Ultrasonic diagnostic apparatus and treatment apparatus for axillary osmidrosis or hyperhidrosis

Abstract

To provide an ultrasonic diagnostic imaging device that visualizes and displays the subcutaneous condition, and a device for treating underarm odor or hyperhidrosis that includes the ultrasonic diagnostic imaging device. An ultrasound imaging diagnostic device according to an embodiment of the present application is an ultrasound imaging diagnostic device 16 having an ultrasound probe 11, a cross-sectional echo image generating device 13, and an analyzing device 14 that analyzes the cross-sectional echo image to recognize sweat glands, wherein the ultrasound probe 11 has a substantially rectangular contact surface 11a having long and short sides and is capable of scanning at least in the long and short side directions, the cross-sectional echo image generating device 13 displays a cross-sectional echo image based on scanning signals generated by scanning the ultrasound probe 11 in the length direction and operating it in the short side direction on the epidermis surface of a living body, and the analyzing device 14 obtains and displays information regarding the distribution state, position, and depth, or information regarding the position, spread state, depth, and infiltration degree of a malignant tumor in the skin, based on the cross-sectional echo image.

Description

Technical Field

[0001] The present invention is effective in preoperative diagnosis, postoperative diagnosis, and recurrence diagnosis of eccrine glands and apocrine glands, which are sweat glands present under the human skin, and visualizes and displays information regarding the distribution state, density, position, and depth, or diagnoses, positions, spread states, depths, and invasion degrees of skin benign and malignant tumors. The present invention relates to an ultrasonic diagnostic apparatus and a treatment apparatus for axillary osmidrosis or hyperhidrosis equipped with this ultrasonic diagnostic apparatus.

Background Art

[0002] Eccrine glands are sweat glands present almost all over the human body, especially in large numbers on the head, face, back, etc. Most of the sweat of the human body comes from these eccrine glands. The sweat from these eccrine glands is mostly water, and the main component other than water is salt. On the other hand, apocrine glands are sweat glands present particularly in the armpits, ears, areola, and genitals, and the sweat from apocrine glands contains 70% - 80% water, as well as proteins, lipids, ammonia, etc. Unpleasant odors such as so-called axillary osmidrosis (axillary bromhidrosis) are caused by the sweat from apocrine glands.

[0003] Excessive secretion of sweat from these apocrine glands and eccrine glands causes axillary osmidrosis (axillary bromhidrosis) and hyperhidrosis, so treatment methods for suppressing excessive sweating have been studied conventionally. For example, Patent Document 1 discloses a sweating suppression device including an electrode needle and a cooling unit in which a through-hole through which the electrode needle can be inserted is formed, bringing the cooling unit into close contact with the skin surface of a living body, protruding the electrode needle from the cooling unit and energizing it to heat the tip side of the electrode needle, thereby destroying the sweat glands on the tip side of the electrode needle. By destroying the sweat glands with such a sweating suppression device, excessive secretion of sweat from apocrine glands or eccrine glands can be suppressed.

[0004] The sweat glands targeted for destruction by the hair removal suppression device are present at various depth positions from the dermis to the subcutaneous tissue. However, the thickness of the dermis and subcutaneous tissue not only varies from person to person but also differs depending on the part of the living body. Therefore, in order to reliably destroy the sweat glands, it is necessary to heat the entire depth direction from the dermis to the subcutaneous tissue while gradually changing the puncture depth of the electrode needle according to the thickness of the dermis and subcutaneous tissue.

[0005] However, since the conventional hair removal suppression device is not equipped with means for detecting the distribution and depth of the apocrine glands and eccrine glands in the living body (including the dermis and subcutaneous tissue; the same applies hereinafter), as a result, the range and depth of heating by the electrodes cannot be grasped, and there is a risk of overheating the living body or insufficient heating. Therefore, there is a demand for means that can confirm in advance the sites and depths where apocrine glands and eccrine glands are present. In addition, in surgical methods such as excision surgery and ablation surgery, the surgery was performed without grasping the range and depth.

[0006] In addition, in the current diagnosis situation of skin cancer, since there is no diagnosis method, tissue is shaved from the skin surface, and after reaching the cancer tissue, the pathological tissue is diagnosed to determine the treatment as skin cancer. And when skin cancer does not appear at a shallow position, a primitive diagnosis method of further shaving the tissue deeper to determine whether there is skin cancer is adopted. Therefore, there is a demand for the development of means that can visualize and display the state in the depth direction of the lower tissue from the surface of the skin to confirm the position, spread state, depth of penetration, etc. of the cancer.

Prior Art Documents

Patent Documents

[0007]

Patent Document 1

Patent Document 2

Summary of the Invention

Problems to be Solved by the Invention

[0008] On the one hand, as a means for visualizing tissues inside the body, a method and a system for ultrasonic tissue treatment using an ultrasonic probe are known. For example, Patent Document 2 discloses that when performing a facelift by contracting the superficial musculo - aponeurotic system (SMAS) of the face using an ultrasonic imaging / therapy probe, the ultrasonic imaging / therapy probe visualizes and displays the subcutaneous cross - sectional structure including the SMAS, and heats and contracts the SMAS by supplying ultrasonic energy from the ultrasonic imaging / therapy probe to perform a facelift. Further, in paragraphs

[0051] to

[0071] of Patent Document 2, the ultrasonic imaging / therapy probe visualizes and displays the subcutaneous cross - sectional structure including sweat glands such as apocrine glands and eccrine glands, and also discloses treating these tissues by supplying ultrasonic energy from the ultrasonic imaging / therapy probe.

[0009] And Patent Document 2 indicates in paragraph

[0062] that "the imaging transducer can operate at a frequency of about 2 MHz to 75 MHz or higher, and the therapeutic energy is introduced at a frequency of about 500 kHz to 15 MHz, usually 2 MHz to 25 MHz." It also has a description in paragraph

[0064] that "for example, as shown in FIG. 2B, according to a typical embodiment, a typical treatment method and system first image the region 222 in the region of interest 206 and are configured to display that region 224 on the display 208 to facilitate the identification of treatment parts such as, for example, the identification of sweat glands 230 and surrounding structures." Examples of displaying sweat glands on the display part are shown in FIGS. 2P and 2Q.

[0010] Thus, although Patent Document 2 mentions the display of sweat glands by an ultrasonic imaging / therapy probe, it does not disclose what configuration of ultrasonic imaging / therapy probe is used, what frequency is used for imaging sweat glands, and how to operate and display the ultrasonic imaging / therapy probe. Since eccrine glands and apocrine glands are located only a few millimeters deep under the skin, for example, at a depth of 0.5 to 3.5 mm, it has been difficult to obtain a clear cross-sectional echo image of sweat glands with conventional ultrasonic probes. As far as the inventor knows, before the filing of this patent application, there has been no known example of obtaining a cross-sectional echo image of sweat glands as shown in FIGS. 2P and 2Q of Patent Document 2 using an ultrasonic probe.

[0011] The present invention has been made to solve the problems of the prior art as described above. That is, the present invention uses an ultrasonic probe to visualize and display eccrine glands, apocrine glands, which are sweat glands present under the human skin, or malignant tumors of the skin, and to obtain information regarding the position, distribution state, and depth of the detected sweat glands or the position, spread state, and depth of the malignant tumor of the skin. An object of the present invention is to provide an ultrasonic diagnostic apparatus and an apparatus for treating axillary osmidrosis or hyperhidrosis equipped with this ultrasonic diagnostic apparatus. Note that malignant tumors of the skin include skin cancer, malignant melanoma, and the like.

Means for Solving the Problems

[0012] The sweat gland treatment system according to the first aspect of the present invention includes an ultrasonic probe, a cross-sectional echo image generation device that generates a cross-sectional echo image based on a scanning signal from the ultrasonic probe, an analysis device that analyzes the cross-sectional echo image from the cross-sectional echo image generation device to recognize the state under the skin, and a sweating suppression device that uses the information from the analysis device to treat axillary osmidrosis or hyperhidrosis. The ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, and is capable of scanning at least along the long side direction and along the short side direction. The cross-sectional echo image generation device, before treatment, AnestheticAfter injection and based on a scanning signal including scanning along at least the long side direction and the short side direction by the ultrasonic probe on the epidermal surface of the living body after treatment, a cross-sectional echo image is displayed, and the cross-sectional echo image generation device (a) A scanning signal obtained by scanning along the long side direction of the ultrasonic probe on the epidermal surface of the living body before treatment. First, a reference point is determined, and from that reference point, scanning is performed along the long side direction of the ultrasonic probe in the direction from the hand to the armpit From the scanning signal along the long side direction including the scanned signal, a pre-treatment long-side direction cross-sectional echo image is generated to obtain the distribution state of sweat glands under the skin having a display range wider than the short side direction length in the direction along the long side direction before treatment, (b) From the scanning signal obtained by scanning along the short side direction of the ultrasonic probe on the epidermal surface of the living body before treatment A pre-treatment short-side direction cross-sectional echo image for grasping the distribution of sweat glands over the long side direction length range of the living body under the skin before treatment is generated, (c) Anesthetic A scanning signal obtained by scanning along the long side direction of the ultrasonic probe on the epidermal surface of the living body after injection. First, a reference point is determined, and from that reference point, scanning is performed along the long side direction of the ultrasonic probe in the direction from the hand to the armpit From the scanning signal along the long side direction including the scanned signal, a post-injection long-side direction cross-sectional echo image is generated to obtain the distribution state of sweat glands under the skin having a display range wider than the short side direction length in the direction along the long side direction after injection, (d) Anesthetic From the scanning signal obtained by scanning along the short side direction of the ultrasonic probe on the epidermal surface of the living body after injection A post-injection short-side direction cross-sectional echo image for grasping the distribution of sweat glands over the long side direction length range of the living body under the skin after injection is generated, (e) Before treatment and after injecting anesthetic By rotating around the long axis direction at the contact surface of the ultrasonic probe on the epidermal surface of at least one living body to perform rotational scanning, a scanning signal is obtained from which At least one of before treatment and after injecting anesthetic a 3D cross-sectional echo image is generated, (f) In the analyzer, using the pre-treatment long-side direction cross-sectional echo image, the pre-treatment short-side direction cross-sectional echo image, the post-injection long-side direction cross-sectional echo image, the post-injection short-side direction cross-sectional echo image, and the 3D cross-sectional echo image generated by the cross-sectional echo image generation device, Based on the pre-treatment long-side direction cross-sectional echo image, the distribution state of sweat glands under the skin having a display range wider than the short side direction length in the direction along the long side direction before treatment is obtained. Then, based on the pre-treatment short-side direction cross-sectional echo image, the distribution of sweat glands over the long side direction length range of the living body under the skin before treatment is grasped, Based on the post-injection long-side direction cross-sectional echo image, the distribution state of sweat glands under the skin having a display range wider than the short side direction length in the direction along the long side direction after injection is obtained. Then, based on the post-injection short-side direction cross-sectional echo image, the distribution of sweat glands over the long side direction length range of the living body under the skin after injection is grasped, By also using the 3D cross-sectional echo image, By analyzing the distribution of the sweat glands by image recognition, information on the distribution range of the sweat glands is displayed, and the information on the distribution range of the sweat glands is provided to a sweating suppression device for treating axillary osmidrosis or hyperhidrosis, (g) After treatment using the sweating suppression device A scanning signal obtained by scanning along the long side direction of the ultrasonic probe on the epidermal surface of the living body. First, a reference point is determined, and from that reference point, scanning is performed along the long side direction of the ultrasonic probe in the direction from the hand to the armpit From the scanning signal along the long side direction including the scanned signal, a post-treatment long-side direction cross-sectional echo image is generated to obtain the distribution state of sweat glands under the skin having a display range wider than the short side direction length in the direction along the long side direction after treatment, (h) Of the living body after treatment From the scanning signal obtained by scanning along the short side direction of the ultrasonic probe on the epidermal surface A post-treatment short-side direction cross-sectional echo image for grasping the distribution of sweat glands over the long side direction length range of the living body under the skin after treatmentGenerate (i) A post-treatment 3D cross-sectional echo image is generated from a scanning signal obtained by performing rotational scanning by rotating around the major axis direction at the contact surface of the ultrasonic probe on the epidermal surface of at least one living body after treatment. (j) In the analyzer, using the post-treatment long-side direction cross-sectional echo image, the post-treatment short-side direction cross-sectional echo image, and the post-treatment 3D cross-sectional echo image generated by the cross-sectional echo image generation device. Based on the post-treatment long-side direction cross-sectional echo image, the distribution state of the post-treatment sweat glands under the skin having a display range wider than the short-side direction length in the direction along the long-side direction is obtained. Then, based on the post-treatment short-side direction cross-sectional echo image, the distribution of the sweat glands over the long-side direction length range of the post-treatment subcutaneous area is grasped. By also using the post-treatment 3D cross-sectional echo image. By analyzing the distribution of the sweat glands after treatment by image recognition, information on the distribution range of the sweat glands after treatment is displayed. The information on the distribution range of the sweat glands obtained by analyzing in the analyzer includes , at least (1) Information of cross-sectional echo images regarding the distribution state of sweat glands existing in the range of 0.5 to 3.5 mm under the skin, (2) Information of cross-sectional echo images regarding the positions of sweat glands existing in the range of 0.5 to 3.5 mm under the skin, and (3) Information of cross-sectional echo images regarding the depths of sweat glands existing in the range of 0.5 to 3.5 mm under the skin is included. The ultrasonic probe is a linear probe type with 128 or more elements and a driving frequency of 20 MHz or more and less than 40 MHz a characterized by this.

[0013] According to the first aspect of the present invention sweat gland treatment system , the ultrasonic probe has a contact surface and can perform multi-directional scanning, and the cross-sectional echo image is displayed based on the scanning signal by the multi-directional operation of the ultrasonic probe on the epidermal surface of the living body by the cross-sectional echo image generation device. Therefore, a cross-sectional echo image with a good display of the state below the epidermis of the living body can be obtained. In addition, since the cross-sectional echo image has a good display of the state below the epidermis of the living body, the analysis device can accurately recognize the state below the epidermis of the living body and accurately recognize the range that requires treatment.

[0015] Also, according to such an aspect sweat gland treatment system , information regarding the distribution state, position, and depth of apocrine glands and eccrine glands can be easily confirmed, so it becomes easier to treat axillary bromhidrosis and hyperhidrosis.

[0017] The higher the driving frequency of the ultrasonic probe, the higher the resolution can be, and it becomes possible to obtain an image of a location close to the skin surface. Also, when using a linear probe, since the ultrasonic waves do not spread, it becomes possible to obtain a cross-sectional echo image with good image quality in a narrow range. Incidentally, the driving frequency of a more preferable ultrasonic probe is 30 MHz or higher. In particular, when the driving frequency of the ultrasonic probe is 30 MHz or higher, a cross-sectional echo image with clear image quality can be obtained, so that even in the case of a moving image, the position, depth, and distribution state of sweat glands or the position, spread state, depth, and infiltration degree of a malignant tumor of the skin can be clearly recognized. Also, in order to enhance the resolution, the number of elements of a linear probe type ultrasonic probe is preferably 128 elements or more, more preferably 192 elements or more, and even more preferably 256 elements or more. Specifically, for example, those with about 200 elements or those with 400 to 600 elements or more can also be used. The more the number of elements (the higher the element density), the more the resolution improves. Since substantially most sweat glands exist in a shallow range of 0.5 mm to 3.5 mm under the skin, by setting the driving frequency to 20 MHz or more and less than 40 MHz, a cross-sectional echo image near the skin surface can be obtained with high sensitivity. Also, since the cross-sectional echo image includes at least before treatment using the sweating suppression device and after treatment using the sweating suppression device, for example, each of the pre-treatment ultrasonic echo image, the ultrasonic echo image after injection of the anesthetic solution, and the post-treatment ultrasonic echo image can be displayed alone, or any two or three ultrasonic echo images can be appropriately selected and displayed, so that the treatment effect can be accurately judged. Furthermore, according to the sweat gland treatment system of such an aspect, since the distribution state, position, and depth of the sweat glands are accurately obtained by the ultrasonic image diagnostic device, the protruding position, protruding length, and energization timing of the electrode needles in the sweating suppression device can be accurately controlled, and the treatment effect of axillary osmidrosis or hyperhidrosis is improved. By combining the diagnosis by the aforementioned ultrasonic image diagnostic device, particularly with the diagnosis using the aforementioned AI means, the distribution range of the sweat glands that require treatment can be automatically set, and the setting and control of the treatment device can be accurately performed. 。

[0018] Also, in such an aspect sweat gland treatment system the ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, and is capable of at least scanning in the long side direction and the short side direction. The analyzer determines a measurement range by scanning in a direction along the long side direction of the ultrasonic probe, and can grasp the state below the epidermis of a living body by scanning in a direction along the short side direction of the ultrasonic probe within the determined measurement range.

[0019] In such an aspect sweat gland treatment system according to this, since the ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, it is possible to clearly judge the state below the epidermis of a living body by scanning in a direction along the long side direction of the ultrasonic probe, and grasp the range that requires treatment. Furthermore, by obtaining a good cross-sectional echo image over a wide range by scanning in a direction along the short side direction, it will become possible to diagnose the distribution and state of sweat glands and malignant tumors of the skin.

[0020] Also, in such an aspect sweat gland treatment system In this case, it is preferable that the cross-sectional echo image generation device obtains a 3D ultrasonic echo image at a position where the state below the epidermis of the living body is obtained.

[0021] According to such an aspect sweat gland treatment system since the state below the epidermis of the living body is accurately determined, for example, useless data such as 3D ultrasonic echo images at positions where sweat glands do not exist is reduced, and the processing burden on the cross-sectional echo image generation device and the analysis device is reduced.

[0024] Also, in such an aspect sweat gland treatment system it is preferable that the analysis device includes AI (artificial intelligence) means.

[0025] AI means is a field with rapid technological progress. By training using a large number of ultrasonic echo images, information regarding the state below the epidermis of the living body can be accurately and automatically obtained. By using AI means, for example, the distribution and state of sweat glands, skin, the distribution, position, and range of malignant tumors of the skin, etc. can be diagnosed.

[0028] According to such an aspect Sweat gland treatment system it is preferable that the sweating suppression device has electrode needles with adjustable protruding lengths, and the control unit controls the protruding lengths of the electrode needles in multiple stages and controls the energization of the electrode needles at each stage.

[0029] According to such an aspect Sweat gland treatment system it becomes possible to substantially completely destroy the sweat glands and improve the treatment effect of axillary osmidrosis or hyperhidrosis. Note that the protruding length of the electrode needle from the cooling part, for example, since many apocrine glands and eccrine glands exist in the range of 0.5 to 3.5 mm below the skin, after inserting to the shallowest position where the presence of sweat glands is confirmed and then energizing, further insert 0.5 mm and energize, and repeat operations such as further inserting 0.5 mm and energizing. Also, the reverse operation may be performed after inserting to the deepest position where the presence of sweat glands is first confirmed.

[0030] In the related aspect Sweat gland treatment system In this case, the sweating suppression device includes the electrode needle and a cooling unit in which a through-hole through which the electrode needle can be inserted is formed. The cooling unit is brought into close contact with the skin surface of the living body, and the electrode needle is protruded from the cooling unit and energized to generate heat at the tip side of the electrode needle, thereby treating the sweat glands on the tip side of the electrode needle. The control unit preferably can control at least one of the position of the electrode needle on the surface of the living body epidermis of the sweating suppression device, the protruding depth from the cooling unit, the timing of energization to the electrode needle, the period of energization to the electrode needle, or the strength of energization to the electrode.

Effect of the Invention

[0031] As described above, according to the ultrasonic diagnostic apparatus of the present invention, a cross-sectional echo image in which the subcutaneous state is favorably displayed can be obtained by the cross-sectional echo image generation device, and moreover, the subcutaneous state can be accurately recognized by the analysis device, and information regarding the distribution state, position, and depth of the sweat glands or the position, spread state, and depth of the malignant tumor of the skin can be obtained. Therefore, the range that requires treatment for axillary osmidrosis or hyperhidrosis or a malignant tumor of the skin can be accurately recognized. Further, according to the axillary osmidrosis or hyperhidrosis treatment device of the present invention, since the distribution state, position, and depth of the sweat glands are accurately obtained by the ultrasonic diagnostic apparatus, the protruding position, protruding length, and energization timing of the electrode needle in the sweating suppression device can be accurately controlled, and the treatment effect of axillary osmidrosis or hyperhidrosis is improved.

Brief Description of the Drawings

[0032]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Figure 11

Figure 12

Figure 13

Figure 14

Figure 15

Figure 16

Mode for Carrying Out the Invention

[0033] Hereinafter, an ultrasonic diagnostic apparatus and an apparatus for treating axillary osmidrosis or hyperhidrosis according to embodiments of the present invention will be described with reference to the drawings. However, each of the embodiments described below is an example of an ultrasonic diagnostic apparatus and an apparatus for treating axillary osmidrosis or hyperhidrosis for embodying the technical idea of the present invention, and is not intended to specify the present invention to these. The present invention can be equally applied to other embodiments included in the claims.

[0034] [Ultrasonic diagnostic apparatus] First, the outline of the ultrasonic diagnostic apparatus 10 used in the present invention will be described with reference to FIG. 1. The ultrasonic diagnostic apparatus 10 itself is already well-known. As shown in FIG. 1, it includes an ultrasonic probe (transducer) 11, an input / output (I / O) unit 12, an echo image generation unit 13, an analysis unit 14, and a display unit 15. Among these, the I / O 12, the echo image generation unit 13, and the analysis unit 14 form a signal processing unit 16. As the display unit 15, a general liquid crystal display device or an organic EL display device can be used.

[0035] The I / O unit 12 supplies an ultrasonic drive signal of a predetermined frequency to the ultrasonic probe 11, receives the echo signal received by the ultrasonic probe 11, and supplies it to the echo image generation unit 13. In the echo image generation unit 13, a signal corresponding to a cross-sectional echo image is generated based on the echo signal, and the cross-sectional echo image is displayed on the display unit 15 based on the signal corresponding to this cross-sectional echo image. Further, the signal corresponding to the cross-sectional echo image generated by the echo image generation unit 13 is also supplied to the analysis unit 14. In the analysis unit 14, for example, using AI or the like, sweat glands are recognized, signals regarding the distribution state of the sweat glands, the position and depth of the sweat glands are generated, these signals are stored, and are supplied to the echo image generation unit 13 and are appropriately displayed on the display unit 15. Note that the echo image generation unit 13 corresponds to the cross-sectional echo image generation device in the present invention, and the analysis unit 14 corresponds to the analysis device in the present invention.

[0036] The ultrasonic probe 11 is a commercially available one, and here a so-called hockey stick type ultrahigh frequency linear probe is used. On the contact surface 11a on the tip side of the ultrasonic probe 11, although individual illustrations are omitted, it is a linear probe in which a large number of, for example, 126 or more ultrasonic elements are arranged in a row. Since the ultrasonic waves are incident perpendicularly to the skin unless an ultrasonic lens is used, the ultrasonic waves do not spread, and a cross-sectional echo image in a narrow range can be obtained with good image quality.

[0037] Also, when the frequency of the ultrasonic waves is increased, the ultrasonic waves are absorbed near the skin. However, since substantially most of the sweat glands exist in a shallow range of 0.5 mm to 3.5 mm below the skin, a cross-sectional echo image near the skin surface can be obtained with high sensitivity. Furthermore, when the number of ultrasonic elements is increased, the resolution is increased, and a high-definition cross-sectional echo image can be obtained.

[0038] As shown in FIG. 2, the dimensions of the contact surface 11a portion of the ultrasonic probe 11 used in the ultrasonic diagnostic apparatus 10 of the embodiment are such that the width is 3 to 5 mm and the length is about 3 cm. In this length direction, 126 or more, and in some cases 256 or more, individual ultrasonic elements are arranged in a row. Specifically, the number of ultrasonic elements can be, for example, about 200, or for example, 400 to 600 or more. Note that the direction corresponding to the length direction of the contact surface 11a in FIG. 2 is the long axis direction, and the direction corresponding to the width direction is the short axis direction.

[0039] The ultrasonic probe 11 has a substantially rectangular contact surface 11a having a long side and a short side. As the scanning direction of the ultrasonic probe, the scanning direction along the long side direction and the direction along the short side direction are selectively used, so that the distribution state of sweat glands can be accurately and efficiently determined. When determining the treatment range, first, scanning is performed along the long side direction to grasp the distribution range of sweat glands. That is, in the scanning along the long side direction, although the width that can be scanned (the length of the short side) is narrow, the display range (the length of the long side) along the scanning direction is wide, so that sweat glands can be clearly discriminated. When the distribution range of sweat glands is known, next, by scanning along the short side direction, the distribution of a wide range of sweat glands can be efficiently grasped by scanning in a state where the width that can be scanned (the length of the long side) is wide. Moreover, since the cross-sectional echo image obtained in this way is of higher resolution and higher quality than the conventional one, the analysis unit 14 can more accurately recognize sweat glands and obtain information regarding the distribution state of sweat glands, the position and depth of sweat glands.

[0040] Further, according to the ultrasonic diagnostic apparatus 10 of the embodiment, since the position and depth of sweat glands are accurately determined by the analysis unit 14, by rotating and performing rotational scanning about the long axis direction on the contact surface of the ultrasonic probe 11 at this position, or by performing scanning along the short side direction of the ultrasonic probe 11, a 3D ultrasonic echo image can be obtained. Moreover, since the distribution range of sweat glands is grasped by the above-described scanning direction along the long side direction and the direction along the short side direction, that is, since the positions where sweat glands do not exist are known in advance, acquisition of unnecessary 3D data is reduced, and the processing burdens on the cross-sectional echo image generation unit 13 and the analysis unit 14 are reduced.

[0041] In addition, when treating axillary osmidrosis or hyperhidrosis, since an anesthetic is injected before treatment, it is preferable that as the image to be displayed on the display unit 15, three types of images before treatment (before injection of an anesthetic), after injection of an anesthetic, and after treatment can be appropriately selected and displayed. Thereby, the treatment effect can be more accurately recognized. The image after injection of an anesthetic tends to make it easier to grasp the position of sweat glands by the ultrasonic probe 11 than the image before injection of an anesthetic.

[0042] [Sweating suppression device] Next, with reference to FIG. 3, a sweating suppression device 20 used in combination with the ultrasonic diagnostic apparatus 10 of the embodiment will be described. Note that a combination of the ultrasonic diagnostic apparatus 10 and the sweating suppression device 20 corresponds to the auxiliary or hyperhidrosis treatment device 50 of the present invention. However, as the sweating suppression device 20, not only the one shown in FIG. 3 but also those having other well-known configurations can be used.

[0043] This sweating suppression device 20 mainly includes an electrode needle 21, a cooling member 22, a support 23, and a driving device 24. The electrode needle 21 is made of a metal material having conductivity such as stainless steel, and is formed to be tapered so that the tip portion 21a can be punctured. A portion of the electrode needle 21 other than the tip portion 21a is covered with an insulating film 21b made of an electrically insulating material. A plurality of electrode needles 21 are arranged in a matrix and fixed to a rectangular plate-shaped holder 25.

[0044] Preferably, about 20 to 30 needles (or more) of the electrode needles 21 are arranged, and the interval between adjacent electrode needles 21 is preferably set to about 0.5 to 3 mm (more preferably 1 to 3 mm). The thickness of each electrode needle 21 is preferably about 0.1 to 0.3 mm. The arrangement shape of the plurality of electrode needles 21 may be various shapes such as an annular shape or a polygonal shape in addition to the matrix shape. The holder 25 is made of a plastic material or the like, and a concave portion 25a is formed in the center. An elastically deformable engaging protrusion 25b is provided on the inner peripheral surface of the concave portion 25a. The tip portion 21a of the electrode needle 21 is formed as a blunt needle that penetrates the skin and subcutaneous tissue but does not penetrate the membrane tissue portion between the subcutaneous tissue and the muscle layer, whereby only the depth region where sweat glands may exist can be safely punctured.

[0045] The cooling member 22 includes a Peltier element 26, a cooling plate 27, and a heat dissipation block 28. The Peltier element 26 has a known configuration in which a p-type semiconductor and an n-type semiconductor are thermally arranged in parallel. The cooling plate 27 is provided on the heat absorption side of the Peltier element 26, and the heat dissipation block 28 is provided on the heat generation side of the Peltier element 26. A plurality of Peltier elements 26 of appropriate sizes are arranged in a matrix. The cooling plate 27 and the heat dissipation block 28 have a plurality of openings 27a and 28a formed in the gaps between the plurality of Peltier elements 26, and a plurality of through holes 29 penetrating the front and back surfaces of the cooling member 22 are formed by the openings 27a and 28a facing each other. The cooling plate 27 has a planar cooling portion 27b on the surface side, and the cooling portion 27b can be brought into close contact with the epidermis of the human body or the like.

[0046] On the surface of the cooling portion 27b avoiding the opening 27a at approximately the center, a contact detection sensor 30 for detecting the contact state between the punctured portion such as the epidermis of the human body and the cooling portion 27b is provided. The contact detection sensor 30 is composed of a pressure sensor with a thin thickness (for example, about 0.1 mm), and outputs a contact signal or a non-contact signal with the punctured portion.

[0047] The support 23 includes a rectangular housing portion 31 that is open at the bottom in a plan view shown in FIG. 3A, and a cylindrical portion 32 connected to communicate with the center of the top plate of the housing portion 31. The electrode needle 21 is held inside the housing portion 31. The housing portion 31 has guide grooves 31a formed in the vicinity of the openings of a pair of opposing side walls. The cooling member 22 is supported by the support 23 so that the heat dissipation block 28 can slide along the guide grooves 31a. At the closing position covering the opening of the housing portion 31, the tip portion 21a of each electrode needle 21 faces the through hole 29, and the electrode needle 21 can be inserted into the through hole 29. A terminal portion (not shown) is provided in the guide groove 31a, and when the cooling member 22 is in the above-described closing position, the Peltier element 26 can be energized.

[0048] The drive device 24 includes a drive motor 33 composed of a servo motor or the like, an encoder 34 for detecting the rotational speed of the drive motor 33, and a rod 36 that moves forward and backward by the rotation of the drive motor 33. A shaft 35 is connected to the rotation shaft 33a of the drive motor 33, and a threaded portion 35a is formed on the outer peripheral surface of the shaft 35. The rod 36 is formed in a hollow cylindrical shape and is slidably accommodated in the cylindrical portion 32 of the support 23. A nut 36a that engages with the threaded portion 35a of the shaft 35 is fixed to the inner peripheral surface of the rod 36. On the other hand, a protrusion 36b is provided on the outer peripheral surface of the rod 36, and the rod 36 is made non-rotatable by the engagement of the protrusion 36b with a groove portion 32a formed on the inner peripheral surface of the cylindrical portion 32. With the above configuration of the drive device 24, the rod 36 can be advanced downward in FIG. 3B by the rotation of the drive motor 33, and the advancement amount of the rod 36 can be controlled based on the detection of the encoder 34.

[0049] An engagement recess 36c is formed on the outer peripheral surface of the tip side (the lower end side in FIG. 3A) of the rod 36. By fitting the rod 36 into the recess 25a of the holder 25 and engaging the engagement recess 36c with the engagement protrusion 25b, the holder 25 can be detachably fixed to the rod 36. In this way, the holder 25 can be pressed by the drive device 24, and by the forward and backward movement of the rod 36, the tip portion 21a of the electrode needle 21 can be made to protrude from and retract into the cooling portion 27b as shown by the dashed line in FIG. 3A. The protruding amount of the electrode needle 21 from the lowermost surface of the cooling portion 27b can be set to about 0.1 to 10 mm, for example.

[0050] Also, a terminal (not shown) for supplying power to each electrode needle 21 when the holder 25 is attached is provided at the tip of the rod 36, and each electrode needle 21 is electrically connected to a high-frequency oscillator (not shown) installed outside. The electrode needle 21 can apply a high-frequency current between the electrode needle 21 in a state of being punctured into the human body and a surface electrode (not shown) separately arranged on the human body surface, and thereby heat the biological tissue near the electrode needle 21. When a plurality of electrode needles 21 are provided, it can also be configured such that a high-frequency current is applied between two adjacent electrode needles 21.

[0051] The energization of the electrode needles 21, the cooling member 22, and the drive device 24 can be manually performed by a switch operation of an operation unit 40 provided on the cylindrical portion 32 of the support 23. The sweating suppression device 20 of the present embodiment can be connected to a control device 45 that can be installed outside, such as a personal computer. A detection signal of the contact state (contact or non-contact) by the contact detection sensor 30 is input to the control device 45, and the energization of the electrode needles 21, the cooling member 22, and the drive device 24 can also be controlled by the control device 45.

[0052] In addition, the ultrasonic diagnostic apparatus 10 has an output unit (not shown) that outputs ultrasonic echo images and analysis results, and the information from the output unit is input to the control device 45. Since information such as the diagnostic result information from the ultrasonic diagnostic apparatus 10 is input to the control device 45, by using this information, the control device 45 can appropriately grasp the treatment range (range such as the distribution and depth of sweat glands) and then control the sweating suppression device 20. The control device 45 can control the position of the electrode needles on the surface of the living body epidermis of the sweating suppression device, the protruding depth from the cooling unit, the timing of energization to the electrode needles, the period of energization to the electrode needles, and the strength of energization to the electrodes, etc., based on this information. It is also possible to include in the diagnostic result information from the ultrasonic diagnostic apparatus 10 the control parameters used by the control device 45. As control parameters, in addition to information such as the distribution of sweat glands, the position of sweat glands, the depth range of sweat glands, and the density of sweat glands, information necessary for treatment according to each site, for example, the timing of energization to the electrode needles, the period of energization to the electrode needles, and the strength of energization to the electrodes, etc., corresponding to the position of the electrode needles on the surface of the living body epidermis of the sweating suppression device and the protruding depth from the cooling unit, can be included. In particular, when the ultrasonic diagnostic apparatus 10 is equipped with AI means, more detailed information necessary for treatment can be obtained. Also, since the control device 45 stores information on the patient's past treatment history, it is possible to control the sweating suppression device 20 in consideration of the past treatment history. Furthermore, all or part of the signal processing unit 16 of the ultrasonic diagnostic apparatus 10 and all or part of the control device 45 can be shared and realized as control means such as a single personal computer. It is also possible to use AI for the calculations in the control device 45. In this case, it becomes possible to determine the control parameters of the sweating suppression device 20 for the treatment range and treatment site in this treatment by using a large amount of treatment history information and a large amount of information from the ultrasonic diagnostic apparatus 10.

[0053] Furthermore, by obtaining information regarding the distribution state, position, and depth of sweat glands obtained by the analysis unit 14 of the ultrasonic diagnostic apparatus 10 (see FIG. 1) described above, the protruding amount of the electrode needles 21 can be displayed on the display unit of the control device 45, and at the same time, the protruding amount and energization of the electrode needles 21 can be automatically controlled. Note that the control device 45 can also be incorporated in the operation unit 40, and this control device 45 corresponds to the control unit in the auxiliary sweating or hyperhidrosis treatment device of the present invention. To display information regarding the distribution state, position, and depth of sweat glands obtained by the analysis unit 14 of the ultrasonic diagnostic apparatus 10 on the display unit of the control device 45, the ultrasonic diagnostic apparatus 10 and the control device 45 can use wired connections such as LAN, IEEE1394 serial bus, USB, etc., infrared communication, Bluetooth (registered trademark), IEEE802.11 wireless, etc., or it can also be done manually.

[0054] Next, a method of using the sweating suppression device 20 having the above configuration will be described. First, the holder 25 having the electrode needles 21 is attached to the rod 36 of the drive device 24. With the cooling member 22 retracted from the support 23 and the opening of the housing portion 31 open, the holder 25 can be fixed to the rod 36 by engaging the engaging projection 25b with the engaging recess 36c. Next, the cooling portion 27b of the cooling member 22 is brought into close contact with the epidermal surface of the puncture site including the sweat glands. When the distribution state of the sweat glands is confirmed by the ultrasonic diagnostic apparatus 10, it is preferable to mark the skin surface so that the puncture site by the sweating suppression device 20 can be identified, as this can suppress heating up to a range where there are no sweat glands that require treatment.

[0055] When the cooling portion 27b is in close contact with the epidermal surface, a contact signal is input from the contact detection sensor 30 to the control device 45. In this state, by operating the operation unit 40, the control device 45 rotates the drive motor 33 of the drive device 24. Since the rod 36 has the protrusion 36b engaged with the groove portion 34a and is in a non-rotatable state, and the nut 36a is screwed onto the shaft 35, the rod 36 advances according to the rotation amount of the drive motor 33, and each electrode needle 21 gradually protrudes from the cooling portion 27b.

[0056] Generally, most of the apocrine glands and eccrine glands are substantially present in the range of 0.5 mm to 3.5 mm under the skin. When the existence range of the sweat glands is determined by the ultrasonic diagnostic apparatus 10 and it is found that the sweat glands exist, for example, in the range of 1.5 mm to 3.0 mm, first set the protruding depth L of the electrode needle 21 to 1.5 mm and energize it, then increase the protruding amount by another 0.5 mm and energize it, and then increase the protruding amount by another 0.5 mm and energize it, and repeat this operation until the protruding amount of the electrode core 21 reaches 3.0 mm, and finally just pull out the needle. Conversely, the electrode needle 21 may be driven from the deeper side to the shallower side.

[0057] Thereby, uniform heating can be performed along the depth direction of the punctured site, and all the sweat glands existing in this area can be efficiently and surely destroyed. The thermal energy supplied from the electrode needle 21 may be changed according to the depth interval, and the larger the depth interval is, the larger the thermal energy may be supplied. The supply of thermal energy can be performed using various types such as high frequency, radio wave, and microwave.

[0058] Since the surface of the epidermis is cooled by the close contact of the cooling part 27b around the puncture site, burns can be prevented and analgesia during puncture and thermal energy supply can be improved. If a local anesthetic is injected subcutaneously in advance to make the cooling part 27b in close contact, not only can an analgesic effect be obtained, but also, as will be described later, in the echo image of the sweat glands by the ultrasonic probe 11 of the ultrasonic diagnostic apparatus 10, the sweat glands can be recognized well.

[0059] [Electron micrograph image of subcutaneous tissue] First, to explain the structure of the skin tissue, an electron micrograph image of a skin tissue sample obtained by collecting and staining the skin tissue is shown in FIG. 4. The subcutaneous tissue has a dermis layer about 0.5 mm thick below the epidermis, and apocrine glands and eccrine glands are present below it. The depth at which these apocrine glands and eccrine glands are present is about 0.5 mm to 3.5 mm. Note that the lower part of the apocrine glands and eccrine glands is the fat layer. It is known that the thickness of the epidermis varies significantly depending on the site, being thin on the ears and sides, and thick on the palms and soles.

[0060] [Observation Example] In the following, in order to confirm the effect of the axilla or hyperhidrosis treatment device 50 of the present invention, using the above ultrasonic diagnostic apparatus 10, at each site of 10 patients, (1) Before treatment, (2) After injecting an anesthetic subcutaneously, and, (3) After treatment using the above sweating suppression device 20, ultrasonic cross-sectional echo images were obtained at three time points, and 3D ultrasonic echo images in any of the states (1) to (3) above were also obtained as appropriate. The results are shown in FIGS. 5 to 14.

[0061] However, the positions where each ultrasonic cross-sectional echo image and 3D ultrasonic echo image were taken were such that after the measurement before treatment was completed once with the ultrasonic probe, the ultrasonic probe was removed, and after injecting the anesthetic, the ultrasonic probe was brought into contact with a position that seemed to be the same again for measurement. Therefore, a slight deviation occurs. Therefore, microscopically, the images do not necessarily show the same measurement location. This is also the case after injecting the anesthetic and after treatment.

[0062] The scanning range by the ultrasonic probe 11 was first determined by a reference point, and from that reference point, for example, in the direction from the hand to the armpit, scanning was performed along the long side direction of the ultrasonic probe 11 for about 50 mm, and then scanning was performed along the long side direction of the ultrasonic probe 11 in the peripheral direction for about 30 mm to obtain the distribution state of the sweat glands. Thereafter, at the position where the presence of sweat glands was confirmed, cross-sectional echo images of the sweat glands were obtained by scanning in two perpendicular directions along the short side direction of the ultrasonic probe 11.

[0063] In addition, for the treatment by the sweating suppression device 20, based on the depth range of the presence of sweat glands previously determined by the ultrasonic diagnostic apparatus 10, the protruding depth L of the electrode needle 21 was first energized with the shallowest presence depth, then the protruding amount was increased by 0.5 mm and energized, then the protruding amount was further increased by 0.5 mm and energized, and this operation was repeated until the protruding amount of the electrode needle 21 reached the deepest presence depth.

[0064] In Observation Examples 1 to 7, Aplio i-800 (trade name) manufactured by Canon Medical Systems was used as the ultrasonic diagnostic apparatus, and the same high-frequency linear probe PLI-20020BT (trade name) was used as the ultrasonic probe. Also, the ultrasonic probe had about 200 elements of ultrasonic elements, and ultrasonic waves of 22 MHz were used for measurement. And the distribution state of the sweat glands was obtained by scanning in the direction along the long side direction of the ultrasonic probe, and further, cross-sectional echo images of the sweat glands were obtained by scanning in the direction along the short side direction, whereby the treatment range of the sweat glands was specified. The three-dimensional ultrasonic echo image was obtained by rotating around the long axis direction on the contact surface of the ultrasonic probe, or by scanning along the short axis direction. Also, in the three-dimensional ultrasonic echo image, the ultrasonic cross-sectional echo image noted on the left side is for confirming that the blood vessels are not damaged. As the sweating suppression device, Viewhot III (trade name) of the induction heating method using an electrode needle was used. Also, in Observation Examples 8 to 10, as the ultrasonic probe, those using ultrasonic waves of 33 MHz with about 400 to 600 elements of ultrasonic elements were used for measurement.

[0065] In each of the drawings of the following observation examples, the areas marked with circles, ellipses, rectangles, etc. are the areas where sweat glands are present. In the present embodiment, the analysis unit 14 of the ultrasonic diagnostic apparatus 10 analyzes the distributions of these sweat glands, and the distribution of sweat glands, the position of sweat glands, the depth range of sweat glands, the density of sweat glands, etc. are grasped.

[0066] [Observation Example 1] FIG. 5 is an observation example of the armpit of a 12-year-old female. FIGS. 5A, 5B, 5C, and 5D are ultrasonic cross-sectional echo images before treatment, after injecting an anesthetic subcutaneously, after treatment, and after treatment at another position, respectively. FIGS. 5E, 5F, and 5G are 3D ultrasonic echo images before treatment, after injecting an anesthetic subcutaneously, and after treatment, respectively.

[0067] According to the ultrasonic cross-sectional echo images shown in FIGS. 5A to 5D, apocrine sweat glands and eccrine glands (hereinafter sometimes simply referred to as "sweat glands") could be well confirmed both before treatment (FIG. 5A) and after injecting the anesthetic solution (FIG. 5B). However, it was confirmed that the sweat glands had substantially disappeared after treatment (FIGS. 5C and 5D). This can also be confirmed from FIGS. 5E to 5G of the 3D ultrasonic echo images. Further, according to the ultrasonic echo images shown on the left side of each of FIGS. 5E to 5G, particularly in FIG. 5G, since there is no area where blood has leaked, it was confirmed that the blood vessels were not damaged during treatment.

[0068] [Observation Example 2] FIG. 6 is an observation example of the armpit of a 19-year-old female. FIGS. 6A, 6B, and 6C are ultrasonic cross-sectional echo images before treatment, after injecting an anesthetic subcutaneously, and after treatment, respectively. FIGS. 6D, 6E, and 6F are 3D ultrasonic echo images before treatment, before treatment viewed from a direction different from FIG. 6D, and after treatment, respectively.

[0069] According to the ultrasonic cross-sectional echo images shown in FIGS. 6A to 6C, sweat glands could be well confirmed both before treatment (FIG. 6A) and after injecting the anesthetic solution (FIG. 6B). However, it was confirmed that the sweat glands had substantially disappeared after treatment (FIG. 6C). This can also be confirmed from FIGS. 6D to 6F of the 3D ultrasonic echo images.

[0070] [Observation Example 3] Figure 7 shows an observation example of the armpit of a 55-year-old woman. Figure 7A is the ultrasonic cross-sectional echo image before treatment, Figure 7B is the ultrasonic cross-sectional echo image after injecting anesthetic under the skin, Figure 7C is the ultrasonic cross-sectional echo image after treatment, Figure 7D is the 3D ultrasonic echo image before treatment, and Figure 7E is the 3D ultrasonic echo image after treatment, respectively.

[0071] According to the ultrasonic cross-sectional echo images shown in Figures 7A - 7C, the sweat glands could be well confirmed before treatment (Figure 7A). After injecting the anesthetic solution (Figure 7B), although the outline of the sweat glands was not clear, they could still be confirmed. After treatment (Figure 7C), it was confirmed that the sweat glands had substantially disappeared. This can also be confirmed from the 3D ultrasonic echo images of Figures 7D and 7E. Also, according to the ultrasonic echo images shown on the left side of Figures 7D and 7E respectively, especially in Figure 7E, there was no area where blood leaked, so it was confirmed that the blood vessels were not damaged during the treatment.

[0072] [Observation Example 4] Figure 8 shows an observation example of the outer side of the right thigh of a 53-year-old man. Figure 8A is the ultrasonic cross-sectional echo image before treatment, Figure 8B is the ultrasonic cross-sectional echo image after injecting anesthetic under the skin, Figure 8C is the ultrasonic cross-sectional echo image after treatment, Figure 8D is the 3D ultrasonic echo image before treatment, and Figure 8E is the 3D ultrasonic echo image after treatment, respectively.

[0073] According to the ultrasonic cross-sectional echo images shown in Figures 8A - 8C, the sweat glands could be well confirmed before treatment (Figure 8A). After injecting the anesthetic solution (Figure 8B), although the outline of the sweat glands was not clear, they could still be confirmed. After treatment (Figure 8C), it was confirmed that the sweat glands had substantially disappeared. This can also be confirmed from the 3D ultrasonic echo images of Figures 8D and 8E.

[0074] [Observation Example 5] Figure 9 shows an observation example of the back of an 18-year-old man. Figure 9A is the ultrasonic cross-sectional echo image before treatment, Figure 9B is the ultrasonic cross-sectional echo image after injecting anesthetic under the skin, Figure 9C is the ultrasonic cross-sectional echo image after treatment, Figure 9D is the 3D ultrasonic echo image before treatment, and Figure 9E is the 3D ultrasonic echo image after treatment, respectively.

[0075] According to the ultrasonic cross-sectional echo images shown in FIGS. 9A to 9C, before treatment (FIG. 9A), the sweat glands could be clearly confirmed. After the injection of the anesthetic solution (FIG. 9B), although the outline of the sweat glands was not clear, they could still be confirmed to some extent. After treatment (FIG. 9C), it was confirmed that the sweat glands had substantially disappeared. This can also be confirmed from FIGS. 9D and 9E of the 3D ultrasonic echo images.

[0076] [Observation Example 6] FIG. 10 shows an observation example of the armpit of a 55-year-old woman. FIG. 10A is a 3D ultrasonic echo image before treatment, and FIG. 10B is a 3D ultrasonic echo image after treatment.

[0077] According to the 3D ultrasonic echo images shown in FIGS. 10A and 10B, before treatment (FIG. 10A), the sweat glands could be clearly confirmed. After treatment (FIG. 10B), it was confirmed that the sweat glands had substantially disappeared. This can also be confirmed from FIGS. 9D and 9E of the 3D ultrasonic echo images. Also, according to the ultrasonic echo images shown on the left side of FIGS. 10A and 10B respectively, since there is no area where blood has leaked, especially in FIG. 10B, it was confirmed that the blood vessels were not damaged during the treatment.

[0078] [Observation Example 7] FIG. 11 shows an observation example of the armpit of a 38-year-old woman. FIG. 11A is a 3D ultrasonic echo image before treatment, and FIG. 11B is a 3D ultrasonic echo image after treatment.

[0079] According to the 3D ultrasonic echo images shown in FIGS. 11A and 11B, before treatment (FIG. 11A), the sweat glands could be clearly confirmed. After treatment (FIG. 11B), it was confirmed that the sweat glands had substantially disappeared.

[0080] [Observation Example 8] FIG. 12 shows an observation example of the armpit of a 13-year-old female who complained of recurrence after surgery using the sweating suppression device of the embodiment. FIGS. 12A and 12B are the ultrasonic cross-sectional echo image and the 3D ultrasonic cross-sectional echo image of the non-recurrent site respectively, and FIGS. 12C and 12D are the ultrasonic cross-sectional echo image and the 3D ultrasonic cross-sectional echo image of the recurrent site respectively.

[0081] In the ultrasonic cross-sectional echo image shown in FIG. 12A and the 3D ultrasonic cross-sectional echo image shown in FIG. 12B, no recurrence image was observed. However, in the ultrasonic cross-sectional echo image shown in FIG. 12C and the 3D ultrasonic cross-sectional echo image shown in FIG. 12D, a sweat gland image was observed at the site indicated by the frame and was determined to be a recurrence.

[0082] [Observation Example 9] FIG. 13 shows a preoperative observation example of eccrine glands in a 14-year-old female with palmar hyperhidrosis. FIG. 13A is an ultrasonic cross-sectional echo image, and FIG. 13B is also a 3D ultrasonic cross-sectional echo image.

[0083] According to FIGS. 13A and 13B, it was confirmed that when using the ultrasonic probe of the embodiment, the sweat glands in a location with a thick epidermal layer such as the palm can also be clearly observed.

[0084] [Observation Example 10] FIG. 14 shows an observation example of apocrine glands using a 33 MHz drive probe on the side of a 14-year-old female. FIG. 14A is before treatment, FIGS. 14B and 14C are after local anesthesia, respectively, ultrasonic cross-sectional echo images, FIG. 14D is a 3D ultrasonic cross-sectional echo image before treatment, FIG. 14E is an ultrasonic cross-sectional echo image after treatment, and FIG. 14F is a 3D ultrasonic cross-sectional echo image after treatment.

[0085] According to FIGS. 14A to 14F, when the ultrasonic probe used in the embodiment is driven at a high frequency of 33 MHz, as is clear when compared with FIGS. 5A to 5G which is the case of driving at 22 MHz, it can be seen that clearer images can be obtained both before and after treatment. In particular, when comparing FIGS. 14A to 14D with FIGS. 14E and 14F, the apocrine gland image and its disappearance state can be better understood.

[0086] Prior to the operation, the ultrasonic cross-sectional echo images obtained from the video using the 33 MHz drive probe on the side of the 14-year-old female are shown in FIG. 15, and the ultrasonic cross-sectional echo images obtained from the video after local anesthesia are shown in FIG. 16. FIGS. 15 and 16 show the images obtained when the ultrasonic probe is scanned from positions where the apocrine glands are not present. Even from the videos, it becomes possible to clearly recognize the apocrine glands, which are the treatment sites on the side.

[0087] In the ultrasonic diagnostic apparatus according to the above-described embodiment, not only the cross-sectional image in a single cross-section of the still image but also ultrasonic cross-sectional echo images including 3D images and moving images can be displayed. In the ultrasonic diagnostic apparatus according to the above-described embodiment, by incorporating AI means, for example, AI means having an advantage in image recognition such as a neural network or a convolutional neural network, and training using ultrasonic echo images as teacher data, information regarding the distribution state of sweat glands, the position and depth of sweat glands, the position, spread state, depth, and infiltration degree of malignant tumors of the skin, etc. can be obtained quickly and accurately from the ultrasonic echo images of the subject. Also in this case, not only the cross-sectional image in a single cross-section of the still image but also ultrasonic cross-sectional echo images including 3D images and moving images can be used. In particular, by using the ultrasonic cross-sectional echo images obtained from the video, more accurate analysis of sweat glands and malignant tumors of the skin becomes possible.

[0088] In the observation example using the ultrasonic diagnostic apparatus of the above-described embodiment, an example in which ultrasonic cross-sectional images of the exocrine gland and the apocrine gland were displayed was shown. However, for example, by applying this ultrasonic diagnostic apparatus to the case of skin cancer, a good diagnostic effect for skin cancer can be obtained. That is, according to the ultrasonic diagnostic apparatus of the above-described embodiment, since a cross-sectional echo image in which the subcutaneous state is favorably displayed is obtained by the cross-sectional echo image generation apparatus, the position, spread state, and depth of skin cancer can be clearly displayed, and it becomes possible to contribute to the improvement of the treatment effect of skin cancer. For example, when using the 33Mhz ultrasonic probe described in Observation Examples 8 to 10, it is possible to perform a particularly excellent diagnosis of skin cancer within 1 cm from the skin surface. Similarly, it is possible to diagnose malignant tumors of the skin including skin cancer and malignant melanoma.

Explanation of Signs

[0089] 10…Ultrasonic diagnostic apparatus 11…Ultrasonic probe (probe) 11a…Contact surface 12…Input / output (I / O) unit 13…Echo image generation unit 14…Analysis unit 15…Display unit 20…Sweating suppression device 21…Electrode needle 21a…Tip 21b…Insulating film 22…Cooling member 23…Support 24…Drive device 25…Holder 25a…Recess 25b…Engaging protrusion 26…Peltier element 27…Cooling plate 27a…Opening 27b…Cooling part 28…Heat dissipation block 28a…Opening 29…Through hole 30…Contact detection sensor 31…Housing part 31a…Guide groove 32…Cylindrical part 32a…Groove part 33…Drive motor 33a…Rotating shaft 34…Encoder 35…Shaft 35a…Threaded part 36…Rod 36a…Nut 36b…Projection 36c…Engaging recess 40…Operation part 45…Control device Treatment device for axillary osmidrosis or hyperhidrosis

Claims

1. An ultrasonic probe, A cross-sectional echo image generation device that generates a cross-sectional echo image based on a scanning signal from the ultrasonic probe, An analysis device that analyzes the cross-sectional echo image generated by the cross-sectional echo image generation device to recognize the subcutaneous state, A sweating suppression device that treats axillary osmidrosis or hyperhidrosis using information from the analysis device, A sweat gland treatment system having: The ultrasonic probe has a substantially rectangular contact surface having a long side and a short side, and is capable of scanning at least along the long side direction and along the short side direction, The cross-sectional echo image generation device displays a cross-sectional echo image based on a scanning signal including at least scanning along the long side direction and scanning along the short side direction by the ultrasonic probe on the epidermal surface of the living body before treatment, after injecting an anesthetic, and after treatment, The cross-sectional echo image generation device, (a) A scanning signal obtained by scanning along the long side direction of the ultrasonic probe on the epidermal surface of the living body before treatment. First, a reference point is determined, and from that reference point, in the direction from the hand to the armpit, a cross-sectional echo image of the sweat glands before treatment under the skin having a display range wider than the short side direction length in the direction along the long side is obtained from the scanning signal along the long side direction including the scanning signal scanned along the long side direction of the ultrasonic probe to generate a pre-treatment long side direction cross-sectional echo image, (b) Generate a pre-treatment short side direction cross-sectional echo image that grasps the distribution of sweat glands over the range of the long side direction length before treatment under the skin from the scanning signal obtained by scanning along the short side direction of the ultrasonic probe on the epidermal surface of the living body before treatment, (c) A scanning signal obtained by scanning along the long side direction of the ultrasonic probe on the epidermal surface of the living body after injecting an anesthetic. First, a reference point is determined, and from that reference point, in the direction from the hand to the armpit, a cross-sectional echo image of the sweat glands after injection under the skin having a display range wider than the short side direction length in the direction along the long side is obtained from the scanning signal along the long side direction including the scanning signal scanned along the long side direction of the ultrasonic probe to generate a post-injection long side direction cross-sectional echo image, (d) Generate a post-injection short side direction cross-sectional echo image that grasps the distribution of sweat glands over the range of the long side direction length after injection under the skin from the scanning signal obtained by scanning along the short side direction of the ultrasonic probe on the epidermal surface of the living body after injecting an anesthetic, (e) generating at least one 3D cross-sectional echo image before treatment and after injection of an anesthetic from a scanning signal obtained by performing rotational scanning by rotating about the major axis direction at the contact surface of the ultrasonic probe on the epidermal surface of at least one living body, (f) in the analyzer, using the pre-treatment long-side direction cross-sectional echo image, the pre-treatment short-side direction cross-sectional echo image, the post-injection long-side direction cross-sectional echo image, the post-injection short-side direction cross-sectional echo image, and the 3D cross-sectional echo image generated by the cross-sectional echo image generation device, from the pre-treatment long-side direction cross-sectional echo image, obtaining the distribution state of pre-treatment sweat glands under the skin having a display range wider than the short-side direction length in the direction along the long-side direction, and grasping the distribution of sweat glands over the long-side direction length range of the pre-treatment under the skin from the pre-treatment short-side direction cross-sectional echo image, from the post-injection long-side direction cross-sectional echo image, obtaining the distribution state of post-injection sweat glands under the skin having a display range wider than the short-side direction length in the direction along the long-side direction, and grasping the distribution of sweat glands over the long-side direction length range of the post-injection under the skin from the post-injection short-side direction cross-sectional echo image, also by using the 3D cross-sectional echo image, information on the distribution range of sweat glands is displayed by analyzing the distribution of the sweat glands by image recognition, and the information on the distribution range of the sweat glands is provided to a sweating suppression device for treating axillary hyperhidrosis or hyperhidrosis, (g) a scanning signal obtained by scanning along the long-side direction of the ultrasonic probe on the epidermal surface of the living body after treatment using the sweating suppression device, first determining a reference point, and from that reference point, scanning along the long-side direction of the ultrasonic probe in the direction from the hand to the armpit, generating a post-treatment long-side direction cross-sectional echo image for obtaining the distribution state of post-treatment sweat glands under the skin having a display range wider than the short-side direction length in the direction along the long-side direction from the scanning signal along the long-side direction including the scanning signal, (h) generating a post-treatment short-side direction cross-sectional echo image for grasping the distribution of sweat glands over the long-side direction length range of the post-treatment under the skin from a scanning signal obtained by scanning along the short-side direction of the ultrasonic probe on the epidermal surface of the living body after treatment, (i) generating a post-treatment 3D cross-sectional echo image from a scanning signal obtained by performing rotational scanning by rotating about the major axis direction at the contact surface of the ultrasonic probe on the epidermal surface of at least one living body after treatment, (j)In the analysis device, using the post-treatment long-side direction cross-sectional echo image, the post-treatment short-side direction cross-sectional echo image, and the post-treatment 3D cross-sectional echo image generated by the cross-sectional echo image generation device, Based on the post-treatment long-side direction cross-sectional echo image, the distribution state of the post-treatment sweat glands under the skin having a display range wider than the short-side direction length along the long-side direction is obtained. Then, based on the post-treatment short-side direction cross-sectional echo image, the distribution of the sweat glands over the long-side direction length range under the skin is grasped. By also using the post-treatment 3D cross-sectional echo image, By analyzing the distribution of the sweat glands after treatment by image recognition, information on the distribution range of the sweat glands after treatment is displayed. The information on the distribution range of the sweat glands obtained by analysis in the analysis device includes at least (1) Information on the cross-sectional echo image regarding the distribution state of the sweat glands present in the range of 0.5 to 3.5 mm under the skin. (2) Information on the cross-sectional echo image regarding the positions of the sweat glands present in the range of 0.5 to 3.5 mm under the skin, and (3) Information on the cross-sectional echo image regarding the depths of the sweat glands present in the range of 0.5 to 3.5 mm under the skin is included. The ultrasonic probe is a linear probe type having 128 or more elements and a driving frequency of 20 MHz or more and less than 40 MHz, and is characterized by a sweat gland treatment system.

2. The ultrasonic probe is a linear probe type having 400 to 600 elements, a driving frequency of 33 MHz, and not using an ultrasonic lens, and is characterized by the sweat gland treatment system according to claim 1.

Images