Embodiments described herein relate generally to an ultrasound diagnosis apparatus.
Conventionally, ultrasound diagnosis apparatuses have been used in today's medicine for performing a medical examination and making a diagnosis on various tissues in the body of an examined subject (hereinafter, “subject”) such as the heart, the liver, a kidney, a mammary gland, and the like, because ultrasound diagnosis apparatuses have advantages realized by simpler operability and non-invasiveness (i.e., no possibility of causing radiation exposures) over other medical image diagnosis apparatuses such as X-ray diagnosis apparatuses and X-ray computed tomography apparatuses. For example, an ultrasound diagnosis apparatus is configured to, when an ultrasound probe is pressed against a subject by an operator such as a medical doctor, generate an ultrasound image that is an image of a structure of a tissue inside the subject, by receiving a reflected-wave signal obtained when an ultrasound wave transmitted from the ultrasound probe is reflected by the tissue inside the subject. Consequently, the ultrasound diagnosis apparatus is capable of generating ultrasound images of mutually-different tissues in correspondence with the sites against which the ultrasound probe is pressed by the operator.
An ultrasound diagnosis apparatus according to an aspect includes an ultrasound probe and a processing apparatus. The ultrasound probe is configured so that a contact face thereof to be in contact with a subject for the purpose of adhering thereto is formed so as to have a shape that can be fitted to a projection part of the subject. The processing apparatus processes a reflected-wave signal of an ultrasound wave that is transmitted from the ultrasound probe attached to the subject toward the subject.
First, a diagnosis system according to a first embodiment will be explained, with reference to
The diagnosis apparatus 1 is a portable ultrasound diagnosis apparatus that is carried by the subject P and is integrally provided with a Holter electrocardiography device. The diagnosis apparatus 1 is configured to wirelessly communicate with the access point 11. More specifically, the diagnosis apparatus 1 includes an apparatus main body 100 and an ultrasound probe 101 that is thin and can be fixed onto the subject P. The apparatus main body 100 is configured to regularly record an electrocardiogram (ECG) while the subject P is leading a daily life and to generate ultrasound images from reflected-wave signals of ultrasound waves transmitted from the ultrasound probe 101 to the subject P. Further, the apparatus main body 100 transmits the ECGs and the ultrasound images to the server apparatus 12 via the network 10, by regularly transmitting the ECGs and the ultrasound images to the access point 11.
The server apparatus 12 stores therein, for each examined subject (i.e., subject), personal information regarding the subject and various types of medical data such as ECGs and ultrasound images obtained from the subject. The server apparatus 12 according to the first embodiment is configured to accumulate therein the ECGs and the ultrasound images that are obtained from the subject P while the subject P is leading a daily life, by receiving the ECGs and the ultrasound images that are regularly transmitted from the apparatus main body 100. With this arrangement, a medical doctor or the like who is in the hospital is able to view the ECGs and the ultrasound images obtained from the subject P who is in the personal residence, by accessing the server apparatus 12 via a portable terminal or a personal computer.
In this situation, the apparatus main body 100 according to the first embodiment is configured to analyze the ECGs regularly acquired from the subject P. Further, when having detected an abnormality in the subject P as a result of analyzing the ECGs, the apparatus main body 100 generates an ultrasound image of the subject P by causing the ultrasound probe 101 to transmit an ultrasound wave. In other words, when there is a possibility that the subject P may have an abnormality as a result of the analysis using the ECGs, the apparatus main body 100 generates the ultrasound image by immediately scanning the subject P by using the ultrasound probe 101. Further, every time an ultrasound image is generated, the apparatus main body 100 transmits the ultrasound image to the server apparatus 12, together with the ECG corresponding to the time when the abnormality was detected. As a result, the diagnosis apparatus 1 according to the first embodiment makes it possible to examine the subject P while using not only the ECGs but also the ultrasound images, when there is a possibility that subject P may have an abnormality. Generally speaking, because ECGs are obtained from small electric signals flowing in the subject P, waveforms of the ECGs may change due to changes in the posture of the subject P, and waveforms of the ECGs may have noise due to body movements of the subject. However, the diagnosis apparatus 1 according to the first embodiment makes it possible to examine the subject P in an integral manner while using the ECGs and the ultrasound images. Thus, even if the waveforms of the ECGs are disturbed by the posture changes and/or the body movements of the subject P, it is possible to improve the level of precision of the diagnoses made by the medical doctor.
Next, the diagnosis apparatus 1 described above will be explained further in detail. In the following sections, the ultrasound probe 101 that makes it possible to examine the subject P in an integral manner will be explained first. Secondly, a configuration and a processing procedure of the apparatus main body 100 will be explained. In the first embodiment, an example will be explained in which the diagnosis apparatus 1 is configured to regularly record an ECG of the subject P and also to generate, when an abnormality has been detected, an ultrasound image of the chest (e.g., the heart) of the subject P. It should be noted, however, that it is acceptable to configure the diagnosis apparatus 1 so as to generate ultrasound images of a site (e.g., the abdomen) other than the chest.
The apparatus main body 100 and the ultrasound probe 101 are connected to each other by a cable 102 so as to allow electric communication therebetween, whereas the apparatus main body 100 and the Holter ECG probes 111 are connected to each other by a cable 112 so as to allow electric communication therebetween. The cable 102 and the cable 112 are bendable members and are configured with, for example, metal wires each covered with an electrically-insulating material such as rubber.
The Holter ECG probes 111 are fixed onto the body surface of the subject P by adhesive pads or the like and are configured to obtain ECG data by detecting small electric signals from the inside of the subject P. The ultrasound probe 101 is configured so that a contact face thereof to be in contact with the subject P for the purpose of adhering thereto is formed so as to have a shape that can be fitted to a projection part (e.g., a rib) of the subject P. The ultrasound probe 101 transmits an ultrasound wave to the subject P and receives a reflected-wave signal obtained when the ultrasound wave is reflected on the inside of the subject P. The apparatus main body 100 is a processing apparatus that processes the reflected-wave signal of the ultrasound wave that is transmitted from the ultrasound probe 101 attached to the subject P toward the subject P. More specifically, the apparatus main body 100 is configured to receive the ECG data obtained by the Holter ECG probes 111 and to generate an ultrasound images by using the reflected-wave signal received by the ultrasound probe 101.
Because the diagnosis apparatus 1 is configured so as to be attachable to the subject P, the diagnosis apparatus 1 is able to obtain the ECG data and the ultrasound images from the subject P, while the subject P is leading a daily life. In particular, because the ultrasound probe 101 according to the first embodiment is configured so as to be thin and have a plate-like shape, it is possible to fix the ultrasound probe 101 onto the subject P.
Next, the shape of the ultrasound probe 101 according to the first embodiment will be explained, with reference to
In the example shown in
As shown in
Further, as shown in
Further, the ultrasound probe 101 is structured so that, when the contact face 104 of the exterior case 103 is considered as the upper face, an acoustic matching layer 106, the piezoelectric elements 107, and a backing member 108 are laminated in the direction from the acoustic lens 105 toward the lower face of the exterior case 103. As mentioned above, the acoustic lens 105 is configured to converge the ultrasound waves. The acoustic matching layer 106 mitigates mismatches of acoustic impedances between the piezoelectric elements 107 and the subject P.
The piezoelectric elements 107 are connected to the cable 102 by electrodes 109 of a flexible cable or the like and are configured to transmit and receive electric signals to and from the apparatus main body 100 via the electrodes 109. The piezoelectric elements 107 generate ultrasound waves based on transmission signals supplied from the apparatus main body 100 and receive reflected-wave signals from the subject P. More specifically, the piezoelectric elements 107 according to the first embodiment generate the ultrasound waves in a substantially thickness direction F1 of the exterior case 103. Although not shown in the drawing, the piezoelectric elements 107 include two or more piezoelectric elements each of which generates an ultrasound wave and receives a reflected-wave signal. It is assumed that, in the example illustrated in
For example, when an ultrasound wave is transmitted from the ultrasound probe 101 to the subject P, the transmitted ultrasound wave is repeatedly reflected on a surface of discontinuity of acoustic impedances at a tissue in the body of the subject and is received as a reflected-wave signal by the piezoelectric elements 107 included in the ultrasound probe 101. The amplitude of the received reflected-wave signal is dependent on the difference between the acoustic impedances on the surface of discontinuity on which the ultrasound wave is reflected. When the transmitted ultrasound pulse is reflected on the surface of a flowing bloodstream or a cardiac wall, the reflected-wave signal is, due to the Doppler effect, subject to a frequency shift, depending on a velocity component of the moving members with respect to the ultrasound wave transmission direction. Further, the reflected-wave signal received by the ultrasound probe 101 is transmitted to the apparatus main body 100 via the cable 102. By using the reflected-wave signals received from the ultrasound probe 101, the apparatus main body 100 generates the ultrasound image of the subject P.
As explained above, the ultrasound probe 101 according to the first embodiment includes the plate-like exterior case 103 as illustrated in the examples in
The ultrasound waves emitted from the ultrasound probe 101 described above are substantially totally reflected by the bones and the like inside the subject P. For this reason, even if the user wishes to have an ultrasound image of the heart generated, there is a possibility that the heart may not properly be rendered in the ultrasound image when a bone is positioned between the ultrasound probe 101 and the heart serving as the image taking target. Consequently, when an ultrasound image of the chest of the subject P is to be generated as described in the exemplary embodiment above, it is desirable to arrange the ultrasound waves emitted from the ultrasound probe 101 so as to arrive at the heart or the like while avoiding the ribs of the subject P. For this reason, it is desirable to arrange the acoustic lens 105 included in the ultrasound probe 101 described above so as to have a convex shape that fits an intercostal region of the subject P. This aspect will be explained, with reference to
Further, in the first embodiment described above, the example is explained in which the ultrasound probe 101 is a one-dimensional ultrasound probe in which the plurality of piezoelectric vibrators are arranged in a row. However, it is acceptable to configure the ultrasound probe 101 with a two-dimensional ultrasound probe in which a plurality of piezoelectric vibrators are two-dimensionally arranged in a grid formation.
Next, the apparatus main body 100 according to the first embodiment will be explained, with reference to
The input apparatus 21 is configured with input devices such as a panel switch, a touch command screen, a trackball, a button, and/or the like. These input devices are provided on a lateral face of the apparatus main body 100, for example. The apparatus main body 100 receives an operation instruction from a user (e.g., the subject P) via the input apparatus 21.
Further, the apparatus main body 100 is connected to the network 10 and an external storage device 22. In the first embodiment, it is assumed that the apparatus main body 100 is wirelessly connected to the network 10 and the external storage device 22. The external storage device 22 is, for example, the server apparatus 12 installed in the hospital as illustrated in
Further, as shown in
The Holter ECG probes 111 obtain the ECG data by detecting the small electric signals from the inside of the subject P, while being fixed to the body surface of the subject P by the adhesive pad or the like. The Holter ECG system 121 receives the ECG data obtained by the Holter ECG probes 111. Further, the Holter ECG system 121 stores the ECG data into the internal storage device 131. The Holter ECG system 121 according to the first embodiment is configured to constantly receive the ECG data from the Holter ECG probes 111 and to accumulate the received ECG data into the internal storage device 131.
The analyzing circuit 122 receives the ECG data from the Holter ECG probes 111 and judges whether any abnormality is occurring in the subject P by analyzing the received ECG data in a real-time manner. Further, when having determined that there is a possibility that an abnormality may be occurring in the subject P as a result of the analysis, the analyzing circuit 122 transmits an abnormality occurrence notification to the bookmark circuit 123 and to the system controller 124.
The analyzing process performed by the analyzing circuit 122 can be explained as follows: For example, the analyzing circuit 122 obtains, from the ECG data, a P-wave, QRS waves (a Q-wave, an R-wave, and an S-wave), and a T-wave representing a waveform of cardiac cycles and judges whether an abnormality is occurring in the subject P by using these waves. For example, a time period between the Q-wave and the S-wave denotes a ventricular systolic period, whereas a time period between the S-wave and the T-wave denotes a ventricular diastolic period. Thus, the analyzing circuit 122 judges whether the subject P is suspected to have an ischemic heart disease or a myocardial infarction, by analyzing the motions of the heart in the S-T period (the time period between the S-wave and the T-wave). As another example, a section where the waveform is horizontal at 0 mv can be observed in an S-T period. Angina pectoris makes the horizontal portion lower than that in a normal state, whereas a myocardial infarction makes the horizontal portion higher. Thus, by analyzing the S-T period, the analyzing circuit 122 judges whether the subject P is suspected to have angina pectoris.
When having received an abnormality occurrence notification from the analyzing circuit 122, the bookmark circuit 123 stores therein an abnormality occurrence time indicating the time at which the abnormality occurrence notification was received. For example, the bookmark circuit 123 stores the abnormality occurrence time into a predetermined storage memory as a log. In addition, the bookmark circuit 123 may add the abnormality occurrence time, as a piece of data, to the ECG data from which the abnormality was detected by the analyzing circuit 122.
The system controller 124 is configured by using an electronic circuit such as a Central Processing Unit (CPU) or a Micro Processing Unit (MPU) or an integrated circuit such as an Application Specific Integrated Circuit (ASIC) or a Field Programmable Gate Array (FPGA) and is configured to exercise overall control of the processes performed by the apparatus main body 100. Although the controlling lines are not illustrated in
When having received an abnormality occurrence notification from the analyzing circuit 122, the system controller 124 according to the first embodiment controls the scan controller 125 so as to perform a scanning process using the ultrasound probe 101 until a predetermined period of time (e.g., one second, two seconds, or five seconds) has elapsed since the time at which the abnormality occurrence notification is received.
By controlling the transmitting and receiving unit 126, the scan controller 125 causes the ultrasound probe 101 to start a scan. In this situation, the scan controller 125 controls the transmitting and receiving unit 126 so as to perform the scan for the time period specified by the system controller 124.
The transmitting and receiving unit 126 performs an ultrasound transmitting and receiving process. More specifically, to transmit ultrasound waves, the transmitting and receiving unit 126 causes a pulser therein to sequentially generate high-voltage pulses in correspondence with predetermined delay periods. When the high-voltage pulses are sequentially applied to the vibrator cells of the piezoelectric elements 107 included in the ultrasound probe 101, an ultrasound wave is generated in each of the vibrator cells.
Further, to receive the ultrasound waves, the vibrator cells of the piezoelectric elements 107 within the ultrasound probe 101 receive the reflected waves of the ultrasound beams, so that reception signals corresponding to a plurality of channels are input to the transmitting and receiving unit 126. After a gain correcting process is applied to the reception signals by a pre-amplifier, the transmitting and receiving unit 126 performs an Analog/Digital (A/D) conversion thereon. Subsequently, after performing delay control and an adding process (a phase-matching addition) on the signals resulting from the A/D conversion for each of the channels in correspondence with each reception focus position, the transmitting and receiving unit 126 generates reflected-wave data by controlling a signal bandwidth by using a quadrature detection and a bandwidth limiting filter and further transmits the generated reflected-wave data to the B-mode processing unit 127 and the Doppler mode processing unit 128.
The B-mode processing unit 127 receives the reflected-wave data from the transmitting and receiving unit 126 and generates data (B-mode data) in which the strength of each signal is expressed by a degree of brightness, by performing a logarithmic amplification, an envelope detection process, and the like on the received reflected-wave data.
The Doppler mode processing unit 128 extracts bloodstreams, tissues, and contrast echo components under the influence of the Doppler effect by performing a frequency analysis so as to obtain velocity information from the reflected-wave data received from the transmitting and receiving unit 126, and further generates data (Doppler data) obtained by extracting bloodstream information such as an average velocity, the dispersion, the power, and the like for a plurality of points.
The B-mode data generated by the B-mode processing unit 127 and the Doppler data generated by the Doppler mode processing unit 128 may be referred to as raw data and are stored in the internal storage device 131. The raw data is also transmitted to the coordinate converting circuit 129.
The coordinate converting circuit 129 converts the raw data received from the B-mode processing unit 127 and the Doppler mode processing unit 128, from a coordinate system used when the data was reception beams, into a rectangular coordinate system used for displaying images.
The image synthesizing circuit 130 stores a B-mode image and a Doppler-mode/color-mode image of which the coordinate systems were changed into the rectangular coordinate system by the coordinate converting circuit 129, into the internal storage device 131 and further performs an image synthesizing process thereon so as to synthesize the images with text information indicating an image acquisition condition or the like. After that, the image synthesizing circuit 130 assigns Red-Green-Blue (RGB) map values thereto. Thus, the image synthesizing circuit 130 generates synthesized images as the ultrasound images.
The internal storage device 131 is a storage device configured with a Random Access Memory (RAM), a flash memory, a flash Solid State Drive (SSD), or the like. The internal storage device 131 stores therein the raw data generated by the B-mode processing unit 127 and the Doppler mode processing unit 128, as well as the ultrasound images and the like generated by the image synthesizing circuit 130.
The external interface unit 132 transmits and receives various types of data to and from external apparatuses via wireless communications. More specifically, the system controller 124 has a wireless communication function and is capable of storing the raw data, the ultrasound images, and the like stored in the internal storage device 131 into the external storage device 22.
In this situation, when the system controller 124 according to the first embodiment has received the abnormality occurrence notification from the analyzing circuit 122 and has controlled the scan controller 125 so as to perform the scanning process for the predetermined period of time, the system controller 124 stores the abnormality occurrence time recorded by the bookmark circuit 123, the ECG data from which the abnormality was detected by the analyzing circuit 122, and the ultrasound image generated as a result of controlling the scan controller 125, into the internal storage device 131 while keeping these items in correspondence with one another. Further, the system controller 124 transmits the group of data that is stored in the internal storage device 131 and in which the abnormality occurrence time, the ECG data, and the ultrasound image are kept in correspondence with one another to the server apparatus 12. The system controller 124 may regularly obtain such a group of data from the internal storage device 131 and transmit the obtained group of data to the server apparatus 12 or may transmit such a group of data to the server apparatus 12 every time an abnormality is detected by the analyzing circuit 122.
Next, a processing procedure performed by the diagnosis apparatus 1 according to the first embodiment will be explained, with reference to
As shown in
On the contrary, when an abnormality is detected in the subject P by the analyzing circuit 122 (step S102: Yes), the system controller 124 included in the apparatus main body 100 starts a scanning process using the ultrasound probe 101 by controlling the scan controller 125 (step S103). As a result, the ultrasound probe 101, the transmitting and receiving unit 126, the B-mode processing unit 127, the Doppler mode processing unit 128, the coordinate converting circuit 129, the image synthesizing circuit 130, and the like perform processes, and the apparatus main body 100 thus generates an ultrasound image (step S104).
After that, the system controller 124 stores the ECG data from which the abnormality was detected at step S102 and the ultrasound image generated at step S104, into the internal storage device 131, while keeping these items in correspondence with each other (step S105). Subsequently, the system controller 124 transmits the set that is made up of the ECG data and the ultrasound image and is stored in the internal storage device 131 to the server apparatus 12 (step S106).
As explained above, according to the first embodiment, it is possible to attach the ultrasound probe 101 to the subject P.
Further, according to the first embodiment, it is possible to examine the subject in an integral manner while using the ECGs and the ultrasound images. Thus, even if the waveforms of the ECGs are disturbed by the posture changes and/or the body movements of the subject P, it is possible to improve the level of precision of the diagnosis made by the medical doctor.
In the first embodiment, the example is explained in which the diagnosis apparatus 1 generates an ultrasound image when an abnormality is detected by analyzing the ECG. However, it is acceptable to configure the diagnosis apparatus 1 so as to generate an ultrasound image even if no abnormality is detected in an analysis result of the ECG. For example, it is acceptable to configure the diagnosis apparatus 1 so as to start the scanning process using the ultrasound probe 101 and to generate an ultrasound image every time a predetermined period of time has elapsed.
In another example, it is also acceptable to configure the diagnosis apparatus 1 so as to generate an ultrasound image at a specific time. For example, generally speaking, it is known that arrhythmias and coronary spastic angina involving a spasm of a coronary artery often occur at night or in the early morning regardless of physical exertion. Thus, it is sometimes difficult to make a diagnosis from an ECG test or a stress ECG test performed at a hospital. Consequently, it is acceptable to configure the diagnosis apparatus 1 so that the process of causing the ultrasound probe 101 to start the scanning process is performed in a concentrated manner at night and in the early morning. With this arrangement, the diagnosis apparatus 1 may be able to generate an ultrasound image that makes it possible to diagnose coronary spastic angina or the like of the subject P.
Further, when the diagnosis apparatus 1 is used for the purpose of regularly generating ultrasound images or for the purpose of generating ultrasound images in specific periods of time as described in the examples above, the diagnosis apparatus 1 does not necessarily have to include the ECG system. More specifically, the diagnosis apparatus 1 does not necessarily have to include the Holter ECG probes 111, the Holter ECG system 121, the analyzing circuit 122, and the bookmark circuit 123 shown in
Further, in the first embodiment described above, the example is explained in which, if occurrence of an abnormality is detected by analyzing an ECG, the diagnosis apparatus 1 performs the scanning process using the ultrasound probe 101, until the predetermined period of time has elapsed since the abnormality occurrence time. However, it is also acceptable to configure the diagnosis apparatus 1 so as to, if occurrence of an abnormality is detected, perform the scanning process using the ultrasound probe 101 until a predetermined number of ultrasound images have been generated.
Further, in the first embodiment described above, it is acceptable to configure the diagnosis apparatus 1 so as to identify cardiac phases by analyzing the ECG and to intermittently perform the scanning process using the ultrasound probe 101 at times in a specific cardiac phase. Further, it is acceptable to configure the diagnosis apparatus 1 so as to transmit the intermittently-generated ultrasound images and such ECGs that were obtained when the ultrasound images were generated, to the server apparatus 12. In that situation, it is acceptable to configure the server apparatus 12 so as to analyze, in a real-time manner, the ultrasound images and the ECGs transmitted from the diagnosis apparatus 1 and so as to, if an abnormality is detected in motions of the cardiac walls or the like, store an abnormality occurrence time into a predetermined storage memory as a log.
Further, in the first embodiment described above, it is acceptable to configure the diagnosis apparatus 1 so as to obtain volume data, which is three-dimensional medical image data, if the ultrasound probe 101 is configured with a two-dimensional ultrasound probe as illustrated in
Further, in the first embodiment described above, it is acceptable to configure the system controller 124 included in the diagnosis apparatus 1 so as to send, via e-mail for example, an alert to a portable terminal or the like that is held by a medical doctor or the like, when the number of times an abnormality is detected by the analyzing circuit 122 has exceeded a predetermined value or when the analyzing circuit 122 has kept detecting abnormalities for a predetermined period of time.
Further, in the first embodiment described above, it is acceptable to configure the diagnosis apparatus 1 so as to include a wrist-watch-style pulse measuring apparatus configured to obtain a pulse rate of the subject P, instead of the Holter ECG probes 111. In that situation, the analyzing circuit 122 determines that an abnormality has occurred in the subject P when, for example, the pulse rate is not in a predetermined threshold range.
Further, in the first embodiment described above, it is acceptable to configure the transmitting and receiving unit 126, the B-mode processing unit 127, the Doppler mode processing unit 128, the coordinate converting circuit 129, the image synthesizing circuit 130, and the like illustrated in
Further, in the first embodiment described above, it is acceptable to configure the diagnosis apparatus 1 so as not to generate the ultrasound images, but so as to transmit the reflected-wave signals received by the ultrasound probe 101 to the server apparatus 12. In that situation, the ultrasound probe 101 does not necessarily have to include the B-mode processing unit 127, the Doppler mode processing unit 128, the coordinate converting circuit 129, and the image synthesizing circuit 130 illustrated in
In the examples described above, it is acceptable to configure the diagnosis apparatus 1 so as to perform up to the process of generating the raw data from the reflected-wave signals received by the ultrasound probe 101 and to transmit the generated raw data to the server apparatus 12. In that situation, the ultrasound probe 101 does not necessarily have to include the coordinate converting circuit 129 and the image synthesizing circuit 130 illustrated in
Further, in the examples described above, it is acceptable to configure the diagnosis apparatus 1 so that the transmission is directed to a desktop personal computer, a notebook personal computer, a tablet personal computer, a portable terminal, or the like used by a medical doctor, a nurse, or the like. Further, it is also acceptable to configure the diagnosis apparatus 1 so as to transmit only the ECGs or only the ultrasound images to the server apparatus 12 or to a personal computer or the like used by a medical doctor or the like, instead of transmitting the sets each made up of an ECG and an ultrasound image. Further, it is also acceptable to configure the diagnosis apparatus 1 so as to transmit sets made up of ECGs and ultrasound images obtained before and after the time at which an abnormality is detected by the analyzing circuit 122.
In the first embodiment, the shape of the ultrasound probe 101 that is thin and has a plate-like shape was explained, with reference to
Sloped Face
In the first embodiment, the example is explained in which the ultrasound probe has the exterior case 103 having the shape of a substantially rectangular parallelepiped in which the upper face and the lower face are positioned substantially parallel to each other. However, it is acceptable to configure an ultrasound probe so as to have an exterior case in which the two faces are not positioned parallel to each other. This aspect will be explained with reference to
As shown in
Grooves
In the first embodiment described above, the example is explained in which the ultrasound probe has the plate-like exterior case 103 having the shape of a substantially rectangular parallelepiped in which the upper face and the lower face are positioned substantially parallel to each other. However, it is also acceptable to configure an ultrasound probe so as to have an exterior case in which concave portions to be engaged with projection parts (e.g., bones) of the subject P are formed in the contact face which is one of the upper and the lower faces that has the acoustic lens 105 provided thereon. This aspect will be explained with reference to
As shown in
Because the concave portions 304a and 304b are shaped so as to be easily fitted to an intercostal region, it is possible to easily fix the ultrasound probe 301 onto the subject P. More specifically, because the ultrasound probe 301 has the exterior case 303 in which the concave portions 304a and 304b are formed on either side of the acoustic lens 105, the concave portions 304a and 304b are positioned at the ribs of the subject P, in the example illustrated in
Adaptors
In the first embodiment described above, the example is explained in which the ultrasound probe has the plate-like exterior case 103 having the shape of a substantially rectangular parallelepiped in which the upper face and the lower face are positioned substantially parallel to each other. However, it is also acceptable to configure an ultrasound probe so as to have an exterior case provided with expandable members that are expandable in a direction away from the contact face (i.e., a plurality of plate-like adhesive members among which one or more are piled up). This aspect will be explained with reference to
As shown in
The adaptors 404a and 404b are members that are capable of freely expanding and contracting in the thickness direction of the exterior case 403. For example, as shown in the example in
Even if the piezoelectric elements included therein are not of a swingable type, the ultrasound probe 401 according to the third modification example is able to transmit the ultrasound waves in the directions other than the direction substantially perpendicular to the body surface, in accordance with the expansion/contraction state of the adaptors 404a and 404b. Further, by changing the expansion/contraction state of the adaptors 404a and 404b, it is possible to adjust the emission directions of the ultrasound waves of the ultrasound probe 401. Like in the example shown in
Further, although not shown in the drawings, it is acceptable to configure the ultrasound probe 401 according to the third modification example so as to be provided with another member that is expandable/contractible or an elastic member, instead of the adaptors 404a and 404b. With this arrangement, when the ultrasound probe 401 is adhered, with pressure, to the body surface of the subject P by a fixation band or the like, it is possible to adjust the angle formed by the contact face 404 and the body surface by changing the shape of the expandable/contractible member or the like. Consequently, like in the example in
Further, although not shown in the drawings, it is also acceptable to configure the ultrasound probe 101 according to the first embodiment in such a manner that adhesive pads having mutually-different thicknesses are pasted on the contact face 104. In this situation also, the ultrasound probe 101 is able to transmit the ultrasound waves in the directions other than the direction substantially perpendicular to the body surface, like in the example in
The shapes of the ultrasound probes 101, 201, 301, and 401 are not limited to the examples described above. For instance, in the examples described above, the faces (e.g., the contact face) of the exterior case are substantially rectangular. However, the faces of the exterior case may have an arbitrary shape that is circular, oval, trapezoidal, or the like. Further, in the examples described above, the acoustic lens 105 is provided near the center of the contact face. However, it is acceptable to provide the acoustic lens 105 in an area other than the area near the center of the contact face.
Further, in the example shown in
Further, in the example in
Further, it is effective to apply the ultrasound probes of which the ultrasound transmission directions are controllable as shown in
Stationary-Type Apparatus
In the exemplary embodiments explained with reference to
An exemplary embodiment of the diagnosis apparatus 1 of a stationary type will be explained, while using a stress echo test as an example. In recent years, tests called “stress echo tests” are performed for the purpose of checking for heart diseases such as an ischemic heart disease. A stress echo test is an ultrasound examination performed while stress is applied to the heart, for the purpose of checking for the changes in the motions of myocardia and in the blood flows that cannot be observed while the subject is at rest. Examples of stress echo tests include exercise-stress cardiac echo tests and drug-stress cardiac echo tests. The heart rate and the blood pressure are raised, by prompting the subject to do physical exercise of mutually-different levels of stress in the former example and by changing the amount of the drug (e.g., dobutamine) in stages in the latter example. When the subject is not capable of doing physical exercise, a drug-stress test is performed. However, exercise-stress tests are preferred because exercise-stress tests use no drug and are safer. During an exercise-stress cardiac echo test, after the subject P does physical exercise as described above, the ultrasound probe is pressed against the subject P so as to record ultrasound images in the form of a moving picture or a group of still images for the duration of one heartbeat or longer, and an ECG is also recorded by attaching the ECG probes to the subject P. In this situation, during the exercise-stress cardiac echo test, it is required to record the ultrasound images and the ECG before a predetermined period of time (e.g., 90 seconds) elapses since the end of the physical exercise of the subject P. In other words, the operator such as the medical doctor is required to press the ultrasound probe against the subject P and to attach the ECG probes to the subject P, immediately after the subject P has finished the physical exercise. To record the ultrasound images, it is necessary to press the ultrasound probe against the subject P, while ensuring that the observation target site (e.g., the heart) is irradiated by the ultrasound waves. Consequently, operators who give stress echo tests are required to be highly skillful.
In contrast, when the diagnosis apparatus 1 of a stationary type according to the exemplary embodiment described above is used, the operator is not required to be highly skillful and is able to easily record the ultrasound images and the ECG. More specifically, while the ultrasound probe 101 and the Holter ECG probes 111 according to the embodiment are attached to the subject P, the subject P is prompted to do physical exercise. After that, when the subject P has finished the physical exercise, the operator is able to immediately record the ultrasound images and the ECG of the subject P who has finished the physical exercise, by operating the apparatus main body 100. As explained above, because the ultrasound probe 101 according to the embodiment is fixed onto the subject P while being fitted to the intercostal region or the like, it is possible to prevent the ultrasound probe 101 from making positional shifts even while the subject P is doing the physical exercise. Consequently, the operator is able to attach the ultrasound probe 101 to the subject P before the start of the physical exercise, spending sufficient time to ensure that the observation target site (e.g., the heart) is irradiated by the ultrasound waves. Further, even after the subject P has finished the physical exercise, the operator is able to record the ultrasound images of the observation target without the need to adjust the attachment position of the ultrasound probe 101.
As explained above, even if the apparatus main body 100 is of a stationary type, the diagnosis apparatus 1 described above is able to realize a medical examination such as a stress echo test that has a high level of precision and is efficient, because the ultrasound probe 101 and the Holter ECG probes 111 are fixed onto the subject P. Further, by attaching the ultrasound probe 101 to the same location of the subject P again and again, it is possible to record ultrasound images of the same observation target many times. Thus, it is possible to utilize the diagnosis apparatus 1 described above as an ultrasound diagnosis apparatus having high reproducibility.
It is also acceptable to configure the diagnosis apparatus 1 described above so as to include a plurality of ultrasound probes 101. In that situation, when there are a plurality of observation targets, the operator is able to record a plurality of ultrasound images at once, by attaching the ultrasound probes 101 to the subject P in such a manner that the observation targets are irradiated by the ultrasound waves. For example, during an exercise-stress cardiac echo test, to record ultrasound images on a specific cross-sectional plane of the heart that can be viewed from a plurality of observation positions in intercostal regions such as an apical window and a parasternal window, which are called cardiac acoustic windows, a certain skill is required to be able to press the ultrasound probe against the subject at an appropriate angle in the observation positions, within a predetermined period of time since the end of the physical exercise. In some situations, it may be required to have the subject P do the physical exercise many times. However, because the diagnosis apparatus 1 according to the embodiment is able to record a plurality of ultrasound images at once, it is possible to realize a stress echo test without the need to have the subject P do the physical exercise many times. If the reflected waves of the ultrasound waves from the probes interfere with one another, time-difference control is exercised so that the transmissions and the receptions are performed while sequentially switching among the probes.
Automatic Exercise-Stress Cardiac Echo Test
In the description above, the example is explained in which the exercise-stress cardiac echo test is performed by the operator who operates the apparatus main body 100 after the subject P does the physical exercise. However, it is also acceptable to configure the apparatus main body 100 so as to automatically record the ultrasound images and the ECG immediately after the physical exercise by detecting the point in time at which the subject P has finished the physical exercise. This aspect will be specifically explained with reference to
In the example shown in
Further, by analyzing the ultrasound images G11 to G13 and G21 to G23, the apparatus main body 100 judges whether the subject P is currently exercising. More specifically, even if the subject P is not exercising, the shape and the position of the heart change due to the expansion and contraction motions of the heart. However, at the times when the R-waves are detected, the shape and the position of the heart are considered to be substantially the same, as long as the subject is not exercising. For this reason, by analyzing (e.g., by applying a cross-correlation process to) a motion vector or the like among the ultrasound images generated at the times when the R-waves are detected, the apparatus main body 100 detects whether the shape and the position of the heart are changing. Further, the apparatus main body 100 determines that the subject P is not exercising if the magnitude of the motion vector is smaller than a predetermined value and determines that the subject P is exercising if the magnitude of the motion vector is equal to or larger than the predetermined value.
For instance, in the example in
As another example, in the example in
By analyzing the ultrasound images corresponding to the R-waves in the ECG waveform W10 in this manner, the apparatus main body 100 determines whether the subject P is currently exercising. Further, the apparatus main body 100 generates the ultrasound images consecutively when the subject P has transitioned from an exercising state into a non-exercising state. In other words, the apparatus main body 100 transitions from the state in which the apparatus main body 100 intermittently generates the ultrasound images at the times when the R-waves are detected to the state in which the apparatus main body 100 consecutively generates the ultrasound images regardless of the timing with which the R-waves are detected. In that situation, a moving picture or a group of still images for the duration of one heartbeat or longer is acquired and stored. The user is able to specify, in advance, the acquisition period or the number of heartbeats. Further, it is also judged in parallel, as necessary, whether the subject P is exercising during the acquisition period. When it has been detected that the subject P is exercising during the acquisition period, the moving picture or the group of still images is discarded or information indicating that there have been movements is added thereto, and at the same time, the user is informed by a display on a screen.
With these arrangements, the apparatus main body 100 consecutively generates the ultrasound images automatically, when the subject P who is doing the physical exercise comes to a halt. Thus, the stress echo test is automatically performed without the operator's having to operate the apparatus main body 100.
The process of judging whether the subject P is exercising or not described above may be performed by the system controller 124 included in the apparatus main body 100 or may be performed by a dedicated computer chip or a dedicated computer program included in the apparatus main body 100. Further, in the description above, the example is explained in which the ultrasound images are generated at the times when the R-waves are detected; however, it is acceptable to configure the apparatus main body 100 so as to generate the ultrasound images at the times when other waves such as P-waves, Q-waves, S-waves, T-waves, or U-waves are detected or at the times defined by arbitrary delay periods since an easily-detected wave.
As explained above, according to the first and the second embodiments, it is possible to attach the ultrasound probe to the subject.
While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions. Indeed, the novel embodiments described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions and changes in the form of the embodiments described herein may be made without departing from the spirit of the inventions. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of the inventions.
Number | Date | Country | Kind |
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2011-207203 | Sep 2011 | JP | national |
2012-208086 | Sep 2012 | JP | national |
This application is a continuation of PCT international application Ser. No. PCT/JP2012/074262 filed on Sep. 21, 2012 which designates the United States, incorporated herein by reference, and which claims the benefit of priority from Japanese Patent Application No. 2011-207203, filed on Sep. 22, 2011; and Japanese Patent Application No. 2012-208086, filed on Sep. 21, 2012, the entire contents of which are incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2012/074262 | Sep 2012 | US |
Child | 14177271 | US |