JP2008142330A - Ultrasonic diagnostic apparatus and catheter navigation system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic diagnostic apparatus which can provide an ultrasonic image permitting the current position of a catheter and a blood vessel in which the catheter remains inserted to be appropriately visually recognized in a blood intervention under the guidance of ultrasonic waves. <P>SOLUTION: The ultrasonic diagnostic apparatus generates and displays a navigation image in which the current position of the catheter and the blood vessel in which the catheter remains inserted are clearly imaged on an ultrasonic image acquired in real time. The apparatus determines whether or not there is a branch of the blood vessel in which the catheter remains inserted. If there is a branch, the apparatus selects the direction in which the catheter should be advanced. The blood vessel corresponding to the selected direction is clearly shown on the navigation image. The apparatus determines whether or not the operation of the catheter is correct on the basis of the current position of the catheter and the position of the blood vessel corresponding to the selected direction, and displays the result of the judgment. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an ultrasonic diagnostic apparatus for facilitating insertion of a catheter into a desired blood vessel when the catheter is inserted into a blood vessel by a technique under an ultrasonic guide.

  Ultrasound diagnosis can be performed repeatedly by simply touching the ultrasound probe from the body surface, and the heart beats and fetal movements can be obtained in real time, and it is highly safe. . In addition, it can be said that this is a simple diagnostic method in which the scale of the system is smaller than other diagnostic devices such as X-rays, CT, and MRI, and inspection can be easily performed while moving to the bedside. Ultrasound diagnostic devices used in this ultrasound diagnosis vary depending on the types of functions that they have, but small ones that can be carried with one hand have been developed. Thus, there is no influence of exposure, and it can be used in obstetrics and home medical care.

  In recent years, in the treatment with an intravascular catheter (vascular intervention), as a method for monitoring the position of the catheter in the body, there is a method using an ultrasound image in addition to angiography by X-ray. This is because, in an ultrasound image, images of both the blood vessel wall (that is, the blood flow and its surrounding tissues) and the catheter can be visualized. For example, when a blood vessel branch exists, the catheter is placed in the target blood vessel. This is because it is possible to easily determine whether it is inserted (True) or whether it is inserted into another branched blood vessel (Sub), and there are advantages such as easy advancement of the catheter. The vascular intervention is applied to many blood vessels such as the carotid artery, renal artery, aorta, coronary artery, upper limb artery / vein, lower limb artery / vein.

In addition, as a well-known document relevant to this application, there exist the following, for example.
JP 2004-283373 A Japanese Patent Laid-Open No. 11-318884 JP 2003-305039 A

  However, when imaging a blood vessel using a conventional ultrasonic diagnostic apparatus, in order to obtain a scan cross section passing through the blood vessel, an appropriate angle as shown in FIGS. You have to look for the position etc. Therefore, in the vascular intervention for performing the catheter operation, the burden of man-made work during the operation is increased. In addition, blood vessels usually have a three-dimensional structure such as bending or branching. For this reason, it is difficult to extract an ultrasonic cross-sectional image along the traveling direction of the blood vessel, particularly when performing monitoring using a one-dimensional array probe.

  In order to solve the above problems, for example, using Doppler information or blood vessel wall information to determine the travel of the blood vessel in the ultrasonic volume data, draw an ultrasonic cross-sectional image along the central axis in the travel direction of the blood vessel, Further, when the blood vessel is bent, there is a method of rendering a two-dimensional tomographic image as a curved surface. However, in this method, in order to insert a catheter into a living body under ultrasound guidance and reach a desired site, the blood vessel containing the catheter is artificially determined from a plurality of blood vessels in the image. I have to do it. Therefore, it can be said that the work burden on the surgeon is still large.

  The present invention has been made in view of the above-described circumstances, and an ultrasonic image capable of satisfactorily recognizing a current catheter position and a blood vessel in which the catheter is inserted in a vascular intervention under an ultrasonic guide. It is an object of the present invention to provide an ultrasonic diagnostic apparatus and a catheter navigation system capable of providing the above.

  In order to achieve the above object, the present invention takes the following measures.

  A first aspect of the present invention is to provide data acquisition means for acquiring volume data relating to a region including a blood vessel to be inserted into a catheter by performing ultrasonic scanning on the subject, and for specifying a spatial position of the catheter. Based on first position information and position information acquisition means for acquiring second position information for specifying a spatial position corresponding to the volume data, the first and second position information, and the image data And an image generating means for generating a navigation image that is an ultrasonic image for highlighting a blood vessel to be inserted into the catheter, and a display means for displaying the navigation image. This is a sonic diagnostic apparatus.

  According to a second aspect of the present invention, there is provided a data acquisition means for acquiring volume data relating to a region including a blood vessel to be inserted into a catheter, and a catheter position for detecting first position information for specifying a spatial position of the catheter. Based on detection means, volume data position information acquisition means for detecting second position information for specifying a spatial position corresponding to the volume data, the first and second position information, and the image data. And an image generating means for generating a navigation image that is an ultrasonic image for highlighting a blood vessel to be inserted into the catheter, and a display means for displaying the navigation image. It is a navigation system.

  As described above, according to the present invention, in the blood vessel intervention under the ultrasonic guide, the ultrasonic diagnostic apparatus capable of providing an ultrasonic image that can favorably visually recognize the current position of the catheter and the blood vessel in which the catheter is inserted. And a catheter navigation system can be realized.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

  FIG. 1 is a diagram showing a configuration of a catheter navigation system 1 according to the present embodiment. As shown in FIG. 1, the catheter navigation system 1 includes a catheter system 2 and an ultrasonic diagnostic apparatus 3.

  The catheter system 2 includes a catheter 2a, a position specifying information transmitting device 2b and a catheter position detecting device 2c provided in a predetermined portion (in the present embodiment, a tip portion) of the catheter. The catheter 2a is used for blood vessel intervention, and is provided with a balloon, a cutter, or the like at the tip thereof according to the purpose, and is inserted into a predetermined position through the blood vessel. The position specifying information transmitting device 2b transmits information (catheter position specifying information) for specifying the spatial position of the distal end portion of the catheter 2a to the catheter position detecting device 2c by wire or wirelessly. The catheter position detecting device 2c detects the spatial position of the catheter based on the position specifying information received from the position specifying information transmitting device 2b.

  The catheter position detection device 2c is not necessarily included on the catheter system 2 side. For example, the ultrasonic diagnostic device 3 may have the same function. Further, in this embodiment, in order to make the explanation concrete, a blood vessel intervention of the lower limbs (for example, a catheter is inserted into the blood vessel from the base of the left foot and advanced to the toe to advance the catheter to a planned arrival position around the ankle. Vascular intervention). However, the technical idea of the present invention is not limited to this, and can be applied to any vascular intervention in which a catheter is inserted into a blood vessel under an ultrasonic guide.

  FIG. 2 shows a block diagram of the ultrasonic diagnostic apparatus 3 of the system 1. As shown in the figure, the ultrasonic diagnostic apparatus 3 includes a main body 11, an ultrasonic probe 12, an input device 13, and a monitor 14.

  The ultrasonic probe 12 generates ultrasonic waves based on a drive signal from the apparatus main body 11, converts a reflected wave from the subject into an electric signal, a matching layer provided in the piezoelectric vibrator, It has a backing material that prevents the propagation of ultrasonic waves from the piezoelectric vibrator to the rear. When ultrasonic waves are transmitted from the ultrasonic probe 12 to the subject P, the transmitted ultrasonic waves are successively reflected by the discontinuous surface of the acoustic impedance of the body tissue and received by the ultrasonic probe 12 as an echo signal. . The amplitude of this echo signal depends on the difference in acoustic impedance at the discontinuous surface that is supposed to be reflected. In addition, the echo when the transmitted ultrasonic pulse is reflected by the moving blood flow or the surface of the heart wall depends on the velocity component in the ultrasonic transmission direction of the moving body due to the Doppler effect, and the frequency Receive a shift.

  The ultrasonic probe 12 is provided with a position specifying information transmitting device 120 connected to the ultrasonic diagnostic apparatus 3 by wire or wirelessly. This transmits information (probe position specifying information) for specifying the position of the probe 12 to the ultrasonic diagnostic apparatus 3. This probe position specifying information is used to specify the spatial position of the ultrasonic scanning region (a two-dimensional scanning plane in the case of acquiring a two-dimensional image and a three-dimensional scanning space in the case of acquiring a three-dimensional image).

  The input device 13 is connected to the device main body 11, and various switches, buttons, and tracks for taking various instructions, conditions, region of interest (ROI) setting instructions, various image quality condition setting instructions, etc. from the operator into the device main body 11. It has a ball, mouse, keyboard, etc. For example, when the operator operates the end button or the freeze button of the input device 13, the transmission / reception of the ultrasonic wave is ended, and the ultrasonic diagnostic apparatus is temporarily stopped.

  The monitor 14 displays in vivo morphological information and blood flow information as an image based on the video signal from the apparatus main body 11.

  The apparatus main body 11 includes an ultrasonic transmission unit 21, an ultrasonic reception unit 22, a B-mode processing unit 23, a Doppler processing unit 24, an image generation unit 25, a navigation image generation unit 26, an image composition unit 27, and a control processor (CPU). 28, a storage unit 29, and an interface unit 30 are provided. Hereinafter, the function of each component will be described.

  The ultrasonic transmission unit 21 includes a trigger generation circuit, a delay circuit, a pulsar circuit, and the like (not shown). In the pulsar circuit, a rate pulse for forming a transmission ultrasonic wave is repeatedly generated at a predetermined rate frequency fr Hz (period: 1 / fr second). Further, in the delay circuit, a delay time necessary for focusing the ultrasonic wave into a beam shape for each channel and determining the transmission directivity is given to each rate pulse. The trigger generation circuit applies a drive pulse to the probe 12 at a timing based on this rate pulse.

  The ultrasonic receiving unit 22 has an amplifier circuit, an A / D converter, an adder and the like not shown. The amplifier circuit amplifies the echo signal captured via the probe 12 for each channel. In the A / D converter, a delay time necessary for determining the reception directivity is given to the amplified echo signal, and thereafter, an addition process is performed in the adder. By this addition, the reflection component from the direction corresponding to the reception directivity of the echo signal is emphasized, and a comprehensive beam for ultrasonic transmission / reception is formed by the reception directivity and the transmission directivity.

  The B-mode processing unit 23 receives the echo signal from the transmission / reception unit 21, performs logarithmic amplification, envelope detection processing, and the like, and generates data in which the signal intensity is expressed by brightness.

  The Doppler processing unit 24 performs frequency analysis on velocity information from the echo signal received from the transmission / reception unit 21, extracts blood flow, tissue, and contrast agent echo components due to the Doppler effect, and obtains blood flow information such as average velocity, dispersion, and power. Ask for multiple points. The obtained blood flow information is sent to the image generation unit 25 and displayed in color on the monitor 14 as an average velocity image, a dispersion image, a power image, and a combination image thereof.

  The image generation unit 25 converts the signal sequence from the B-mode processing unit 23 (scanning line signal sequence for ultrasonic scanning) into a scanning line signal sequence in a general video format typified by a television or the like, and performs ultrasonic diagnosis. Image data (two-dimensional tomographic image data, volume image data) is generated. At this time, various image filters such as edge enhancement, temporal smoothing, and spatial smoothing are also applied to provide image quality according to user preferences. Note that data before entering the image generation unit 25 may be referred to as “raw data”.

  The navigation image generation unit 26 highlights the catheter and the blood vessel into which the catheter has been inserted based on the volume data generated by the image generation unit 25 and its position information, and the position information of the catheter calculated by the control processor 28. Generated navigation image is generated. The generation of the navigation image will be described in detail later.

  The image synthesis unit 27 synthesizes the image received from the image generation unit 25 or the navigation image generation unit 26 with character information, scales, and the like of various parameters, and outputs them as a video signal to the monitor 14. In particular, the image composition unit 27 synthesizes the navigation image with the accompanying information generated by the control processor 28.

  The control processor 28 has a function as an information processing apparatus (computer) and controls the operation of the main body of the ultrasonic diagnostic apparatus. The control processor 28 reads out a control program for executing image generation / display, etc. from the storage unit 29, a dedicated program for realizing the catheter navigation function, etc., expands it on its own memory, and calculates / Execute control etc.

  Further, the control processor 28 specifies the spatial position of the catheter based on the catheter position specifying information, specifies the spatial position of the ultrasound scanning region based on the probe position specifying information (that is, the spatial position of the volume data), Correspondence between the spatial position and the ultrasonic scanning region, calculation of the position of the catheter on the volume data, and the like are performed. Further, the control processor 28 is useful information for specifying the blood vessel into which the catheter is inserted and observing the generated navigation image based on the position of the catheter on the calculated volume data. Generate incidental information.

  The storage unit 29 is a control program for executing transmission / reception conditions, image generation, and display processing, diagnostic information (patient ID, doctor's findings, etc.), diagnostic protocol, probe scanning line angle information, probe position information, catheter Position information, body mark generation program, dedicated program for realizing the catheter navigation function, and other data groups are stored. The data in the storage unit 29 can be transferred to another device via the interface unit 80.

  The interface unit 30 is an interface related to the input device 13, a network, a new external storage device (not shown), a catheter position detection device 2c, and a probe position specifying information transmission device. Note that data such as ultrasonic images and analysis results obtained by the apparatus can be transferred by the interface unit 30 to another apparatus via a network.

(Catheter navigation function)
Next, the catheter navigation function of the ultrasonic diagnostic apparatus 3 will be described. This function is roughly divided into a navigation image generation function and an accompanying information provision function. Each function will be described below.

[Navigation image generation function]
The navigation image generation function generates an ultrasound image (navigation image) for highlighting at least one of a catheter inserted into a blood vessel and a blood vessel into which the catheter is inserted (catheter-inserted blood vessel) and displays it in real time. It is a function to do. According to this function, for example, even when a plurality of blood vessels are visualized on an ultrasonic image as shown in FIG. 3, the blood vessel into which the catheter is inserted is shown in FIG. Highlighted. Therefore, the user can easily visually recognize the current position of the catheter and the running form of the catheter insertion blood vessel.

  FIG. 5 is a flowchart showing a flow of processing (navigation image generation processing) according to the navigation image generation function. The operation of the ultrasonic diagnostic apparatus 3 relating to the navigation image generation process will be described with reference to FIG.

  First, according to a predetermined scan sequence, a predetermined region including a blood vessel into which a catheter as shown in FIG. 6 is inserted is ultrasonically scanned, and volume data relating to the region is acquired (step S1).

  Next, the control processor 28 acquires the probe position specifying information and the catheter position specifying information via the interface unit 30, and based on this, the spatial position of the ultrasound scanning region (volume data) and the spatial position of the catheter Are calculated and associated with each other (step S2).

  Next, the navigation image generation unit 26 calculates the position of the distal end portion of the catheter on the volume data (step S3), and extracts a blood vessel cross-sectional image including the distal end portion of the catheter (step S4). For extracting such a blood vessel cross-sectional image, for example, methods disclosed in Japanese Patent Application Laid-Open Nos. 2004-283373, 11-318884, 2003-305039, and the like can be used.

  Next, the navigation image generation unit 26 identifies the catheter insertion blood vessel in the blood vessel cross-sectional image including the distal end portion of the catheter (step S5), and the catheter and the catheter insertion blood vessel are highlighted (for example, high-intensity display, color display, A navigation image is generated for clarification by an arrow, drawing a region by a line, etc. (step S6). In addition, specification of the catheter insertion blood vessel in the blood vessel cross-sectional image including the distal end portion of the catheter can be realized by using, for example, a technique disclosed in Japanese Patent Application Laid-Open No. 2004-350791. The generated navigation image is displayed on the monitor 14 in a predetermined form together with, for example, supplementary information described later (step S7).

[Attached information provision function]
The supplementary information providing function refers to supplementary information useful for observing the generated navigation image (for example, information for informing the existence of a branch of a catheter insertion blood vessel, or any direction when a branch of the catheter insertion blood vessel exists) And the like for selecting whether to advance the catheter.

  7 and 8 are diagrams for explaining an example of the incidental information providing function. For example, as shown in FIG. 7, when a blood vessel branch exists in the direction of catheter insertion, the control processor 28 selects information indicating the presence of the blood vessel branch and which blood vessel is selected as the catheter route. (For example, a message such as “There is a blood vessel branch. Which one should be selected above or below?”) Is generated as incidental information. The generated incidental information is displayed together with the navigation image, for example, in the form shown in FIG. 7 (or output by voice).

  Further, it is assumed that when the supplementary information shown in FIG. 7 is presented, the user inputs an instruction to select a lower blood vessel in a branch on the screen, for example, via the input device 13. In such a case, the control processor 28 generates a navigation image that highlights the blood vessel present on the lower side in the branch on the screen, and confirms that the blood vessel present on the lower side in the branch on the screen is selected as the catheter path. Information (for example, a message such as “select below”) is generated as supplementary information. The generated incidental information is displayed (or output by voice) together with the navigation image in the form shown in FIG. 8, for example.

  Furthermore, if the catheter is in a different blood vessel than the vessel selected as the catheter path, the control processor 28 may provide information to inform the user that the catheter is not on the selected blood vessel (eg, “Attention! Message is inserted as supplementary information. On the other hand, if the catheter exists in the same blood vessel as the vessel selected as the catheter route, the control processor 28 informs that the catheter exists in the vessel selected as the route (for example, “normally Message) "is generated as incidental information. The generated incidental information is displayed together with the navigation image in the form shown in FIGS. 9 and 10 (or output by voice), for example.

  Note that the determination of whether or not the catheter is present in the blood vessel selected as the course (that is, the determination of which blood vessel the catheter is proceeding to) can be realized as follows, for example. That is, the control processor 28 monitors the deviation between the current catheter position and the position of the blood vessel selected as the course, and if the deviation does not exceed a predetermined threshold, the catheter is placed in the vessel selected as the course. If the deviation exceeds a predetermined threshold value, it is determined that the catheter does not exist in the blood vessel selected as the course. Further, the blood vessel branch in the traveling direction of the catheter can be detected using, for example, Doppler information.

  According to the configuration described above, the following effects can be obtained.

  According to the present catheter navigation system, a catheter inserted in a blood vessel can be visualized, and a navigation image for highlighting the catheter-inserted blood vessel can be generated and displayed in real time. Therefore, the user can easily and quickly visually recognize the current position of the catheter and the catheter insertion blood vessel by observing the displayed navigation image.

  Further, according to the catheter navigation system, information for informing the presence of a branch on the catheter insertion blood vessel, information for selecting which of the branching blood vessels should be highlighted as the catheter route, Information for notifying whether or not the catheter is correctly present on the catheter path is output as supplementary information together with the navigation image. Therefore, the user can quickly recognize the presence of the blood vessel branch and the appropriateness of the current catheter position. As a result, it is possible to prevent an erroneous operation of the catheter in the vascular intervention and contribute to the improvement of the quality of medical practice.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Specific examples of modifications are as follows.

  (1) Each function according to the present embodiment can also be realized by installing a program for executing the processing in a computer such as a workstation and developing the program on a memory. At this time, a program capable of causing the computer to execute the technique is stored in a recording medium such as a magnetic disk (floppy (registered trademark) disk, hard disk, etc.), an optical disk (CD-ROM, DVD, etc.), or a semiconductor memory. It can also be distributed.

  (2) When the current position of the catheter is out of the blood vessel selected as the course, the supplementary information provided together with the navigation image includes, for example, the shortest distance between the current position of the catheter tip and the blood vessel selected as the path ( The amount of deviation) may include quantitative information. This quantitative information can be easily calculated using the current position of the catheter tip and the position of the blood vessel selected as the course.

  In addition, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, constituent elements over different embodiments may be appropriately combined.

  As described above, according to the present invention, in the blood vessel intervention under the ultrasonic guide, the ultrasonic diagnostic apparatus capable of providing an ultrasonic image that can favorably visually recognize the current position of the catheter and the blood vessel in which the catheter is inserted. And a catheter navigation system can be realized.

FIG. 1 is a diagram showing a configuration of a catheter navigation system 1 according to the present embodiment. FIG. 2 shows a block diagram of the ultrasonic diagnostic apparatus 3 of the catheter navigation system 1. FIG. 3 is a diagram for explaining the navigation image. FIG. 4 is a diagram illustrating an example of a navigation image. FIG. 5 is a flowchart showing a flow of processing (navigation image generation processing) according to the navigation image generation function. FIG. 6 is a diagram schematically showing an ultrasonic scanning region including a blood vessel into which a catheter is inserted. FIG. 7 is a diagram for explaining an example of the incidental information providing function. FIG. 8 is a diagram for explaining an example of the incidental information providing function. FIG. 9 is a diagram for explaining another example of the incidental information providing function. FIG. 10 is a diagram for explaining another example of the incidental information providing function. FIG. 11 is a diagram for explaining a normal ultrasonic monitoring technique in vascular intervention. FIG. 12 is a diagram for explaining a normal ultrasonic monitoring technique in vascular intervention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic apparatus, 11 ... Apparatus main body, 12 ... Ultrasonic probe, 13 ... Input device 13, 14 ... Monitor, 21 ... Ultrasonic transmission unit, 22 ... Ultrasonic reception unit, 23 ... B mode processing unit, 24 ... Doppler processing unit, 25 ... Image generation unit, 26 ... Navigation image generation unit, 27 ... Image composition unit, 28 ... Control processor (CPU), 29 ... Storage unit, 30 ... Interface unit

Claims (5)

Data acquisition means for acquiring volume data relating to a region including a blood vessel to be inserted into a catheter by ultrasonically scanning a subject;
Position information acquisition means for acquiring first position information for specifying a spatial position of a catheter and second position information for specifying a spatial position corresponding to the volume data;
Image generating means for generating a navigation image, which is an ultrasonic image for highlighting a blood vessel to be inserted into the catheter, based on the first and second position information and the image data;
Display means for displaying the navigation image;
An ultrasonic diagnostic apparatus comprising:   The ultrasonic diagnostic apparatus according to claim 1, further comprising a branch detection unit that detects a branch of the blood vessel to be inserted into the catheter in a catheter traveling direction. A selection means for selecting a blood vessel in which the catheter is to be advanced in the branch when the branch is detected, and
The image generating means generates the navigation image for highlighting the selected blood vessel;
The ultrasonic diagnostic apparatus according to claim 2. Determination means for determining which blood vessel the catheter is progressing based on the associated first and second positional information;
The display means displays information relating to a determination result of the determination means;
The ultrasonic diagnostic apparatus according to claim 1, wherein: Data acquisition means for acquiring volume data relating to a region including a blood vessel to be inserted into a catheter;
Catheter position detecting means for detecting first position information for specifying a spatial position of the catheter;
Volume data position information acquisition means for detecting second position information for specifying a spatial position corresponding to the volume data;
Image generating means for generating a navigation image, which is an ultrasonic image for highlighting a blood vessel to be inserted into the catheter, based on the first and second position information and the image data;
Display means for displaying the navigation image;
A catheter navigation system comprising:

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