JP2009273815A - Medical image processor and medical image processing program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image processor capable of automatically detecting a site of the myocardial infarction from image data indicating the form of the heart captured by an MRI apparatus. <P>SOLUTION: A tunica intima extraction section 10 finds a gradient of luminance values with respect to locations on a first MR image acquired by a black blood method and detects the tunica intima of the cardiac muscle based on the gradient. A tunica externa extraction section 20 finds a gradient of luminance values with respect to locations on a second MR image acquired by a delayed contrast-enhanced method and detects the tunica externa of the cardiac muscle based on the gradient. An infarction site extraction section 30 detects the myocardial infarction site based on the luminance values of the second MR image, with defining an area between the tunica intima and the tunica externa as the detection region. A display control section 43 makes the detected myocardial infarction site identifiable on the MR image and allows the display section 44 to display it. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical image processing apparatus and a medical image processing program for extracting a myocardial infarction region based on cardiac image data captured by an MRI apparatus (magnetic resonance imaging apparatus).

  In order to identify the position and size of the myocardial infarction site, medical image diagnostic apparatuses such as an ultrasonic diagnostic apparatus, a nuclear medicine diagnostic apparatus, an X-ray CT apparatus, and an MRI apparatus are used. For example, a myocardial infarction site is identified by myocardial SPECT examination, myocardial ischemia analysis by FDG-PET examination, CAG examination (coronary angiography: CAG), etc. Also, an ultrasonic diagnostic apparatus is used. The myocardial infarction site is specified by analyzing the behavior of the myocardium based on the ultrasonic image acquired by the above and displaying the analysis result in color (Patent Document 1). In this method, blood flow imaging technology is applied to the detection of ischemic heart diseases such as myocardial infarction, specifically by changing the characteristics of the blood flow detection filter. Instead, by detecting the movement of the myocardium and displaying the detected myocardial movement in color, the myocardial infarction site is expressed by a color change. There is a method of imaging an infarct site at the time of myocardial infarction in an ultrasonic diagnostic apparatus (Patent Document 2) In the method described in Patent Document 2, a region of interest (ROI) centered on a certain point in an ultrasound image is disclosed. The cross-correlation coefficient of the region of interest is calculated between frames, and the maximum value of the cross-correlation coefficient is used as video information at that point. Based on the measurement result, the size of the region is manually measured using CT images acquired with an X-ray CT apparatus or MR images acquired with an MRI apparatus. Thus, the myocardial infarction site is identified.

JP-A-5-84246 JP-A-8-164139

  As described above, it is possible to specify a myocardial infarction site by SPECT examination or PET examination, but the image acquired by the nuclear medicine diagnostic apparatus has low resolution. Therefore, it is difficult to specify the exact position and size of the myocardial infarction site, and it is difficult to grasp the relative positional relationship between the myocardial infarction site and the coronary artery. In addition, it is difficult for the CAG examination to observe three-dimensionally the spread of an infarct site important in the diagnosis of myocardial infarction.

  On the other hand, by using a CT image or an MRI image, it is possible to observe a myocardial infarction region on a high-resolution three-dimensional image. However, in CT images, since there is no difference in contrast between the myocardial infarction site and other sites, it is difficult to automatically detect the myocardial infarction site. Further, in the MR image, the myocardial infarction site is detected with a relatively high signal, but unlike the CT image, the same site is not detected with the same signal value even with the same imaging method. In other words, even when the same part is imaged by the same imaging method, the signal value of the part changes depending on the imaging condition, so it is difficult to automatically detect the myocardial infarction part using the signal value. It is.

  The present invention solves the above-described problems, and a medical image processing apparatus capable of automatically detecting a myocardial infarction site from image data representing the form of the heart imaged by an MRI apparatus, and medical use An object of the present invention is to provide a medical image processing program for executing the functions of an image processing apparatus.

The invention according to claim 1 accepts a first MR image having a myocardial brightness value higher than that of the lumen acquired by imaging the heart of a subject by a black blood method using an MRI apparatus, and further a contrast agent Receiving means for receiving a second MR image in which the luminance value of the lumen is higher than that of the myocardium, obtained by imaging the heart of the subject into which the blood vessel has been injected by delayed contrast imaging using an MRI apparatus; and the first MR A gradient of a luminance value with respect to a position for an image, an intima extraction means for detecting an intima of the myocardium based on the gradient; a gradient of a luminance value with respect to the position for the second MR image; An outer membrane extraction means for detecting the outer membrane of the myocardium based on the detection area, and a region between the detected intima and outer membrane as a detection region, and the inside of the detection region based on the luminance value of the second MR image An infarct region extracting means for detecting a myocardial infarction region, and an MR image acquired by imaging the heart of the subject with an MRI apparatus, and identifying the detected myocardial infarction region in the received MR image A medical image processing apparatus comprising: a display control unit that enables display on a display unit.
The invention according to claim 10 accepts a first MR image having a myocardial brightness value higher than that of the lumen acquired by imaging the heart of the subject by the black blood method using an MRI apparatus. Furthermore, a reception function for receiving a second MR image in which the luminance value of the lumen is higher than that of the myocardium obtained by imaging the heart of the subject into which the contrast medium has been injected by delay contrast imaging using an MRI apparatus An intima extraction function for obtaining a gradient of a luminance value with respect to a position for the first MR image, and detecting an intima of the myocardium based on the gradient;
An outer membrane extraction function for obtaining a gradient of a luminance value with respect to a position with respect to the second MR image, and detecting an outer membrane of the myocardium based on the gradient, and a detection region between the detected intima and outer membrane And receiving an infarct region extraction function for detecting a myocardial infarction region from within the detection region based on the luminance value of the second MR image, and an MR image acquired by imaging the heart of the subject with an MRI apparatus. And a display control function for causing the display device to display the detected myocardial infarction site in the received MR image so as to be identifiable.

  According to the present invention, the intima is detected based on the first MR image acquired by the black blood method, the adventitia is detected based on the second MR image acquired by the delayed contrast method, and the intima By setting the interval as the detection region, it becomes possible to more accurately detect the myocardial infarction region based on the luminance value of the second MR image. That is, even if the difference between the luminance value of the lumen and the luminance value of the myocardial infarction region is small in the second MR image, the intima is detected based on the first MR image acquired by the black blood method, and the intima By making the outside of the region a myocardial infarction region detection region, the myocardial infarction region can be detected by distinguishing the lumen from the myocardial infarction region in the second MR image.

[First Embodiment]
A medical image processing apparatus according to a first embodiment of the present invention will be described with reference to FIG. FIG. 1 is a block diagram showing a medical image processing apparatus according to the first embodiment of the present invention.

  The medical image processing apparatus according to the first embodiment includes an intima extraction unit 10, an outer membrane extraction unit 20, an infarct site extraction unit 30, and an image output unit 40. This medical image processing apparatus receives MR images acquired by the MRI apparatus, detects the intima and outer membranes of the myocardium based on the MR images, and further detects the myocardial infarction site.

(Inner membrane extraction unit 10)
The intima extraction unit 10 includes a first image input unit 11, a first reference point setting unit 12, a first line setting unit 13, a first luminance value curve generation unit 14, a first gradient calculation unit 15, and an intima detection unit. 16 is provided. The intima extraction unit 10 receives first MR image data acquired by imaging the heart of a subject by the black blood method (Black Blood method) using an MRI apparatus, and the myocardium based on the first MR image data. Detect the inner membrane of the. Hereinafter, each part of the inner membrane extraction part 10 is demonstrated.

(First image input unit 11)
The first image input unit 11 receives first MR image data (MR cine image data) acquired by imaging the heart of a subject by the black blood method using an MRI apparatus, and receives the first MR image data as the first MR image data. Output to the reference point setting unit 12. For example, by using an MRI apparatus installed outside the medical image processing apparatus, an arbitrary cross section of the heart is imaged by the black blood method, and first MR image data representing the form of the heart in the cross section is acquired. The first image input unit 11 receives first MR image data output from an MRI apparatus installed outside the medical image processing apparatus, and outputs the first MR image data to the first reference point setting unit 12. Here, the MRI apparatus and the black blood method will be briefly described.

  An MRI apparatus (magnetic resonance imaging apparatus) includes a magnet gantry, a bed unit that inserts a subject into the magnet gantry, and a control unit that controls driving of the magnet gantry and the bed unit and reconstructs image data. . The subject is placed on the top plate of the bed unit, the top plate is moved into the magnet stand, and the subject is inserted into the magnet stand. The magnet mount excites a nuclear spin of a subject tissue placed in a static magnetic field with a high-frequency signal (RF pulse) having a Larmor frequency, and acquires a magnetic resonance signal (MR signal) generated by this excitation. . The control unit reconstructs an image in the subject based on the MR signal acquired by the magnet mount.

  The magnet mount includes a static magnetic field magnet, a gradient magnetic field coil, a transmission RF (Radio Frequency) coil, and a reception RF coil. The static magnetic field magnet is formed in a hollow cylindrical shape and acts so as to generate a uniform static magnetic field in its internal space. The gradient magnetic field coil has a hollow cylindrical shape and is arranged in an internal space formed by a static magnetic field magnet. This gradient magnetic field coil is formed by combining three coils corresponding to respective coordinate axes of a preset three-dimensional orthogonal coordinate system (XYZ coordinate system). These three coils are individually supplied with power and generate a gradient magnetic field in which the magnetic field strength is inclined along the X, Y, and Z coordinate axes. The Z axis is disposed along the body axis direction of the subject (the longitudinal direction of the top plate), and the static magnetic field magnet generates a static magnetic field in the Z direction. The transmission RF coil is disposed in the internal space of the gradient coil. The transmission RF coil receives a high-frequency pulse corresponding to the Larmor frequency and generates a high-frequency magnetic field. The reception RF coil is arranged in the internal space of the gradient coil and includes a plurality of RF coils. The plurality of RF coils each receive a magnetic resonance signal emitted from the subject due to the influence of the generated high-frequency magnetic field, and output a signal representing the reception result to the control unit. The control unit performs image reconstruction processing such as Fourier transform on the magnetic resonance signal data, thereby generating image data representing the tissue in the body of the subject. Thereby, image data of a tomographic image of the subject is generated.

  Next, the black blood method (Black Blood method) will be described. The black blood method is a method in which a pulse for suppressing the collection of blood MR signals is added before a pulse train of normal RF excitation and echo collection. For example, a selective inversion pulse that reversely excites the same area as the imaging cross section and a non-selective inversion pulse that reversely excites the entire imaging target are continuously applied, and after this application, RF excitation and echo for imaging are applied. A double inversion recovery method that performs collection is used. By imaging the heart of the subject by this black blood method, it is possible to suppress blood signals and generate first MR image data (black blood image data) having a myocardial luminance value higher than that of the lumen. For example, the first MR image data can be generated by executing an imaging method described in JP-A-2002-143125. The intima extraction unit 10 detects the intima of the myocardium based on the first MR image data.

  Here, FIG. 2 shows the first MR image acquired by the black blood method. FIG. 2 is a diagram showing a first MR image acquired by the black blood method. The first MR image 100 is a two-dimensional image acquired by the black blood method, and represents a form in an arbitrary cross section of the heart. In this first MR image 100, a heart lumen 101 and a myocardium 102 are represented. Since the image is taken by the black blood method, the signal of the lumen 101 is suppressed, and the myocardium 102 is represented by a high signal (high luminance).

(First reference point setting unit 12)
The first reference point setting unit 12 receives the first MR image data from the first image input unit 11 and sets the first reference point in the first MR image. In this embodiment, the first reference point setting unit 12 sets the first reference point inside the lumen 101 shown in the first MR image 100. As an example, imaging is performed so that the lumen of the heart is represented near the center of the image, and the first reference point setting unit 12 detects the center point of the first MR image 100 obtained by the imaging, and the center Set the point as the first reference point. For example, as shown in FIG. 2, the first reference point setting unit 12 sets the center point 103 of the first MR image 100 as the first reference point. The first reference point setting unit 12 outputs information (coordinate information) indicating the position of the first reference point to the first line setting unit 13.

  Further, the first reference point setting unit 12 may set a point designated by the operator on the first MR image 100 as the first reference point. In this case, the display control unit 43 receives the first MR image data and causes the display unit 44 to display the first MR image 100 based on the first MR image data. The operator designates the first reference point on the first MR image 100 using an operation unit (not shown) such as a pointing device. For example, the operator designates the first reference point inside the lumen 101 shown in the first MR image 100 using the operation unit. When the first reference point is specified by an operation unit (not shown), the display control unit 43 outputs the coordinate information of the first reference point on the first MR image 100 to the first line setting unit 13.

(First line setting unit 13)
The first line setting unit 13 receives the coordinate information of the first reference point on the first MR image 100 from the first reference point setting unit 12, and sets a plurality of first lines extending radially from the first reference point. . At this time, the first line setting unit 13 sets the first line every predetermined angular interval. For example, as shown in FIG. 2, the first line setting unit 13 sets first lines 110, 111, 112,... That extend radially from the center point 103 (first reference point). Hereinafter, the first lines 110, 111, 112,... May be abbreviated as “first line 110 etc.”. The first lines 110 and the like are set at predetermined angular intervals. The first line setting unit 13 outputs each piece of coordinate information such as the first line 110 on the first MR image 100 to the first luminance value curve generation unit 14.

(First luminance value curve generator 14)
The first luminance value curve generation unit 14 receives the coordinate information of the first line from the first line setting unit 13, and in the first MR image data, the first luminance value curve representing the luminance value at each position on the first line. Is generated. In this embodiment, the first luminance value curve generation unit 14 receives coordinate information of each of the first lines 110 and the like from the first line setting unit 13 and represents the luminance value at each position on each first line. One luminance value curve is generated. For example, as illustrated in FIG. 2, the first luminance value curve generation unit 14 generates a first luminance value curve 120 representing the luminance value at each position on the first line 110 in the first MR image 100. The first luminance value curve generation unit 14 generates a first luminance value curve representing the luminance value at each position on the line for each of the first lines 110, 111, 112,. Then, the first luminance value curve generation unit 14 outputs the first luminance value curve in each first line to the first gradient calculation unit 15.

(First slope calculation unit 15)
The first gradient calculation unit 15 receives the first luminance value curve from the first luminance value curve generation unit 14, and obtains the gradient of the luminance value with respect to the position based on the first luminance value curve. For example, the first gradient calculation unit 15 obtains the gradient of the luminance value at each position on the first line 110 based on the first luminance value curve 120 representing the luminance value on the first line 110.

  Furthermore, the first gradient calculation unit 15 detects a point (hereinafter referred to as “intimal point”) where the gradient is a positive value and is equal to or greater than a preset threshold value. At this time, the first gradient calculation unit 15 determines a point where the positive gradient is equal to or greater than the threshold and is located closest to the center point 103 (first reference point) (innermost point) Detect as a film point. This intima point is detected as a point constituting the intima of the myocardium. As an example, the first gradient calculation unit 15 obtains the gradient of the luminance value sequentially from the first reference point (center point 103) set in the lumen 101, and the positive gradient is the first time. A point that is equal to or greater than the threshold is detected as an intima point.

  The first MR image 100 acquired by the black blood method has a luminance at the boundary between the lumen 101 and the myocardium 102 because the lumen 101 has a low signal (low luminance) and the myocardium 102 has a high signal (high luminance). The positive slope of the value increases. Therefore, the gradient of the luminance value is obtained using the first MR image 100, and the boundary between the lumen 101 and the myocardium 102 is identified and the intima is detected by detecting the point where the gradient is equal to or greater than the threshold value. Is possible. As described above, the intima of the myocardium can be detected using the characteristics of the first MR image acquired by the black blood method. For example, as shown in FIG. 2, the first gradient calculation unit 15 obtains the gradient of the luminance value for each position based on the first luminance value curve 120, and detects the intima point 130 where the positive gradient is equal to or greater than the threshold value. . Then, the first gradient calculation unit 15 obtains the gradient of the luminance value for the first luminance value curve other than the first luminance value curve 120, and obtains an intima point at which the gradient is equal to or greater than the threshold value. The first gradient calculation unit 15 outputs the coordinate information of each intima point to the intima detection unit 16.

(Intimal detector 16)
The intima detection unit 16 receives the coordinate information of each intima point from the first gradient calculation unit 15 and specifies the position of the intima of the myocardium by connecting the intima points. For example, as shown in FIG. 2, the intima detection unit 16 specifies the position of the intima 140 of the myocardium by connecting the intima points 130 and the like detected by the first gradient calculation unit 15. Then, the intima detection unit 16 outputs the coordinate information of the intima 140 to the detection region setting unit 31 of the infarct site extraction unit 30. Further, the intima detection unit 16 outputs the coordinate information of the intima 140 to the marker generation unit 42 of the image output unit 40.

(Outer membrane extraction unit 20)
Next, the outer membrane extraction unit 20 will be described. The outer membrane extraction unit 20 includes a second image input unit 21, a second reference point setting unit 22, a second line setting unit 23, a second luminance value curve generation unit 24, a second gradient calculation unit 25, and an outer membrane detection unit. 26. The outer membrane extraction unit 20 receives the second MR image data (delayed contrast image data) acquired by imaging the heart of the subject into which the contrast medium has been injected by delay contrast imaging using an MRI apparatus, The outer membrane of the myocardium is detected based on the second MR image data. Hereinafter, each part of the outer membrane extraction unit 20 will be described.

(Second image input unit 21)
The second image input unit 21 receives second MR image data acquired by imaging the heart of the subject by delayed contrast using an MRI apparatus, and receives the second MR image data in the second reference point setting unit 22. Output. Further, the second image input unit 21 outputs the second MR image data to the detection region setting unit 31 of the infarct site extraction unit 30. For example, by using an MRI apparatus installed outside the medical image processing apparatus, an arbitrary cross section of the heart is imaged by delayed contrast imaging, and second MR image data representing the form of the heart in the cross section is acquired. The second image input unit 21 receives the second MR image data output from the MRI apparatus installed outside the medical image processing apparatus, and outputs the second MR image data to the second reference point setting unit 22 and the detection region setting unit 31. The first image input unit 11 and the second image input unit 21 constitute an example of the “accepting means” of the present invention. Here, the delayed contrast method will be briefly described.

  For example, when a gadolinium contrast agent is used as the contrast agent, the gadolinium contrast agent does not flow into normal cardiomyocytes but is distributed in the extracellular fluid. However, the contrast agent that has flowed into the necrotic myocardium due to infarction or the contrast agent that has flowed into the fibrous tissue caused by cardiomyopathy is delayed in discharge compared to the surrounding extracellular fluid. A method for rendering the contrast difference of the contrast agent with a good contrast is a delayed contrast method, and an image acquired by the method is a delayed contrast image. For example, imaging is performed using an inversion recovery method (inversion recovery method: IR method). In order to clarify the difference between the normal site and the lesion site, it is preferable to perform imaging after a predetermined time has elapsed since the contrast medium was injected into the subject. As an example, imaging is performed after about 20 minutes have passed since the contrast medium was injected into the subject. Further, in order to prevent a signal from being generated from the myocardium during imaging, imaging is performed with fine adjustment of the inversion time (TI). The outer membrane extraction unit 20 detects the outer membrane of the myocardium based on the second MR image data (delayed contrast image data).

  Here, the 2nd MR image acquired by the delay contrast method is shown in FIG. FIG. 3 is a diagram showing a second MR image acquired by delayed contrast imaging. The second MR image 200 is a two-dimensional image acquired by delayed contrast imaging, and represents a form in an arbitrary cross section of the heart. In this second MR image 200, a heart lumen 201 and a myocardium 202 are shown. Since the imaging is performed by the delayed contrast method, the signal of the myocardium 202 is suppressed, and the lumen 201 is represented by a high signal (high luminance).

(Second reference point setting unit 22)
The second reference point setting unit 22 receives the second MR image data from the second image input unit 21 and sets the second reference point in the second MR image. In this embodiment, the second reference point setting unit 22 sets the second reference point inside the lumen 201 shown in the second MR image 200. As an example, imaging is performed so that the lumen of the heart is represented near the center of the image, and the second reference point setting unit 22 detects the center point of the second MR image 200 obtained by the imaging, and the center Set the point as the second reference point. For example, as shown in FIG. 3, the second reference point setting unit 22 sets the center point 203 of the second MR image 200 as the second reference point. The second reference point setting unit 22 outputs information (coordinate information) indicating the position of the second reference point to the second line setting unit 23.

  Further, the second reference point setting unit 22 may set a point designated by the operator on the second MR image 200 as the second reference point. In this case, the display control unit 43 receives the second MR image data and causes the display unit 44 to display the second MR image 200 based on the second MR image data. The operator designates the second reference point on the second MR image 200 using the operation unit. For example, the operator designates the second reference point inside the lumen 201 represented in the second MR image 200 using the operation unit. When the second reference point is designated, the display control unit 43 outputs the coordinate information of the second reference point on the second MR image 200 to the second line setting unit 23.

(Second line setting unit 23)
The second line setting unit 23 receives the coordinate information of the second reference point on the second MR image 200 from the second reference point setting unit 22 and sets a plurality of second lines extending radially from the second reference point. . At this time, the second line setting unit 23 sets the second line for each predetermined angular interval. For example, as illustrated in FIG. 3, the second line setting unit 23 sets second lines 210, 211, 212,... That extend radially from the center point 203 (second reference point). Hereinafter, the second lines 210, 211, 212,... May be abbreviated as “second line 210 etc.”. The second lines 210 and the like are set at predetermined angular intervals. The second line setting unit 23 outputs each coordinate information of the second line 210 and the like on the second MR image 200 to the second luminance value curve generation unit 24.

(Second luminance value curve generator 24)
The second luminance value curve generation unit 24 receives the coordinate information of the second line from the second line setting unit 23, and in the second MR image data, the second luminance value curve representing the luminance value at each position on the second line. Is generated. In this embodiment, the second luminance value curve generation unit 24 receives the coordinate information of the second line 210 and the like from the second line setting unit 23, and represents the luminance value at each position on each second line. A two luminance value curve is generated. For example, as illustrated in FIG. 3, the second luminance value curve generation unit 24 generates a second luminance value curve 220 representing the luminance value at each position on the second line 210. The second luminance value curve generation unit 24 generates a second luminance value curve representing the luminance value at each position on the line for each of the second lines 210, 211, 212,. Then, the second luminance value curve generation unit 24 outputs the second luminance value curve in each second line to the second gradient calculation unit 25.

(Second gradient calculation unit 25)
The second gradient calculation unit 25 receives the second luminance value curve from the second luminance value curve generation unit 24, and obtains the gradient of the luminance value with respect to the position based on the second luminance value curve. For example, the second gradient calculation unit 25 obtains the gradient of the luminance value at each position on the second line 210 based on the second luminance value curve 220 representing the luminance value on the second line 210.

  Further, the second gradient calculation unit 25 detects points (hereinafter referred to as “outer membrane points”) that constitute the outer membrane based on the gradient of the luminance value. Processing for detecting an outer membrane point will be described. First, the second gradient calculation unit 25 sequentially obtains the gradient of the luminance value from the second reference point (center point 203) set in the lumen 201 to the outside, and the gradient is a negative value. Then, a point that falls below a preset threshold value is detected. Next, the second gradient calculating unit 25 detects a region outside the point and having a luminance value gradient within a predetermined range set in advance. Further, the second gradient calculating unit 25 obtains the gradient of the luminance value in order toward the outside of the region, and determines that the gradient is a positive value and is equal to or greater than a preset threshold value. Detect as a point.

  The second MR image 200 acquired by delayed contrast imaging has a luminance at the boundary between the lumen 201 and the myocardium 202 because the lumen 201 has a high signal (high luminance) and the myocardium 202 has a low signal (low luminance). The slope of the value is negative. Furthermore, since the luminance value is low in the myocardium 202 and the change in the luminance value is small, the gradient of the luminance value is included in the predetermined range. Furthermore, since the luminance value decreases in the myocardium 202 and increases in the tissue outside the myocardium 202, the positive gradient of the luminance value increases at the boundary between the myocardium 202 and the tissue outside the myocardium 202. In this way, by using the characteristics of the second MR image acquired by the delayed contrast method, it is possible to identify the boundary between the myocardium and the outer membrane and detect the outer membrane. For example, as shown in FIG. 3, the second gradient calculation unit 25 calculates the gradient of the luminance value for each position based on the second luminance value curve 220. Further, the second gradient calculation unit 25 detects a point where the gradient becomes negative and the negative gradient is equal to or less than a threshold value, and is a region outside the point, and the gradient of the luminance value is within a predetermined range. Detect the area. Then, the second gradient calculating unit 25 detects an outer membrane point 230 that is outside the region and has a positive gradient equal to or greater than a threshold value. The second gradient calculation unit 25 obtains the gradient of the luminance value for the second luminance value curve other than the second luminance value curve 220, and obtains the outer membrane point based on the gradient. Then, the second gradient calculation unit 25 outputs the coordinate information of each outer membrane point to the outer membrane detection unit 26.

(Outer membrane detection unit 26)
The epicardial detection unit 26 receives the coordinate information of each epicardial point from the second gradient calculation unit 25, and specifies the position of the epicardium of the myocardium by connecting the epicardial points. For example, as shown in FIG. 3, the outer membrane detection unit 26 specifies the position of the outer membrane 240 of the myocardium by connecting the outer membrane points 230 and the like detected by the second gradient calculation unit 25. Then, the outer membrane detection unit 26 outputs the coordinate information of the outer membrane 240 to the detection region setting unit 31 of the infarct site extraction unit 30. Further, the outer membrane detection unit 26 outputs the constellation information of the outer membrane 240 to the marker generation unit 42 of the image output unit 40.

(Infarct site extraction unit 30)
Next, the infarct region extraction unit 30 will be described. The infarct site extraction unit 30 includes a detection region setting unit 31, a high signal region detection unit 32, and an infarct site detection unit 33. Based on the second MR image data (delayed contrast image data), the infarct region extraction unit 30 detects a myocardial infarction region for the range between the intima and the adventitia. Hereinafter, each part of the infarct region extraction unit 30 will be described.

(Detection area setting unit 31)
The detection region setting unit 31 receives the second MR image data (delayed contrast image data) from the second image input unit 21, receives the intima coordinate information from the intima detection unit 16, and further receives the epicardial coordinate information. Accepted from the film detector 26. Then, the detection region setting unit 31 specifies a region between the intima and the outer membrane based on the intima coordinate information and the outer membrane coordinate information in the second MR image (delayed contrast image), An area is defined as a detection area. A myocardial infarction site is detected in the detection area. That is, a myocardial infarction site is detected in the region outside the intima and inside the adventitia. This makes it possible to detect the myocardial infarction region by distinguishing the lumen from the myocardial infarction region. An example of the detection area will be described with reference to FIG. FIG. 4 is a diagram showing a second MR image acquired by delayed contrast imaging. The detection region setting unit 31 identifies the inner membrane 140 and the outer membrane 240 in the second MR image 200 and defines the region between the inner membrane 140 and the outer membrane 240 as the detection region 250. Then, the detection area setting unit 31 outputs the coordinate information of the detection area 250 to the high signal area detection unit 32.

(High Signal Area Detection Unit 32)
The high signal region detection unit 32 receives the coordinate information of the detection region 250 from the detection region setting unit 31, and targets the detection region 250 as an object in which the luminance value is equal to or higher than a preset threshold value in the second MR image 200 ( High signal area) is detected. That is, the high signal region detection unit 32 detects a region where the luminance value is equal to or greater than the threshold value in the region between the inner membrane 140 and the outer membrane 240. At this time, it is preferable to use a relative value as the threshold value. For example, the high signal region detection unit 32 detects a region having a luminance value equal to or higher than a preset percentage in the luminance value range (0% to 100%). In the MRI apparatus, since the luminance value changes depending on the imaging conditions even in the same part, it is preferable to use a relative value based on the range of the luminance value without using the absolute value of the luminance value. . Then, the high signal region detection unit 32 outputs coordinate information of a region (high signal region) where the luminance value is equal to or greater than the threshold value to the infarct region detection unit 33.

(Infarct site detector 33)
The infarct region detection unit 33 receives the coordinate information of the high signal region from the high signal region detection unit 32, and the size of the region (high signal region) in which the luminance value is equal to or higher than the threshold in the second MR image is set in advance. A region having a predetermined size or more is detected as a myocardial infarction site. That is, the infarct region detection unit 33 detects a region in which regions having luminance values equal to or greater than the threshold in the second MR image are continuous as a myocardial infarction region. For example, as illustrated in FIG. 4, the infarct region detection unit 33 detects a myocardial infarction region 260 having a size greater than or equal to a predetermined size in a region where the luminance value is equal to or greater than a threshold in the second MR image 200. To do. Then, the infarct region detection unit 33 outputs the coordinate information of the myocardial infarction region 260 to the marker generation unit 42 of the image output unit 40.

(Image output unit 40)
Next, the image output unit 40 will be described. The image output unit 40 includes a display image input unit 41, a marker generation unit 42, a display control unit 43, and a display unit 44. The image output unit 40 displays the MR image on the display unit 44 and also displays the MR image detected by the infarct region extraction unit 30 on the MR image so that the myocardial infarction region can be identified. Hereinafter, the image output unit 40 will be described.

(Display image input unit 41)
The display image input unit 41 receives MR image data acquired by imaging the heart of the subject using the MRI apparatus, and outputs the MR image data to the display control unit 43. For example, the display image input unit 41 receives first MR image data acquired by the black blood method, and outputs the first MR image data to the display control unit 43. Alternatively, the display image input unit 41 receives second MR image data (delayed contrast image data) acquired by the delay contrast method, and outputs the second MR image data to the display control unit 43.

(Marker generator 42)
The marker generation unit 42 receives the coordinate information of the myocardial infarction site from the infarct site detection unit 33 and generates an infarct site marker representing the shape of the detected myocardial infarction site. For example, the marker generation unit 42 may generate an infarct site marker that represents the outline of the myocardial infarction site, or may generate a two-dimensional marker that fills the myocardial infarction site. In addition, the marker generation unit 42 may receive the intima coordinate information from the intima extraction unit 10 and generate an intima marker representing the detected intima shape. Similarly, the marker generation unit 42 may receive coordinate information of the outer membrane from the outer membrane extraction unit 20 and generate an outer membrane marker representing the detected shape of the outer membrane. For example, the marker generation unit 42 generates an intima marker that represents the contour of the intima, and also generates an epicardial marker that represents the contour of the epicardium. The marker generation unit 42 outputs coordinate information indicating the position of the infarct site marker, coordinate information indicating the position of the intimal marker, and coordinate information indicating the position of the epicardial marker to the display control unit 43.

(Display control unit 43)
The display control unit 43 receives MR image data from the display image input unit 41 and causes the display unit 44 to display an MR image based on the MR image data. For example, the display control unit 43 causes the display unit 44 to display a first MR image based on the first MR image data. Alternatively, the display control unit 43 causes the display unit 44 to display a second MR image (delayed contrast image) based on the second MR image data (delayed contrast image data). Further, the display control unit 43 receives the infarct site marker from the marker generation unit 42 and causes the display unit 44 to display the infarct site marker on the position of the myocardial infarction site represented in the MR image. Here, a display example of the MR image will be described with reference to FIG. FIG. 5 is a diagram illustrating an example of an MR image displayed on the display unit. As an example, the display control unit 43 causes the display unit 44 to display the first MR image 100. Further, the display control unit 43 causes the infarct site marker 290 to be superimposed and displayed at the position of the myocardial infarction site shown in the first MR image 100. As shown in FIG. 5, the display control unit 43 superimposes the intima marker 270 on the intima position represented in the first MR image 100 and superimposes the adventitia marker 280 on the epicardium position. 44 may be displayed. By highlighting and displaying the myocardial infarction site in this way, the operator can recognize the infarct site in the myocardium. The display control unit 43 may display the second MR image 200 (delayed contrast image) on the display unit 44 and display the infarct site marker 290 on the second MR image 200.

  The display unit 44 includes a monitor such as a CRT or a liquid crystal display, and displays an MR image on the screen. The medical image processing apparatus is provided with an operation unit (not shown). The operation unit includes a pointing device such as a joystick or a trackball, a switch, various buttons, or a keyboard.

  The inner membrane extraction unit 10 includes a CPU (not shown) and a storage device (not shown) such as a ROM and a RAM. The storage device stores an intima extraction program for executing the function of the intima extraction unit 10. The intima extraction program includes a first image input program for executing the function of the first image input unit 11, a first reference point setting program for executing the function of the first reference point setting unit 12, The first line setting program for executing the function of the one line setting unit 13, the first luminance value curve generating program for executing the function of the first luminance value curve generating unit 14, and the function of the first gradient calculating unit 15 are provided. A first gradient calculation program for execution and an intima detection program for executing the function of the intima detection unit 16 are included. Then, the CPU reads the first MR image data by executing the first image input program. The CPU executes the first reference point setting program to set the first reference point in the first MR image. In addition, the CPU executes the first line setting program to set the first line extending radially from the first reference point, and the first luminance value curve generation program executes each position on the first line. A first luminance value curve representing the luminance value of is generated. Further, the CPU executes the first gradient calculation program to obtain the gradient of the luminance value with respect to the position based on the first luminance value curve, and further detects the intima point based on the gradient. Then, the CPU executes the intima detection program to connect the intima points in the first lines and specify the intima of the myocardium.

  The outer membrane extraction unit 20 includes a CPU (not shown) and a storage device (not shown) such as a ROM and a RAM. The storage device stores an outer membrane extraction program for executing the function of the outer membrane extraction unit 20. The outer membrane extraction program includes a second image input program for executing the function of the second image input unit 21, a second reference point setting program for executing the function of the second reference point setting unit 22, The second line setting program for executing the function of the two-line setting unit 23, the second luminance value curve generating program for executing the function of the second luminance value curve generating unit 24, and the function of the second gradient calculating unit 25 A second gradient calculation program for execution and an outer membrane detection program for executing the function of the outer membrane detection unit 26 are included. Then, the CPU reads the second MR image data by executing the second image input program. The CPU executes the second reference point setting program to set the second reference point in the second MR image, and the CPU executes the second line setting program to radiate from the second reference point. A second luminance value curve representing the luminance value at each position on the second line is generated by setting the extended second line and executing the second luminance value curve generation program. Further, the CPU executes the second gradient calculation program to obtain the gradient of the luminance value with respect to the position based on the second luminance value curve, and further detects the outer membrane point based on the gradient. Then, when the CPU executes the outer membrane detection program, the outer membrane points in each second line are connected to identify the outer membrane of the myocardium.

  The infarct region extraction unit 30 includes a CPU (not shown) and a storage device (not shown) such as a ROM and a RAM. The storage device stores an infarct site extraction program in order to execute the function of the infarct site extraction unit 30. The infarct region extraction program includes a detection region setting program for executing the function of the detection region setting unit 31, a high signal region detection program for executing the function of the high signal region detecting unit 32, and an infarct region detection An infarct site detection program for executing the function of the unit 33 is included. Then, when the CPU executes the detection region setting program, the region between the intima and the outer membrane is defined as the detection region on the second MR image. Then, the CPU executes the high signal area detection program to detect an area having a luminance value equal to or higher than the threshold in the detection area, and further executes the infarct site detection program to detect the larger of the detected areas. A region having a predetermined size or more is detected as a myocardial infarction site.

  The display image input unit 41, the marker generation unit 42, and the display control unit 43 are each configured by a CPU (not shown) and a storage device (not shown) such as a ROM and a RAM. The storage device includes a display image input program for executing the function of the display image input unit 41, a marker generation program for executing the function of the marker generation unit 42, and display control for executing the function of the display control unit 43. The program is stored. The CPU reads the MR image data by executing the display image input program. Further, the CPU generates a marker representing the myocardial infarction site by executing the marker generation program. Then, the CPU executes the display control program, and a marker representing the myocardial infarction site is superimposed on the MR image and displayed on the display unit 44.

  An intima extraction program, an epicardium extraction program, an infarct site extraction program, a display image input program, a marker generation program, and a display control program constitute one example of the “medical image processing program” of the present invention.

  In the first embodiment, the MRI apparatus is provided outside the medical image processing apparatus. However, even if the medical image diagnostic apparatus is configured by the medical image processing apparatus and the MRI apparatus according to the first embodiment, The same operations and effects as the medical image processing apparatus according to the embodiment can be obtained.

(Operation)
Next, the operation of the medical image processing apparatus according to the first embodiment will be described with reference to FIGS. 6 to 9 are flowcharts showing a series of operations by the medical image processing apparatus according to the first embodiment of the present invention.

(Step S01)
First, the first image input unit 11 receives first MR image data acquired by imaging the heart of a subject by the black blood method using an MRI apparatus, and outputs the first MR image data to the first reference point setting unit 12.

(Step S02)
Then, the intima extraction unit 10 detects the intima of the myocardium based on the first MR image data acquired by the black blood method. Here, detailed processing in step S02 will be described with reference to FIG.

(Step S11)
The first reference point setting unit 12 sets a first reference point inside the lumen represented in the first MR image. For example, as shown in FIG. 2, a center point 103 of the first MR image 100 is detected, and the center point 103 is set as a first reference point. Then, the first reference point setting unit 12 outputs the coordinate information of the first reference point (center point 103) to the first line setting unit 13.

(Step S12)
The first line setting unit 13 sets the first line 110 and the like that extend radially from the center point 103 (first reference point) set on the first MR image 100. The first lines 110 and the like are set at predetermined angular intervals. Then, the first line setting unit 13 outputs each piece of coordinate information such as the first line 110 on the first MR image 100 to the first luminance value curve generation unit 14.

(Step S13)
The first luminance value curve generation unit 14 generates a first luminance value curve representing the luminance value at each position on each first line in the first MR image 100. For example, as illustrated in FIG. 2, the first luminance value curve generation unit 14 generates a first luminance value curve 120 representing the luminance value at each position on the first line 110 in the first MR image 100. Then, the first luminance value curve generation unit 14 outputs the first luminance value curve in each first line to the first gradient calculation unit 15.

(Step S14)
The first gradient calculation unit 15 obtains the gradient of the luminance value with respect to the position based on the first luminance value curve. Further, the first gradient calculation unit 15 detects an intima point whose gradient is a positive value and is equal to or greater than a predetermined threshold value. At this time, the first gradient calculation unit 15 detects a point at which the positive gradient is equal to or greater than the threshold and is located closest to the center point 103 (first reference point) as an intima point. That is, the first gradient calculation unit 15 searches and specifies the intima point where the positive gradient is equal to or greater than the threshold from the center point 103. The first gradient calculation unit 15 detects each intima point based on each first luminance value curve, and outputs the coordinate information of each intima point to the intima detection unit 16.

(Step S15)
The intima detection unit 16 specifies the position of the intima of the myocardium by connecting the intima points detected by the first gradient calculation unit 15. For example, as shown in FIG. 2, the intima detection unit 16 specifies the position of the intima 140 of the myocardium by connecting the intima points 130 and the like detected by the first gradient calculation unit 15.

(Step S03)
On the other hand, the second image input unit 21 receives second MR image data (delayed contrast image data) acquired by imaging the heart of the subject by delayed contrast using the MRI apparatus, and sets the second reference point. To the unit 22.

(Step S04)
Then, the outer membrane extraction unit 20 detects the outer membrane of the myocardium based on the second MR image data acquired by the delayed contrast method. Here, detailed processing in step S04 will be described with reference to FIG.

(Step S21)
The second reference point setting unit 22 sets a second reference point inside the lumen represented in the second MR image. For example, as shown in FIG. 3, a center point 203 of the second MR image 200 is detected, and the center point 203 is set as a second reference point. Then, the second reference point setting unit 22 outputs the coordinate information of the second reference point (center point 203) to the second line setting unit 23.

(Step S22)
The second line setting unit 23 sets a second line 210 and the like that extend radially from the center point 203 (second reference point) set on the second MR image 200. The second lines 210 and the like are set at predetermined angular intervals. Then, the second line setting unit 23 outputs each coordinate information such as the second line 210 on the second MR image 200 to the second luminance value curve generation unit 24.

(Step S23)
The second luminance value curve generation unit 24 generates a second luminance value curve representing the luminance value at each position on each second line in the second MR image 200. For example, as illustrated in FIG. 3, the second luminance value curve generation unit 24 generates a second luminance value curve 220 representing the luminance value at each position on the second line 210 in the second MR image 200. Then, the second luminance value curve generation unit 24 outputs the second luminance value curve in each second line to the second gradient calculation unit 25.

(Step S24)
The second gradient calculation unit 25 obtains the gradient of the luminance value with respect to the position based on the second luminance value curve. Further, the second gradient calculation unit 25 obtains the gradient of the luminance value in order from the center point 203 set in the lumen 201 to the outside, and the gradient is a negative value that is equal to or less than a predetermined threshold value. Detect the point that becomes. Next, the second gradient calculating unit 25 detects a region outside the point and having a luminance value gradient within a predetermined range. Then, the second gradient calculating unit 25 sequentially obtains the gradient of the luminance value toward the outside of the region, and a point where the gradient is a positive value and becomes equal to or greater than a predetermined threshold is determined as an outer membrane point. To detect. That is, the second gradient calculation unit 25 searches the center point 203 for the epicardial point where the positive gradient is equal to or greater than the threshold value. The second gradient calculation unit 25 detects each outer membrane point based on each second luminance value curve, and outputs the coordinate information of each outer membrane point to the outer membrane detection unit 26.

(Step S25)
The outer membrane detection unit 26 connects the outer membrane points detected by the second gradient calculation unit 25 to identify the position of the outer membrane of the myocardium. For example, as shown in FIG. 3, the outer membrane detection unit 26 specifies the position of the outer membrane 240 of the myocardium by connecting the outer membrane points 230 and the like detected by the second gradient calculation unit 25.

(Step S05)
Then, the infarct region extraction unit 30 detects the myocardial infarction region from the region between the intima and the outer membrane using the second MR image data. Here, detailed processing in step S05 will be described with reference to FIG.

(Step S31)
First, the detection region setting unit 31 specifies a region between the intima and the outer membrane based on the intima coordinate information and the outer membrane coordinate information in the second MR image (delayed contrast image), An area is defined as a detection area. For example, as illustrated in FIG. 3, the detection region setting unit 31 defines a region between the inner membrane 140 and the outer membrane 240 as the detection region 250 in the second MR image 200. Then, the detection area setting unit 31 outputs the coordinate information of the detection area 250 to the high signal area detection unit 32.

(Step S32)
The high signal area detection unit 32 detects a high signal area whose luminance value is equal to or greater than a predetermined threshold in the second MR image 200 with the detection area 250 as a target.

(Step S33, Step S34)
Then, the infarct region detection unit 33 detects, as a myocardial infarction region, a region having a size greater than or equal to a predetermined size among regions (high signal regions) where the luminance value is equal to or greater than a threshold value in the second MR image. That is, the infarct region detection unit 33 detects a region where regions where the luminance value is equal to or greater than the threshold value is continuous as a myocardial infarction region.

(Step S06)
And the marker production | generation part 42 receives the coordinate information of a myocardial infarction part from the infarction part detection part 33, and produces | generates the infarction part marker showing the shape of a myocardial infarction part. In addition, the marker generation unit 42 may generate an intima marker that represents the shape of the intima or an outer membrane marker that represents the shape of the outer membrane.

(Step S07)
On the other hand, the display image input unit 41 receives MR image data and outputs it to the display control unit 43. For example, the display image input unit 41 receives the first MR image data or the second MR image data and outputs it to the display control unit 43. The display control unit 43 causes the display unit 44 to display the first MR image or the second MR image, and further superimposes the infarct site marker on the position of the myocardial infarction site represented in the first MR image or the second MR image. To display. For example, as shown in FIG. 5, the display control unit 43 causes the display unit 44 to display an infarct site marker 290 on the position of the myocardial infarction site represented in the first MR image 100. Furthermore, the display control unit 43 may cause the display unit 44 to display the intima marker 270 superimposed on the intima position represented in the first MR image 100 and the epicardium marker 280 superimposed on the epicardial position. .

  As described above, the intima is detected based on the first MR image acquired by the black blood method, the adventitia is detected based on the second MR image acquired by the delayed contrast method, and the intima and outer membrane are detected. By setting the interval as the detection region, it becomes possible to more accurately detect the myocardial infarction region based on the luminance value of the second MR image. That is, even if the difference between the luminance value of the lumen and the luminance value of the myocardial infarction region is small in the second MR image, the intima is detected based on the first MR image acquired by the black blood method, and the intima By making the outside of the detection region a detection region, it is possible to detect the myocardial infarction region by distinguishing the lumen from the myocardial infarction region in the second MR image. Then, by generating a marker representing the myocardial infarction region and displaying it on the MR image, the position and extent of the myocardial infarction region can be observed. As described above, since the myocardial infarction region can be highlighted and displayed on the high-resolution MR image, the myocardium is compared with the inspection methods such as CAG inspection, SPECT inspection, and PET inspection according to the prior art. It is possible to provide information effective for the diagnosis of infarction.

  In the first embodiment, the intima, the outer membrane, and the myocardial infarction site are detected with respect to the MR image in one cross section, but the detection may be performed with respect to MR images in a plurality of cross sections. In this case, the first MR image data group including the first MR image data in the plurality of cross sections is acquired using the MRI apparatus, and the second MR image data group including the second MR image data in the plurality of cross sections is acquired. The intima extracting unit 10 detects the intima from each first MR image of each cross section included in the first MR image data group. The outer membrane extraction unit 20 detects the outer membrane from the second MR image of each cross section included in the second MR image data group. Then, the infarct region extraction unit 30 detects the myocardial infarction region from the second MR image in each cross section. And the infarct site extraction part 30 specifies the myocardial infarction site | part in three-dimensional space by connecting the myocardial infarction site | part in each cross section. This makes it possible to grasp the position and extent of the myocardial infarction site in the three-dimensional space.

[Second Embodiment]
Next, a medical image processing apparatus according to a second embodiment of the present invention will be described with reference to FIG. FIG. 10 is a block diagram showing a medical image processing apparatus according to the second embodiment of the present invention.

  The medical image processing apparatus according to the second embodiment includes an outer membrane extraction unit 20A instead of the outer membrane extraction unit 20 according to the first embodiment. The outer membrane extraction unit 20A according to the second embodiment includes an inner membrane expansion unit 27 in addition to the outer membrane extraction unit 20 according to the first embodiment. Since the configuration other than the outer membrane extraction unit 20A is the same as the configuration of the medical image processing apparatus according to the first embodiment, the outer membrane extraction unit 20A will be described in detail.

(Inner membrane extraction unit 10)
The intima extraction unit 10 detects the intima of the myocardium based on the first MR image data acquired by the black blood method, as in the first embodiment described above. The intima detection unit 16 outputs the detected intima coordinate information to the detection region setting unit 31 and the marker generation unit 42, and further outputs to the intima extension unit 27 of the outer membrane extraction unit 20A.

(Outer membrane extraction unit 20A)
The outer membrane extraction unit 20A according to the second embodiment expands the position of the inner membrane detected by the inner membrane extraction unit 10 using a morphological filter, and is based on the second MR image data (delayed contrast image data). Thus, the outer membrane is detected between the inner membrane and the expanded position.

(Intimal expansion part 27)
The intima expander 27 receives the intima coordinate information from the intima detector 16 and expands the intima using a morphological filter, thereby obtaining the position of the intima. For example, the intima-expansion unit 27 obtains the intima by increasing the size of the intima while maintaining the intima shape. At this time, it is preferable that the intima-expanding portion 27 changes the size of the range in which the intima is expanded in accordance with the heart region. That is, since the thickness of the myocardium is different for each part of the heart, it is preferable to change the size of the range for expanding the intima for each part of the heart in order to respond to the thickness. As an example, in the case of the atrial wall, the intima is expanded by 2-3 mm, in the case of the right ventricular wall, by 2-4 mm, the intima is expanded, in the case of the left ventricular wall, by 8-11 mm, the intima Expand. Then, the intima extension unit 27 outputs the intima coordinate information and the expanded intima coordinate information to the second gradient calculation unit 25.

  Here, the inner membrane expanded by the morphological filter is shown in FIG. FIG. 11 is a diagram showing a second MR image acquired by delayed contrast imaging. The second MR image 200 is a two-dimensional image acquired by delayed contrast imaging. Similar to the first embodiment described above, the second reference point setting unit 22 sets the center point 203 of the second MR image 200 as the second reference point. The inner membrane 140 is a membrane detected by the inner membrane extraction unit 10. The dilated intima 150 is a film dilated by the intimal dilator 27.

  As in the first embodiment described above, the second line setting unit 23 sets a plurality of second lines 210 that extend radially from the second reference point. The second luminance value curve generation unit 24 generates a second luminance value curve that represents the luminance value at each position on each second line.

(Second gradient calculation unit 25)
And the 2nd gradient calculation part 25 calculates | requires the gradient of the luminance value with respect to a position based on a 2nd luminance value curve. For example, as illustrated in FIG. 11, the second gradient calculating unit 25 obtains the gradient of the luminance value at each position on the second line based on the second luminance value curve 220 representing the luminance value on the second line 210. . And the 2nd gradient calculation part 25 detects an outer-membrane point based on the gradient of a luminance value. In the second embodiment, the second gradient calculation unit 25 detects an epicardial point in the detection region, with the area between the intima 140 and the expanded intima 150 as a detection region. That is, the second gradient calculation unit 25 sequentially obtains the gradient of the luminance value from the position of the inner membrane 140 toward the outside, and the point where the gradient is a positive value and becomes equal to or greater than a preset threshold value. Detect as outer membrane point. At this time, the second gradient calculation unit 25 sequentially obtains the gradient of the luminance value from the position of the intima 140 toward the outside in the detection region between the intima 140 and the expanded intima 150. The point (the innermost point) at which the gradient of the first becomes equal to or greater than the threshold value is detected as an epicardial point. For example, as shown in FIG. 11, the second gradient calculation unit 25 obtains a gradient of the luminance value for the range between the intima 140 and the expanded intima 150 based on the second luminance value curve 220, and corrects it. The outer membrane point 230 where the gradient is equal to or greater than the threshold value is detected for the first time. Then, the second gradient calculation unit 25 obtains the gradient of the luminance value between the inner membrane 140 and the expanded inner membrane 150 for the second luminance value curve other than the second luminance value curve 220, and based on the gradient. Obtain the outer membrane point. The second gradient calculation unit 25 outputs the coordinate information of each outer membrane point to the outer membrane detection unit 26.

  Note that the second gradient calculation unit 25 uses the range from the inner side of the intima to the dilated intima as a detection region in order to take a margin for the position of the intima in consideration of the influence of noise. The outer membrane may be detected in the region. For example, the second gradient calculation unit 25 may detect the adventitia within the detection region, with the range from the position inward of the intima 140 to the dilated intima 150 as a detection region.

(Outer membrane detection unit 26)
The outer membrane detection unit 26 specifies the position of the outer membrane of the myocardium by connecting the outer membrane points as in the first embodiment described above. For example, as shown in FIG. 11, the outer membrane detection unit 26 specifies the position of the outer membrane 240 of the myocardium by connecting the outer membrane points 230 and the like detected by the second gradient calculation unit 25. Then, the outer membrane detection unit 26 outputs the coordinate information of the outer membrane 240 to the detection region setting unit 31 and the marker generation unit 42.

  Similar to the first embodiment, the infarct region detection unit 33 uses the region between the intima and the adventitia as a detection region, based on the second MR image data (delayed contrast image data), and based on the luminance value. Identify the infarct site. Similarly to the first embodiment, the image output unit 40 generates an infarct site marker representing a myocardial infarction site, and superimposes the infarct site marker on the MR image such as the first MR image or the second MR image. 44.

  The outer membrane extraction unit 20A includes a CPU and a storage device. The storage device stores an outer membrane extraction program for executing the function of the outer membrane extraction unit 20A. In addition to the program according to the first embodiment, the outer membrane extraction program according to the second embodiment includes an intima extension program for executing the function of the intima extension unit 27.

  Similarly to the first embodiment, even if the medical image diagnostic apparatus is configured by the medical image processing apparatus and the MRI apparatus according to the second embodiment, the same operation and effect as the medical image processing apparatus according to the second embodiment. It is possible to play.

(Operation)
Next, the operation of the medical image processing apparatus according to the second embodiment will be described with reference to FIGS. 12 and 13 are flowcharts showing a series of operations by the medical image processing apparatus according to the second embodiment of the present invention.

(Step S41, Step S42)
As in the first embodiment, the intima extraction unit 10 reads the first MR image data acquired by the black blood method, and detects the intima of the myocardium based on the first MR image data. The intima detection process in step S42 is the same as the process according to the first embodiment, and a description thereof will be omitted. The intima extraction unit 10 outputs intima coordinate information to the detection region setting unit 31, the marker generation unit 42, and the intima extension unit 27.

(Step S43, Step S44)
On the other hand, the second image input unit 21 of the outer membrane extraction unit 20A reads the second MR image data (delayed contrast image data) acquired by the delay contrast method (step S43), and the second MR is input to the second reference point setting unit 22. Output image data. Then, the outer membrane extraction unit 20A detects the outer membrane between the intima and the dilated intima based on the second MR image data (step S44). Here, detailed processing in step S44 will be described with reference to FIG.

(Step S51)
First, the second reference point setting unit 22 sets the second reference point inside the lumen shown in the second MR image, as in the first embodiment. For example, as shown in FIG. 11, the center point 203 of the second MR image 200 is detected, and the center point 203 is set as the second reference point.

(Step S52)
The intima expander 27 receives the intima coordinate information from the intima detector 16 and expands the intima using a morphological filter to determine the position of the intima. For example, the intima-expansion unit 27 obtains the intima by increasing the size of the intima while maintaining the intima shape. Then, the intima expander 27 outputs the intima coordinate information and the expanded intima coordinate information to the second gradient calculator 25. For example, as shown in FIG. 11, the intima extension unit 27 expands the intima 140 to obtain the position of the intima 150, and the coordinate information of the intima 140 and the coordinate information of the dilatation intima 150 are second gradient It outputs to the calculation part 25.

(Step S53)
On the other hand, the second line setting unit 23 sets a plurality of second lines 210 and the like that extend radially from the center point 203 (second reference point) set on the second MR image 200, and each of the second lines 210 and the like. Is output to the second luminance value curve generation unit 24.

(Step S54)
The second luminance value curve generation unit 24 generates a second luminance value curve representing the luminance value at each position on each second line in the second MR image 200, and the second luminance value curve in each second line is generated. It outputs to the 2nd gradient calculation part 25.

(Step S55)
The second gradient calculating unit 25 detects an epicardial point in the detection area, with the area between the intima and the dilated intima as a detection area. For example, as shown in FIG. 11, the second gradient calculating unit 25 obtains the gradient of the luminance value in order from the position of the intima 140 toward the outside, and the gradient is a positive value, and for the first time exceeds the threshold value. Is detected as an outer membrane point. At this time, the second gradient calculating unit 25 obtains the gradient of the luminance value between the intima 140 and the expanded intima 150, and detects the epicardial point based on the gradient. For example, as shown in FIG. 11, the second gradient calculation unit 25 obtains a gradient of the luminance value for the range between the intima 140 and the expanded intima 150 based on the second luminance value curve 220, and corrects it. The outer membrane point 230 where the gradient is equal to or greater than the threshold is detected for the first time. The second gradient calculation unit 25 detects each outer membrane point based on each second luminance value curve, and outputs the coordinate information of each outer membrane point to the outer membrane detection unit 26.

(Step S56)
The outer membrane detection unit 26 connects the outer membrane points detected by the second gradient calculation unit 25 to identify the position of the outer membrane of the myocardium. For example, as shown in FIG. 11, the outer membrane detection unit 26 specifies the position of the outer membrane 240 of the myocardium by connecting the outer membrane points 230 and the like detected by the second gradient calculation unit 25.

(Step S45)
Then, the infarct region extraction unit 30 detects the myocardial infarction region based on the luminance value of the second MR image data, using the second MR image data as a detection region.

(Step S46, Step S47)
The marker generation unit 42 generates an infarct site marker representing the shape of the myocardial infarction site (step S47). Then, the display control unit 43 causes the display unit 44 to display an infarct site marker on the position of the myocardial infarction site represented in the MR image such as the first MR image or the second MR image.

  As described above, also in the medical image processing apparatus according to the second embodiment, it is possible to more accurately detect a myocardial infarction region based on the luminance value by setting the area between the intima and the adventitia as a detection region. It becomes possible.

  Similarly to the first embodiment, for MR images in a plurality of cross sections, an intima, an outer membrane, and a myocardial infarction site may be detected in each cross section. Thereby, the position and extent of myocardial infarction in the three-dimensional space can be grasped.

[Third Embodiment]
Next, a medical image processing apparatus according to a third embodiment of the invention will be described with reference to FIG. FIG. 14 is a block diagram showing a medical image processing apparatus according to the third embodiment of the present invention.

  The medical image processing apparatus according to the third embodiment includes an image analysis unit 50 instead of the image output unit 40 according to the first embodiment. Since the intima extraction unit 10, the outer membrane extraction unit 20, and the infarct region extraction unit 30 perform the same processing as the medical image processing apparatus according to the first embodiment, the image analysis unit 50 will be described in detail. Instead of the outer membrane extraction unit 20, an outer membrane extraction unit 20A according to the second embodiment may be provided.

(Image analysis unit 50)
The image analysis unit 50 includes an analysis unit 51, a display control unit 52, and a display unit 53. The analysis unit 51 receives intima coordinate information from the intima detection unit 16, receives epicardial coordinate information from the outer membrane detection unit 26, and receives myocardial infarction site coordinate information from the infarct site detection unit 33. For example, the intima extraction unit 10 detects the intima in each cross section for the first MR images in a plurality of cross sections. Similarly, the outer membrane extraction unit 20 detects the outer membrane in each cross section for the second MR images in a plurality of cross sections. Then, the infarct region extraction unit 30 detects the myocardial infarction region from the second MR image in each cross section. Then, the intima detection unit 16 outputs the intima coordinate information in each cross section to the analysis unit 51, and the epicardium detection unit 26 outputs the epicardial coordinate information in each cross section to the analysis unit 51, and the infarct site The detection unit 33 outputs the coordinate information of the myocardial infarction site in each cross section to the analysis unit 51.

  The analysis unit 51 arranges the intima, the adventitia, and the myocardial infarction site in a plurality of cross sections in the same space, thereby creating so-called Bull's eye data in which the change in luminance value over time is represented as a color map. . The display control unit 52 causes the display unit 53 to display an image based on the data.

  In addition, when the intima, the outer membrane, and the myocardial infarction site are detected from the MR images in each cross section of each time phase, their motion can be displayed as a moving image. For example, the intima extraction unit 10 detects the intima from the first MR image in each cross section of each time phase, and the outer membrane extraction unit 20 detects the adventitia from the second MR image in each cross section of each time phase, The infarct region extraction unit 30 detects a myocardial infarction region from the second MR image in each cross section of each time phase. The analysis unit 51 receives such information and generates three-dimensional image data in each time phase based on the intima, outer membrane, and myocardial infarction site of each cross section in each time phase. The display control unit 52 causes the display unit 53 to display the three-dimensional image in each time phase in the order of time phases.

  Here, an image obtained by the analysis unit 51 is shown in FIG. FIG. 15 is a diagram illustrating an image obtained from a detection result of a myocardial infarction site or the like. For example, the color map image 310 can display the relative positional relationship between the adventitia and the myocardial infarction site in a Bull's eye. In the color map image 310, the myocardial infarction site can be represented by changing the display color according to the change in luminance value with time. Moreover, the behavior of the heart can be displayed as a moving image by displaying the three-dimensional image 300 in each time phase in the order of the time phase.

  The analysis unit 51 includes a CPU and a storage device. In the storage device, an analysis program for executing the function of the analysis unit 51 is stored. When the CPU executes the analysis program, image data such as a color map image is generated.

  Similarly to the first embodiment, even if the medical image diagnostic apparatus is configured by the medical image processing apparatus and the MRI apparatus according to the third embodiment, the same operation and effect as the medical image processing apparatus according to the third embodiment. It is possible to play.

[Fourth Embodiment]
Next, a medical image processing apparatus according to the fourth embodiment of the present invention will be described with reference to FIG. FIG. 16 is a block diagram showing a medical image processing apparatus according to the fourth embodiment of the present invention.

  The medical image processing apparatus according to the fourth embodiment includes an image output unit 40A instead of the image output unit 40 according to the first embodiment. The image output unit 40A according to the fourth embodiment includes a responsible blood vessel detection unit 45 in addition to the image output unit 40 according to the first embodiment. Since the configuration other than the image output unit 40A is the same as the configuration of the medical image processing apparatus according to the first embodiment, the image output unit 40A will be described in detail. Instead of the outer membrane extraction unit 20, an outer membrane extraction unit 20A according to the second embodiment may be provided.

  In the fourth embodiment, three-dimensional image data of the entire region of the heart is collected using the Whole Heart Imaging technique using an MRI apparatus. For example, by using an imaging method such as 3D Balanced TFE method, 3D image data of the heart can be collected. By performing respiration synchronization and k-space processing, artifacts peculiar to the heart can be reduced.

  The display image input unit 41 receives the three-dimensional image data of the heart and outputs it to the display control unit 43 and the responsible blood vessel detection unit 45. Similarly to the third embodiment, the infarct region detection unit 33 detects a myocardial infarction region in each cross section from each of the second MR images in a plurality of cross sections, and takes the coordinate information of the myocardial infarction region in each cross section as the responsible blood vessel. Output to the detector 45.

  The responsible blood vessel detection unit 45 specifies a candidate blood vessel (responsible blood vessel) to be treated from the three-dimensional image by using the position of the myocardial infarction site. The responsible blood vessel detection unit 45 detects the branch (blood vessel) of the coronary artery from the three-dimensional image, and uses the relative positional relationship between the branch of the coronary artery and the wall motion abnormal site (myocardial infarction site), thereby Detect candidates for. As a publicly known technique, a method for specifying which part (branch) each coronary artery branch is anatomically proposed is proposed. By using this method, the responsible blood vessel detection unit 45 identifies a specific branch (blood vessel) as a responsible blood vessel candidate from the three-dimensional image based on the region information of the imaging target at the time of imaging.

  Alternatively, the responsible blood vessel detection unit 45 performs a known technique of myocardial infarction (Electronic Information and Communication Society paper D-II Vol. J88-D-II No. 5 pp. 943-953) and takes responsibility from a three-dimensional image. Blood vessel candidates may be specified. Alternatively, the responsible blood vessel detection unit 45 may expand a wall motion abnormality site (for example, a myocardial infarction site) in the three-dimensional image with a morphological filter and specify the coronary artery that is first contacted as a responsible blood vessel candidate. good. Alternatively, the responsible blood vessel detection unit 45 calculates the distance from the detected coronary artery branch to the wall motion abnormality site (myocardial infarction site), and specifies a nearby branch whose distance is within the threshold as a responsible blood vessel candidate. good.

  The responsible blood vessel detection unit 45 outputs the detected coordinate information of the responsible blood vessel to the marker generation unit 42. The marker generation unit 42 generates an infarct site marker that represents the shape of the myocardial infarction site, and further generates a responsible blood vessel marker that represents the shape of the responsible blood vessel.

  The display control unit 43 receives the three-dimensional image data of the heart from the display image input unit 41 and causes the display unit 44 to display a three-dimensional image based on the three-dimensional image data. Further, the display control unit 43 superimposes the infarct site marker on the position of the myocardial infarction site represented in the three-dimensional image, and displays the responsible blood vessel marker on the position of the responsible blood vessel on the display unit 44.

  Here, a three-dimensional image of the heart is shown in FIG. FIG. 17 is a diagram showing a three-dimensional image of the heart. The display control unit 43 superimposes the infarct site marker 420 on the position of the myocardial infarction site represented in the three-dimensional image 400 of the heart, and causes the display unit 44 to display the responsible blood vessel marker 410 on the position of the responsible blood vessel. Thus, by identifying the responsible blood vessel and the myocardial infarction site and emphasizing them, it is possible to grasp the blood vessel to be treated. Furthermore, by highlighting and displaying the myocardial infarction region on a high-resolution three-dimensional MR image, it is possible to observe the position and extent of myocardial infarction region, which is clinically important information, in three dimensions. It becomes.

  Further, instead of superimposing the infarct site marker on the position of the myocardial infarction site, the display control unit 43 represents the myocardial infarction site represented in the three-dimensional image 400 of the heart as a colored polygon in the three-dimensional image 400. It may be displayed in an overlapping manner. Further, instead of the infarct site marker, the display control unit 43 may display the myocardial infarction site and other sites in the three-dimensional image 400 of the heart on the display unit 44 with different display conditions. In this way, by displaying the myocardial infarction site with a colored polygon or by changing the display conditions, the myocardial infarction site can be highlighted and displayed.

  The responsible blood vessel detection unit 45 includes a CPU and a storage device. The storage device stores a responsible blood vessel detection program for executing the function of the responsible blood vessel detection unit 45. Then, the responsible blood vessel is detected by the CPU executing the responsible blood vessel detection program.

  Similarly to the first embodiment, even if the medical image diagnostic apparatus is configured by the medical image processing apparatus and the MRI apparatus according to the fourth embodiment, the same operation and effect as the medical image processing apparatus according to the fourth embodiment. Can be played.

[Fifth Embodiment]
Next, a medical image processing apparatus according to a fifth embodiment of the invention will be described with reference to FIG. FIG. 18 is a block diagram showing a medical image processing apparatus according to the fifth embodiment of the present invention.

  The medical image processing apparatus according to the fifth embodiment includes an evaluation unit 60 in addition to the medical image processing apparatus according to the first embodiment. Since the configuration other than the evaluation unit 60 is the same as the configuration of the medical image processing apparatus according to the first embodiment, the evaluation unit 60 will be described in detail. Instead of the outer membrane extraction unit 20, an outer membrane extraction unit 20A according to the second embodiment may be provided.

  In the fifth embodiment, a first MR image data group including first MR image data in a plurality of cross sections is acquired using an MRI apparatus, and a second MR image data group including second MR image data in a plurality of cross sections is acquired. The intima extraction unit 10 detects each intima from the first MR image of each cross section, and the outer membrane extraction unit 20 detects each outer film from the second MR image of each cross section. Then, the infarct region extraction unit 30 detects the myocardial infarction region from the second MR image in each cross section. The outer membrane detection unit 26 outputs the coordinate information of the outer membrane in each cross section to the detection region setting unit 31, the marker generation unit 42, and the determination unit 61 of the evaluation unit 60. Further, the infarct region detection unit 33 outputs the coordinate information of the myocardial infarction region in each cross section to the marker generation unit 42 and the determination unit 61.

(Evaluation part 60)
The evaluation unit 60 includes a determination unit 61 and an evaluation value calculation unit 62. The evaluation unit 60 determines whether the detected myocardial infarction site is a transmural wall based on the myocardial infarction site of each cross section detected by the infarct site extraction unit 30 and the outer membrane of each cross section detected by the outer membrane extraction unit 20. It is determined whether the infarct is a transmural infarction, and if it is determined to be a transmural infarction, an evaluation value indicating the extent of the myocardial infarction site is obtained. Hereinafter, each part of the evaluation unit 60 will be described.

(Determination unit 61)
The determination unit 61 receives the coordinate information of the myocardial infarction site in each cross section from the infarct site detection unit 33, and receives the coordinate information of the epicardium in each cross section from the epicardium detection unit 26. And the determination part 61 specifies the position of the myocardial infarction site | part in the three-dimensional space, and the position of the adventitia by arrange | positioning the myocardial infarction site | part and outer membrane | film | coat in each cross section on the same space. For example, the determination unit 61 specifies the position of the myocardial infarction site in the three-dimensional space by connecting the myocardial infarction sites in each cross section, and connects the epicardium in each cross section to connect the epicardium in the three-dimensional space. Identify the location. Then, the determination unit 61 determines whether or not the myocardial infarction site and the outer membrane are in contact with each other based on the position of the myocardial infarction site and the position of the outer membrane in the three-dimensional space. When the myocardial infarction site is not in contact with the outer membrane, the determination unit 61 determines that the myocardial infarction site is a non-transmural infarction. On the other hand, when the myocardial infarction site and the outer membrane are in contact with each other, the determination unit 61 determines that the part of the myocardial infarction in contact with the transmural infarction. Based on this determination, the determination unit 61 specifies the position of the non-transmural infarction and the position of the transmural infarction.

  A method for determining transmural infarction will be described with reference to FIG. FIG. 19 is a diagram illustrating an image for explaining processing for determining transmurality. For example, in the MR image 510 in a certain cross section, since the outer membrane 512 and the myocardial infarction site 513 are not in contact, the determination unit 61 determines that the myocardial infarction site 513 in this cross section is a non-transmural infarction. On the other hand, since the outer membrane 522 and the myocardial infarction site 523 are in contact with each other in the MR image 520 in a certain cross section, the determination unit 61 determines the myocardial infarction site 523 in this cross section as a transmural infarction. In this manner, the determination unit 61 determines whether the myocardial infarction site and the outer membrane are in contact with each other in each part of the three-dimensional space, thereby converting the myocardial infarction site into a non-transmural infarction and a transmural infarction. Classify. Then, the determination unit 61 outputs the coordinate information of the non-transmural infarction and the coordinate information of the transmural infarction to the display control unit 43.

(Evaluation Value Calculation Unit 62)
Based on the position of the myocardial infarction site and the position of the adventitia in the three-dimensional space, the evaluation value calculation unit 62 obtains the area of the portion where the myocardial infarction site and the adventitia are in contact. This area is used for evaluation of myocardial infarction as Transient Extent (an index of the extent of myocardial infarction from the intima to the outer membrane). Then, the evaluation value calculation unit 62 outputs the area value of the contacting part to the display control unit 43.

  The display control unit 43 receives MR image data from the display image input unit 41 and causes the display unit 44 to display the MR image. Further, the display control unit 43 receives the infarct site marker representing the myocardial infarction site from the marker generation unit 42 and causes the display unit 44 to display the infarct site marker on the position of the myocardial infarction site represented in the MR image. . Further, the display control unit 43 receives the area value of the portion where the myocardial infarction site and the outer membrane are in contact with each other from the evaluation value calculation unit 62 and causes the display unit 44 to display the area value. The display control unit 43 receives the coordinate information of the non-transmural infarction and the coordinate information of the transmural infarction from the determination unit 61, and displays the infarct site marker representing the non-transmural infarction and the transmural infarction. The displayed infarct site marker is displayed on the display unit 44 separately. For example, the display control unit 43 changes the color of the infarct site marker for non-transmural infarction and the color of the infarct site marker for transmural infarction to display on the display unit 44.

  An example of an image displayed on the display unit 44 is shown in FIG. For example, the display control unit 43 receives the two-dimensional MR image data from the display image input unit 41, and displays the infarct region marker superimposed on the position of the myocardial infarction region 513 represented in the MR image 510 of the two-dimensional image. This is displayed on the unit 44. In addition, the display control unit 43 receives the two-dimensional MR image data in another cross section from the display image input unit 41, and displays the infarct site marker at the position of the myocardial infarction site 523 represented in the MR image 520 of the two-dimensional image. Are displayed on the display unit 44. Further, the display control unit 43 distinguishes between the infarct site marker for non-transmural infarction and the infarct site marker for transmural infarction based on the transmural determination result by the determination unit 61 and causes the display unit 44 to display it. . Specifically, the display control unit 43 receives the coordinate information of the non-transmural infarction and the coordinate information of the transmural infarction from the determination unit 61, and determines the position of the non-transmural infarction and the transmural infarction. The position is specified, and an infarct site marker representing each infarct site is distinguished and displayed on the display unit 44. For example, when the determination unit 61 determines that the myocardial infarction region 513 represented in the MR image 510 is a non-transmural infarction, the display control unit 43 sets the color of the infarction region marker in advance. Instead of the transmural infarct color, the image is displayed on the display unit 44 so as to overlap the MR image 510. When the determination unit 61 determines that the myocardial infarction region 523 represented in the MR image 520 is a transmural infarction, the display control unit 43 sets the color of the infarct region marker in advance. Instead of the color of the cerebral infarction, the image is displayed on the display unit 44 so as to overlap the MR image 520. Thus, the transmural infarction and the non-transmural infarction are distinguished and displayed on the display unit 44. In addition, the display control unit 43 displays the marker indicating the intima 511 and the marker 512 indicating the outer membrane 512 on the display unit 44 so as to overlap the MR image 510 and displays the marker indicating the inner membrane 521 and the marker indicating the outer membrane 522. And the MR image 520 may be displayed on the display unit 44.

  As shown in FIG. 19, the display control unit 43 may receive three-dimensional MR image data from the display image input unit 41 and display a three-dimensional image 500 of the heart on the display unit 44. Further, the display control unit 43 causes the display unit 44 to display the infarct site marker 501 and the infarct site marker 502 on the position of the myocardial infarction site represented in the three-dimensional image 500. At this time, the display control unit 43 distinguishes between the infarct site marker of the non-transmural infarction and the infarct site marker of the transmural infarction on the display unit 44 based on the determination result of the transmural property by the determination unit 61. Let In the example shown in FIG. 19, the display control unit 43 represents a transmural infarct site by the infarct site marker 501 and represents a non-transmural infarct site by the infarct site marker 502. Then, the display control unit 43 changes the color of the infarct site marker 501 and the color of the infarct site marker 502 to display on the display unit 44.

  The evaluation unit 60 includes a CPU and a storage device. In the storage device, an evaluation program for executing the function of the evaluation unit 60 is stored. The evaluation program includes a determination program for executing the function of the determination unit 61 and an evaluation value calculation program for executing the function of the evaluation value calculation unit 62. Then, the CPU executes the determination program to determine transmurality based on the positional relationship between the outer membrane and the myocardial infarction site. Further, the CPU executes the evaluation value calculation program to obtain the area of the portion where the outer membrane is in contact with the myocardial infarction site.

  Similarly to the first embodiment, even if the medical image diagnostic apparatus is configured by the medical image processing apparatus and the MRI apparatus according to the fifth embodiment, the same operations and effects as the medical image processing apparatus according to the fifth embodiment are provided. It is possible to play.

(Operation)
Next, the operation of the medical image processing apparatus according to the fifth embodiment will be described with reference to FIG. FIG. 20 is a flowchart showing a series of operations by the medical image processing apparatus according to the fifth embodiment of the present invention.

(Step S61)
The determination unit 61 receives the epicardial coordinate information in each cross section from the epicardial detection unit 26 and the coordinate information of the myocardial infarction site in each cross section from the infarct site detection unit 33. Then, the determination unit 61 locates the outer membrane and the myocardial infarction site in each cross section in the same three-dimensional space, thereby specifying the position of the outer membrane and the position of the myocardial infarction site in the three-dimensional space.

(Step S62)
Then, the determination unit 61 determines whether or not the myocardial infarction site is in contact with the outer membrane based on the position of the outer membrane and the position of the myocardial infarction site in the three-dimensional space.

(Step S63)
When the myocardial infarction site is not in contact with the adventitia (step S62, No), the determination unit 61 determines that the myocardial infarction site is non-transmural (step S63) and outputs the determination result to the display control unit 43. To do. For example, the determination unit 61 outputs the coordinate information of the non-transmural infarction to the display control unit 43.

(Step S64)
Upon receiving the determination result from the determination unit 61, the display control unit 43 displays the MR image on the display unit 44, and further processes the infarct region marker representing the myocardial infarction region into a marker representing the non-transmural infarction. Then, the image is displayed superimposed on the position of the myocardial infarction site shown in the MR image. For example, the display control unit 43 changes the color of the infarct region marker to a preset color of non-transmural infarction and causes the display unit 44 to display the color. For example, as shown in FIG. 19, the display control unit 43 superimposes an infarct site marker 513 indicating a non-transmural infarction on the position of the myocardial infarction site shown in the two-dimensional MR image 510 on the display unit 44. Display. In addition, the display control unit 43 causes the display unit 44 to display an infarct site marker 502 representing non-transmural infarction at the position of the myocardial infarction site represented in the three-dimensional image 500.

(Step S65)
On the other hand, if the myocardial infarction site is in contact with the adventitia (step S62, Yes), the determination unit 61 determines that the myocardial infarction site is transmural (step S65) and sends the determination result to the display control unit 43. Output. For example, the determination unit 61 outputs coordinate information of transmural infarction to the display control unit 43.

(Step S66)
Based on the position of the myocardial infarction site and the position of the adventitia in the three-dimensional space, the evaluation value calculation unit 62 obtains the area of the portion where the myocardial infarction site and the adventitia are in contact and controls the display of the area value. To the unit 43.

(Step S67)
When the display control unit 43 displays the MR image on the display unit 44 and further receives an area value from the evaluation value calculation unit 62, the display control unit 43 displays the area value as an evaluation value indicating the extent of the myocardial infarction site. This is displayed on the unit 44. Further, the display control unit 43 processes the infarct site marker representing the myocardial infarction site into a marker representing the transmural infarction and displays the marker on the position of the myocardial infarction site represented in the MR image. For example, the display control unit 43 changes the color of the infarct site marker to a preset color of transmural infarction and causes the display unit 44 to display the color. For example, as illustrated in FIG. 19, the display control unit 43 displays an infarct site marker representing a transmural infarction on the display unit 44 at the position of the myocardial infarction site 523 represented in the two-dimensional MR image 520. Let Further, the display control unit 43 causes the display unit 44 to display an infarct site marker 501 representing a transmural infarction at the position of the myocardial infarction site represented in the three-dimensional image 500.

  When it is determined that the myocardial infarction site is transmural, it is necessary to treat immediately, so distinguishing between transmural and non-transmural is important when determining the urgency of treatment. Useful. In the fifth embodiment, it is determined whether or not the myocardial infarction site is transmural based on the positional relationship between the outer membrane and the myocardial infarction site, and the determination result is displayed on the display unit 44. Accordingly, by observing the MR image displayed on the display unit 44, it is possible to determine whether the myocardial infarction site is transmural or non-transmural, and to determine the urgency of treatment. Furthermore, by displaying the value of the area where the myocardial infarction site is in contact with the outer membrane, the extent of the myocardial infarction site from the intima to the outer membrane can be evaluated.

  There is a demand for diagnosis of the heart region by so-called one-stop shop inspection using an MRI apparatus. According to the medical image processing apparatus according to the first to fifth embodiments described above, it is possible to provide useful information in the one-stop shop examination.

1 is a block diagram illustrating a medical image processing apparatus according to a first embodiment of the present invention. It is a figure which shows the 1st MR image acquired by the black blood method. It is a figure which shows the 2nd MR image acquired by the delay contrast method. It is a figure which shows the 2nd MR image acquired by the delay contrast method. It is a figure which shows an example of MR image displayed on a display part. It is a flowchart which shows a series of operation | movement by the medical image processing apparatus which concerns on 1st Embodiment of this invention. It is a flowchart which shows a series of operation | movement by the medical image processing apparatus which concerns on 1st Embodiment of this invention. It is a flowchart which shows a series of operation | movement by the medical image processing apparatus which concerns on 1st Embodiment of this invention. It is a flowchart which shows a series of operation | movement by the medical image processing apparatus which concerns on 1st Embodiment of this invention. It is a block diagram which shows the medical image processing apparatus which concerns on 2nd Embodiment of this invention. It is a figure which shows the 2nd MR image acquired by the delay contrast method. It is a flowchart which shows a series of operation | movement by the medical image processing apparatus which concerns on 2nd Embodiment of this invention. It is a flowchart which shows a series of operation | movement by the medical image processing apparatus which concerns on 2nd Embodiment of this invention. It is a block diagram which shows the medical image processing apparatus which concerns on 3rd Embodiment of this invention. It is a figure which shows the image obtained from detection results, such as a myocardial infarction site | part. It is a block diagram which shows the medical image processing apparatus which concerns on 4th Embodiment of this invention. It is a figure which shows the three-dimensional image of the heart. It is a block diagram which shows the medical image processing apparatus which concerns on 5th Embodiment of this invention. It is a figure which shows the image for demonstrating the process which performs a penetration-wall property determination. It is a flowchart which shows a series of operation | movement by the medical image processing apparatus which concerns on 5th Embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Inner membrane extraction part 11 1st image input part 12 1st reference point setting part 13 1st line setting part 14 1st luminance value curve generation part 15 1st gradient calculation part 16 Intima detection part 20, 20A Outer membrane extraction part 21 Second Image Input Unit 22 Second Reference Point Setting Unit 23 Second Line Setting Unit 24 Second Luminance Value Curve Generation Unit 25 Second Gradient Calculation Unit 26 Outer Membrane Detection Unit 27 Intimal Expansion Unit 30 Infarct Site Extraction Unit 31 Detection Region setting unit 32 High signal region detection unit 33 Infarct site detection unit 40, 40A Image output unit 41 Display image input unit 42 Marker generation unit 43, 52 Display control unit 44, 53 Display unit 45 Responsible blood vessel detection unit 50 Image analysis unit 51 Analysis unit 60 Evaluation unit 61 Determination unit 62 Evaluation value calculation unit

Claims (10)

A first MR image having a higher myocardial luminance value than the lumen is received by imaging the subject's heart by the black blood method using an MRI apparatus, and the subject's heart into which a contrast medium has been injected. Receiving means for receiving a second MR image having a luminance value of the lumen higher than that of the myocardium, acquired by imaging a delayed contrast method using an MRI apparatus;
An intima extraction means for obtaining a gradient of a luminance value with respect to a position for the first MR image, and detecting an intima of the myocardium based on the gradient;
An outer membrane extraction means for obtaining a gradient of a luminance value with respect to a position for the second MR image, and detecting an outer membrane of the myocardium based on the gradient;
An infarct site extraction means for detecting a myocardial infarction site from within the detection region based on the luminance value of the second MR image, with the detected region between the intima and outer membrane as a detection region;
Display control means for accepting an MR image acquired by imaging the heart of the subject by an MRI apparatus, displaying the detected myocardial infarction site in the accepted MR image, and displaying the MR image on the display means;
A medical image processing apparatus comprising: The intima extraction means sets a first reference point in the lumen, sets a plurality of first lines extending radially from the first reference point for the first MR image, and sets the plurality of first lines. A gradient of a luminance value with respect to a position on each line is obtained, an intima point at which the gradient value is equal to or greater than a predetermined threshold value is obtained for each first line, and the intima is connected by connecting the intima points. Identify,
The outer membrane extraction means sets a second reference point in the lumen, sets a plurality of second lines extending radially from the second reference point for the second MR image, and sets the second second points. In each of the lines, the gradient of the luminance value with respect to the position is obtained, the point where the gradient value is equal to or less than a predetermined negative value is detected, and the point outside the point is the predetermined gradient value. The medical image processing apparatus according to claim 1, wherein an epicardial point that is equal to or greater than a threshold value is obtained for each second line, and the epicardium is specified by connecting the epicardial points.   The outer membrane extraction means expands the position of the inner membrane detected by the inner membrane extraction means outward by a morphological filter, and between the inner membrane and the expanded position in the second MR image, The medical image processing apparatus according to claim 1, wherein an outer membrane is detected.   The outer membrane extraction means detects the outer membrane between the inner membrane and the expanded position by changing the size of the range expanded by the morphological filter according to the heart site. The medical image processing apparatus according to claim 3, wherein the medical image processing apparatus is a medical image processing apparatus.   The infarct region extracting means detects, as the myocardial infarction region, a region in which the luminance value is a predetermined threshold value or more in the detection region, and the region size is a predetermined size or more. The medical image processing apparatus according to any one of claims 1 to 4, wherein the medical image processing apparatus is characterized in that:   The display control means further includes marker generation means for generating a marker representing the detected myocardial infarction site, and the display means is displayed on the display means by superimposing the marker on the received MR image. The medical image processing apparatus according to any one of claims 1 to 5. Determination means for determining whether the detected myocardial infarction site is a transmural infarction or a non-transmural infarction based on the positional relationship between the detected outer membrane and the detected myocardial infarction site When,
An evaluation value calculating means for obtaining an area of a portion where the outer membrane and the myocardial infarction site are in contact with each other when it is determined that the determination means is a transmural infarction;
Further comprising
The display control means causes the display means to display the determination result by the determination means, and further displays the area value on the display means when it is determined that the transmural infarction is present. The medical image processing apparatus according to claim 1, wherein the medical image processing apparatus is a medical image processing apparatus.   The said display control means distinguishes and displays the said transmural infarction and the said non-transmural infarction on the said display means in the said MR image displayed on the said display means. Medical image processing apparatus. A blood vessel detecting means for receiving an MR image acquired by imaging the heart of the subject with an MRI apparatus and detecting a coronary artery from the received MR image;
The medical device according to any one of claims 1 to 8, wherein the display control unit displays the detected coronary artery and the detected myocardial infarction site on the display unit in a distinguishable manner. Image processing device. On the computer,
A first MR image having a higher myocardial luminance value than the lumen is received by imaging the subject's heart by the black blood method using an MRI apparatus, and the subject's heart into which a contrast medium has been injected. A reception function for receiving a second MR image in which the luminance value of the lumen acquired by imaging with a contrast imaging method using an MRI apparatus is higher than that of the myocardium;
An intima extraction function for obtaining a gradient of a luminance value with respect to a position for the first MR image, and detecting the intima of the myocardium based on the gradient;
An outer membrane extraction function for obtaining a gradient of a luminance value with respect to a position for the second MR image, and detecting an outer membrane of the myocardium based on the gradient;
An infarct site extraction function for detecting a myocardial infarction site from within the detection region based on the luminance value of the second MR image, with the detected region between the intima and outer membrane as a detection region;
A display control function for receiving an MR image acquired by imaging the heart of the subject by an MRI apparatus and displaying the detected myocardial infarction site in the received MR image on a display device;
A medical image processing program characterized in that