WO2023047876A1 - 超音波診断システム、及び超音波診断システムの作動方法 - Google Patents
超音波診断システム、及び超音波診断システムの作動方法 Download PDFInfo
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Definitions
- the present invention provides an ultrasonic diagnostic system that performs polarization processing on a plurality of depolarized ultrasonic transducers when performing ultrasonic elastography for evaluating the hardness of a tissue of an observation target site, and an ultrasonic It relates to a method of operating a diagnostic system.
- An ultrasonic endoscope having an ultrasonic observation section at the distal end of an endoscope is used as an ultrasonic diagnostic system for the purpose of observing the bile and pancreas through the gastrointestinal tract.
- Such an ultrasonic diagnostic system obtains an ultrasonic image of the inside of the body cavity of the subject by driving a plurality of ultrasonic transducers in the body cavity of the subject and transmitting and receiving ultrasonic waves.
- it is necessary to avoid a decrease in sensitivity while the system is inside the body cavity of the subject.
- a plurality of ultrasonic transducers in an ultrasonic diagnostic system are composed of, for example, single-crystal transducers that are piezoelectric elements, and are normally used in a polarized state.
- An ultrasonic transducer composed of a single-crystal transducer can receive ultrasonic waves with high sensitivity, but depolarization may occur in which the degree of polarization decreases as the driving time increases. .
- the reception sensitivity of the ultrasonic transducer is lowered, which may affect the image quality of the ultrasonic image. For this reason, it is also known that sensitivity is recovered by performing repolarization treatment (simply referred to as polarization treatment) as a countermeasure against depolarization of the single crystal resonator.
- the risk of depolarization is correlated with the thickness of the vibrator, that is, the resonance frequency, and the thicker the vibrator (lower frequency), the lower the risk. Therefore, the risk of depolarization is avoided by using a vibrator using a single crystal vibrator for the body surface and using it in a low frequency band of 1 to 6 MHz.
- the frequency of the ultrasonic waves must be set to a high frequency band of 7 to 8 MHz, so the thickness is relatively large.
- a thin vibrator is used, and the thinner the vibrator, the higher the risk of depolarization. For this reason, a repolarization process is required in the case of a vibrator with a small thickness.
- the ultrasonic sensor as a piezoelectric sensor device described in Patent Document 1 includes a piezoelectric element having a piezoelectric body and a pair of electrodes sandwiching the piezoelectric body, and detecting a detection signal output from the piezoelectric element. and a dedicated polarization processing circuit that applies a polarization voltage to the piezoelectric element to perform the polarization processing.
- the detection circuit detects depolarization from the difference in characteristics between the piezoelectric elements, and a dedicated polarization processing circuit is used to perform polarization processing, thereby obtaining polarization. can be recovered.
- the polarization process is performed, for example, at the timing when the power is turned on, at the timing when a request signal for performing the detection process is input (every reception timing), or at the timing when a predetermined standby transition time has elapsed after the end of the detection process. be implemented.
- the piezoelectric element can be polarized again, and the receiving sensitivity of the piezoelectric element can be maintained.
- the ultrasonic sensor described in Patent Document 2 has a piezoelectric element and a drive circuit that drives the piezoelectric element.
- the drive circuit first maintains the polarization of the piezoelectric element with a first potential V1, then applies the maximum potential VH and the minimum potential VL at least once to cause the piezoelectric element to transmit ultrasonic waves, and Then, waiting the piezoelectric element at a second potential V2, then raising the second potential V2 to a third potential V3, and then holding the third potential while the piezoelectric element receives ultrasonic waves.
- the piezoelectric element is driven by a driving waveform having a step of maintaining the potential V3 and then returning from the third potential V3 to the first potential V1.
- Patent Literature 2 In the ultrasonic diagnostic apparatus described in Patent Literature 2 having such a configuration, by driving the piezoelectric element with a drive waveform having the six steps described above, the piezoelectric element can be driven while maintaining the polarization of the piezoelectric element. It becomes possible. That is, Patent Document 2 describes that depolarization is prevented by devising a waveform for driving the piezoelectric element.
- the ultrasonic diagnostic apparatuses described in Patent Documents 3 and 4 transmit ultrasonic waves to a subject using an ultrasonic transducer array, and include an ultrasonic observation unit that receives reflected waves of the ultrasonic waves.
- An ultrasonic endoscope and an ultrasonic processor for generating an ultrasonic image based on a received signal, the ultrasonic processor for transmitting ultrasonic waves for ultrasonic diagnosis, and a control circuit that performs polarization processing on the plurality of ultrasonic transducers during a non-diagnostic period in which reception is not performed.
- the existing Polarization processing of the ultrasonic transducer can be performed using the existing transmission circuit that transmits the transmission signal to the ultrasonic transducer of the ultrasonic endoscope without significantly changing the circuit configuration and expanding the circuit scale. I think it can be done.
- an image diagnosis is performed by deforming the tissue by an external force, estimating the hardness from the deformation, and imaging or quantifying the hardness of the tissue.
- ultrasound elastography to do.
- an ultrasonic probe is pressed against the observation target site, and deformation such as movement of the observation target tissue is observed on a B-mode image.
- strain elastography which is a method of evaluating the hardness of a tissue based on the magnitude of deformation, such that a larger one is softer. That is, strain elastography examines strain due to pressurization.
- ARFI is a physical phenomenon in which a force that pushes an object backward is generated by irradiation of ultrasonic waves.
- ARFI Imaging i.e., ARFI elastography, which evaluates tissue hardness by deforming the tissue to be observed and measuring the displacement of the tissue using Acoustic Radiation Force Impulse) (ARFI Elastography) is known.
- ARFI is used to generate shear waves (SW: shear waves) in the tissue to be observed, and the propagation speed of the shear waves, that is, the speed of sound, is measured.
- SW shear waves
- SWE shear wave imaging
- shear wave elastography measures the propagation velocity of shear waves.
- the ultrasonic system described in Patent Document 5 has an ultrasonic probe having an array of ultrasonic transducer elements, a transmission channel coupled to the ultrasonic transducer elements, and an asymmetric transmission signal during each transmission interval to the elements.
- This ultrasound system drives the elements of an ultrasound probe with an asymmetric transmit signal that enhances poling (polarization) of the probe transducer.
- the ultrasound probe element is a long-duration, high-energy pressure pulse, such as a shear wave push pulse for the measurement of shear waves in the body. Depolarization can be prevented by using an asymmetric waveform when used to generate waves.
- the piezoelectric element made of a piezoelectric body, the ultrasonic transducer, and the ultrasonic probe It is possible to repolarize and restore or maintain the polarization of an ultrasonic transducer element such as a .
- providing a dedicated circuit for repolarizing, a depolarization detection mechanism, etc. requires a large change in hardware, and it is difficult to install it in an existing system. is very difficult.
- the pulse length of the drive waveform is lengthened by putting a DC component in each drive waveform, so the frame rate is degraded and may affect the quality of the ultrasound image.
- using such a drive waveform to prevent depolarization involves a trade-off between image quality and the risk of depolarization.
- the repolarization process usually uses a transmission waveform different from that for image rendering, the ultrasonic output is weak, but in the above-described conventional ultrasonic apparatus, etc., if it is performed during scanning, the frame rate will decrease. There is a problem.
- an excitation pulse hereinafter also referred to as a push pulse
- a strong force is applied to the tissue to be observed in a short time. It will input ultrasonic waves.
- the time-average intensity that can be input into the living body is the guidance of the US FDA (Food and Drug Administration) as a premarket notification 510 (k), from the safety issue to the living body, the attenuation spatial peak time It is stipulated that the average intensity (Ispta. ⁇ ) should be 720 mW/cm 2 or less.
- FIG. 13 shows an example using share wave (SW).
- an ultrasonic wave (track pulse: track pulse P2) for detecting share waves is transmitted and received, and then a pause period 3 is entered.
- the thick line shown on the left side of FIG. 13 indicates the transmission of the push pulse P1 to (the piezoelectric element of) the ultrasonic transducer 48
- the one-dot chain line indicates the transmission of the track pulse P2
- the two-dot chain line indicates the track pulse P2.
- Reception of reflected wave P3 of pulse P2 is shown.
- the rest period 3 is the period until .
- strong voltage application increases the risk of depolarization, so it is necessary to quickly repolarize after the push pulse. In the repolarization process, since the probe is pulse-driven outside the band, there is almost no ultrasonic output from the element (ultrasonic transducer), and the effect on the time-average intensity is suppressed.
- the polarization of the ultrasonic transducer element can be reduced by making the transmission signal asymmetric. , but the amplitude asymmetry in the signal waveform of the transmitted signal produces a larger electric field in the direction that enhances the polarization of the piezoelectric material and a smaller electric field in the direction that opposes and degrades the polarization of the piezoelectric material. By generating it, the polarization is strengthened. Therefore, there is a problem that it is necessary to select the amplitude asymmetry of the signal waveform by the polarization of the ultrasonic transducer elements.
- the time-average intensity exceeds the above-mentioned limit value even if the polarization can be maintained.
- the work flow would be degraded depending on the rest period according to the intensity.
- An object of the present invention is to solve the above-mentioned problems of the prior art, and to inspect the state of the tissue of the observation target site, such as hardness, by generating ultrasonic waves including excitation ultrasonic waves for generating acoustic radiation pressure.
- the polarization processing of the ultrasonic transducer can be performed using the existing transmission circuit that has transmitted this transmission signal.
- Another object of the present invention is to provide an ultrasonic diagnostic system and an operating method of the ultrasonic diagnostic system which can continue examination of an observation target site while maintaining performance without lowering the workflow.
- the ultrasonic diagnostic system of the first aspect of the present invention acquires an ultrasonic image and uses acoustic radiation pressure to evaluate the hardness of a tissue to be diagnosed.
- a system for transmitting ultrasonic waves including at least excitation ultrasonic waves for vibrating tissue by acoustic radiation pressure using an ultrasonic transducer array in which a plurality of ultrasonic transducers are arranged, and
- An ultrasonic observation unit for receiving reflected waves from tissue, and a transmission signal for ultrasonic wave generation consisting of a driving pulse applied to each of the plurality of ultrasonic transducers to generate ultrasonic waves from the plurality of ultrasonic transducers.
- the ultrasonic processor device transmits ultrasonic waves and receives reflected waves, and uses the transmission circuit during the rest period of all ultrasonic transmissions after the transmission of ultrasonic waves
- a control circuit for performing polarization processing on a plurality of ultrasonic transducers that have transmitted ultrasonic waves the control circuit controlling the transmission circuit to generate a transmission signal for ultrasonic wave generation composed of drive pulses
- a transmission signal for ultrasonic wave generation that controls a transmission circuit to generate a transmission signal for polarization processing to be transmitted to the ultrasonic transducer of and generates an ultrasonic wave that includes at least an excitation ultrasonic wave that generates an acoustic radiation pressure.
- a transmission circuit After the transmission of the ultrasonic wave generation transmission signal and the polarization processing transmission signal according to the acoustic output value generated at the time of transmission of the polarization processing time is set within the rest period, and in the polarization processing time A transmission circuit transmits a transmission signal for polarization processing to at least a plurality of ultrasonic transducers that have transmitted excitation ultrasonic waves, thereby performing polarization processing.
- the control circuit calculates the acoustic output value in the polarization process in response to the user's manipulation of the tissue, and adjusts the polarization process time so that the acoustic output value is equal to or less than a preset acoustic output index value. It is preferable to control within the rest period. Further, the control circuit calculates the depolarization levels of the plurality of ultrasonic transducers generated by transmission of the ultrasonic waves from the transmission time of the ultrasonic wave generation transmission signal composed of the drive pulse, and depolarizes the calculated depolarization levels. It is preferable to calculate the acoustic output value in the treatment and control the polarization treatment time within the pause period according to the calculated acoustic output value.
- the transmission circuit transmits a first transmission signal composed of an excitation pulse as a transmission signal for ultrasonic wave generation to at least some of the plurality of ultrasonic transducers, and transmits a first transmission signal composed of excitation pulses from the plurality of ultrasonic transducers for excitation.
- An ultrasonic wave is generated and transmitted to a tissue to press and displace the tissue
- the receiving circuit receives a first received signal of a reflected wave from the tissue as a received signal
- the evaluation unit receives the first received signal.
- the stiffness of the tissue is evaluated by calculating the displacement of the tissue based on the ultrasonic image obtained from the 1st transmission signal. It is preferably a period until the start of transmission.
- the transmission circuit transmits a first transmission signal composed of an excitation pulse as a transmission signal for ultrasonic wave generation to at least some of the plurality of ultrasonic transducers, and transmits a first transmission signal for excitation from the plurality of ultrasonic transducers.
- An ultrasonic wave is generated and transmitted to the tissue to press and displace the tissue, and then a second transmission signal consisting of a detection pulse for detecting the displacement of the tissue is transmitted to generate the ultrasonic wave for detection.
- the receiving circuit receives a second received signal of the reflected wave of the ultrasonic wave for detection from the tissue as a received signal, and the evaluation unit receives an ultrasonic image obtained from the second received signal
- the rest period is the period from the end of transmission of the second transmission signal to the start of transmission of the next first transmission signal. is preferred.
- the transmission circuit transmits a first transmission signal composed of an excitation pulse as a transmission signal for ultrasonic wave generation to at least some of the plurality of ultrasonic transducers, and transmits a first transmission signal for excitation from the plurality of ultrasonic transducers.
- the ultrasonic wave for detection is generated and transmitted to the tissue in which the shear wave is generated
- the receiving circuit receives a third received signal of the reflected wave of the ultrasonic wave for detection from the tissue as a received signal
- the evaluation unit The stiffness of the tissue is evaluated by calculating the sound velocity of the shear wave based on the third received signal. It is preferably a period until the start. Further, it is preferable to have an ultrasonic endoscope including an endoscope observation section for acquiring an endoscopic image and an ultrasonic observation section.
- a method for operating an ultrasonic diagnostic system acquires an ultrasonic image and uses acoustic radiation pressure to evaluate the hardness of a tissue to be diagnosed.
- the ultrasonic diagnostic system comprises an ultrasonic observation unit having an ultrasonic transducer array in which a plurality of ultrasonic transducers are arranged; An ultrasonic wave comprising a transmission circuit that transmits a transmission signal for sound wave generation, a reception circuit that outputs reception signals of reflected waves received by a plurality of ultrasonic transducers, and an evaluation unit that evaluates tissue hardness based on the reception signals.
- a processor device for ultrasonic wave generation comprising a driving pulse applied to each of the plurality of ultrasonic transducers by controlling a transmission circuit in order to generate ultrasonic waves from the plurality of ultrasonic transducers.
- a first signal generating step of generating a signal transmitting a transmission signal for ultrasonic wave generation generated by a transmission circuit to a plurality of ultrasonic transducers; applying drive pulses to the plurality of ultrasonic transducers; a first transmission step of generating ultrasonic waves including at least excitation ultrasonic waves that generate radiation pressure and transmitting the generated ultrasonic waves to a tissue;
- the transmission circuit transmits the transmission signal for polarization processing to the plurality of ultrasonic transducers that have transmitted at least the ultrasonic waves for excitation, and performs the polarization processing. and a step.
- the acoustic output value in the polarization process is calculated in response to the user's operation on the tissue, and the polarization process time is adjusted so that the acoustic output value is equal to or less than a preset acoustic output index value. It is preferable to set within the rest period. Also, in the setting step, depolarization levels of a plurality of ultrasonic transducers generated by transmission of ultrasonic waves are calculated from transmission times of transmission signals for ultrasonic wave generation composed of drive pulses, and polarization is obtained from the calculated depolarization levels. It is preferable to calculate the acoustic output value in the treatment and control the polarization treatment time within the pause period according to the calculated acoustic output value.
- a first transmission signal composed of an excitation pulse is transmitted from the transmission circuit to at least a part of the plurality of ultrasonic transducers as a transmission signal for ultrasonic wave generation, thereby generating ultrasonic waves for excitation. is generated and transmitted to the tissue to press and displace the tissue.
- the reception circuit receives a first reception signal based on the reflected wave from the tissue as the reception signal, and the reflected wave is
- the displacement of tissue is calculated based on the ultrasonic image obtained from the first received signal by the evaluation unit to estimate the stiffness of the tissue. It is preferable that the pause period is a period from after the transmission of the first transmission signal is finished to when the transmission of the next first transmission signal is started.
- a first transmission signal composed of an excitation pulse is transmitted from the transmission circuit to at least a part of the plurality of ultrasonic transducers as a transmission signal for ultrasonic wave generation.
- a sound wave is generated and transmitted to the tissue to press and displace the tissue, and after the tissue is displaced, a transmission circuit is subsequently controlled to detect the displacement of the tissue from a detection pulse.
- a third signal generating step of generating a second transmission signal comprising a detection pulse from the transmission circuit to a plurality of ultrasonic transducers to generate ultrasonic waves for detection to generate a tissue and a second transmitting step of transmitting to, the outputting step receiving as a received signal a second received signal based on a reflected wave of the detection ultrasonic wave from the tissue by the receiving circuit, and evaluating The step is to calculate the displacement of the tissue based on the ultrasonic image obtained from the second received signal by the evaluation unit to evaluate the stiffness of the tissue, and the rest period is to transmit the second transmission signal. It is preferable that the period is from after the end to the start of transmission of the next first transmission signal.
- a first transmission signal composed of an excitation pulse is transmitted from the transmission circuit to at least a part of the plurality of ultrasonic transducers as a transmission signal for ultrasonic wave generation.
- a sound wave is generated and transmitted to the tissue to excite the tissue to generate a shear wave, and after generating the shear wave, the transmission circuit is subsequently controlled to detect the speed of sound of the shear wave.
- the output step is the receiving circuit, the third In the evaluation step, the evaluation unit calculates the sound velocity of the shear wave based on the third received signal to evaluate the stiffness of the tissue. is preferably a period from the end of transmission of the first transmission signal to the start of transmission of the next first transmission signal.
- ultrasonic waves including vibration ultrasonic waves for generating acoustic radiation pressure when performing ultrasonic elastography for examining a state such as hardness of a tissue of an observation target site.
- the existing transmission circuit that transmitted this transmission signal can be used to perform polarization processing of the ultrasonic transducer, and the workflow can be improved. It is possible to continue the examination of the observation target site while maintaining the performance without deterioration.
- the polarization processing time corresponding to the acoustic output value generated when transmitting the transmission signal for generating the ultrasonic wave and the transmission signal for performing the polarization processing can be appropriately set within the pause period,
- the polarization treatment can be appropriately performed on the ultrasonic transducer in the set polarization treatment time.
- the reception sensitivity of a plurality of ultrasonic transducers can always be kept good without deteriorating the image quality of the ultrasonic image.
- High-quality ultrasound images can be obtained.
- the polarization processing of a plurality of ultrasonic transducers is performed using an existing transmission circuit that transmits transmission signals to the ultrasonic transducers of the ultrasonic endoscope, so that the existing circuit configuration can be greatly reduced. , and the polarization processing of the ultrasonic transducer can be performed without increasing the circuit scale.
- an ultrasonic diagnostic system having a highly sensitive ultrasonic endoscope that can repolarize with an optimum waveform for the polarization even when a single crystal transducer is adopted, Further, it is possible to provide an operation method of an ultrasonic diagnostic system capable of performing repolarization with respect to polarization of a single-crystal transducer with an optimum waveform in a highly sensitive ultrasonic endoscope.
- FIG. 1 is a diagram showing a schematic configuration of an ultrasonic diagnostic system according to one embodiment of the present invention
- FIG. 2 is a plan view showing the distal end portion of the insertion section of the ultrasonic endoscope shown in FIG. 1 and its surroundings
- FIG. 3 is a view showing a cross section of the distal end portion of the insertion portion of the ultrasonic endoscope shown in FIG. 2 taken along the II cross section shown in FIG. 2
- FIG. 2 is a block diagram showing the configuration of the ultrasonic processor shown in FIG. 1
- FIG. 5 is a time chart showing transmission periods of push pulses, track pulses, and polarization drive pulses transmitted from the transmission circuit shown in FIG.
- FIG. 4 is a graph showing the relationship between the sensitivity and frequency of the drive waveform of the polarization drive pulse shown in FIG. 8A; 5 is a graph showing another example of a pulse waveform of a polarization drive pulse transmitted from the transmission circuit shown in FIG. 4; 9C is a graph showing the relationship between the sensitivity and frequency of the drive waveform of the polarization drive pulse shown in FIG. 8C.
- 2 is a diagram showing the flow of diagnostic processing using the ultrasonic diagnostic system shown in FIG. 1;
- FIG. FIG. 10 is a diagram showing a procedure of a tissue hardness evaluation step in the diagnosis step shown in FIG. 9;
- FIG. 10 is a diagram showing the procedure of an image generation step in the diagnosis step shown in FIG. 9;
- FIG. FIG. 4 is a conceptual diagram of an example representing a display mode;
- FIG. 10 is a diagram showing an example in which share waves are performed in a conventional ultrasound system;
- FIG. 1 is a diagram showing a schematic configuration of an ultrasonic diagnostic system 10.
- the ultrasonic diagnostic system 10 uses ultrasonic waves to acquire ultrasonic images, evaluate the state of an observation target site in the body of a patient as a subject, especially the hardness of tissue, and make a diagnosis ( hereinafter also referred to as ultrasonic diagnosis).
- This ultrasonic diagnostic system 10 particularly uses acoustic radiation pressure to evaluate the tissue hardness of an observation target site (hereinafter also referred to as a diagnosis target).
- Ultrasonic elastography can be performed to evaluate the thickness and diagnose the state of the observation target site and the presence or absence of abnormalities. Ultrasonic elastography is roughly divided into strain elastography for examining tissue distortion at the observation target site and shear wave elastography for measuring the propagation velocity of shear waves in the tissue at the observation target site. Both can be implemented.
- the site to be observed is a site that is difficult to inspect from the patient's body surface side, such as the gallbladder or pancreas.
- the ultrasonic diagnostic system 10 it is possible to ultrasonically diagnose the condition and the presence or absence of an abnormality in an observation target site through the gastrointestinal tract, such as the esophagus, stomach, duodenum, small intestine, and large intestine, which are body cavities of a patient. It is possible.
- the ultrasonic diagnostic system 10 will be described as having a function of performing ultrasonic diagnosis and a function of acquiring an endoscopic image. It is also possible to have an ultrasonic diagnosis only. That is, the ultrasonic diagnostic system 10 of the present invention does not need to have an ultrasonic endoscope 12 having an ultrasonic observation unit 36 and an endoscope observation unit 38, which will be described later, and acquires endoscopic images. It does not have the endoscopic observation unit 38, the light source device 18, and the components necessary only for endoscopic observation, and can perform ultrasonic elastography and acquire an ultrasonic image. It may have the ultrasonic observation unit 36 for ultrasonic observation and components required only for ultrasonic observation.
- the ultrasonic diagnostic system 10 acquires an ultrasonic image and an endoscopic image, and as shown in FIG. It has a processor device 16 , a light source device 18 , a monitor 20 , a water supply tank 21 a , a suction pump 21 b and an operator console 100 .
- the ultrasonic endoscope 12 is an endoscope, and includes an insertion section 22 inserted into a patient's body cavity, an operation section 24 operated by an operator (user) such as a doctor or a technician, and an insertion section 22. and an ultrasonic transducer unit 46 (see FIGS. 2 and 3) attached to the distal end 40 of the.
- the operator obtains an endoscopic image of the inner wall of the patient's body cavity and an ultrasonic image of the observation target region using the functions of the ultrasonic endoscope 12 .
- an "endoscopic image” is an image obtained by photographing the inner wall of a patient's body cavity using an optical technique.
- An “ultrasonic image” is an image obtained by receiving reflected waves (echoes) of ultrasonic waves transmitted from the body cavity of a patient toward an observation target site and imaging the received signals. Note that the ultrasonic endoscope 12 will be described in detail in a later section.
- the ultrasonic processor device 14 is connected to the ultrasonic endoscope 12 via a universal cord 26 and an ultrasonic connector 32a provided at its end.
- the ultrasonic processor device 14 controls the ultrasonic transducer unit 46 of the ultrasonic endoscope 12 to generate acoustic radiation pressure for vibrating the tissue to be diagnosed.
- ultrasound is also transmitted, such as detection ultrasound for detecting tissue strain or shear waves generated in tissue.
- the ultrasonic processor 14 generates an ultrasonic image by imaging the received signal when the ultrasonic transducer unit 46 receives the reflected wave (echo) of the transmitted ultrasonic wave.
- the ultrasonic processor unit 14 will be described in detail in a later section.
- the endoscope processor device 16 is connected to the ultrasonic endoscope 12 via the universal cord 26 and an endoscope connector 32b provided at the end thereof.
- the endoscope processor device 16 acquires image data of a region adjacent to the observation target imaged by the ultrasonic endoscope 12 (more specifically, a solid-state imaging device 86, which will be described later), and performs predetermined processing on the acquired image data. Image processing is performed to generate an endoscopic image.
- the "adjacent site to be observed" is a portion of the inner wall of the patient's body cavity that is adjacent to the site to be observed.
- the ultrasound processor 14 and the endoscope processor 16 are composed of two separate devices (computers). However, the present invention is not limited to this, and both the ultrasound processor device 14 and the endoscope processor device 16 may be configured by one device.
- the light source device 18 is connected to the ultrasonic endoscope 12 via the universal cord 26 and a light source connector 32c provided at its end.
- the light source device 18 emits white light or specific wavelength light composed of the three primary colors of red, green, and blue light when imaging a site adjacent to the observation target using the ultrasonic endoscope 12 .
- the light emitted by the light source device 18 propagates through the ultrasonic endoscope 12 through a light guide (not shown) included in the universal cord 26, and passes through the ultrasonic endoscope 12 (detailedly, an illumination window 88, which will be described later). emitted from As a result, the adjacent site to be observed is illuminated by the light from the light source device 18 .
- the monitor 20 is connected to the ultrasound processor device 14 and the endoscope processor device 16, and displays the ultrasound images generated by the ultrasound processor device 14 and the ultrasound images generated by the endoscope processor device 16.
- Display endoscopic images As a display method for the ultrasonic image and the endoscopic image, a method in which one of the images is switched and displayed on the monitor 20, or a method in which both images are displayed at the same time may be used. Display modes for ultrasonic images and endoscopic images will be described later. In this embodiment, an ultrasonic image and an endoscopic image are displayed on the single monitor 20, but a monitor for displaying the ultrasonic image and a monitor for displaying the endoscopic image are provided separately. good too. Also, the ultrasonic image and the endoscopic image may be displayed in a display form other than the monitor 20, for example, in a display form of a terminal carried by the operator.
- the operator console 100 is a device provided for the operator to input necessary information for ultrasonic diagnosis and to instruct the ultrasonic processor device 14 to start ultrasonic diagnosis.
- the operator console 100 includes, for example, a keyboard, mouse, trackball, touch pad, touch panel, and the like.
- the CPU (control circuit) 152 (see FIG. 4) of the ultrasonic processor device 14 controls each part of the device (for example, a receiving circuit 142 and a transmitting circuit 144 which will be described later) in accordance with the contents of the operation. Control.
- the operator before starting ultrasonic diagnosis, the operator provides examination information (for example, examination order information including date and order number, patient information including patient ID and patient name, and , inspection content and inspection target site information) are input at the console 100 .
- examination information for example, examination order information including date and order number, patient information including patient ID and patient name, and , inspection content and inspection target site information
- the CPU 152 of the ultrasonic processor unit 14 executes ultrasonic diagnosis based on the inputted examination information.
- Each section of the ultrasonic processor unit 14 is controlled.
- the operator can set various control parameters at the console 100 when performing ultrasonic diagnosis. Control parameters include, for example, the result of selection between live mode and freeze mode, the set value of display depth (depth), and the result of selection of ultrasonic image generation mode.
- the "live mode” is a mode in which ultrasonic images (moving images) obtained at a predetermined frame rate are sequentially displayed (real-time display).
- the “freeze mode” is a mode in which a one-frame image (still image) of an ultrasound image (moving image) generated in the past is read from the cine memory 150 described later and displayed.
- the B mode is a mode for displaying a tomographic image by converting the amplitude of an ultrasonic echo into luminance.
- the CF mode is a mode in which average blood flow velocity, flow fluctuation, flow signal intensity, flow power, etc. are mapped in various colors and displayed superimposed on a B-mode image.
- the PW mode is a mode for displaying the velocity of an ultrasonic echo source (for example, blood flow velocity) detected based on the transmission and reception of pulse waves.
- ultrasonic image generation mode is merely an example, and modes other than the three types of modes described above, such as A (Amplitude) mode, M (Motion) mode, contrast mode, etc., may be further included. However, a mode for obtaining Doppler images may also be included.
- FIG. 2 is an enlarged plan view showing the distal end portion of the insertion portion 22 of the ultrasonic endoscope 12 and its surroundings.
- FIG. 3 is a cross-sectional view showing a cross section of the distal end portion 40 of the insertion portion 22 of the ultrasonic endoscope 12 taken along the II cross section shown in FIG.
- the ultrasonic endoscope 12 has the insertion portion 22 and the operation portion 24 as described above.
- the insertion section 22 includes a distal end portion 40, a curved portion 42, and a flexible portion 43 in order from the distal end side (free end side), as shown in FIG.
- the distal end portion 40 is provided with an ultrasonic observation section 36 and an endoscope observation section 38 as shown in FIG.
- an ultrasonic transducer unit 46 having a plurality of ultrasonic transducers 48 is arranged in the ultrasonic observation section 36 .
- the treatment instrument lead-out port 44 serves as an outlet for a treatment instrument (not shown) such as forceps, a puncture needle, or a high-frequency scalpel.
- the treatment instrument lead-out port 44 also serves as a suction port for sucking substances such as blood and body waste.
- the bending portion 42 is a portion that is continuous with the proximal end side (the side opposite to the side where the ultrasonic transducer unit 46 is provided) from the distal end portion 40, and is bendable.
- the flexible portion 43 is a portion that connects the bending portion 42 and the operation portion 24 , has flexibility, and is provided in an elongated state.
- a plurality of ducts for air/water supply and a plurality of ducts for suction are formed inside each of the insertion portion 22 and the operation portion 24, a treatment instrument channel 45 is formed, one end of which communicates with the treatment instrument outlet 44.
- the ultrasonic observation section 36, the endoscope observation section 38, the water supply tank 21a and the suction pump 21b, and the operation section 24 will be described in detail.
- the ultrasonic observation section 36 is a section provided for acquiring an ultrasonic image, and is arranged on the distal end side of the distal section 40 of the insertion section 22 .
- the ultrasonic observation unit 36 includes an ultrasonic transducer unit 46, a plurality of coaxial cables 56, and an FPC (Flexible Printed Circuit) 60, as shown in FIG.
- the ultrasonic transducer unit 46 corresponds to an ultrasonic probe (probe), and ultrasonic waves are generated using an ultrasonic transducer array 50 in which a plurality of ultrasonic transducers 48, which will be described later, are arranged in a patient's body cavity.
- the ultrasonic transducer unit 46 is of a convex type, and transmits ultrasonic waves radially (in an arc).
- the type (model) of the ultrasonic transducer unit 46 is not particularly limited to this, and other types may be used as long as they can transmit and receive ultrasonic waves, such as sector type, linear type and radial type. etc.
- the ultrasonic transducer unit 46 is configured by laminating a backing material layer 54, an ultrasonic transducer array 50, an acoustic matching layer 74, and an acoustic lens 76, as shown in FIG.
- the ultrasonic transducer array 50 may be configured by arranging a plurality of ultrasonic transducers 48 in a two-dimensional array.
- Each of the N ultrasonic transducers 48 is configured by arranging electrodes on both sides of a single-crystal transducer, which is a piezoelectric element.
- Crystal lithium niobate, lead magnesium niobate (PMN), lead magnesium niobate-lead titanate (PMN-PT), lead zinc niobate (PZN), lead zinc niobate-titanate Any one of lead (PZN-PT), lead indium niobate (PIN), lead titanate (PT), lithium tantalate, langasite, and zinc oxide is used.
- the electrodes consist of individual electrodes (not shown) individually provided for each of the plurality of ultrasonic transducers 48 and a transducer ground (not shown) common to the plurality of ultrasonic transducers 48 .
- the electrodes are also electrically connected to the ultrasound processor unit 14 via the coaxial cable 56 and the FPC 60 .
- the ultrasonic transducer 48 needs to be driven (vibrated) at a relatively high frequency of 7 MHz to 8 MHz for the purpose of acquiring an ultrasonic image of the body cavity of the patient. Therefore, the thickness of the piezoelectric element forming the ultrasonic transducer 48 is designed to be relatively thin, for example, 75 ⁇ m to 125 ⁇ m, preferably 90 ⁇ m to 110 ⁇ m.
- a diagnostic drive pulse which is a pulsed drive voltage, is supplied to each ultrasonic transducer 48 as an input signal (transmission signal) from the ultrasonic processor 14 through the coaxial cable 56 .
- the piezoelectric element expands and contracts to drive (vibrate) the ultrasonic transducer 48 .
- a pulsed ultrasonic wave is output from the ultrasonic transducer 48 .
- the amplitude of the ultrasonic waves output from the ultrasonic transducer 48 has a magnitude corresponding to the intensity (output intensity) when the ultrasonic transducer 48 outputs the ultrasonic waves.
- the output intensity is defined as the magnitude of the sound pressure of the ultrasonic waves output from the ultrasonic transducer 48 .
- the ultrasonic transducer 48 transmits an excitation pulse such as a push pulse of strong ultrasonic output for performing ultrasonic elastography as a drive pulse, and emits an excitation ultrasonic wave.
- an excitation pulse such as a push pulse of strong ultrasonic output for performing ultrasonic elastography as a drive pulse
- an excitation ultrasonic wave such as a push pulse of strong ultrasonic output for performing ultrasonic elastography as a drive pulse
- shear elastic wave which is a transverse wave generated by vibration of the tissue of the observation target site by the vibration ultrasonic wave
- shear A detection pulse such as a track pulse for detecting a wave (share wave) is transmitted to generate an ultrasonic wave for detection.
- each ultrasonic transducer 48 When each ultrasonic transducer 48 receives a reflected ultrasonic wave (echo), it vibrates (drives) accordingly, and the piezoelectric element of each ultrasonic transducer 48 generates an electric signal.
- the reflected waves received by each ultrasonic transducer 48 are directly transmitted from the tissue of the observation target site that has been pressed and displaced by receiving the excitation ultrasonic waves generated by the excitation pulse. It may be a reflected wave that is reflected, or a detection ultrasonic wave generated by a detection pulse for detecting the displacement (distortion) of the tissue of the observation target site that has been pressed and displaced by receiving the excitation ultrasonic wave.
- each ultrasonic transducer 48 It may be a reflected wave, or a reflected wave of ultrasonic waves for detection for detecting shear waves (shear waves) generated in the tissue of the observation target site that is vibrated by receiving the ultrasonic waves for excitation.
- An electrical signal generated by each ultrasonic transducer 48 is output from each ultrasonic transducer 48 toward the ultrasonic processor 14 as an ultrasonic reception signal.
- the magnitude (voltage value) of the electric signal output from the ultrasonic transducer 48 corresponds to the reception sensitivity when the ultrasonic transducer 48 receives ultrasonic waves.
- the reception sensitivity is defined as the ratio of the amplitude of the electric signal output by the ultrasonic transducer 48 after receiving the ultrasonic wave to the amplitude of the ultrasonic wave transmitted by the ultrasonic transducer 48 .
- an electronic switch such as a multiplexer 140
- the ultrasonic waves output from the m drive target transducers are immediately synthesized, and the synthesized wave (ultrasonic beam) is transmitted toward the observation target region. After that, each of the m drive target transducers receives the ultrasonic waves (echoes) reflected by the observation target site, and outputs an electric signal (reception signal) corresponding to the reception sensitivity at that time.
- the positions of the driven transducers in the N ultrasonic transducers 48 are changed one by one (one This is repeated by shifting the ultrasonic transducers 48 at a time. More specifically, the above series of steps are performed from the m number of driven transducers on both sides of the ultrasonic transducer 48 positioned at one end of the N ultrasonic transducers 48. be started. The series of steps described above is repeated every time the position of the transducer to be driven shifts due to switching of the aperture channel by the multiplexer 140 . Ultimately, the series of steps described above is performed up to the m number of driven transducers on both sides of the ultrasonic transducer 48 located at the other end of the N ultrasonic transducers 48. This is repeated N times in total.
- the backing material layer 54 supports each ultrasonic transducer 48 of the ultrasonic transducer array 50 from the back side. In addition, the backing material layer 54 attenuates the ultrasonic waves propagated to the backing material layer 54 side among the ultrasonic waves emitted from the ultrasonic transducer 48 or the ultrasonic waves (echoes) reflected at the observation target site. have a function.
- the backing material is made of a rigid material such as hard rubber, and an ultrasonic damping material (ferrite, ceramics, etc.) is added as necessary.
- the acoustic matching layer 74 is overlaid on the ultrasound transducer array 50 and provided for acoustic impedance matching between the patient's body and the ultrasound transducers 48 .
- the acoustic matching layer 74 By providing the acoustic matching layer 74, it is possible to increase the transmittance of ultrasonic waves.
- the material of the acoustic matching layer 74 various organic materials having acoustic impedance values closer to those of the patient's human body than the piezoelectric element of the ultrasonic transducer 48 can be used.
- Specific examples of materials for the acoustic matching layer 74 include epoxy resin, silicon rubber, polyimide, and polyethylene.
- the acoustic lens 76 superimposed on the acoustic matching layer 74 is for converging the ultrasonic waves emitted from the ultrasonic transducer array 50 toward the site to be observed.
- the acoustic lens 76 is made of, for example, silicon-based resin (millable type silicon rubber (HTV rubber), liquid silicon rubber (RTV rubber), etc.), butadiene-based resin, polyurethane-based resin, or the like. , alumina or silica are mixed.
- the FPC 60 is electrically connected to electrodes provided on each ultrasonic transducer 48 .
- Each of the plurality of coaxial cables 56 is wired to the FPC 60 at one end thereof.
- each of the plurality of coaxial cables 56 is connected at the other end (the side opposite to the FPC 60 side). It is electrically connected to the ultrasonic processor device 14 .
- the ultrasonic endoscope 12 includes an endoscope-side memory 58 (see FIG. 4).
- the endoscope-side memory 58 may store driving times of the plurality of ultrasonic transducers 48 during ultrasonic diagnosis. Strictly speaking, the endoscope-side memory 58 may store the cumulative driving time of the drive target transducer among the plurality of ultrasonic transducers 48 .
- the ultrasonic transducers 48 whose cumulative drive time exceeds a predetermined value may be removed from the transducers to be driven, and the removed ultrasonic transducers 48 may be subjected to polarization processing.
- the ultrasonic diagnosis is performed, that is, the period from the start to the end of acquisition of an ultrasonic image (moving image) (more specifically, the ultrasonic diagnosis is performed in live mode).
- the time during which the drive voltage is supplied to the driven vibrator may be used as the cumulative drive time.
- the CPU 152 of the ultrasonic processor device 14 accesses the endoscope-side memory 58, and the accumulated data stored in the endoscope-side memory 58 You can also read the drive time. Further, the CPU 152 of the ultrasound processor 14 rewrites the cumulative driving time stored in the endoscope-side memory 58 to the default value, or renews the cumulative driving time when the cumulative driving time changes due to the implementation of ultrasonic diagnosis. It may be updated to the cumulative driving time of
- the endoscopic observation section 38 is a portion provided for acquiring an endoscopic image, and is arranged closer to the proximal side than the ultrasonic observation section 36 at the distal end portion 40 of the insertion section 22 .
- the endoscope observation section 38 is composed of an observation window 82, an objective lens 84, a solid-state imaging device 86, an illumination window 88, a cleaning nozzle 90, a wiring cable 92, and the like, as shown in FIGS.
- the observation window 82 is attached to the distal end portion 40 of the insertion portion 22 so as to be inclined with respect to the axial direction (longitudinal axis direction of the insertion portion 22).
- the light incident through the observation window 82 and reflected by a portion adjacent to the observation object is imaged on the imaging surface of the solid-state imaging device 86 by the objective lens 84 .
- the solid-state imaging device 86 photoelectrically converts the reflected light from the observation target adjacent region that has passed through the observation window 82 and the objective lens 84 and is imaged on the imaging surface, and outputs an imaging signal.
- a CCD Charge Coupled Device
- CMOS Complementary Metal Oxide Semiconductor
- a captured image signal output by the solid-state imaging device 86 is transmitted to the endoscope processor device 16 via the universal cord 26 via a wiring cable 92 extending from the insertion section 22 to the operation section 24 .
- the illumination windows 88 are provided on both sides of the observation window 82 .
- An output end of a light guide (not shown) is connected to the illumination window 88 .
- the light guide extends from the insertion section 22 to the operation section 24 and its incident end is connected to the light source device 18 connected via the universal cord 26 .
- the illumination light emitted by the light source device 18 travels through the light guide and is irradiated from the illumination window 88 toward the site adjacent to the observation target.
- the cleaning nozzle 90 is a jet hole formed in the distal end portion 40 of the insertion portion 22 for cleaning the surfaces of the observation window 82 and the illumination window 88 . and is jetted toward the illumination window 88 .
- the cleaning liquid jetted from the cleaning nozzle 90 is water, especially deaerated water.
- the cleaning liquid is not particularly limited, and may be another liquid such as normal water (non-deaerated water).
- the water supply tank 21a is a tank for storing degassed water, and is connected to the light source connector 32c by an air/water supply tube 34a.
- the degassed water is used as the cleaning liquid jetted from the cleaning nozzle 90 .
- the suction pump 21b sucks the aspirate (including the degassed water supplied for washing) inside the body cavity through the treatment instrument outlet 44 .
- the suction pump 21b is connected to the light source connector 32c through a suction tube 34b.
- the ultrasonic diagnostic system 10 may include an air supply pump or the like that supplies air to a predetermined air supply destination.
- a treatment instrument channel 45 and an air/water supply conduit are provided in the insertion section 22 and the operation section 24 .
- the treatment instrument channel 45 communicates between the treatment instrument insertion port 30 and the treatment instrument outlet port 44 provided in the operation section 24 .
- the treatment instrument channel 45 is connected to a suction button 28b provided on the operation section 24 .
- the suction button 28b is connected to the treatment instrument channel 45 and also to the suction pump 21b.
- One end of the air/water supply conduit communicates with the cleaning nozzle 90 , and the other end thereof is connected to an air/water supply button 28 a provided on the operation unit 24 .
- the air/water supply button 28a is connected to the water supply tank 21a in addition to the air/water supply conduit.
- the operation unit 24 is a portion operated by the operator at the start of ultrasonic diagnosis, during diagnosis, at the end of diagnosis, etc., and one end of a universal cord 26 is connected to one end of the operation unit 24 .
- the operation unit 24 also has an air/water supply button 28a, a suction button 28b, a pair of angle knobs 29, and a treatment instrument insertion opening (forceps opening) 30, as shown in FIG.
- the bending portion 42 is remotely operated to bend and deform. This deformation operation enables the distal end portion 40 of the insertion portion 22 provided with the ultrasonic observation portion 36 and the endoscope observation portion 38 to be directed in a desired direction.
- the treatment instrument insertion port 30 is a hole formed for inserting a treatment instrument (not shown) such as forceps, and communicates with the treatment instrument outlet 44 via a treatment instrument channel 45 .
- the treatment instrument inserted into the treatment instrument insertion port 30 is introduced into the body cavity from the treatment instrument outlet port 44 after passing through the treatment instrument channel 45 .
- the air/water supply button 28a and the suction button 28b are two-stage switching push buttons, and are operated to switch opening and closing of the channels provided inside the insertion section 22 and the operation section 24, respectively.
- the ultrasonic processor device 14 causes the ultrasonic transducer unit 46 to transmit and receive ultrasonic waves, and converts the received signal output by the ultrasonic transducer 48 (more specifically, the element to be driven) into an image when receiving the ultrasonic waves. Generate an image.
- the ultrasound processor device 14 also displays the generated ultrasound image on the monitor 20 . Furthermore, in this embodiment, the ultrasound processor device 14 supplies a polarization voltage to a polarization target transducer among the N ultrasound transducers 48 to polarize the polarization target transducer.
- the ultrasonic transducer 48 that has been depolarized by repeated ultrasonic diagnosis can be repolarized, thereby increasing the reception sensitivity of the ultrasonic transducer 48 to ultrasonic waves to a favorable level. It is possible to recover up to
- the ultrasound processor device 14 includes a multiplexer 140, a receiving circuit 142, a transmitting circuit 144, an A/D converter 146, an ASIC (Application Specific Integrated Circuit) 148, a cine memory 150, and a CPU (Central Processing Unit). 152, and a DSC (Digital Scan Converter) 154.
- the receiving circuit 142 and the transmitting circuit 144 are electrically connected to the ultrasonic transducer array 50 of the ultrasonic endoscope 12 .
- the multiplexer 140 selects up to m number of transducers to be driven from among the N number of ultrasonic transducers 48 and opens the channels thereof.
- the transmission circuit 144 consists of FPGA (field programmable gate array), pulser (pulse generation circuit 158), SW (switch), etc., and is connected to MUX (multiplexer 140). Note that an ASIC (application specific integrated circuit) may be used instead of the FPGA.
- the transmission circuit 144 applies a driving voltage for transmitting ultrasonic waves to the transducers to be driven selected by the multiplexer 140 according to control signals sent from the CPU 152.
- the drive voltage is a pulsed voltage signal (transmission signal) and is applied to the electrodes of the vibrator to be driven via the universal cord 26 and coaxial cable 56 .
- the transmission circuit 144 has a pulse generation circuit 158 that generates a transmission signal based on a control signal. Under the control of the CPU 152, the pulse generation circuit 158 is used to drive a plurality of ultrasonic transducers 48 to generate ultrasonic waves. A transmission signal for generating sound waves is generated and supplied to a plurality of ultrasonic transducers 48 .
- the transmission circuit 144 uses the pulse generation circuit 158 to generate an ultrasonic wave generation transmission signal having a driving voltage for ultrasonic diagnosis.
- the pulse generation circuit 158 of the transmission circuit 144 generates an excitation pulse for generating an excitation ultrasonic wave in the ultrasonic transducer 48 as a transmission signal for ultrasonic wave generation, That is, it is necessary to generate a first transmission signal consisting of push pulses.
- the pulse generation circuit 158 is used as an ultrasonic wave generation transmission signal for generating detection ultrasonic waves in the ultrasonic transducer 48 to detect distortion caused in the tissue to be diagnosed by excitation ultrasonic waves by push pulses. or a third transmission signal consisting of a detection pulse for measuring the propagation velocity of the shear wave generated in the tissue to be diagnosed by the excitation ultrasound due to the push pulse.
- a third transmission signal consisting of a detection pulse for measuring the propagation velocity of the shear wave generated in the tissue to be diagnosed by the excitation ultrasound due to the push pulse.
- the same pulse generation circuit 158 as used for generating the transmission signal for ultrasonic wave generation is used to generate the transmission signal for polarization processing having the voltage for polarization for performing the polarization processing.
- the ultrasonic transducer 48 receives a reflected wave (echo) from the distorted tissue with respect to the excitation ultrasonic wave and generates a first received signal.
- the second transmission signal and the third transmission signal each composed of a detection pulse are transmitted to the ultrasonic transducer 48, the ultrasonic waves for detection generated from the ultrasonic transducer 48 are applied to the distorted tissue.
- the shear waves are transmitted to the tissue where the shear wave is generated, and the reflected wave (echo) from the tissue where the strain is generated and the reflected wave corresponding to the shear wave from the tissue where the shear wave is generated ( echoes) are received by the ultrasonic transducer 48 to generate a second received signal and a third received signal.
- the receiving circuit 142 is a circuit for receiving an electric signal output from the transducer to be driven that has received an ultrasonic wave (echo), that is, a received signal.
- the receiving circuit 142 receives the first received signal of the reflected wave of the ultrasonic wave for excitation from the distorted tissue, which is generated from the ultrasonic transducer 48, and the ultrasonic wave for detection from the distorted tissue.
- a second received signal of the reflected wave or a third received signal of the reflected wave of the detection ultrasound from the tissue in which the shear wave was generated is received.
- the receiving circuit 142 amplifies the received signal received from the ultrasonic transducer 48 according to the control signal sent from the CPU 152 and transfers the amplified signal to the A/D converter 146 .
- the A/D converter 146 is connected to the receiving circuit 142 , converts the received signal received from the receiving circuit 142 from an analog signal to a digital signal, and outputs the converted digital signal to the ASIC 148 .
- the ASIC 148 is connected to the A/D converter 146, and as shown in FIG. , and the memory controller 151 .
- hardware circuits such as the ASIC 148 perform the functions described above (specifically, the phase matching unit 160, the B mode image generation unit 162, the PW mode image generation unit 164, the CF mode image generation unit 166, Although the evaluation unit 168 and the memory controller 151) are implemented, the present invention is not limited to this.
- the above functions may be realized by cooperation between a central processing unit (CPU) and software (computer program) for executing various data processing.
- the phase matching unit 160 performs a process of applying a delay time to the received signal (received data) digitized by the A/D converter 146 and performing phasing addition (adding after matching the phase of the received data). do.
- a sound ray signal in which the focus of the ultrasonic echo is narrowed is generated by the phasing and addition processing.
- the B-mode image generator 162, the PW-mode image generator 164, and the CF-mode image generator 166 drive one of the plurality of ultrasonic transducers 48 when the ultrasonic transducer unit 46 receives an ultrasonic wave (echo).
- An ultrasonic image is generated based on the electrical signal output by the target transducer (strictly speaking, the audio signal generated by phasing and adding the received data).
- the B-mode image generation unit 162 is an image generation unit that generates a B-mode image, which is a tomographic image of the inside (inside the body cavity) of the patient.
- the B-mode image generator 162 corrects the attenuation caused by the propagation distance according to the depth of the reflection position of the ultrasonic waves by STC (Sensitivity Time Gain Control) for the sequentially generated sound ray signals.
- the B-mode image generation unit 162 also performs envelope detection processing and log (logarithmic) compression processing on the corrected sound ray signal to generate a B-mode image (image signal).
- the PW mode image generator 164 is an image generator that generates an image that displays the blood flow velocity in a predetermined direction.
- the PW mode image generation unit 164 extracts frequency components by performing a fast Fourier transform on a plurality of sound ray signals in the same direction among the sound ray signals sequentially generated by the phase matching unit 160 . After that, the PW mode image generator 164 calculates the blood flow velocity from the extracted frequency components, and generates a PW mode image (image signal) displaying the calculated blood flow velocity.
- the CF mode image generation unit 166 is an image generation unit that generates an image that displays blood flow information in a predetermined direction.
- the CF-mode image generating unit 166 generates an image signal indicating information about blood flow by obtaining the autocorrelation of a plurality of sound ray signals in the same direction among the sound ray signals sequentially generated by the phase matching unit 160. . After that, the CF-mode image generation unit 166 generates a CF-mode image (image signal ).
- the evaluation unit 168 evaluates an electric signal (strictly speaking, received data). The hardness of the tissue to be diagnosed is evaluated based on the audio signal generated by delaying and adding the . The evaluation unit 168 evaluates the received signal from the first received signal when the receiving circuit 142 receives the first received signal and from the second received signal when the second received signal is received. Based on a sound wave image, for example, a B-mode ultrasonic image generated by the B-mode image generation unit 162, the displacement (distortion) of the tissue to be diagnosed is calculated to evaluate the stiffness of the tissue.
- a sound wave image for example, a B-mode ultrasonic image generated by the B-mode image generation unit 162
- the evaluation unit 168 calculates the sound velocity of the shear wave generated in the tissue to be diagnosed based on the third reception signal, and calculates the hardness of the tissue. Evaluate These hardness evaluations can be performed with reference to the following URL. https://www.jstage.jst.go.jp/article/mit/32/2/32_75/_pdf
- the memory controller 151 stores the image signal generated by the B-mode image generator 162 , PW-mode image generator 164 or CF-mode image generator 166 in the cine memory 150 .
- the DSC 154 is connected to the ASIC 148, and converts the image signal generated by the B-mode image generator 162, PW-mode image generator 164, or CF-mode image generator 166 into an image signal conforming to a normal television signal scanning method. (raster conversion), and the image signal is output to the monitor 20 after being subjected to various necessary image processing such as gradation processing.
- the cine memory 150 has a capacity for accumulating image signals for one frame or several frames.
- the image signal generated by the ASIC 148 is output to the DSC 154 and also stored in the cine memory 150 by the memory controller 151 .
- the memory controller 151 reads the image signal stored in the cine memory 150 and outputs it to the DSC 154 .
- an ultrasonic image (still image) based on the image signal read from the cine-memory 150 is displayed on the monitor 20 .
- the CPU 152 functions as a control section (control circuit) that controls each section of the ultrasonic processor device 14, and is connected to the receiving circuit 142, the transmitting circuit 144, the A/D converter 146, and the ASIC 148 to control these devices. Control. More specifically, the CPU 152 is connected to the operator console 100 and controls each section of the ultrasonic processor device 14 according to examination information, control parameters, and the like input from the operator console 100 . Further, when the ultrasonic endoscope 12 is connected to the ultrasonic processor device 14 via the ultrasonic connector 32a, the CPU 152 automatically recognizes the ultrasonic endoscope 12 by a method such as PnP (Plug and Play). do. After that, the CPU 152 can also access the endoscope-side memory 58 of the ultrasonic endoscope 12 and read the cumulative driving time stored in the endoscope-side memory 58 .
- PnP Plug and Play
- the CPU 152 accesses the endoscope-side memory 58 at the end of the ultrasonic diagnosis, and changes the cumulative driving time stored in the endoscope-side memory 58 to the time required for the immediately preceding ultrasonic diagnosis. It may be updated to the added value.
- the ultrasonic endoscope 12 stores the accumulated driving time, but the present invention is not limited to this. It may be stored for each scope 12 .
- an excitation pulse (push pulse) is generated in the pulse generation circuit 158 during the execution of ultrasonic diagnosis, and a plurality of ultrasonic waves of the ultrasonic transducer array 50 are transmitted from the transmission circuit 144.
- the attenuation spatial peak time average intensity (hereinafter simply referred to as time average intensity) Ispta. ⁇ or because the time-average intensity Ispta. ⁇ exceeds or is likely to exceed the US FDA limit of 720 mW/ cm2 .
- a rest period (freeze period) was provided.
- the pulse generating circuit 158 continues to detect pulses ( hereinafter also referred to as a track pulse) is generated and supplied from the transmission circuit 144 to each of the plurality of ultrasonic transducers 48 to output ultrasonic waves for detection toward the tissue, the time average intensity Ispta. ⁇ further increases. As described above, a pause period (freeze period) is provided after the ultrasonic wave for detection is output.
- the attenuation spatial peak time average intensity Ispta Since it exceeds or is likely to exceed cm 2 , it is necessary to provide a pause period (freeze period), resulting in a drop in the frame rate of ultrasonic diagnosis.
- the transmission circuit 144 (pulse generation circuit 158) is controlled to generate a polarization driving pulse, which is a pulsed driving voltage, during the pause period in order to reduce the time-average intensity Ispta. ⁇ . are generated and supplied to each of the plurality of ultrasonic transducers 48 of the ultrasonic transducer array 50 to perform polarization processing of each ultrasonic transducer 48 .
- a polarization driving pulse which is a pulsed driving voltage
- the CPU 152 is connected to the pulse generation circuit 158 of the transmission circuit 144, and generates an excitation pulse (push pulse) in the pulse generation circuit 158 during the period of ultrasonic diagnosis, and transmits the pulse to the transmission circuit.
- 144 to each of the plurality of ultrasonic transducers 48 of the ultrasonic transducer array 50 to generate strong excitation ultrasonic waves in a short period of time and output them to the tissue to be diagnosed, or push pulses.
- a detection pulse (track pulse) is generated in the pulse generation circuit 158, and supplied to the plurality of ultrasonic transducers 48 from the transmission circuit 144, respectively, and the ultrasonic wave for excitation is supplied to the plurality of ultrasonic transducers 48.
- the transmission circuit 144 (pulse generation circuit 158) is controlled to generate a polarization drive pulse, which is a pulsed drive voltage, to generate ultrasonic vibration.
- a polarization drive pulse which is a pulsed drive voltage
- the driving pulse for polarization is a push pulse for vibrating and displacing the tissue to be diagnosed or generating a shear wave, and a strain due to the displacement of the tissue or for detecting a shear wave. or a diagnostic drive pulse such as an image drive pulse for acquiring an ultrasonic image of a diagnostic target.
- the transmission circuit 144 has the same circuit configuration as an existing transmission circuit that does not have a new circuit configuration for generating the polarization drive pulse.
- the transmission circuit 144 transmits at least two drive voltages: the drive voltage for hardness evaluation of the push pulse and the track pulse, the drive voltage for image of the drive pulse for image, and the drive voltage for polarization of the drive pulse for polarization.
- the polarization drive voltage is preferably set to a voltage higher than the hardness evaluation drive voltage and the image drive voltage, and is set to a higher voltage within the settable voltage range. It is more preferable that the voltage is set to the upper limit voltage.
- the polarization drive pulse main lobe is a drive pulse in a frequency band different from the probe frequency band of diagnostic drive pulses such as push pulses, track pulses, and image drive pulses.
- the driving voltage applied to the ultrasonic transducer 48 during the polarization process is the same as the diagnostic drive voltage applied to the ultrasonic transducer 48 during evaluation of tissue hardness and ultrasonic diagnosis such as acquisition of an ultrasonic image. Unlike voltage, it can be said to be a higher voltage.
- the polarization drive pulse wave applied to the ultrasonic transducer 48 during the polarization process is applied to the ultrasonic transducer 48 during evaluation of tissue hardness and ultrasonic diagnosis such as acquisition of an ultrasonic image. It is generated by the same transmission circuit 144 as the push pulse wave, the track pulse wave, and the diagnostic drive pulse wave such as the image drive pulse wave.
- the drive pulse wave has a different polarization drive voltage within the same settable voltage range as the drive pulse wave and has a frequency different from the probe frequency band for ultrasonic diagnosis.
- the polarization drive pulse has a frequency different from the probe frequency band of the diagnostic drive pulse.
- the ultrasonic transducer 48 undergoing polarization processing hardly outputs ultrasonic waves, and it can be said that the influence on the spatial peak time average intensity is suppressed to a low level.
- the present invention has an existing transmission circuit configuration, uses the same transmission circuit 144 for driving pulse output as that for ultrasonic diagnosis, and uses the same settable voltage range as the diagnostic driving pulse for ultrasonic diagnosis. and a driving pulse for polarization with a frequency different from the probe frequency band, and rest after application of the push pulse when evaluating the hardness of the tissue, or after application of the push pulse and subsequent application of the track pulse During this period, the polarization processing of the ultrasonic transducer 48 of the ultrasonic endoscope 12 is performed.
- the drive voltage for polarization (voltage value or potential) of the drive pulse for polarization is within the settable voltage range of the transmission circuit 144, and the ultrasonic endoscope connected to the ultrasonic processor device 14 12 (specifically, the thickness and material of the ultrasonic transducer 48), the CPU 152 sets an appropriate value that satisfies the conditions for obtaining the effect of repolarization.
- the time during which the drive voltage for the polarization drive pulse is supplied is the time within the pause period in which no drive pulse is applied after the push pulse is transmitted, or after the push pulse is transmitted and the track pulse is subsequently transmitted.
- the CPU 152 sets an appropriate value that satisfies the conditions for obtaining the effect of repolarization according to the cumulative drive time and the specifications of the ultrasonic transducer 48 (more specifically, the thickness and material of the ultrasonic transducer 48).
- the CPU 152 performs polarization processing based on the values of the attenuated spatial peak temporal average acoustic output and the attenuation spatial peak temporal average intensity, or further, based on the accumulated driving time and the set value.
- This push pulse period Tx is the same as the push pulse transmission period 1 shown in FIG.
- This track pulse period Ty is the same as the track pulse transmission/reception period 2 shown in FIG.
- polarization processing period Tz The time from the start of polarization processing (transmission of a driving pulse for polarization) to the start of transmission of the next push pulse is defined as a polarization processing period Tz, which is a drive pulse rest period during which no push pulse or track pulse is transmitted. be.
- This polarization processing period Tz is the same as the rest period 3 shown in FIG. 13 in the sense that it is the rest period of the drive pulse.
- the polarization processing period Tz there are cases where the polarization processing is not performed during the entire period. is the sum of the complete pause time during which no polarization processing is performed due to the transmission of .
- the acoustic output value generated in the ultrasonic transducer 48 when the push pulse is transmitted to the plurality of ultrasonic transducers 48 of the ultrasonic transducer unit 46 that is, the attenuation spatial peak time average
- the value of the acoustic output be X (mJ/cm 2 ).
- the attenuated spatial peak time average acoustic output represents the energy of ultrasonic waves radiated from the plurality of ultrasonic transducers 48 of the ultrasonic transducer unit 46 to a unit area perpendicular to the traveling direction of the ultrasonic waves within a unit time.
- Y (mJ/cm 2 ) be the value of the damped spatial peak time average acoustic output generated in the ultrasonic transducer 48 when the track pulse is transmitted to the ultrasonic transducer 48 in the track pulse period Ty.
- the value of the attenuation spatial peak time average acoustic output (hereinafter simply referred to as time average acoustic output) generated in the ultrasonic transducer 48 during the polarization processing of the ultrasonic transducer 48 is Z (mJ/cm 2 ).
- the total attenuation spatial peak time average intensity Ispta. ⁇ (mW/cm 2 ) is calculated by the following formula (1).
- Ispta. ⁇ (X+Y+Z)/(Tx+Ty+Tz) (1)
- the CPU 152 calculates the time-average intensity Ispta. ⁇ based on the values X, Y, and Z of the time-average acoustic output.
- the CPU 152 performs specific processing according to the acoustic output values X, Y, and Z of the spatial peak time-average acoustic outputs generated when the drive pulses, ie, the track pulses, the track pulses, and the polarizing drive pulses are transmitted.
- the attenuation spatial peak time average intensity Ispta. ⁇ is calculated, and according to the calculated time average intensity Ispta. ⁇ , that is, the calculated time average intensity
- the required polarization processing time is set within the polarization processing period Tz, which is a rest period during which no push pulse or track pulse is transmitted.
- Y is the value of the attenuation spatial peak time average acoustic output
- the values of X and Z can also be obtained in a similar manner. Depending on the mode, the values X, Y, and Z may contain multiple pulses. It is possible to obtain by a method such as preparing a table of conditions for combinations of pulses obtained and referring to it.
- the push pulse period Tx and the track pulse period Ty vary depending on the tissue position and/or range of the diagnosis target or observation target site. Therefore, the push pulse period Tx, the track pulse period Ty, and the time-averaged acoustic output values X and Y are determined according to the ROI (region of interest) set by the operator (user). , the control of the poling period Tz and the value Z of the time-averaged acoustic output can be implemented accordingly. That is, the CPU 152 controls the sound of the ultrasonic transducer 48 in the polarization process, specifically before (immediately before) the polarization process, when performing the polarization process in response to the operator's operation on the tissue to be diagnosed.
- the output value (X + Y + Z) is calculated, and the polarization processing is performed so that the acoustic output value (X + Y + Z) is equal to or less than a preset acoustic output index value. control. Further, the CPU 152 calculates the depolarization level of the ultrasonic transducer 48 generated by the transmission of the push pulse and the track pulse from the transmission time of the push pulse and the track pulse, and calculates the depolarization level immediately before the polarization processing from the calculated depolarization level. is calculated, and the polarization processing time is controlled within the polarization processing period Tz (idle period 3) according to the calculated acoustic output value (X+Y+Z).
- X 50 mJ/cm 2
- Y 20 mJ/cm 2
- Z 2 mJ/cm 2
- X+Y+Z 72 mJ/cm 2
- Tx+Ty 0.05s
- Tz is 0.05 s or more.
- a push pulse (first transmission signal) is transmitted from the transmission circuit 144 to the ultrasonic transducer 48 under the control of the CPU 152, and the excitation ultrasonic waves generated in the ultrasonic transducer 48 are transmitted.
- a track pulse for detecting the displacement (distortion) of the tissue to the ultrasonic transducer 48
- the ultrasonic wave for detection generated by the ultrasonic transducer 48 is transmitted to the displaced tissue
- the reflected wave of the ultrasonic wave for detection corresponding to the displacement (distortion) of the tissue is received by the ultrasonic transducer 48, and the signal is sent from the receiving circuit 142.
- a received signal (second received signal) based on the reflected wave received by the ultrasonic transducer 48 is output, and the displacement (distortion) of the tissue is calculated in the evaluation unit 168 based on the second received signal.
- the pause period of the push pulse and the track pulse is the polarization processing period Tz, which is the period from the end of transmission of the track pulse (second transmission signal) to the start of transmission of the next first transmission signal.
- Tz the polarization processing period
- a trigger generating circuit is provided for detecting the end of transmission of the track pulse (second transmission signal) and generating a trigger signal, and the polarization process is started based on the trigger signal. Also good.
- an excitation ultrasonic wave generated from the ultrasonic transducer 48 that has transmitted a push pulse (first transmission signal) from the transmission circuit 144 is transmitted to the tissue to be diagnosed,
- the tissue is vibrated and displaced, the reflected wave of the excitation ultrasonic wave from the tissue due to the displacement (distortion) is received by the ultrasonic transducer 48, and the reflected wave received by the ultrasonic transducer 48 is transmitted from the receiving circuit 142.
- the evaluation unit 168 calculates the displacement (distortion) of the tissue based on the first received signal, and evaluates the hardness of the tissue based on the displacement (distortion). sometimes. Therefore, no track pulse is transmitted in this case.
- the polarization processing period Tz starts immediately after the push pulse period Tx. Therefore, the pause period of the push pulse is the polarization processing period Tz, which is the period from the end of transmission of the first transmission signal to the start of transmission of the next first transmission signal.
- a trigger generating circuit is provided to detect the end of transmission of the push pulse (first transmission signal) and generate a trigger signal, so that the polarization process is started based on the trigger signal. Also good.
- shear wave imaging the sound velocity of a transverse wave (shear wave) generated in a tissue to be diagnosed by applying a push pulse is detected by a track pulse, and the hardness of the tissue is evaluated from the detected sound velocity.
- This shear wave imaging consists of a push pulse period Tx, a track pulse period Ty, and a polarization processing period Tz, as shown in FIG.
- a push pulse (first transmission signal) is transmitted from the transmission circuit 144 to the ultrasonic transducer 48 under the control of the CPU 152, and the excitation ultrasonic waves generated in the ultrasonic transducer 48 are transmitted.
- the ultrasonic wave for detection generated by the ultrasonic transducer 48 is transmitted to the tissue where the shear wave is generated, and the reflected wave of the ultrasonic wave for detection is transmitted by the ultrasonic transducer 48 according to the sound speed of the shear wave
- a received signal (third received signal) based on the reflected wave received by the ultrasonic transducer 48 is output from the receiving circuit 142, and the evaluation unit 168 generates a signal generated in the tissue based on the third received signal.
- the pause period of the push pulse and track pulse is the polarization processing period Tz, which is the period from the end of transmission of the third transmission signal to the start of transmission of the next first transmission signal.
- a trigger generating circuit is provided for detecting the end of transmission of the track pulse (third transmission signal) and generating a trigger signal, and the polarization process is started based on the trigger signal. Also good.
- Spatial Peak Temporal Average Intensity Ispta represents the sound energy passing through a unit area perpendicular to the direction of travel of sound waves (ultrasonic waves) within a unit time. It is defined as the value of the time-averaged intensity (mW/cm 2 ) at the point in the sound field where the intensity is the maximum or the maximum in a specific region, and the attenuated spatial peak time-average intensity Ispta . 3 is defined to be the value of Ispta reduced (attenuated) by 0.3 dBcm ⁇ 1 MHz ⁇ 1 to account for soft tissue acoustic attenuation.
- the spatial peak temporal average intensity Ispta can be obtained as follows.
- the pulse square integral (Pulse Integral Intensity) PII (mJ/cm 2 ) of the driving pulse can be obtained by integrating the square of the entire observed pulse, and can be expressed by the following formula (2).
- p(t) is the instantaneous sound pressure (MPa)
- ⁇ t is the sample interval ( ⁇ s)
- ⁇ is the density (kg/m 3 )
- c speed of sound in water (m/ s).
- the spatial peak temporal average intensity Ispta can be calculated by the following formula (4) or (5).
- Ispta (mW/cm 2 ) is calculated differently depending on whether it is a scan mode (B mode, CD mode) or a non-scan mode (M mode, PW mode).
- M mode a non-scan mode
- Ispta PII ⁇ PRF (4)
- PRF pulse repetition frequency (kHz)
- Ispta PII ⁇ k ⁇ FR (5)
- FR Frame rate (frame/s)
- k Weighting of beam overlap
- the attenuation spatial peak temporal average intensity Ispta It can be obtained by the following formula (6).
- Ispta. ⁇ Attenuated spatial peak temporal average intensity (mW/cm 2 )
- Ispta Spatial peak temporal average intensity (mW/cm 2 )
- ⁇ acoustic attenuation coefficient z: distance from the external aperture of the probe to the point of interest f awf : acoustic working frequency
- the attenuation spatial peak temporal average intensity Ispta. ⁇ can also be obtained from the pulse square integration (pulse intensity integration) PII (mJ/cm 2 ) of the driving pulse as follows.
- the attenuation pulse intensity integration PII. ⁇ (mJ/cm 2 ) can be obtained from the pulse intensity integration PII (mJ/cm 2 ) by the following Equation (7).
- PII. ⁇ PII.10 - ⁇ .z.fawf/10 (7)
- the attenuation pulse intensity integral PII. ⁇ is multiplied by the number of times N that the ultrasonic transducer 48 has transmitted the drive pulse, and divided by the total transmission time T during which the drive pulse is transmitted.
- the values X, Y, and Z of the attenuation spatial peak time average acoustic output correspond to PII. ⁇ N in the above equation (8).
- the total transmission time T in (8) above must be indicated by the time of one frame, and in the case of single mode, the time of one frame is included in T in (8) above, but in a mode where various transmissions are mixed In the case of , the total time including all modes is divided.
- the attenuation spatial peak temporal average intensity Ispta. ⁇ can be obtained from X, Y, Z in each mode (each period Tx, Ty, Tz) according to the following equation (9).
- the CPU (control circuit) 152 controls a plurality of ultrasonic waves for generating excitation ultrasonic waves or further detection ultrasonic waves when performing diagnosis by evaluating the hardness of a tissue to be diagnosed.
- the transmission circuit 144 (pulse generation circuit 158) is controlled so as to generate diagnostic drive pulses to be applied to each of the plurality of ultrasonic transducers 48 to be generated.
- the CPU (control circuit) 152 sets different polarization drive voltages within the same settable voltage range as the diagnostic drive pulse in order to perform the polarization processing of the plurality of ultrasonic transducers 48 . and controls the transmission circuit to generate a polarization driving pulse having a frequency different from the probe frequency band of the ultrasonic probe (ultrasonic transducer unit 46) for acquiring an ultrasonic image.
- the driving pulse for polarization is applied to the plurality of ultrasonic transducers 48, and the driving pulse for polarization causes the plurality of ultrasonic transducers 48 to polarize. is polarized.
- 6A and 6B are graphs showing an example of the drive waveform of the polarization drive pulse transmitted from the transmission circuit shown in FIG. 4, and graphs showing the relationship between the sensitivity and frequency of the drive waveform.
- the drive waveform shown in FIG. 6A is a unipolar one-wave waveform with a frequency of 1.25 MHz.
- the driving waveform of the polarizing driving pulse is not particularly limited, but a polarizing driving pulse having a unipolar waveform shown in FIG.
- the probe frequency band for acquiring ultrasound images is about 2.7 MHz to about 11.7 MHz, as indicated by the dashed line.
- the band of the main lobe of the drive waveform of the polarization drive pulse indicated by the solid line is about 2.3 MHz or less. That is, the band characteristics of the frequency of the driving pulse for polarization and the band characteristics of the frequency of the driving pulse for diagnosis do not overlap at a sensitivity level of -20 dB or higher.
- the frequency band of the main lobe and the probe frequency band indicated by the dashed line do not overlap at a sensitivity level of -20 dB or more. preferable.
- the frequency band of the main lobe is preferably lower than the probe frequency band at a sensitivity level of -20 dB or higher.
- the upper limit temperature of the distal end portion of the ultrasonic endoscope 12 inserted into the body cavity of the subject is strictly limited so as not to affect the body cavity, etc., and it is necessary to prevent the temperature from rising.
- the driving pulse for polarization (main lobe) is transmitted outside the probe frequency band, the input energy to the ultrasonic transducer 48 is reduced and the temperature rise is suppressed. Further, since the area outside the probe frequency band is outside the resonance band in which the ultrasonic transducer 48 resonates, even if the polarization drive pulse (main lobe) is applied to the ultrasonic transducer 48, the output sound pressure also becomes small.
- the drive waveform of the polarizing drive pulse shown in FIG. 6B in addition to the main lobe, there are also one or more side polarizers shown by solid lines, and four side polarizers in the example shown in FIG. It can be seen that lobes are generated.
- the maximum sensitivity of these sidelobes within the probe frequency band are preferably all less than -10 dB, and the average sensitivity of these sidelobes is preferably less than -20 dB, as shown in FIG. 6B.
- the driving waveform of the polarizing driving pulse is not particularly limited, and may be a bipolar waveform shown in FIG. 7A, but may be a unipolar waveform as shown in FIG. 6A. preferable.
- the reason for this is that, as in the frequency characteristics of the driving waveform shown in FIG. This is because the unipolar waveform is lower than the bipolar waveform. Therefore, by making the transmission waveform a unipolar waveform as shown in FIG. 6A, not only the main lobe but also the harmonic components can be suppressed, and a higher effect can be expected.
- the polarizing drive pulse shown in FIG. 8A has a drive waveform including two pulse waves of the polarizing drive pulse shown in FIG. 6A.
- FIG. 8B shows the frequency characteristics of the drive waveform of the polarization drive pulse shown in FIG. 8A.
- the frequency characteristic of the drive waveform shown in FIG. 8B is different from the frequency characteristic of the drive waveform shown in FIG. 6B in the waveform of the main lobe, but the waveform of the side lobe does not change significantly. Further, as shown in FIG.
- the transmission circuit 144 can output a plurality of unipolar waveforms as the polarization drive pulse with the interval of the waveforms being the minimum number of clocks defined in the ultrasonic processor device 14 .
- the reason for this is that although it is optimal to apply a DC voltage for the polarization process, DC voltage cannot be transmitted when using the transmission circuit 144 having an existing transmission circuit configuration as in the present invention. .
- the minimum and maximum time widths are determined depending on the type of pulser (pulse generation circuit 158) of the transmission circuit 144 of the ultrasonic processor device 14 used in the ultrasonic diagnostic system 10.
- FIG. Therefore, as the minimum time width, the time of the minimum number of clocks specified in the transmission circuit 144 is used, the minimum time width is interposed between a plurality of unipolar waveforms, and a polarized waveform close to a DC voltage is obtained. A high repolarization effect can be expected.
- the minimum time width of the two unipolar pulse waveforms, that is, the strongest pulse width is determined by the specifications of the pulser (pulse generation circuit 158) of the transmission circuit 144.
- the above-mentioned FPGA in the transmission circuit 144 outputs control to keep this specification. 8D, by using a combination of a plurality of unipolar waveforms shown in FIG. 8C as the drive waveform of the polarization drive pulse, one unipolar waveform shown by the solid line in FIG. 8D can be obtained.
- the maximum sensitivity of side lobes can be lowered more than the drive waveform of the polarization drive pulse composed of .
- the drive waveform and pulse waveform of the push pulse and track pulse basically use the same frequency band as for image rendering, but only the push pulse is long enough for several milliseconds. It becomes a burst wave and becomes a considerably narrow band.
- FIG. 9 is a diagram showing the flow of diagnostic processing using the ultrasonic diagnostic system 10.
- FIG. 10 is a diagram showing the procedure of the tissue stiffness evaluation step of the diagnosis step shown in FIG.
- FIG. 11 is a diagram showing the procedure of the image generation step of the diagnosis step shown in FIG.
- each part of the ultrasound diagnosis system 10 is powered on, which is used as a trigger for diagnosis. Processing is started.
- an input step is first performed (S001).
- the operator inputs examination information, control parameters, and the like through the console 100 .
- a standby step is performed until an instruction to start diagnosis is given (S002).
- the CPU 152 of the ultrasound processor device 14 reads the cumulative driving time from the endoscope-side memory 58 of the ultrasound endoscope 12 (S003).
- the CPU 152 controls each part of the ultrasonic processor device 14 to perform a diagnosis step (S005).
- diagnosis step first, it is determined whether or not the hardness diagnosis is to be performed as a diagnosis (S011).
- the CPU 152 controls each part of the ultrasonic processor device 14. to perform a hardness diagnosis step (S012).
- the CPU 152 controls each part of the ultrasonic processor device 14 to perform an image generation step (S013).
- the CPU 152 determines whether or not the ultrasonic diagnosis is finished (S014). If the ultrasonic diagnosis has not been completed (No in S014), the process returns to the step S011 for determining the hardness diagnosis at the start of the diagnosis step. Repeatedly implemented. As a diagnosis end condition, for example, the operator may instruct the end of diagnosis through the console 100 .
- the hardness diagnosis step (S012) of the diagnosis step (S005) proceeds along the flow shown in FIG. , when performing SWE (Yes in S021), the CPU 152 controls each part of the ultrasonic processor device 14 to adjust the sound velocity of the shear wave generated in the tissue to be diagnosed using the push pulse and the track pulse. (S022), and the hardness of the tissue is evaluated based on the calculated sound velocity of the shear wave (S023).
- SWE is not performed as hardness evaluation (No in S021), it is determined whether or not a track pulse is used (S024).
- the CPU 152 controls each part of the ultrasonic processor device 14 to calculate the displacement (distortion) of the tissue to be diagnosed using the push pulses and track pulses (S025 ), and the hardness of the tissue is evaluated based on the calculated displacement (strain) (S026).
- the CPU 152 controls each part of the ultrasonic processor device 14 to calculate the displacement (distortion) of the tissue to be diagnosed using only the push pulse (S027), The hardness of tissue is evaluated based on the calculated displacement (strain) (S028). Subsequently, the CPU 152 determines whether or not the hardness evaluation has ended (S029). If the hardness evaluation is not completed (No in S029), the process returns to the SWE determination step S021 at the start of the hardness diagnosis step (S012). It is executed repeatedly until the condition is satisfied.
- the condition for ending the hardness evaluation includes, for example, the operator instructing the end of the diagnosis through the console 100, and the like.
- the polarization treatment is performed.
- the image generation step (S012) of the diagnosis step (S005) proceeds along the flow shown in FIG.
- Each part of the ultrasonic processor unit 14 is controlled to generate (S032). If the specified image generation mode is not the B mode (No in S031) but the CF mode (Yes in S033), each part of the ultrasonic processor device 14 is controlled to generate a CF mode image ( S034). Furthermore, if the designated image generation mode is not the CF mode (No in S033) but the PW mode (Yes in S035), each part of the ultrasound processor device 14 is controlled to generate a PW mode image ( S036). If the designated image generation mode is not the PW mode (No in S036), the process proceeds to step S037.
- the CPU 152 determines whether image generation has ended (S037). If the image generation has not ended (No in S037), the process returns to the image generation mode determination step S031, and the ultrasonic image generation in each image generation mode is repeatedly performed until the image generation end condition is satisfied.
- the image generation end condition for example, the operator instructs the end of diagnosis through the console 100, or the like.
- the CPU 152 saves the time required for the ultrasonic image generation that has been performed up to that time to the endoscope side memory 58 in step S003. is added to the cumulative driving time read from the endoscope side memory 58, and the cumulative driving time stored in the endoscope side memory 58 is updated to the cumulative driving time after the addition (S038).
- the image generation step (S013) ends when the series of steps (S031 to S038) in the image generation step ends. Subsequently, returning to FIG.
- the ultrasonic transducer 48 when the ultrasonic transducer 48 generates an ultrasonic image for ultrasonic diagnosis, the time at which ultrasonic waves are transmitted for ultrasonic image generation and the reflected waves of the ultrasonic waves are received.
- the cumulative drive time of the plurality of ultrasonic transducers 48 the dipoles applied to both surfaces of the ultrasonic transducers 48 decrease and depolarization progresses. Therefore, it is not possible to directly determine whether or not the ultrasonic transducer 48 is depolarized. It is necessary to determine whether or not there is, and to perform polarization processing when the cumulative drive time of the plurality of ultrasonic transducers 48 for performing ultrasonic diagnosis is equal to or longer than a specified time.
- a default value of the time may be set as the specified time, or an arbitrary time may be set by the user's instruction. Note that the specified time is an arbitrary time, and may be on the order of several hours or on the order of several frame times.
- the polarization process can be started when a user presses a button for instructing the start of the polarization process.
- the polarization process can be started at any timing according to the user's instruction.
- the buttons may be electronic buttons displayed within the touch panel of the console 100 or mechanical buttons provided on the operation unit 24 of the ultrasonic endoscope 12 .
- the ultrasonic waves transmitted from the ultrasonic transducer 48 are generally set to a low power that does not destroy the bubbles contained in the contrast medium.
- the S/N ratio of the image is lowered, so that depolarization tends to have an adverse effect on sensitivity reduction.
- It is generally set at a low power that does not destroy the bubbles contained in the contrast agent.
- the S/N ratio of the image is lowered, so that depolarization tends to have an adverse effect on sensitivity reduction.
- the polarization process can be started when the display depth of the ultrasonic image for ultrasonic diagnosis is set to a certain depth or more. According to the user's instruction, the display depth of the ultrasonic image for performing ultrasonic diagnosis can be set to, for example, a position with a depth of 4 cm and a position with a depth of 10 cm.
- the polarization processing is not started when the display depth of the ultrasonic image is set to a position of 4 cm in depth, and the display depth is set to a position of 10 cm in depth.
- the polarization process is started.
- the polarization processing may be started when the brightness of the B-mode ultrasound image acquired with the display depth set to a certain depth or more is below a certain brightness.
- a default value of brightness may be set as the constant brightness, or an arbitrary brightness may be set according to a user's instruction.
- the polarization process can be preferably performed regardless of the image quality. Accordingly, the polarization processing may be started when it is recognized based on the ultrasound image that the user is performing treatment while viewing the ultrasound image.
- the ultrasound diagnostic system 10 can also acquire ultrasound images and endoscopic images, and display these ultrasound images and endoscopic images on the monitor 20 in various display modes.
- the display modes include a first display mode for displaying only an ultrasonic image, and a second display mode for displaying an ultrasonic image larger than an endoscopic image by picture-in-picture (PinP).
- a third display mode in which the ultrasonic image is displayed smaller than the endoscopic image and a fourth display mode in which only the endoscopic image is displayed.
- the user can arbitrarily switch between the first to fourth display modes for display.
- the third display mode the ultrasonic image is displayed smaller than the endoscopic image, so polarization processing can be preferably performed regardless of the image quality. Accordingly, the polarization processing may be performed when the third display mode is set and the ultrasonic image is displayed smaller than the endoscopic image by picture-in-picture.
- the polarization process may be started based on arbitrary factors other than the above factors.
- the termination condition of the polarization processing is, for example, when the accumulated processing time of the polarization processing reaches a certain time, or when the termination of the polarization processing is instructed by the user, the contrast mode is changed to another ultrasonic image generation mode.
- the display depth of ultrasound for performing ultrasound diagnosis is set to less than a certain depth, when it is no longer recognized based on the endoscopic image that the user is undergoing treatment, ultrasound
- the polarization process may be terminated by other termination conditions.
- the ultrasonic diagnostic system 10 performs detection by transmitting track pulses after transmitting ultrasonic waves for excitation by push pulse transmission or following transmission of ultrasonic waves for excitation by push pulse transmission. Polarization processing is performed immediately during the rest period of the diagnostic drive pulse after the ultrasonic wave is transmitted. Therefore, even during the period of ultrasonic diagnosis, the attenuation spatial peak temporal average intensity Ispta. ⁇ , which has increased due to transmission of push pulses or further track pulses, etc., or has increased and exceeded the limit value, is equal to or less than the limit value.
- the ultrasonic diagnostic system 10 performs polarization processing using the existing transmission circuit 144, more specifically, the pulse generation circuit 158, it is possible to perform the polarization process during the ultrasonic diagnosis without significantly changing the existing circuit. Polarization treatment can be performed.
- the total number of ultrasonic transducers 48 and the number of aperture channels may be changed to any number.
- the number of aperture channels is the same as the total number of ultrasonic transducers 48, instead of the transmission signals for the two polarization processings, polarization processing 1 and 2, for driving 128 ultrasonic transducers 48, It is also possible to provide a transmit signal for one polarization process.
- the number of aperture channels is a quarter of the total number of ultrasonic transducers 48, four polarization processing transmission signals, polarization processing 1 to 4, which drive 32 ultrasonic transducers 48, respectively, are transmitted. can also be supplied.
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Abstract
Description
超音波診断システムにおいて複数の超音波振動子は、例えば、圧電素子である単結晶振動子によって構成されており、通常、分極した状態で用いられる。単結晶振動子によって構成された超音波振動子は、高感度にて超音波を受信することが可能であるが、駆動時間が長くなるにつれて分極の度合いが低下する脱分極現象が生じることがある。脱分極現象が生じると、超音波振動子の受信感度が低下してしまい、超音波画像の画質に影響を及ぼす虞がある。このため、単結晶振動子の脱分極の対策として、再分極処理(単に分極処理とも言う)を行うことで感度が回復することも知られている。
これに対し、被検体の体腔内において各超音波振動子を駆動して超音波を送受信する場合、超音波の周波数を7~8MHzレベルの高周波帯域に設定する必要があるため、比較的厚みが薄い振動子を利用することになるが、振動子の厚みが薄くなるほど、脱分極現象の発生リスクが高くなる。このため、厚みが薄い振動子の場合には再分極のプロセスが必要となる。
これに対し、ストレインエラストグラフィーにおいて、近年、超音波プローブを物理的に押し付け観察対象の組織を変形させるのではなく、超音波の照射によって物体を後方に押しやる力が生じる物理現象であるARFI(アーフィ―:Acoustic Radiation Force Impulse:音波照射力インパルス)を利用して、観察対象の組織を変形させて組織の変位を測ることで組織の硬さを評価するARFIイメージング(ARFI Imaging)、即ちARFIエラストグラフィー(ARFI Elastography)が知られている。
これらのARFIイメージング、及びSWイメージングは、プッシュパルス(Push Pulse)と呼ばれる加振パルスによる強い超音波の照射により、組織の歪みを発生させ、組織の変位量、又は組織に発生した剪断波の音速から組織の硬さを評価する手法である。
しかしながら、特許文献1に記載の超音波センサーのように、再度分極を行うための専用回路、及び脱分極の検出機構等を設けることはハードウェアの変更要素が大きく、既存のシステムに搭載するのは非常に困難であるという問題がある。
また、特許文献2に記載の超音波センサーにおいては、脱分極を防止し、分極を維持するために、各駆動波形中に直流成分を入れることによって駆動波形のパルス長が長くなるため、フレームレートが低下して超音波画像の画質に影響を及ぼす可能性があるという問題がある。また、このような駆動波形を使って脱分極を防ぐには、画質と脱分極のリスクとのトレードオフとなるという問題がある。
また、再分極プロセスには、通常、画像描出と異なる送信波形を用いるため、超音波出力は弱いが、上記の従来の超音波装置等において、スキャン走査中に実施するとフレームレートが低下してしまうという問題がある。
(https://www.fda.gov/media/71100/download:Marketing Clearance of Diagnostic Ultrasound Systems and Transducers:診断用超音波システム、及びトランスデューサのマーケティングクリアランス)
このため、強力な超音波出力を行った際には減衰空間ピーク時間平均強度(Ispta.α)を下げるため、休止期間(フリーズ区間)を入れる必要がある。
一方、単結晶を用いた超音波振動子を用いる場合、強力な電圧印加は脱分極のリスクが上がるため、プッシュパルス後、速やかに再分極を行う必要がある。再分極プロセスにおいては、プローブの帯域外のパルス駆動となるため、素子(超音波振動子)からの超音波出力はほとんどなく、時間平均強度への影響も低く抑えられる。
また、超音波トランスデューサ要素にプッシュパルスを含む送信信号を印加した場合、分極を維持することはできても、時間平均強度が上記制限値を超えてしまい、休止期間を設ける必要が生じ、時間平均強度に応じた休止期間によっては、ワークフローが低下してしまうという問題もあった。
また、制御回路は、超音波の送信によって発生する複数の超音波振動子の脱分極のレベルを駆動パルスからなる超音波発生用送信信号の送信時間から算出し、算出した脱分極のレベルから分極処理における音響出力値を計算し、計算された音響出力値に応じて分極処理時間を休止期間以内において制御することが好ましい。
また、送信回路は、複数の超音波振動子の少なくとも一部に、超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、複数の超音波振動子から加振用超音波を発生させて組織に送信して組織を押圧して変位させ、受信回路は、受信信号として組織からの反射波の第1の受信信号を受信し、評価部は、第1の受信信号から得られた超音波画像に基づいて組織の変位を算出して組織の硬さを評価するものであり、休止期間は、第1の送信信号の送信終了後から次の第1の送信信号の送信開始までの期間であることが好ましい。
また、送信回路は、複数の超音波振動子の少なくとも一部に、超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、複数の超音波振動子から加振用超音波を発生させて組織に送信して組織を加振して剪断波を発生させた後、続いて剪断波の音速を検出するための検出パルスからなる第3の送信信号を送信して検出用超音波を発生させて剪断波が発生している組織に送信し、受信回路は、受信信号として組織からの検出用超音波の反射波の第3の受信信号を受信し、評価部は、第3の受信信号に基づいて剪断波の音速を算出して組織の硬さを評価するものであり、休止期間は、第3の送信信号の送信終了後から次の第1の送信信号の送信開始までの期間であることが好ましい。
また、更に、内視鏡画像を取得するための内視鏡観察部、及び超音波観察部を備える超音波内視鏡を有することが好ましい。
また、設定ステップは、超音波の送信によって発生する複数の超音波振動子の脱分極のレベルを駆動パルスからなる超音波発生用送信信号の送信時間から算出し、算出した脱分極のレベルから分極処理における音響出力値を計算し、計算された音響出力値に応じて分極処理時間を休止期間以内において制御することが好ましい。
また、第1の送信ステップは、送信回路から複数の超音波振動子の少なくとも一部に、超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して加振用超音波を発生させて組織に送信して組織を押圧して変位させるものであり、出力ステップは、受信回路によって、受信信号として組織からの反射波に基づく第1の受信信号を受信し、反射波に基づく第1の受信信号を受信回路から出力するものであり、評価ステップは、評価部によって第1の受信信号から得られた超音波画像に基づいて組織の変位を算出して組織の硬さを評価するものであり、休止期間は、第1の送信信号の送信終了後から次の第1の送信信号の送信開始までの期間であることが好ましい。
また、第1の送信ステップは、送信回路から複数の超音波振動子の少なくとも一部に、超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、加振用超音波を発生させて組織に送信して組織を加振して剪断波を発生させるものであり、更に、剪断波を発生させた後、続いて送信回路を制御して、剪断波の音速を検出するための検出パルスからなる第3の送信信号を生成する第4の信号生成ステップと、送信回路から検出パルスからなる第3の送信信号を複数の超音波振動子に送信して検出用超音波を発生させて剪断波が発生している組織に送信する第3の送信ステップと、を有し、出力ステップは、受信回路によって、受信信号として組織からの検出用超音波の反射波の第3の受信信号を受信し、評価ステップは、評価部によって第3の受信信号に基づいて剪断波の音速を算出して組織の硬さを評価するものであり、休止期間は、第3の送信信号の送信終了後から次の第1の送信信号の送信開始までの期間であることが好ましい。
本発明によれば、超音波を発生させる送信信号、及び分極処理を行う送信信号の送信の際に発生する音響出力値に応じた分極処理時間を休止期間内に適切に設定することができ、設定された分極処理時間において超音波振動子に適切に分極処理を行うことができる。
また、本発明によれば、超音波内視鏡の超音波振動子に送信信号を送信する既存の送信回路を用いて複数の超音波振動子の分極処理を行うため、既存の回路構成を大幅に変更することなく、また、回路規模の拡大を招くことなく、超音波振動子の分極処理を行うことができる。
本発明によれば、単結晶振動子を採用する際にも、その分極に対して最適な波形で再分極することができる高感度の超音波内視鏡を有する超音波診断システムを提供でき、また、高感度の超音波内視鏡において単結晶振動子の分極に対する再分極を最適な波形で行うことができる超音波診断システムの作動方法を提供できる。
なお、本実施形態は、本発明の代表的な実施態様であるが、あくまでも一例に過ぎず、本発明を限定するものではない。
また、本明細書において、「~」を用いて表される数値範囲は、「~」の前後に記載される数値を下限値及び上限値として含む範囲を意味する。
本実施形態に係る超音波診断システム10について、図1を参照しながら、その概要を説明する。図1は、超音波診断システム10の概略構成を示す図である。
超音波診断システム10は、超音波を用いて、超音波画像を取得したり、被検体である患者の体内の観察対象部位の状態、特に組織の硬さを評価したりして診断を行う(以下、超音波診断ともいう)ために用いられる。この超音波診断システム10は、特に、音響放射圧(Acoustic Radiation Pressure)を用いて観察対象部位(以下、診断対象ともいう)の組織の硬さの評価を行うものであり、観察対象部位の硬さを評価して観察対象部位の状態及び異常の有無を超音波診断する超音波エラストグラフィー(Ultrasonic Elastography)を実施することができる。なお、超音波エラストグラフィーは、観察対象部位の組織の歪みを診るストレインエラストグラフィーと、観察対象部位の組織のシェアウェーブの伝搬速度を測定するシェアウェーブエラストグラフィーとに大別されるが、本発明では、両方とも実施することができる。
ここで、観察対象部位は、患者の体表側からは検査な困難な部位であり、例えば胆嚢又は膵臓である。超音波診断システム10を用いることにより、患者の体腔である食道、胃、十二指腸、小腸、及び大腸等の消化管を経由して、観察対象部位の状態及び異常の有無を超音波診断することが可能である。
超音波内視鏡12は、内視鏡スコープであり、患者の体腔内に挿入される挿入部22と、医師又は技師等の術者(ユーザ)によって操作される操作部24と、挿入部22の先端部40に取り付けられた超音波振動子ユニット46(図2、及び図3を参照)と、を備える。術者は、超音波内視鏡12の機能によって、患者の体腔内壁の内視鏡画像と、観察対象部位の超音波画像を取得する。
ここで、「内視鏡画像」は、患者の体腔内壁を光学的手法によって撮影することで得られる画像である。また、「超音波画像」は、患者の体腔内から観察対象部位に向かって送信された超音波の反射波(エコー)を受信し、その受信信号を画像化することで得られる画像である。
なお、超音波内視鏡12については、後の項で詳しく説明する。
なお、超音波用プロセッサ装置14については、後の項で詳しく説明する。
ここで、「観察対象隣接部位」とは、患者の体腔内壁のうち、観察対象部位と隣り合う位置にある部分である。
なお、本実施形態では、超音波用プロセッサ装置14及び内視鏡用プロセッサ装置16が、別々に設けられた2台の装置(コンピュータ)によって構成されている。ただし、これに限定されるものではなく、1台の装置によって超音波用プロセッサ装置14及び内視鏡用プロセッサ装置16の双方が構成されてもよい。
なお、本実施形態では、一台のモニタ20に超音波画像及び内視鏡画像を表示するが、超音波画像表示用のモニタと、内視鏡画像表示用のモニタとが別々に設けられてもよい。また、モニタ20以外の表示形態、例えば、術者が携帯する端末のディスプレイに表示する形態にて超音波画像及び内視鏡画像を表示してもよい。
また、術者は、超音波診断の実施に際して、各種の制御パラメータを操作卓100にて設定することが可能である。制御パラメータとしては、例えば、ライブモード及びフリーズモードの選択結果、表示深さ(深度)の設定値、及び、超音波画像生成モードの選択結果等が挙げられる。
ここで、「ライブモード」は、所定のフレームレートにて得られる超音波画像(動画像)を逐次表示(リアルタイム表示)するモードである。「フリーズモード」は、過去に生成された超音波画像(動画像)の1フレームの画像(静止画像)を、後述のシネメモリ150から読み出して表示するモードである。
なお、上述した超音波画像生成モードは、あくまでも一例であり、上述した3種類のモード以外のモード、例えば、A(Amplitude)モード、M(Motion)モード及び造影モード等が更に含まれてもよいし、ドップラー画像を得るモードが含まれていても良い。
ところで、上述したように、本実施形態においては、術者は、超音波診断のための検査として、操作卓100にて超音波エラストグラフィーを選択することができるのは言うまでもない。
次に、超音波内視鏡12の構成について、既出の図1、及び図2~図4を参照しながら説明する。図2は、超音波内視鏡12の挿入部22の先端部及びその周辺を拡大して示した平面図である。図3は、超音波内視鏡12の挿入部22の先端部40を図2に図示のI-I断面にて切断したときの断面を示す断面図である。
超音波内視鏡12は、前述したように挿入部22及び操作部24を有する。挿入部22は、図1に示すように先端側(自由端側)から順に、先端部40、湾曲部42及び軟性部43を備える。先端部40には、図2に示すように超音波観察部36及び内視鏡観察部38が設けられている。超音波観察部36には、図3に示すように、複数の超音波振動子48を備える超音波振動子ユニット46が配置されている。
また、図2に示すように先端部40には処置具導出口44が設けられている。処置具導出口44は、鉗子、穿刺針、若しくは高周波メス等の処置具(不図示)の出口となる。また、処置具導出口44は、血液及び体内汚物等の吸引物を吸引する際の吸引口にもなる。
挿入部22及び操作部24の各々の内部には、送気送水用の管路及び吸引用の管路が、それぞれ複数形成されている。更に、挿入部22及び操作部24の各々の内部には、一端が処置具導出口44に通じる処置具チャンネル45が形成されている。
次に、超音波内視鏡12の構成要素のうち、超音波観察部36、内視鏡観察部38、送水タンク21a及び吸引ポンプ21b、並びに操作部24に関して詳しく説明する。
超音波観察部36は、超音波画像を取得するために設けられた部分であり、挿入部22の先端部40において先端側に配置されている。超音波観察部36は、図3に示すように超音波振動子ユニット46と、複数の同軸ケーブル56と、FPC(FlexiblePrinted Circuit)60とを備える。
超音波振動子ユニット46は、超音波探触子(プローブ)に相当し、患者の体腔内において、後述する複数の超音波振動子48が配列された超音波振動子アレイ50を用いて超音波を送信し、且つ、観察対象部位にて反射した超音波の反射波(エコー)を受信して受信信号を出力する。本実施形態に係る超音波振動子ユニット46は、コンベックス型であり、放射状(円弧状)に超音波を送信する。ただし、超音波振動子ユニット46の種類(型式)については特にこれに限定されるものではなく、超音波を送受信できるものであれば他の種類でもよく、例えば、セクタ型、リニア型及びラジアル型等であってもよい。
超音波振動子アレイ50は、一次元アレイ状に配列された複数の超音波振動子48(超音波トランスデューサ)からなる。より詳しく説明すると、超音波振動子アレイ50は、N個(例えば、N=128)の超音波振動子48が先端部40の軸線方向(挿入部22の長手軸方向)に沿って凸湾曲状に等間隔で配列されることで構成されている。なお、超音波振動子アレイ50は、複数の超音波振動子48を二次元アレイ状に配置して構成されたものであってもよい。
電極は、複数の超音波振動子48の各々に対して個別に設けられた個別電極(不図示)と、複数の超音波振動子48に共通の振動子グランド(不図示)とからなる。また、電極は、同軸ケーブル56及びFPC60を介して超音波用プロセッサ装置14と電気的に接続される。
各超音波振動子48には、パルス状の駆動電圧である診断用駆動パルスが、入力信号(送信信号)として、超音波用プロセッサ装置14から同軸ケーブル56を通じて供給される。この駆動電圧が超音波振動子48の電極に印加されると、圧電素子が伸縮して超音波振動子48が駆動(振動)する。この結果、超音波振動子48からパルス状の超音波が出力される。このとき、超音波振動子48から出力される超音波の振幅は、その超音波振動子48が超音波を出力した際の強度(出力強度)に応じた大きさとなっている。ここで、出力強度は、超音波振動子48から出力された超音波の音圧の大きさとして定義される。
また、本実施形態に係る超音波振動子48は、駆動パルスとして、超音波エラストグラフィーを実施するための強力な超音波出力のプッシュパルス等の加振パルスが送信されて加振用超音波を発生させるのみならず、加振用超音波による観察対象部位の組織の変位(歪み)、又は加振用超音波による観察対象部位の組織の加振により発生した横波である剪断弾性波、即ち剪断波(シェアウェーブ)を検出するためのトラックパルス等の検出パルスが送信されて検出用超音波を発生させるものである。
各超音波振動子48が発生する電気信号は、超音波の受信信号として各超音波振動子48から超音波用プロセッサ装置14に向けて出力される。この時、超音波振動子48から出力される電気信号の大きさ(電圧値)は、その超音波振動子48が超音波を受信した際の受信感度に応じた大きさとなっている。ここで、受信感度は、超音波振動子48が送信する超音波の振幅に対する、その超音波振動子48が超音波を受信して出力した電気信号の振幅の比として定義される。
音響整合層74は、超音波振動子アレイ50の上に重ねられており、患者の人体と超音波振動子48との間の音響インピーダンス整合をとるために設けられている。音響整合層74が設けられていることにより、超音波の透過率を高めることが可能となる。音響整合層74の材料としては、音響インピーダンスの値が超音波振動子48の圧電素子に比して、より患者の人体のものの値に近い様々な有機材料を用いることができる。音響整合層74の材料としては、具体的にはエポキシ系樹脂、シリコンゴム、ポリイミド及びポリエチレン等が挙げられる。
FPC60は、各超音波振動子48が備える電極と電気的に接続される。複数の同軸ケーブル56の各々は、その一端にてFPC60に配線されている。そして、超音波内視鏡12が超音波用コネクタ32aを介して超音波用プロセッサ装置14に接続されると、複数の同軸ケーブル56の各々は、その他端(FPC60側とは反対側)にて超音波用プロセッサ装置14と電気的に接続される。
なお、本実施形態では、超音波診断の実施期間中、つまり、超音波画像(動画像)の取得が開始されてから終了されるまでの期間(より詳しくは、ライブモードで超音波診断が実施された時間)を累積駆動時間としているが、これに限定されるものではなく、駆動対象振動子に駆動電圧を供給した時間を累積駆動時間としてもよい。
内視鏡観察部38は、内視鏡画像を取得するために設けられた部分であり、挿入部22の先端部40において超音波観察部36よりも基端側に配置されている。内視鏡観察部38は、図2~図3に示すように観察窓82、対物レンズ84、固体撮像素子86、照明窓88、洗浄ノズル90及び配線ケーブル92等によって構成されている。
観察窓82は、挿入部22の先端部40において軸線方向(挿入部22の長手軸方向)に対して斜めに傾けられた状態で取り付けられている。観察窓82から入射されて観察対象隣接部位にて反射された光は、対物レンズ84で固体撮像素子86の撮像面に結像される。
洗浄ノズル90は、観察窓82及び照明窓88の表面を洗浄するために挿入部22の先端部40に形成された噴出孔であり、洗浄ノズル90からは、空気又は洗浄用液体が観察窓82及び照明窓88に向けて噴出される。なお、本実施形態において、洗浄ノズル90から噴出される洗浄用液体は、水、特に脱気水である。ただし、洗浄用液体については、特に限定されるものではなく、他の液体、例えば、通常の水(脱気されていない水)であってもよい。
送水タンク21aは、脱気水を貯留するタンクであり、送気送水用チューブ34aにより光源用コネクタ32cに接続されている。なお、脱気水は、洗浄ノズル90から噴出される洗浄用液体として用いられる。
吸引ポンプ21bは、処置具導出口44を通じて体腔内の吸引物(洗浄用に供給された脱気水を含む)を吸引する。吸引ポンプ21bは、吸引用チューブ34bにより光源用コネクタ32cに接続されている。なお、超音波診断システム10は、所定の送気先に空気を送気する送気ポンプなどを備えていてもよい。
処置具チャンネル45は、操作部24に設けられた処置具挿入口30と処置具導出口44との間を連絡している。また、処置具チャンネル45は、操作部24に設けられた吸引ボタン28bに接続している。吸引ボタン28bは、処置具チャンネル45のほかに、吸引ポンプ21bに接続されている。
送気送水管路は、その一端側で洗浄ノズル90に通じており、他端側では、操作部24に設けられた送気送水ボタン28aに接続している。送気送水ボタン28aは、送気送水管路のほかに、送水タンク21aに接続されている。
操作部24は、超音波診断の開始時、診断中及び診断終了時等において術者によって操作される部分であり、その一端にはユニバーサルコード26の一端が接続されている。また、操作部24は、図1に示すように、送気送水ボタン28a、吸引ボタン28b、一対のアングルノブ29、並びに処置具挿入口(鉗子口)30を有する。
一対のアングルノブ29の各々を回動すると、湾曲部42が遠隔的に操作されて湾曲変形する。この変形操作により、超音波観察部36及び内視鏡観察部38が設けられた挿入部22の先端部40を所望の方向に向けることが可能となる。
送気送水ボタン28a及び吸引ボタン28bは、2段切り替え式の押しボタンであり、挿入部22及び操作部24の各々の内部に設けられた管路の開閉を切り替えるために操作される。
超音波用プロセッサ装置14は、超音波振動子ユニット46に超音波を送受信させ、且つ、超音波受信時に超音波振動子48(詳しくは駆動対象素子)が出力した受信信号を画像化して超音波画像を生成する。また、超音波用プロセッサ装置14は、生成した超音波画像をモニタ20に表示する。
更に、本実施形態において、超音波用プロセッサ装置14は、N個の超音波振動子48のうちの分極対象振動子に対して分極用電圧を供給して分極対象振動子を分極する。この分極処理を実行することにより、超音波診断の繰り返し実施によって脱分極した超音波振動子48を再度分極することができ、これにより、超音波振動子48の超音波に対する受信感度を良好なレベルまで回復させることが可能となる。
受信回路142、及び送信回路144は、超音波内視鏡12の超音波振動子アレイ50と電気的に接続する。マルチプレクサ140は、N個の超音波振動子48の中から最大m個の駆動対象振動子を選択し、そのチャンネルを開口させる。
送信回路144は、超音波振動子ユニット46から超音波を送信するために、CPU152から送られてくる制御信号に従って、マルチプレクサ140により選択された駆動対象振動子に対して超音波送信用の駆動電圧を供給する回路である。駆動電圧は、パルス状の電圧信号(送信信号)であり、ユニバーサルコード26及び同軸ケーブル56を介して駆動対象振動子の電極に印加される。
送信回路144は、制御信号に基づいて送信信号を生成するパルス発生回路158を有しており、CPU152の制御により、パルス発生回路158を用いて、複数の超音波振動子48を駆動して超音波を発生させる送信信号を生成して複数の超音波振動子48に供給する。
また、CPU152の制御により、プッシュパルスによる加振用超音波のみが診断対象の組織に送信された後、又は加振用超音波、及び検出パルスによる検出用超音波が診断対象の組織に送信された後に、分極処理を行う場合に、超音波発生用送信信号を生成する場合と同じパルス発生回路158を用いて、分極処理を行うための分極用電圧を有する分極処理用送信信号を生成する。
ところで、検出パルスからなる第2の送信信号、及び第3の送信信号が超音波振動子48に送信されると、それぞれ超音波振動子48から発生した検出用超音波が、歪みを発生した組織、及び剪断波が発生した組織に送信されて、それぞれ検出用超音波に対する、歪みが発生した組織からの反射波(エコー)、及び剪断波が発生した組織からの剪断波に応じた反射波(エコー)を超音波振動子48は受信して第2の受信信号、及び第3の受信信号を発生する。
また、受信回路142は、CPU152から送られてくる制御信号に従って、超音波振動子48から受信した受信信号を増幅し、増幅後の信号をA/Dコンバータ146に引き渡す。A/Dコンバータ146は、受信回路142と接続しており、受信回路142から受け取った受信信号をアナログ信号からデジタル信号に変換し、変換後のデジタル信号をASIC148に出力する。
なお、本実施形態では、ASIC148のようなハードウェア回路によって上述の機能(具体的には、位相整合部160、Bモード画像生成部162、PWモード画像生成部164、CFモード画像生成部166、評価部168、及びメモリコントローラ151)を実現しているが、これに限定されるものではない。中央演算装置(CPU)と各種データ処理を実行させるためのソフトウェア(コンピュータプログラム)とを協働させることで上記の機能を実現させてもよい。
位相整合部160は、A/Dコンバータ146によりデジタル信号化された受信信号(受信データ)に対して遅延時間を与えて整相加算する(受信データの位相を合わせてから加算する)処理を実行する。整相加算処理により、超音波エコーの焦点が絞り込まれた音線信号が生成される。
Bモード画像生成部162は、患者の内部(体腔内)の断層画像であるBモード画像を生成する画像生成部である。Bモード画像生成部162は、順次生成される音線信号に対し、STC(SensitivityTime gain Control)によって、超音波の反射位置の深度に応じて伝搬距離に起因する減衰の補正を施す。また、Bモード画像生成部162は、補正後の音線信号に対して包絡線検波処理及びLog(対数)圧縮処理を施して、Bモード画像(画像信号)を生成する。
CFモード画像生成部166は、所定方向における血流の情報を表示する画像を生成する画像生成部である。CFモード画像生成部166は、位相整合部160によって順次生成される音線信号のうち、同一方向における複数の音線信号の自己相関を求めることで、血流に関する情報を示す画像信号を生成する。その後、CFモード画像生成部166は、上記の画像信号に基づき、Bモード画像生成部162によって生成されるBモード画像信号に血流に関する情報を重畳させたカラー画像としてのCFモード画像(画像信号)を生成する。
評価部168は、受信回路142が、第1の受信信号を受信した場合には第1の受信信号から、第2の受信信号を受信した場合には第2の受信信号から、得られた超音波画像、例えばBモード画像生成部162によって生成されたBモード超音波画像に基づいて、診断対象の組織の変位(歪み)を算出して組織の硬さを評価する。また、評価部168は、受信回路142が第3の受信信号を受信した場合には、第3の受信信号に基づいて、診断対象の組織に発生した剪断波の音速を算出して組織の硬さを評価する。
これらの硬さの評価については、以下のURLを参照して行うことができる。
https://www.jstage.jst.go.jp/article/mit/32/2/32_75/_pdf
DSC154は、ASIC148に接続されており、Bモード画像生成部162、PWモード画像生成部164又はCFモード画像生成部166が生成した画像の信号を通常のテレビジョン信号の走査方式に従う画像信号に変換(ラスター変換)し、画像信号に階調処理等の各種の必要な画像処理を施した後にモニタ20に出力する。
シネメモリ150は、1フレーム分又は数フレーム分の画像信号を蓄積するための容量を有する。ASIC148が生成した画像信号は、DSC154に出力される一方で、メモリコントローラ151によってシネメモリ150にも格納される。フリーズモード時には、メモリコントローラ151がシネメモリ150に格納された画像信号を読み出し、DSC154に出力する。これにより、モニタ20には、シネメモリ150から読み出された画像信号に基づく超音波画像(静止画像)が表示されるようになる。
また、CPU152は、超音波内視鏡12が超音波用コネクタ32aを介して超音波用プロセッサ装置14に接続されると、PnP(Plug andPlay)等の方式により超音波内視鏡12を自動認識する。その後、CPU152は、超音波内視鏡12の内視鏡側メモリ58にアクセスし、内視鏡側メモリ58に記憶された累積駆動時間を読み取ることもできる。
なお、本実施形態では、超音波内視鏡12に累積駆動時間が記憶されることとしたが、これに限定されるものではなく、超音波用プロセッサ装置14側に累積駆動時間が超音波内視鏡12毎に記憶されていてもよい。
また、プッシュパルスを複数の超音波振動子48に供給して短時間で強力な加振用超音波を発生させて診断対象の組織に出力した後、更に続けてパルス発生回路158において検出パルス(以下、トラックパルスともいう)を生成し、送信回路144から複数の超音波振動子48にそれぞれ供給して検出用超音波を組織に向けて出力すると、更に時間平均強度Ispta.αが高くなるために、検出用超音波の出力後、休止期間(フリーズ期間)を設けていたことは、上述した通りである。
しかしながら、本発明では、この休止期間中に、時間平均強度Ispta.αを低下させるために、送信回路144(パルス発生回路158)を制御して、パルス状の駆動電圧である分極用駆動パルスを生成させて、超音波振動子アレイ50の複数の超音波振動子48にそれぞれ供給して、各超音波振動子48の分極処理を行う。
ここで、送信回路144は、プッシュパルス、及びトラックパルスの硬さ評価用駆動電圧、若しくは画像用駆動パルスの画像用駆動電圧、及び分極用駆動パルスの分極用駆動電圧の少なくとも2つの駆動電圧を設定できる設定可能電圧範囲を有している。組織の硬さ評価を行う場合には、設定可能電圧範囲内の硬さ評価用駆動電圧に設定し、超音波画像を取得する場合には、設定可能電圧範囲内の画像用駆動電圧に設定し、分極処理を行う場合には、同じ設定可能電圧範囲内の硬さ評価用駆動電圧とも、画像用駆動電圧とも、異なる分極用駆動電圧に設定する。なお、本発明においては、分極用駆動電圧は、硬さ評価用駆動電圧よりも、画像用駆動電圧よりも、高い電圧に設定されることが好ましく、設定可能電圧範囲内のより高い電圧に設定されることがより好ましく、上限の電圧に設定されることが最も好ましい。
また、分極用駆動パルス(メインローブ)は、プッシュパルス、及びトラックパルス、並びに画像用駆動パルス等の診断用駆動パルスが有するプローブ周波数帯域とは異なる周波数帯域の駆動パルスである。
以上から、本発明は、既存の送信回路構成を有し、超音波診断と同じ駆動パルス出力用の送信回路144を用いて、超音波診断のための診断用駆動パルスと同じ設定可能電圧範囲内の駆動電圧、かつプローブ周波数帯域と異なる周波数の分極用駆動パルスを出力し、組織の硬さ評価時のプッシュパルスの印加後、又はプッシュパルスの印加、及びこれに続くトラックパルスの印加後の休止期間中に、超音波内視鏡12の超音波振動子48の分極処理を行うものである。
図5に示す例では、プッシュパルス(n=1)を送信してから、トラックパルスの送信を開始する直前までの時間は、プッシュパルス期間Txとし、0.2~5msである。このプッシュパルス期間Txは、図13に示すプッシュパルス送信期間1と同じである。
次に、図5では、トラックパルス(n=10000)の送信を開始してからトラックパルスの送信を終了し、分極処理を開始する直前までの時間は、トラックパルス期間Tyとし、20msである。このトラックパルス期間Tyは、図13に示すトラックパルス送受信期間2と同じである。
また、分極処理(分極用駆動パルスの送信)を開始してから次のプッシュパルスの送信開始までの時間は、分極処理期間Tzとし、プッシュパルス、及びトラックパルスが送信されない駆動パルスの休止期間である。この分極処理期間Tzは、駆動パルスの休止期間であるという意味では、図13に示す休止期間3と同じである。しかしながら、分極処理期間Tzは、その期間の全部において分極処理が行われない場合もあるので、その場合には、分極処理が行われる時間と、プッシュパルス、及びトラックパルスの送信も分極用駆動パルスの送信による分極処理も行われない完全に休止する休止時間との和となる。
次に、トラックパルス期間Tyにおいて、超音波振動子48へのトラックパルスの送信の際に超音波振動子48において発生する減衰空間ピーク時間平均音響出力の値をY(mJ/cm2)とする。
また、分極処理期間Tzにおいて、超音波振動子48への分極処理の際に、超音波振動子48において発生する減衰空間ピーク時間平均音響出力(以下、単に、時間平均音響出力ともいう)の値をZ(mJ/cm2)とする。
Ispta.α=(X+Y+Z)/(Tx+Ty+Tz) ………(1)
こうして求められる時間平均強度Ispta.αが、720mW/cm2以下となった場合に、次のプッシュパルスの送信、若しくは、超音波画像取得のための他のモードスキャンを再開することができる。
本発明においては、時間平均音響出力の値X、Y、及びZに基づく時間平均強度Ispta.αの算出は、CPU152で行う。CPU152は、駆動パルス、即ちトラックパルス、トラックパルス、及び分極用駆動パルスの送信の際に発生する音響出力値、即ち空間ピーク時間平均音響出力の値X、Y、及びZに応じて、具体的には、これらの音響出力値X、Y、及びZから、減衰空間ピーク時間平均強度Ispta.αを算出し、算出された時間平均強度Ispta.αに応じて、即ち、算出された時間平均強度Ispta.αと、米国FDAの制限値720mW/cm2とを比較した上で、必要な分極処理時間をプッシュパルス、及びトラックパルスが送信されない休止期間である分極処理期間Tz内に設定する。
各モード(各期間Tx、Ty、Tz)におけるX、Y、Zの値は、以下のようにして計算することができる。例えば、衰空間ピーク時間平均音響出力の値をYの場合には、トラックパルス期間Tyにおいて、
1)1パルスの減衰ピーク時間平均音響出力値y(mJ/cm2)を算出しておく。
2)この期間Tyにおいて上記1)のパルスを駆動する回数Nを求めておき、値yに回数Nを掛け算して、Yの値を求める(Y=N*y)。
X、及びZの値も、同様にして求めることができる。
モードによって、値X、Y、Zに複数のパルスが含まれる可能性もあり、装置内で1パルスごとの値(x、y、z)を保持して置き、適宜計算する方法、もしくは予め決められたパルスの組み合わせの条件表を用意して置き、それを参照する方法等によって求めることができる。
また、CPU152は、プッシュパルス、及びトラックパルスの送信によって発生する超音波振動子48の脱分極のレベルをプッシュパルス、及びトラックパルスの送信時間から算出し、算出した脱分極のレベルから分極処理直前の音響出力値(X+Y+Z)を計算し、計算された音響出力値(X+Y+Z)に応じて分極処理時間を分極処理期間Tz(休止期間3)以内において制御するものである。
なお、計算された直前の超音波振動子48の音響出力値(X+Y+Z)が指標値以下となる分極処理時間、及び音響出力値(X+Y+Z)に応じた分極処理時間は、予めCPU152に設定されているものである。
以下に、具体的な一例を示す。
例えば、X:50mJ/cm2、Y:20mJ/cm2、Z:2mJ/cm2であり、
X+Y+Z=72mJ/cm2、
Tx+Ty=0.05s
の場合、Tz は0.05s以上でないと、上限値をオーバーする。
ここで、Z=2は、固定値(これだけやれば大丈夫という値)でも良いし、現在の脱分極状態から計算しても良い。必要な分極処理の強さが決まれば、Zが決まり、全体の時間をTzでコントロールして、720mJ/cm2以下に抑えるというものである。
このようなARFIイメージングにおいては、CPU152による制御によって、送信回路144からプッシュパルス(第1の送信信号)を超音波振動子48に送信し、超音波振動子48において発生した加振用超音波を診断対象の組織に送信し、組織を加振して変位させ、続いて、組織の変位(歪み)を検出するためのトラックパルス(第2の送信信号)を超音波振動子48に送信し、超音波振動子48において発生した検出用超音波を変位した組織に送信し、組織の変位(歪み)に応じた検出用超音波の反射波を超音波振動子48で受信し、受信回路142から超音波振動子48が受信した反射波に基づく受信信号(第2の受信信号)を出力して、評価部168において、第2の受信信号に基づいて組織の変位(歪み)を算出し、変位(歪み)に基づいて組織の硬さを評価する。
この場合において、プッシュパルス、及びトラックパルスの休止期間は、分極処理期間Tzであり、トラックパルス(第2の送信信号)の送信終了後から次の第1の送信信号の送信開始までの期間である。なお、本発明においては、トラックパルス(第2の送信信号)の送信終了を検知してトリガ信号を発生するトリガ発生回路を設けておき、トリガ信号に基づいて、分極処理を開始するようにしても良い。
したがって、この場合には、トラックパルスは、送信されない。このため、トラックパルス期間Tyは0(Ty=0)であり、減衰空間ピーク時間平均音響出力の値Yも0mJ/cm2(Y=0)であるので、図5に示す例を始めとして、上述した様々な例において、Ty=0、及びY=0とすればよい。
したがって、このようなARFIイメージングにおいて、減衰空間ピーク時間平均強度Ispta.α(mW/cm2)を算出する場合には、上記式(1)において、Ty=0、及びY=0として、Ispta.αを算出すればよい。
このARFIイメージングでは、プッシュパルス期間Tx後、直ぐに分極処理期間Tzが始まることになる。したがって、プッシュパルスの休止期間は、分極処理期間Tzであり、第1の送信信号の送信終了後から次の第1の送信信号の送信開始までの期間である。なお、本発明においては、プッシュパルス(第1の送信信号)の送信終了を検知してトリガ信号を発生するトリガ発生回路を設けておき、トリガ信号に基づいて、分極処理を開始するようにしても良い。
この場合において、プッシュパルス、及びトラックパルスの休止期間は、分極処理期間Tzであり、第3の送信信号の送信終了後から次の第1の送信信号の送信開始までの期間である。なお、本発明においては、トラックパルス(第3の送信信号)の送信終了を検知してトリガ信号を発生するトリガ発生回路を設けておき、トリガ信号に基づいて、分極処理を開始するようにしても良い。
まず、駆動パルスのパルス二乗積分(パルス強度積分:Pulse Integral Intensity)PII(mJ/cm2)を観測したパルス全体の二乗を積分することで求めることができ、下記式(2)で表すことができる。
ここで、p(t)は瞬時音圧(MPa)であり、Δtはサンプル間隔(μs)であり、ρは、密度(kg/m3)であり、cは、水中での音速(m/s)である。
なお、ρ=1000kg/m3であるとしてパルス二乗積分PIIの単位換算をすると、下記式(3)から(mJ/cm2)であることが分かる。
まず、Ispta(mW/cm2)は、スキャン(scan)モード(Bモード、CDモード)か、ノンスキャン(non-scan)モード(Mモード、PWモード)かで計算が異なる。
ノンスキャンモードの場合
Ispta=PII×PRF …(4)
PRF:パルス繰り返し周波数(kHz)
スキャンモードの場合
Ispta=PII×k×FR …(5)
FR:フレームレート(frame/s)
k:ビームの重なり分の重み付け
以上から、減衰空間ピーク時間平均強度Ispta.α(mW/cm2)は、こうして、上記式(4)又は(5)に従って求められた空間ピーク時間平均強度Isptaから下記式(6)によって求めることができる。
Ispta.α:減衰空間ピーク時間平均強度(mW/cm2)
Ispta:空間ピーク時間平均強度(mW/cm2)
α: 音響減衰係数
z:プローブの外部開口から,関心点までの距離
fawf:音響作動周波数
なお、駆動パルスのパルス二乗積分(パルス強度積分)PII(mJ/cm2)から以下のようにして、減衰空間ピーク時間平均強度Ispta.αを求めることもできる。
まず、上記式(6)と同様の計算を行って、パルス強度積分PII(mJ/cm2)から下記式(7)によって減衰パルス強度積分PII.α(mJ/cm2)を求めることができる。
PII.α=PII・10-α・z・fawf/10 …(7)
次に、下記式(8)のように、減衰パルス強度積分PII.αに、超音波振動子48が駆動パルスを送信した回数Nを掛けて、駆動パルスを送信した全送信時間Tで割り算して減衰空間ピーク時間平均強度Ispta.αを求めることができる。
Ispta.α=PII.α・N/T …(8)
ここで、衰空間ピーク時間平均音響出力の値X、Y、Zは、上記式(8)のPII.α・Nに相当する。
なお、上記(8)の全送信時間Tは1フレームの時間で示す必要があり、単体モードの場合は上記(8)のTに1フレームの時間を入れますが、色々な送信が混ざったモードの場合には、全部のモードを含めた全体の時間で割ことになる。
各モード(各期間Tx、Ty、Tz)におけるX、Y、Zから下記式(9)に従って、減衰空間ピーク時間平均強度Ispta.αを、求めることができる。
Ispta.α=X/(Tx+Ty+Tz)+Y/(Tx+Ty+Tz)+
Z/(Tx+Ty+Tz)
= (X+Y+Z)/(Tx+Ty+Tz) …(9)
一方、CPU(制御回路)152は、分極処理を行う場合には、複数の超音波振動子48の分極処理を行うために、診断用駆動パルスと同じ設定可能電圧範囲内の異なる分極用駆動電圧であり、超音波画像の取得のための超音波探触子(超音波振動子ユニット46)としてのプローブ周波数帯域と異なる周波数の分極用駆動パルスを生成するように送信回路を制御する。
その結果、本発明では、診断用駆動パルスの印加後に分極処理を行う場合には、分極用駆動パルスが複数の超音波振動子48に印加され、分極用駆動パルスによって複数の超音波振動子48の分極処理が行われる。
図6A、及び図6Bは、図4に示す送信回路から送信される分極用駆動パルスの駆動波形の一例のグラフ、及びその駆動波形の感度と周波数の関係を示すグラフである。図6Aに示す駆動波形は、周波数1.25MHzのユニポーラの1つの波の波形である。
本発明においては、分極用駆動パルスの駆動波形は、特に制限的では無いが、図6Aに示すユニポーラの波形を持ち、図6Bに実線で示す周波数特性を持つ駆動波形を有する分極用駆動パルスを用いて超音波振動子48の分極処理を行うことが好ましい。図6Bに示す例では、例えば、-20dB以上のレベルの感度において、超音波画像を取得するためのプローブ周波数帯域は、破線で示すように、約2.7MHz~約11.7MHzであるのに対し、実線で示す分極用駆動パルスの駆動波形のメインローブの帯域は、約2.3MHz以下である。即ち、分極用駆動パルスの周波数の帯域特性と、診断用駆動パルスの周波数の帯域特性とは、-20dB以上のレベルの感度において重ならない。
図6Bに示す分極用駆動パルスの駆動波形においては、メインローブの他に、プローブ周波数帯域内において、メインローブに付随して、同じく実線で示す1つ以上、図6Bに示す例では4つのサイドローブが生じていることが分かる。プローブ周波数帯域内のこれらのサイドローブの最大感度は、図6Bに示すように、全て-10dB以下であることが好ましく、これらのサイドローブの感度の平均は、-20dB以下であることが好ましい。この理由は、以下の通りである。
一般的に、プローブの周波数特性の仕様は、送受信感度の-20dBの帯域で表現される。これは、感度のピークから1/10以下の信号はほとんど画像に影響しない点から決められているからである。一方、送信波の帯域についてはプローブと異なり、送信部分のみであるため、20dB/2=10dBのレベルが閾値となる。そのため、送信成分として考えると-10dBの方がより好ましいからである。
このため、送信波形を図6Aに示すようなユニポーラの波形にすることにより、メインローブだけでなく、高調波成分が抑えられ、より高い効果が期待できる。
また、図8Cに示すように、分極用駆動パルスの駆動波形をユニポーラの波形で波形間に最小クロック数分の時間を開けた複数のパルス波形を繋いだ分極用駆動パルスの送信を行うことが好ましい。即ち、本発明では、送信回路144は、分極用駆動パルスとして、複数のユニポーラの波形を、この波形の間隔を超音波用プロセッサ装置14において規定される最小クロック数の時間空けて出力することが好ましい。
この理由は、分極処理には直流電圧を印加することが最適であるが、本発明のように、既存の送信回路構成を有する送信回路144を用いる場合には直流電圧の送信ができないからである。
また、図8Dに2点鎖線で示すように、分極用駆動パルスの駆動波形として、図8Cに示す複数のユニポーラの波形を組み合わせて用いることにより、図8Dに実線で示す1つのユニポーラの波形をからなる分極用駆動パルスの駆動波形よりも、サイドローブの最大感度を低下させることができる。
なお、図示しないが、プッシュパルス、及びトラックパルスの駆動波形、及びパルス波形については、基本的に画像描出用と同様の周波数帯域を使用するが、プッシュパルスだけが数msの間、打ち続ける長いバースト波となり、かなり狭い帯域となる。
次に、超音波診断システム10の動作例として、超音波診断に関する一連の処理(以下、診断処理とも言う)の流れを、図9~図11を参照しながら説明する。図9は、超音波診断システム10を用いた診断処理の流れを示す図である。図10は、図9に示す診断ステップの組織の硬さ評価ステップの手順を示す図である。図11は、図9に示す診断ステップの画像生成ステップの手順を示す図である。
診断ステップでは、まず、診断として硬さ診断を実施するか否かの判定(S011)を行い、硬さ診断を実施する場合には(S011でYes)、CPU152が、超音波用プロセッサ装置14各部を制御して硬さ診断ステップを実施する(S012)。診断として硬さ診断を実施しない場合には(S011でNo)、CPU152が、超音波用プロセッサ装置14各部を制御して画像生成ステップを実施する(S013)。
硬さ診断ステップ、及び画像生成ステップが終了すると、CPU152は、超音波診断が終了したか否かを判定する(S014)。超音波診断が終了していない場合(S014でNo)、診断ステップのスタートの硬さ診断の実施の判定ステップS011へ戻り、硬さ診断ステップ、及び画像生成ステップが、診断終了条件が成立するまで繰り返し実施される。診断終了条件として、例えば、術者が操作卓100を通じて診断終了を指示しても良い。
硬さ評価としてSWEを実施しない場合には(S021でNo)、トラックパルスを用いるか否かの判定(S024)を行う。トラックパルスを用いる場合には(S024でYes)、CPU152が、超音波用プロセッサ装置14各部を制御してプッシュパルス、及びトラックパルスを用いて診断対象の組織の変位(歪み)を算出し(S025)、算出された変位(歪み)に基づいて組織の硬さを評価する(S026)。
続いて、CPU152は、硬さ評価が終了したか否かを判定する(S029)。硬さ評価が終了していない場合(S029でNo)、硬さ診断ステップ(S012)のスタートのSWEの判定ステップS021へ戻り、各硬さ評価(S023、S026、S028)は、硬さ評価終了条件が成立するまで繰り返し実施される。硬さ評価終了条件としては、例えば、術者が操作卓100を通じて診断終了を指示すること等が挙げられる。
なお、硬さ診断ステップ(S012)においては、剪断波の音速の算出ステップ(S022)、各変位(歪み)の算出ステップ(S025、S027)、及び各硬さ評価ステップ(S023、S026、S028)の間に、同時に分極処理が行われる。
続いて、CPU152は、画像生成が終了したか否かを判定する(S037)。画像生成が終了していない場合(S037でNo)、画像生成モードの判定ステップS031へ戻り、各画像生成モードによる超音波画像の生成は、画像生成終了条件が成立するまで繰り返し実施される。画像生成終了条件としては、例えば、術者が操作卓100を通じて診断終了を指示すること等が挙げられる。
続いて、図9に戻って、診断ステップ(S005)が終了すると、超音波診断システム10各部の電源がオフとなり(S006でYes)、診断処理が終了する。一方で、超音波診断システム10各部の電源がオン状態で維持される場合には(S006でNo)、入力ステップS001に戻り、上述した診断処理の各ステップを繰り返すことになる。
規定時間は、時間のデフォルト値が設定されていてもよいし、ユーザの指示により任意の時間を設定可能としてもよい。なお、規定時間とは、任意の時間であって、数時間のオーダでもよいし、数フレーム時間のオーダでもよい。
ボタンは、操作卓100のタッチパネル内において表示される電子的なボタンでもよいし、あるいは超音波内視鏡12の操作部24に設けられる機械的なボタンでもよい。
造影モードの場合、超音波振動子48から送信される超音波は、一般的に造影剤に含まれるバブルを破壊しない低い出力に設定される。そのため、画像のS/N比が低下するため、脱分極による感度低下の悪影響が出やすい。一般的に造影剤に含まれるバブルを破壊しない低い出力に設定される。そのため、画像のS/N比が低下するため、脱分極による感度低下の悪影響が出やすい。
ユーザの指示により、超音波診断を行うための超音波画像の表示深さを、例えば深さが4cmの位置、及び10cmの位置というように設定することができる。例えば、前述の一定深さが5cmに設定されているとすると、超音波画像の表示深さが深さ4cmの位置に設定された場合には分極処理を開始せず、深さ10cmの位置に設定された場合には分極処理を開始する。
一定輝度は、輝度のデフォルト値が設定されていてもよいし、ユーザの指示により任意の輝度を設定可能としてもよい。
図12に示すように、表示モードには、超音波画像のみを表示する第1の表示モード、ピクチャ・イン・ピクチャ(PinP)により、超音波画像を内視鏡画像よりも大きく表示する第2の表示モード、同じくPinPにより、超音波画像を内視鏡画像よりも小さく表示する第3の表示モード、及び内視鏡画像のみを表示する第4の表示モードがある。
ユーザの指示により、第1~第4の表示モードを任意に切り替えて表示させることができる。
ここで、第3の表示モードの場合、超音波画像が内視鏡画像よりも小さく表示されるため、画質に拘らず好適に分極処理を行うことができる。これに応じて、第3の表示モードに設定されて、ピクチャ・イン・ピクチャにより、超音波画像が内視鏡画像よりも小さく表示された場合に分極処理を行うようにしても良い。
また、分極処理の終了条件は、例えば分極処理の累積処理時間が一定時間に到達した場合、ユーザにより分極処理の終了が指示された場合、造影モードから他の超音波画像生成モードに変更された場合、超音波診断を行うための超音波の表示深さが一定深さ未満に設定された場合、ユーザが処置中であることが、内視鏡画像に基づいて認識されなくなった場合、超音波の表示深さが比較的深い位置において取得されたBモードの超音波画像の輝度が一定輝度よりも大きくなった場合、第3表示モードから他の表示モードに変更された場合などが考えられるが、これ以外の終了条件によって分極処理を終了させてもよい。
超音波診断システム10は、超音波診断の実施期間中に、プッシュパルス送信による加振用超音波の送信後、又はプッシュパルス送信による加振用超音波の送信に続くトラックパルスの送信による検出用超音波の送信後の診断用駆動パルスの休止期間内において直ちに分極処理を行う。そのため、超音波診断の実施期間中であっても、プッシュパルス、又は更にトラックパルスの送信等によって上昇した、又は上昇して制限値を超えた減衰空間ピーク時間平均強度Ispta.αを制限値以下まで、直ちに低下させることができるので、フレームレートを低下させること無く、また、診断対象の組織の硬さ診断の性能を低下させること無く、また、そのための組織の超音波画像の画質を低下させることなく、複数の超音波振動子48の送受信感度を常に良好に保つことができ、したがって常に高精度の硬さ診断を行うことができ、高画質な超音波画像を取得することができる。
また、超音波診断システム10は、既存の送信回路144、より詳しくはパルス発生回路158を用いて分極処理を行うため、既存の回路を大幅に変更することなく、超音波診断の実施期間中に分極処理を行うことができる。
12 超音波内視鏡
14 超音波用プロセッサ装置
16 内視鏡用プロセッサ装置
18 光源装置
20 モニタ
21a 送水タンク
21b 吸引ポンプ
22 挿入部
24 操作部
26 ユニバーサルコード
28a 送水送気ボタン
28b 吸引ボタン
29 アングルノブ
30 処置具挿入口
32a 超音波用コネクタ
32b 内視鏡用コネクタ
32c 光源用コネクタ
34a 送気送水用チューブ
34b 吸引用チューブ
36 超音波観察部
38 内視鏡観察部
40 先端部
42 湾曲部
43 軟性部
44 処置具導出口
45 処置具チャンネル
46 超音波振動子ユニット
48 超音波振動子
50 超音波振動子アレイ
54 バッキング材層
56 同軸ケーブル
58 内視鏡側メモリ
60 FPC
74 音響整合層
76 音響レンズ
82 観察窓
84 対物レンズ
86 固体撮像素子
88 照明窓
90 洗浄ノズル
92 配線ケーブル
100 操作卓
140 マルチプレクサ
142 受信回路
144 送信回路
146 A/Dコンバータ
148 ASIC
150 シネメモリ
151 メモリコントローラ
152 CPU
154 DSC
158 パルス発生回路
160 位相整合器
162 Bモード画像生成部
164 PWモード画像生成部
166 CFモード画像生成部
168 評価部
Claims (13)
- 超音波画像を取得すると共に、音響放射圧を用いて診断対象の組織の硬さの評価を行う超音波診断システムであって、
複数の超音波振動子が配列された超音波振動子アレイを用いて前記音響放射圧による前記組織の加振を行うための加振用超音波を少なくとも含む超音波を送信し、かつ前記組織からの反射波を受信する超音波観察部と、
前記複数の超音波振動子から前記超音波を発生させるために、前記複数の超音波振動子にそれぞれ印加する駆動パルスからなる超音波発生用送信信号を送信する送信回路、前記複数の超音波振動子が受信した前記反射波の受信信号を出力する受信回路、及び前記受信信号に基づいて前記組織の硬さを評価する評価部を備える超音波用プロセッサ装置と、を有し、
前記超音波用プロセッサ装置は、更に、前記超音波の送信、及び前記反射波の受信を行わせると共に、前記超音波の送信後の全ての超音波の送信の休止期間内において、前記送信回路を用いて前記超音波を送信した前記複数の超音波振動子に対して分極処理を行わせる制御回路を備え、
前記制御回路は、前記駆動パルスからなる前記超音波発生用送信信号を生成するように前記送信回路を制御し、前記複数の超音波振動子に送信する分極処理用送信信号を生成するように前記送信回路を制御すると共に、前記音響放射圧を発生させる前記加振用超音波を少なくとも含む前記超音波を発生させる前記超音波発生用送信信号の送信後に、前記超音波発生用送信信号、及び前記分極処理用送信信号の送信の際に発生する音響出力値に応じて前記分極処理を実施する分極処理時間を前記休止期間以内に設定し、
前記分極処理時間において、少なくとも前記加振用超音波を送信した前記複数の超音波振動子に対して、前記送信回路から前記分極処理用送信信号を送信して前記分極処理を行うことを特徴とする超音波診断システム。 - 前記制御回路は、前記組織に対するユーザの操作に対応して、前記分極処理における前記音響出力値を計算し、前記音響出力値が予め設定された音響出力の指標値以下となるように、前記分極処理時間を前記休止期間以内において制御する請求項1に記載の超音波診断システム。
- 前記制御回路は、前記超音波の送信によって発生する前記複数の超音波振動子の脱分極のレベルを前記駆動パルスからなる前記超音波発生用送信信号の送信時間から算出し、算出した前記脱分極のレベルから前記分極処理における前記音響出力値を計算し、計算された前記音響出力値に応じて前記分極処理時間を前記休止期間以内において制御する請求項1又は2に記載の超音波診断システム。
- 前記送信回路は、前記複数の超音波振動子の少なくとも一部に、前記超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、前記複数の超音波振動子から前記加振用超音波を発生させて前記組織に送信して前記組織を押圧して変位させ、
前記受信回路は、前記受信信号として前記組織からの前記反射波の第1の受信信号を受信し、
前記評価部は、前記第1の受信信号から得られた超音波画像に基づいて前記組織の変位を算出して前記組織の硬さを評価するものであり、
前記休止期間は、前記第1の送信信号の送信終了後から次の前記第1の送信信号の送信開始までの期間である請求項1又は2に記載の超音波診断システム。 - 前記送信回路は、前記複数の超音波振動子の少なくとも一部に、前記超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、前記複数の超音波振動子から前記加振用超音波を発生させて前記組織に送信して前記組織を押圧して変位させた後、続いて前記組織の変位を検出するための検出パルスからなる第2の送信信号を送信して検出用超音波を発生させて前記組織に送信し、
前記受信回路は、前記受信信号として前記組織からの前記検出用超音波の前記反射波の第2の受信信号を受信し、
前記評価部は、前記第2の受信信号から得られた超音波画像に基づいて前記組織の変位を算出して前記組織の硬さを評価するものであり、
前記休止期間は、前記第2の送信信号の送信終了後から次の前記第1の送信信号の送信開始までの期間である請求項1又は2に記載の超音波診断システム。 - 前記送信回路は、前記複数の超音波振動子の少なくとも一部に、前記超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、前記複数の超音波振動子から前記加振用超音波を発生させて前記組織に送信して前記組織を加振して剪断波を発生させ後、続いて前記剪断波の音速を検出するための検出パルスからなる第3の送信信号を送信して検出用超音波を発生させて前記剪断波が発生している前記組織に送信し、
前記受信回路は、前記受信信号として前記組織からの前記検出用超音波の前記反射波の第3の受信信号を受信し、
前記評価部は、前記第3の受信信号に基づいて前記剪断波の音速を算出して前記組織の硬さを評価するものであり、
前記休止期間は、前記第3の送信信号の送信終了後から次の前記第1の送信信号の送信開始までの期間である請求項1又は2に記載の超音波診断システム。 - 更に、内視鏡画像を取得するための内視鏡観察部、及び前記超音波観察部を備える超音波内視鏡を有する請求項1又は2に記載の超音波診断システム。
- 超音波画像を取得すると共に、音響放射圧を用いて診断対象の組織の硬さの評価を行う超音波診断システムの作動方法であって、
前記超音波診断システムは、複数の超音波振動子が配列された超音波振動子アレイを有する超音波観察部と、前記複数の超音波振動子に超音波発生用送信信号を送信する送信回路、前記複数の超音波振動子が受信した反射波の受信信号を出力する受信回路、及び前記受信信号に基づいて前記組織の硬さを評価する評価部を備える超音波用プロセッサ装置と、を有し、
前記複数の超音波振動子から前記超音波を発生させるために、前記送信回路を制御して、前記複数の超音波振動子にそれぞれ印加する駆動パルスからなる超音波発生用送信信号を生成する第1の信号生成ステップと、
前記送信回路で生成された前記超音波発生用送信信号を前記複数の超音波振動子に送信して、前記複数の超音波振動子に前記駆動パルスを印加して前記音響放射圧を発生させる前記加振用超音波を少なくとも含む前記超音波を発生させ、発生された前記超音波を前記組織に送信する第1の送信ステップと、
前記超音波が送達された前記組織からの反射波を前記複数の超音波振動子で受信し、前記複数の超音波振動子が受信した前記反射波に基づく受信信号を前記受信回路から出力する出力ステップと、
前記評価部が前記受信回路から出力された前記受信信号に基づいて前記組織の硬さを評価する評価ステップと、
前記超音波の送信後の全ての超音波の送信の休止期間内において、前記超音波を送信した前記複数の超音波振動子に対して分極処理を行わせるために、前記送信回路を制御して、前記複数の超音波振動子に送信する分極処理用送信信号を生成する第2の信号生成ステップと、
前記音響放射圧を発生させる前記加振用超音波を少なくとも含む前記超音波を発生させる前記超音波発生用送信信号の送信後の前記休止期間内において、前記超音波発生用送信信号、及び前記分極処理用送信信号の送信の際に発生する音響出力値に応じて前記分極処理を実施する分極処理時間を前記休止期間以内に設定する設定ステップと、
前記分極処理時間において、少なくとも前記加振用超音波を送信した前記複数の超音波振動子に対して、前記送信回路から前記分極処理用送信信号を送信して前記分極処理を行う分極ステップと、を有することを特徴とする超音波診断システムの作動方法。 - 前記設定ステップは、前記組織に対するユーザの操作に対応して、前記分極処理における前記音響出力値を計算し、前記音響出力値が予め設定された音響出力の指標値以下となるように、前記分極処理時間を前記休止期間以内において設定する請求項8に記載の超音波診断システムの作動方法。
- 前記設定ステップは、前記超音波の送信によって発生する前記複数の超音波振動子の脱分極のレベルを前記駆動パルスからなる前記超音波発生用送信信号の送信時間から算出し、算出した前記脱分極のレベルから前記分極処理における前記音響出力値を計算し、計算された前記音響出力値に応じて前記分極処理時間を前記休止期間以内において制御する請求項8又は9に記載の超音波診断システムの作動方法。
- 前記第1の送信ステップは、前記送信回路から前記複数の超音波振動子の少なくとも一部に、前記超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して前記加振用超音波を発生させて前記組織に送信して前記組織を押圧して変位させるものであり、
前記出力ステップは、前記受信回路によって、前記受信信号として前記組織からの前記反射波に基づく第1の受信信号を受信し、前記反射波に基づく前記第1の受信信号を前記受信回路から出力するものであり、
前記評価ステップは、前記評価部によって前記第1の受信信号から得られた超音波画像に基づいて前記組織の変位を算出して前記組織の硬さを評価するものであり、
前記休止期間は、前記第1の送信信号の送信終了後から次の前記第1の送信信号の送信開始までの期間である請求項8又は9に記載の超音波診断システムの作動方法。 - 前記第1の送信ステップは、前記送信回路から前記複数の超音波振動子の少なくとも一部に、前記超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、前記加振用超音波を発生させて前記組織に送信し、前記組織を押圧して変位させるものであり、
更に、前記組織を変位させた後、続いて前記送信回路を制御して、前記組織の変位を検出するための検出パルスからなる第2の送信信号を生成する第3の信号生成ステップと、
前記送信回路から前記検出パルスからなる前記第2の送信信号を前記複数の超音波振動子に送信して、検出用超音波を発生させて前記組織に送信する第2の送信ステップと、を有し、
前記出力ステップは、前記受信回路によって、前記受信信号として前記組織からの前記検出用超音波の前記反射波に基づく第2の受信信号を受信するものであり、
前記評価ステップは、前記評価部によって前記第2の受信信号から得られた超音波画像に基づいて前記組織の変位を算出して前記組織の硬さを評価するものであり、
前記休止期間は、前記第2の送信信号の送信終了後から次の前記第1の送信信号の送信開始までの期間である請求項8又は9に記載の超音波診断システムの作動方法。 - 前記第1の送信ステップは、前記送信回路から前記複数の超音波振動子の少なくとも一部に、前記超音波発生用送信信号として加振パルスからなる第1の送信信号を送信して、前記加振用超音波を発生させて前記組織に送信して前記組織を加振して剪断波を発生させるものであり、
更に、前記剪断波を発生させた後、続いて前記送信回路を制御して、前記剪断波の音速を検出するための検出パルスからなる第3の送信信号を生成する第4の信号生成ステップと、
前記送信回路から前記検出パルスからなる前記第3の送信信号を前記複数の超音波振動子に送信して検出用超音波を発生させて前記剪断波が発生している前記組織に送信する第3の送信ステップと、を有し、
前記出力ステップは、前記受信回路によって、前記受信信号として前記組織からの前記検出用超音波の前記反射波の第3の受信信号を受信し、
前記評価ステップは、前記評価部によって前記第3の受信信号に基づいて前記剪断波の音速を算出して前記組織の硬さを評価するものであり、
前記休止期間は、前記第3の送信信号の送信終了後から次の前記第1の送信信号の送信開始までの期間である請求項8又は9に記載の超音波診断システムの作動方法。
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