultrasonic reflections ripple at the freezing position of affected part; With
Size detection mechanism obtains the size at the freezing position of affected part based on this reflected signal.
4. cold-therapy device according to claim 3 is characterized in that,
The area of the envelope that described size detection mechanism changed based on the amplitude of reflected signal and time and obtain icing size.
5. cold-therapy device according to claim 3 is characterized in that,
Described size detection mechanism is based on the peak value of the amplitude of reflected signal and obtain icing size.
6. a cold therapy element has metal urceolus and the freezing terminal that is inserted in this urceolus, freezing and the usefulness of thawing, and the disposal that described cold therapy element can carry out the freezing of affected part and thaw is characterized in that,
Have ultrasonic oscillator, described ultrasonic oscillator is installed on the described urceolus, and sends ultrasound wave to the freezing position of affected part, and receives the ultrasonic reflections ripple from the freezing position of affected part that the size detection at the freezing position of affected part is used.
7. cold therapy element according to claim 6 is characterized in that,
Described ultrasonic oscillator can disassembled and assembled freely with respect to the cylinder peripheral part of described urceolus.
8. according to claim 6 or 7 described cold therapy elements, it is characterized in that,
Be provided with the material of ultrasound wave transport properties a little less than than this metal in the leading end side inner of described urceolus.
9. cold-therapy device is characterized in that having:
The cold therapy element, have metal urceolus and the freezing terminal that is inserted in this urceolus, freezing and the usefulness of thawing, the disposal that described cold therapy element can carry out the freezing of affected part and thaw, and described cold therapy element has the ultrasonic oscillator that is installed on the described urceolus;
Be installed in the ultrasonic oscillator on the described urceolus;
Transmitting mechanism encourages described ultrasonic oscillator and sends ultrasound wave to the affected part frozen part;
Receiving mechanism is from having received the described oscillator reception reflected signal from the ultrasonic reflections ripple at the freezing position of affected part; With
Size detection mechanism obtains the size at the freezing position of affected part based on this reflected signal.
10. cold-therapy device according to claim 9 is characterized in that,
The area of the envelope that described size detection mechanism changed based on the amplitude of reflected signal and time and obtain icing size.
11. cold-therapy device according to claim 9 is characterized in that,
Described size detection mechanism is based on the peak value of the amplitude of reflected signal and obtain icing diameter.
12. according to claim 10 or 11 described cold-therapy devices, it is characterized in that,
Described size detection mechanism carries out size detection based on reflected signal except the reflected signal suitable with distance from the ultrasonic oscillator setting position to the urceolus position, that receive after this reflected signal.
13. a cold-therapy device is characterized in that having:
The cold therapy element, have metal urceolus and the freezing terminal that is inserted in this urceolus, freezing and the usefulness of thawing, described metal urceolus is provided with the material material of ultrasound wave transport properties a little less than than described metal, the disposal that described cold therapy element can carry out the freezing of affected part and thaw in leading end side inner;
Be installed in the ultrasonic oscillator on the described urceolus;
In order to send ultrasound wave and to encourage described oscillator to send hyperacoustic transmitting mechanism to the freezing position of affected part to the freezing position of affected part;
Send the transmitting mechanism of pumping signal to the affected part frozen part;
Receiving mechanism is from having received the described oscillator reception reflected signal from the ultrasonic reflections ripple at the freezing position of affected part; With
Size detection mechanism obtains the size at the freezing position of affected part based on this reflected signal, and,
Size detection mechanism service time poor will be via the echo of described material material and do not distinguish via the echo of described material material, and obtain icing size or diameter based on area or the peak value via the envelope of the echo of described material material not.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2010177272 | 2010-08-06 | ||
| JP2010-177272 | 2010-08-06 | ||
| PCT/JP2011/062660 WO2012017731A1 (en) | 2010-08-06 | 2011-06-02 | Cryotherapy element and cryotherapy device |
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| CN103079488A true CN103079488A (en) | 2013-05-01 |
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| JP (1) | JPWO2012017731A1 (en) |
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| WO (1) | WO2012017731A1 (en) |
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| JP6067819B1 (en) | 2015-10-21 | 2017-01-25 | 株式会社東芝 | Hierarchical storage system, storage controller, and method for deduplication and storage tiering |
| PL3620801T3 (en) | 2018-09-07 | 2021-07-19 | Erbe Elektromedizin Gmbh | Device for feeding a medical instrument and method for instrument monitoring |
| CN114271923A (en) * | 2020-09-28 | 2022-04-05 | 上海微创惟美医疗科技(集团)有限公司 | State detection and control method, device and medium |
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| US5741248A (en) * | 1995-06-07 | 1998-04-21 | Temple University-Of The Commonwealth System Of Higher Education | Fluorochemical liquid augmented cryosurgery |
| US20030083574A1 (en) * | 2001-05-16 | 2003-05-01 | Svaasand Lars Othar | Cryosurgical apparatus and methods |
| CN1735384A (en) * | 2002-10-04 | 2006-02-15 | 萨纳鲁斯医疗有限公司 | Method and system for cryoablating fibroadenomas |
| US20060079869A1 (en) * | 2003-03-26 | 2006-04-13 | Bischof John C | Thermal surgical procedures and compositions |
| WO2007086056A2 (en) * | 2006-01-26 | 2007-08-02 | Galil Medical Ltd. | Device for coordinated insertion of a plurality of cryoprobes |
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| JP2010042231A (en) * | 2008-07-15 | 2010-02-25 | Dgs Computer:Kk | Cryotherapy planning device and cryotherapy device |
-
2011
- 2011-06-02 CN CN2011800387216A patent/CN103079488A/en active Pending
- 2011-06-02 WO PCT/JP2011/062660 patent/WO2012017731A1/en active Application Filing
- 2011-06-02 JP JP2012527629A patent/JPWO2012017731A1/en not_active Withdrawn
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5741248A (en) * | 1995-06-07 | 1998-04-21 | Temple University-Of The Commonwealth System Of Higher Education | Fluorochemical liquid augmented cryosurgery |
| US20030083574A1 (en) * | 2001-05-16 | 2003-05-01 | Svaasand Lars Othar | Cryosurgical apparatus and methods |
| CN1735384A (en) * | 2002-10-04 | 2006-02-15 | 萨纳鲁斯医疗有限公司 | Method and system for cryoablating fibroadenomas |
| US20060079869A1 (en) * | 2003-03-26 | 2006-04-13 | Bischof John C | Thermal surgical procedures and compositions |
| WO2007086056A2 (en) * | 2006-01-26 | 2007-08-02 | Galil Medical Ltd. | Device for coordinated insertion of a plurality of cryoprobes |
| CN101579256A (en) * | 2008-05-13 | 2009-11-18 | 上海导向医疗系统有限公司 | Concentric, detachable and replaceable multifunctional targeted tumor scalpel |
| JP2010042231A (en) * | 2008-07-15 | 2010-02-25 | Dgs Computer:Kk | Cryotherapy planning device and cryotherapy device |
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| JPWO2012017731A1 (en) | 2013-10-03 |
| WO2012017731A1 (en) | 2012-02-09 |
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