JP5513790B2 - Ultrasonic diagnostic equipment - Google Patents

Description

  The present invention provides desired ultrasonic image data while referring to and displaying a three-dimensional diagnostic image of a medical image apparatus such as an ultrasonic image, CT image, MRI image, and PET image of an organ or tissue in a living body, or a diseased lesion. The present invention relates to an ultrasonic diagnostic apparatus that acquires and observes and evaluates a target region, and more particularly to an ultrasonic diagnostic apparatus that is used for puncture guides and confirmation of therapeutic effects in puncture treatment.

  More specifically, the present invention relates to an ultrasonic diagnostic apparatus that observes and evaluates a target site with reference to, for example, multi-modal 3D data.

  In order to treat liver cancer and the like, puncture treatment is generally performed in which a treatment needle is inserted into a treatment site using an ultrasonic tomographic image as a guide. The ultrasonic probe used in this procedure can be fitted with a puncture needle adapter, and the estimated reference position for guiding the puncture needle insertion path will be displayed on the display screen of the ultrasonic diagnostic apparatus. It has become. Using such a puncture needle, cancer treatment is performed such as collecting tissue at the target site or injecting ethanol or the like into the target site. Furthermore, in recent years, treatment apparatuses for local ablation using microwaves or radio waves have been developed, and many cancer treatments are performed using this ablation needle.

  In performing the treatment, before the treatment is performed, the tumor image to be treated or the state of the treatment site in the past is displayed, for example, a CT (Computed Tomography) image, a MRI (Magnetic Resonance Imaging) image, a PET (Positron) by a medical imaging apparatus. Emission Tomography) image or ultrasonic image etc. In an actual treatment procedure, the tumor of the treatment target region is displayed in real time while displaying the pretreatment image of the treatment target region acquired in advance as a reference image on one screen of the multi-display screen or the Side by Side screen. It is identified by an ultrasonic diagnostic device that can be easily observed.

  In addition, during treatment, the extent of treatment treatment and the effect of treatment after treatment, that is, the necrosis area due to cauterization or injection at the treatment site, are compared with the tumor images obtained by various medical imaging devices before treatment. Then, the therapeutic effect is determined by the ultrasonic diagnostic apparatus.

  In such liver cancer treatment, it is generally important to cauterize or inject a region with a margin of 5 mm around the tumor to be treated in terms of preventing recurrence after treatment. Are known. If this margin is too large, the area of the liver that is damaged by cauterization or injection becomes too large, resulting in impaired liver function and dysfunction, resulting in poor prognosis. For this reason, it is very important to secure an appropriate margin and treat ablation.

  At present, the tumor image before cauterization, a photograph of the image, or a CT image illuminated on the Schaukasten, and the tumor image after treatment obtained by real-time or freezing with an ultrasonic diagnostic apparatus during treatment are subjective. However, it is difficult to evaluate the ablated area and determine the end of the treatment. For this reason, as a simple evaluation method, the maximum diameter in each image is measured and compared to estimate the spillover range of treatment. In fact, a margin evaluation of 5 mm has been performed. There is no current situation (see Non-Patent Document 1, for example).

Edited by Shigehiro Kokubun and Fuminori Moriyasu “Practical Liver Cancer Radiocoagulation Therapy”, Nankodo, May 10, 2002

  In the treatment with the puncture needle under the guide by the conventional ultrasonic diagnostic apparatus, it is difficult to compare the affected part images displayed on the two screens, that is, the in-treatment image and the reference image, which are displayed on different monitor screens or Shercus Ten on the film, In particular, since the display image magnification and the display position of each display image are different, it has been a big problem that it is difficult to determine the treatment area or the treatment margin in the determination of the treatment effect.

  Further, in the puncture performed under the guidance of the ultrasonic diagnostic apparatus, a tumor that has been imaged by contrast CT or the like and that has been planned for treatment cannot be sufficiently imaged in the B mode of the ultrasonic apparatus, and puncture is difficult. ing. In addition, comparison between CT images and ultrasonic images is difficult to compare because cross-sectional approaches are different.

  The present invention has been made in view of the above problems, and allows a reference image acquired in advance and a real-time image being treated to be observed simultaneously, and the display of the reference image can be aligned and displayed. An object is to provide a possible ultrasonic diagnostic apparatus.

According to the ultrasonic diagnostic apparatus of claim 1 of the present invention, medical image acquisition means for acquiring three-dimensional medical image data for a target region of a subject in advance by another medical image apparatus, and the target from an ultrasonic probe Ultrasonic image data acquisition means for acquiring real - time ultrasonic image data obtained by real - time imaging of a target site for ablation treatment by puncture with respect to the region, and a position for aligning substantially corresponding regions of the medical image data and the real - time ultrasonic image data An alignment unit; a position storage unit that stores position information between the medical image data and the real - time ultrasonic image data that have been aligned; and the medical image data that has been aligned by the alignment unit image display means for displaying an image of the processing result obtained by subtracting the real-time ultrasound image data, To provide an ultrasonic diagnostic apparatus characterized by comprising an interlock operating means which can be varied in conjunction according to a section or area of the image to the user's operation.

According to the ultrasonic diagnostic equipment of the present invention, ultra capable to observe a real-time image being treated and the reference image acquired in advance at the same time, yet displays aligning the display of the reference image An ultrasonic diagnostic apparatus is obtained.

It is explanatory drawing of 4D ultrasonic diagnostic apparatus. (A) is a conceptual diagram of 3D scanning performed using a 4D ultrasonic probe, (b) is volume data reconstructed from 3D scan data, and (c) is an MPR display example of volume data. It is explanatory drawing of the flow of a process of 3D display. 1 is a functional block diagram illustrating a configuration of an ultrasonic diagnostic apparatus according to a first embodiment of the present invention. In one Embodiment of this invention, it is explanatory drawing of a region of interest (ROI) setting to a target region. In one Embodiment of this invention, it is explanatory drawing of the flow of the alignment process. In one Embodiment of this invention, it is explanatory drawing of the flow of a process of real-time 3D registration display. It is a functional block diagram which shows the structure of the ultrasonic diagnosing device which concerns on the 2nd Embodiment of this invention. It is a flowchart of the operation | movement process which the ultrasonic diagnostic apparatus in one Embodiment of this invention performs. It is a figure which shows typically the example of the image displayed on the monitor of the ultrasound diagnosing device in one Embodiment of this invention. It is a flowchart of the other operation | movement process which this ultrasonic diagnostic apparatus in one Embodiment of this invention performs.

  Embodiments of the present invention will be described in detail with reference to the drawings. FIG. 1 is an explanatory diagram of a 4D (four-dimensional) ultrasonic diagnostic apparatus. (A) is a conceptual diagram of 3D scanning performed using a 4D ultrasonic probe, (b) is volume data reconstructed from 3D scan data, and (c) is MPR (Multi -Planar Reconstruction / Reformation)

  As shown in FIG. 1A, in order to collect 4D data, a mechanical 4D probe 101 that can continuously collect 3D (three-dimensional) data by mechanically swinging a normal one-dimensional array probe is provided. use. By applying the mechanical 4D probe 101 to the observation target region of the subject, 3D data of the target region can be continuously collected in time series. As shown in FIG. 1B, the collected 3D data is processed as volume data 102, and is displayed in MPR in real time, for example. The volume data 102 can display a desired arbitrary section, but FIG. 1C shows three orthogonal sections and a three-dimensional shape as an example. The upper left shows a cross section 103, the upper right shows a vertical section 104, the lower left shows a bird's eye view 105, and the lower right shows a three-dimensional image 106.

  For such 3D data collection, in addition to the mechanical 4D probe, a 2D array probe that electronically transmits and receives ultrasonic waves three-dimensionally can also be used.

  FIG. 2 is an explanatory diagram of the flow of 3D display processing. In the ultrasonic diagnostic apparatus, 3D display for generating and displaying a stereoscopic image by obtaining a plurality of images of different cross sections, and 4D display by temporally updating this 3D display at a certain timing. It is possible.

  In FIG. 2, a flow of processing up to 3D display in the ultrasonic diagnostic apparatus and generated data will be described. 3D data collection step S201 that collects 3D stack data by performing 3D scanning, 3D reconstruction step S202 that generates volume data by reconfiguring the collected 3D stack data, and 3D reconstruction The volume data is composed of a 3D display step S203 for rendering the volume data and performing 3D display.

  In the 3D data collection step S201, 3D data can be collected by three-dimensionally scanning the one-dimensional array probe. Furthermore, using a mechanical 4D probe or a two-dimensional array probe, three-dimensional repeated scanning is possible, and 4D data including a time axis can be collected.

  The mechanical 4D probe includes a one-dimensional array probe and a probe swinging motor in an enclosure, and mechanically scans and rotates. The two-dimensional array probe method electronically scans and collects 3D data using a micro vibrator arranged on a two-dimensional surface.

  In the 3D reconstruction step S202, since the plurality of tomographic image stack data collected in step S201 are on different coordinate systems, it is necessary to introduce a coordinate system that can be commonly used for them. Therefore, by interpolating each stack data, an aggregate of small cubes having isotropic luminance values called voxels is constructed, and 3D data is reconstructed (resampling). This is called volume data.

  The 3D display step S203 is generally a step of projecting and displaying 3D image data on a 2D surface, which is called rendering. There are the following rendering methods usually used in an ultrasonic diagnostic apparatus.

(1) MPR (Multi-Planar Reconstruction / Reformation) Method This method creates a tomographic image in an arbitrary direction, and obtains a pixel value by interpolating voxel values in the vicinity of a specified tomographic plane. This method is useful in that it can observe cross sections that cannot be seen with normal ultrasound imaging. Usually, in order to grasp the three-dimensional structure, three cross sections including a designated cross section and two cross sections orthogonal to the cross section are simultaneously displayed.

(2) MIP (Maximum Intensity Projection) method This is a display method in which voxel values existing on a straight line between the viewpoint and the projection plane are examined and the maximum value among them is projected onto the projection plane. This method is useful for 3D imaging of blood vessel images by color Doppler method and contrast echo image by ultrasonic contrast echo method. However, since the depth information disappears in this method, it is necessary to rotate the image created at different angles and display it in cine.

(3) VR (Volume Rendering) method This method is a virtual physical phenomenon in which uniform light is emitted from a virtual screen and reflected, attenuated, or absorbed by a three-dimensional object represented by voxel values. In this simulation, the transmitted light and reflected light are updated from the point on the virtual screen that is the starting point at regular step intervals. By setting the opacity according to the voxel value at the time of this update process, various expressions can be made from the surface to the expression of the internal structure. In particular, it is excellent for extracting fine structures.

<First Embodiment>
FIG. 3 is a functional block diagram showing the configuration of the ultrasonic diagnostic apparatus 300 according to the first embodiment of the present invention. The ultrasonic diagnostic apparatus 300 includes an ultrasonic diagnostic apparatus main body 301 that transmits and receives ultrasonic signals and performs image processing, an ultrasonic probe 302 that transmits ultrasonic waves and receives in-vivo echoes, and an ultrasonic diagnostic apparatus main body. An input device 303 (keyboard, trackball, etc.) for operating the unit 301, an operation panel 304 having a touch command screen, a rotary encoder, and the like, and a monitor 305 capable of displaying at least two screens of ultrasonic images.

  Further, the ultrasonic diagnostic apparatus main body 301 includes an ultrasonic signal transmission unit 311, an ultrasonic signal reception unit 312, a B mode processing unit 313, a color mode processing unit 314, a 3D processing unit 315, a display unit 316, and overall system control. And a control CPU (Central Processing Unit) 317 that performs arithmetic processing, an image database 318 that stores images, a cine memory 319 that stores images, a 3D image processing unit 320 for reference images, and a 3D image alignment processing unit 321. The image database 318 is transmitted from the modality 323 such as another CT apparatus or MRI apparatus or the DICOM (Digital Imaging and Communication in Medicine) server 324 via the network 322, and ultrasonic images (still images, moving images, It is possible to capture and save desired images from 3D images, 4D images) and other modality images (CT images, MR images).

  Also, desired image data is stored in the image database 318 using media such as MO (Magneto-Optical disk), CD-R (Compact Disc Recordable), DVD (Digital Versatile Disk), etc. without going through the network 322. It is also possible.

  While the ultrasonic 3D image is displayed on the monitor 305, the display mode and display section can be selected and changed using the input device 303 and the operation panel 304.

  In a 4D ultrasonic apparatus that performs three-dimensional scanning of an ultrasonic beam and continuously displays a three-dimensional ultrasonic image in real time, the ultrasonic probe 302 is a mechanical two-dimensional array probe or one-dimensional probe. A mechanical 4D probe to be rocked is connected. An electrical pulse is applied to each transducer of the ultrasound probe 302 from the ultrasound signal transmission unit 311, and the ultrasound beam is scanned three-dimensionally on the living body.

  An echo signal for each ultrasonic beam scanned three-dimensionally is received by the ultrasonic signal receiving unit 312. If in the B mode, the B-mode processing unit 313 performs filter processing for each ultrasonic reception beam. , Gain adjustment, envelope detection, and desired signal processing are performed. In the color mode, at the time of transmission / reception for the color mode, the color mode processing unit 314 performs filter processing, speed detection, and the like for each ultrasonic reception beam. The ultrasonic data for each reception beam processed by the B mode processing unit 313 or the color mode processing unit 314 is reconstructed into ultrasonic three-dimensional data by the 3D processing unit 315. In accordance with the display mode selected on the display unit 316, the ultrasonic 3D data is processed into a volume rendering image or an MPR image and displayed on the monitor 305.

  When desired 3D data stored in the image database 318 is selected by the input device 303 connected to the operation panel 304, the reference image 3D image processing unit 320 can generate a desired cross section or 3D display image.

  A desired tomographic image or 3D display image is transferred to the display unit 316 and displayed on the monitor 305. The displayed 3D image of CT can be changed in section position, display format, observation direction, and the like by the input device 303 and the operation panel 304.

  The 3D image alignment processing unit 321 has a function of aligning 3D data of a reference image to be compared with an image under ultrasonic diagnosis, and is displayed on the monitor 315 together with a real-time image during ultrasonic diagnosis.

  FIG. 4 is an explanatory diagram for setting a region of interest (ROI) in the target region of the present invention. As shown in FIG. 4, before starting the alignment, the ROI 401 that is the alignment calculation target is designated on the MPR display, for example, using the input device 303 or the operation panel 304. In the figure, a case of specifying with a square is illustrated.

  The 3D image alignment processing unit 321 performs alignment processing in the designated ROI 401 or in an area including the periphery.

  FIG. 5 shows an example of the flow of processing for positioning two pieces of 3D data. In this example, two 3D data: Volume1 and Volume2 are targeted.

  First, in step S501, the coordinates of Volume2 are changed by a predetermined amount. Next, in step S502, a calculation area to be aligned is obtained from the ROI information set in Volume2 after the coordinate conversion in step S501. Thereafter, in step S503, feature quantities related to the similarity are calculated for Volume1 and Volume2.

  Next, in step S504, the feature amount calculated in step S503 is substituted into the positional deviation evaluation function, and the degree of positional deviation between the two volume data is evaluated.

  In step S505, it is determined whether or not the positional deviation evaluation of Volume1 and Volume2 obtained in step S504 satisfies the optimization criterion.

  If the optimum position deviation criterion is satisfied in step S505, it is determined that the two 3D data match, and the amount of position deviation is estimated (S506). If the optimum standard is not satisfied, the process returns to step S501, and the coordinates are converted again and the same calculation is performed (S507). Accordingly, the flow of the positional deviation evaluation is repeated while changing the spatial coordinates in the target ROI until it is determined that the positions match between the two 3D data of Volume1 and Volume2.

  When the amount of positional deviation between two pieces of 3D image data is determined in this way, the value of the amount of positional deviation is input to the 3D processing unit 315 or the display unit 316, whereby two pieces of aligned 3D image data are obtained. Are displayed in parallel or superimposed on the monitor 305.

  In FIG. 5, the reference volume “Volume 1” is typically 3D data at the start of alignment. Alternatively, ultrasonic 3D data collected in the past from the image database 318 and 3D data of other modalities such as CT are used as reference images. A tomographic image and a 3D display image that have undergone alignment processing are displayed on the monitor 305 from the display unit 316. As a display method, any aligned tomographic image, MPR image, 3D display image, and the like can be considered. Alternatively, various forms such as a two-screen display of a reference image and a real-time image are conceivable.

  FIG. 6 shows the flow of processing for real-time 3D alignment display. Using the alignment method described in FIG. 5, 3D time-series data collected from the 4D probe is aligned in real time. In this case, Volume 1 as the reference volume does not necessarily have to be 3D data of another modality designated in advance, and can be aligned with 3D data slightly before in time of the same ultrasonic diagnostic image. If such a real-time alignment is used, even if the subject changes his body position during diagnosis, it can be aligned in real time with a diagnostic image a little before.

  First, 4D data is collected by the 4D probe (S601). The 3D processing unit 315 sequentially generates time-series 3D data reconstructed into ultrasonic three-dimensional data (S602). For example, as shown in FIG. 6, 3D reconstruction calculation is performed on stack data separated by a time difference Δt in time series, and volume data Volume1 and Volume2 are created. The two volume data are sequentially input to the 3D image alignment processing unit 321. In the 3D image alignment processing unit 321, for example, the alignment processing is performed in the region including the designated ROI or the surrounding area of the ROI in the process flow illustrated in FIG. 4. The position correction is performed from the amount of shift obtained from the 3D position shift calculation, and correction processing is performed under the image incidental conditions (rotation / translation / enlargement / reduction, luminance information, etc.) attached to the image (S603), and a desired tomogram is obtained. The image and the 3D display image are transferred to the display unit 316 and sequentially displayed on the monitor (S604).

  Further, when the MPR image and the Volume image are freely rotated, translated, enlarged, and reduced, after the above alignment, a common interface, for example, the operation panel 303 of the ultrasonic apparatus, is used for a plurality of 3D images displayed in parallel. It is possible to operate in conjunction with the rotary encoder knob.

  According to the first embodiment of the present invention, the reference medical image before treatment for the treatment target region and the real-time ultrasonic image of the desired region of the treatment target are displayed in parallel or superimposed on the monitor, These comparisons can be easily performed.

  In addition, the ROI is set for the real-time ultrasonic image being diagnosed, and the similarity is automatically calculated by calculating the similarity between the region corresponding to the reference medical image. As a result, the display position of the reference medical image data can be automatically changed even if the observation position changes due to a change in the operation position of the ultrasonic probe or the body movement of the subject. There is an effect that real-time ultrasonic diagnostic images can be displayed in parallel or superimposed.

<Second Embodiment>
It is a functional block diagram which shows the structure of the ultrasonic diagnosing device which concerns on the 2nd Embodiment of this invention. As shown in FIG. 7, the ultrasonic diagnostic apparatus 10 of the present invention is attached to know the main body unit 20, the ultrasonic probe 11, and the spatial coordinate position where the ultrasonic probe 11 is operated and the scanning direction and direction. A position sensor 15, a position sensor receiving unit 15 a that is a receiver of the position data signal, an operation panel 13 having a touch command screen and the like, and a control CPU unit 25 of the main body unit 20 via the operation panel 13. An input device 14 composed of a keyboard and a trackball for inputting data to the monitor, and a monitor 12 displaying both at least two screen images including display of ultrasonic image data.

  The main body unit 20 includes a control CPU unit 25 that performs overall system control of the ultrasound diagnostic apparatus 10. The main unit 20 stores various database information including a system control program, and is supervised under the system control of the control CPU unit 25. An ultrasonic transmission unit 21 that acquires sonic image data, an ultrasonic reception unit 22, a B-mode processing unit 23 a for tomographic images, a color mode processing unit 23 b for Doppler images, and a display unit 28 that configures a display image display screen on the monitor 12. It has.

  The ultrasonic diagnostic apparatus 10 includes components corresponding to three-dimensional (3D) ultrasonic image data or two-dimensional (2D) ultrasonic image data, and a B-mode image and a Doppler mode image.

  Further, the main body unit 20 is a network I / O that takes in the medical image data from the image processing unit 27 and the image position processing unit 24 that perform various processes on the display image, the external medical image device or the medical image center 101 via the network 100. An F (interface) 17, an image recording device 29 a for recording and storing medical image data from the outside and image data from the main body unit 20, and a cine memory unit 29 b for recording and storing these moving image data are also provided. . In FIG. 7, a control signal from the control CPU unit 25 is input to and output from each of the functional units constituting the main body unit 20, and a control signal connection 25a indicated by a dotted arrow is formed.

  The acquisition and processing of the ultrasound image performed by the ultrasound diagnostic apparatus 10 according to the embodiment of the present invention is shown in the flowchart of the operation process shown in FIG. 8, and the display screens 12a and 12b of the monitor 12 of the present embodiment shown in FIG. The operation and operation will be described below using schematic diagrams of display examples.

(First display processing example)
The first display processing example in the second embodiment of the ultrasonic diagnostic apparatus of the present application is an ultrasonic diagnostic apparatus that performs a puncture treatment, for example, while observing the treatment status under an ultrasonic image guide, Explains how to compare and display medical image data of the past observation or previous treatment as reference image data and real-time ultrasonic images of the status of the treatment treatment being performed on the target site. To do.

  As shown in FIG. 7, medical image data of past image data of observation at the time of past or previous treatment includes CT images, MRI images acquired from a treatment subject to be stored in a medical image center 101 of a medical facility, It is medical image data of either a PET image or an ultrasound image, and is previously taken into the image recording device 29a of the main body unit 20 via the network 100 in the same facility. The ultrasonic image data may be image data in which image data previously acquired according to the present embodiment is recorded and stored in the image recording device 29a.

  As shown in the flowchart of FIG. 8, the processing performed by the ultrasonic diagnostic apparatus 10 of the present embodiment is as follows. First, in step S11, medical image data observed during past or previous treatment, for example, CT image data 41b is displayed. 9 (a) or as schematically shown on the monitor 12 of FIG. 1, the image is displayed on the display screen B12b of the monitor 12. In this step S11, 3D (three-dimensional) CT image data 41b, for example, the liver of the subject recorded and stored in the image recording device 29a is displayed on the display unit by the control of the control CPU unit 25 shown in FIG. 28, and the display unit 28 displays it on the display screen B12b of the monitor 12.

  Since a 3D morphological observation is generally performed for a site to be treated while observing according to the present embodiment, the ultrasonic diagnostic apparatus 10 according to the present embodiment has a functional configuration for acquiring a 3D ultrasonic image. Is preferred. In the case where an affected area that is flattened is a treatment target, it is clear that the target site of the treatment target can be sufficiently observed even by the 2D medical image and the 2D ultrasonic diagnostic apparatus. The ultrasonic diagnostic apparatus 10 of the present embodiment is It may be performed by a 2D ultrasonic diagnostic apparatus. Note that the illustration of the display screens 12a and 12b of the monitor 12 according to the present embodiment shown in FIG. 9 is complicated, and therefore will be schematically illustrated and described with a 2D image.

  In contrast to the medical image including the past treatment target displayed in step S11, in step S12, real-time ultrasound including the treatment target acquired by operating the ultrasonic probe 11 by the ultrasonic diagnostic apparatus 10 of the present embodiment. The image 31a is displayed on the display screen A12a of the monitor 12, as schematically illustrated in FIG. 9A or FIG. Furthermore, a part of the same living body part as the medical image of the CT image 41b displayed on the display screen B12b, for example, is displayed on the display screen A12a as a real-time ultrasonic image 31a by operating the ultrasonic probe 11. For example, on these display screens, as shown in FIG. 9A, the CT image 41b has a liver image 42b and tumor images 43b, 44b, and 45b, and the ultrasound image 31a has a liver image corresponding to the CT image. 32a and tumor images 33a, 34a, 35a in the liver can be observed.

  For example, the image of the region of the liver 42a displayed on the display screen B12b that has been observed and acquired in advance by the operation of the ultrasonic probe 11 in step S12 and the region of the liver 32a of the ultrasonic image 31a displayed on the display screen A12a. By comparison, an examination engineer who is an operator who has determined that the site to be treated at substantially the same position can be displayed as an ultrasonic image on the display screen A12a operates a switch on the operation panel 13 instructing “superimposed display”. By the operation of this switch, the process proceeds to step S13.

  At step S13, as shown in FIG. 9B, the display of the ultrasonic image 51a on the display screen A12a is continued, and the ultrasonic image data displayed on the display screen A12a is displayed on the display screen B12b. For example, it is superimposed on the past CT image data 41b and displayed as an ultrasonic image 51b on the display screen B12b.

  In step S13, the superimposing ultrasonic image data 51b displayed on the display screen B12b is processed, for example, by luminance information of the pixel data by the image processing unit 27, and is further converted into past image data of the background by the display unit 28. Image processing to be combined is performed and displayed on the monitor 12.

  In the next step S14, the display screen B12b in step S13 in which the real-time ultrasonic image data 51b is further superimposed on the past CT image data 41b, for example, is displayed as shown in FIG. 9B. In addition, the operator searches for a position and direction in which the superimposition of the two image data coincides while changing the position and direction of contact of the ultrasonic probe 11 with the subject surface.

  In step S14, pixel data processing such as enlargement / reduction, rotation / translation is performed on the superimposed image data by the image processing unit 27, and image processing for combining them is performed.

  In step S14, the operator operates the ultrasonic probe 11 to display the body part image of both image data, the liver image of the CT image 41b and the tumor images 43b and 44b, as shown in FIG. The operation of the ultrasonic probe 11 is stopped and the switch of the operation panel 13 instructing “match” is operated at the superposed operation position and direction in which the liver image 52a of the sonic image 51b and the tumor images 53b and 54b completely match. To do.

  By operating the “match” switch, in step S15, the position sensor 15 installed on the ultrasonic probe 11 causes the 3D (three-dimensional) spatial position of the ultrasonic probe 11 and the orientation of the ultrasonic image tomographic plane ( The position setting of the reference position / orientation is set as the probe origin coordinate position in the reference coordinate space (not shown) defined by the ultrasonic diagnostic apparatus 10 equipped with the receiving unit 15a of this position sensor. Do. The processing in step S15 is performed by the image position processing unit 24 under the control of the control CPU unit 25. In the image position processing unit 24, processing for calculating, comparing, and recording the origin coordinates, the moving distance of the ultrasonic probe, the moving position, and the like is executed.

  As a result of the processing in step S15, the reference position / orientation is defined and set in the spatial coordinate system for the CT image data displayed as past reference image data at the time when the “match” operation is performed, as in the case of the ultrasonic image data. The image position processing unit 24 can process these two image data in a common coordinate space.

  Therefore, by setting the probe origin coordinate position in step S15, the change of the probe movement position, the scan direction and the direction by the operation of the ultrasonic probe performed after the setting of "match", that is, the process after step S16, is performed by the position sensor 15. Is detected. This detection data is sequentially input to the control CPU unit 25 via the receiving unit of the position sensor, and the spatial position and scanning direction of the operated ultrasonic probe 11 in the reference coordinate space defined by the ultrasonic diagnostic apparatus 10 are determined. The

  On the other hand, since the display position of the past 3DCT image data displayed on the display screen B12b, for example, the display position of the ultrasonic image data on the display screen B12b is fixed, the coordinate axis of the display space of the 3DCT image data is set. Based on this detection data, the image position processing unit 24 performs processing to display the display position of the volume data relatively moved and rotated in the display screen B12b.

  In step S <b> 16, the operator observes the display screen A <b> 12 a for the site to be treated, and obtains a real-time ultrasound image that can be optimally observed and diagnosed for the treatment purpose. The operation to change the contact position and the scanning direction to the living body is performed, and the best position for the treatment under the guide by the ultrasonic image is searched. In the search operation by the ultrasonic probe 11, the detection data of the movement position of the position sensor 15 and the scan direction / azimuth is sequentially calculated by the image position processing unit 24 from the reference position / azimuth, that is, the amount of change from the probe origin coordinate position. Is calculated.

  In step S17, the movement position and slice plane orientation change of the calculation result are applied to the display space coordinates of the past medical image data displayed on the display screen B12b, and a coordinate space for displaying the volume image data is set. Move position, change direction / direction (rotation).

  That is, the operation of the ultrasonic probe 11 after the instruction of “match” is performed, as shown in FIG. 9C, a target portion of past medical image data that forms a base image of superimposed display on the display screen B12b, for example, a CT image The display of the medical image 41b of the data is displayed by being moved and rotated, and the display of the ultrasonic image data 71b displayed by superimposing transparency is displayed at a predetermined initial stage (FIG. 9) in the same manner as a general ultrasonic image display. (B) Ultrasonic image data 51b) is displayed as ultrasonic image data 72b superimposed on transparency while maintaining the display position and direction.

  In the processing of the background image (medical image 41b) of the display screen B12b in step S17, the amount of change from the probe origin coordinate position by the image position processing unit 24 is sequentially input to the control CPU unit 25, and the rotation / The translation pixel data processing is performed by image processing performed on the past medical image data of the base image displayed on the display screen B12b.

  In step S18, image data that is the best for the site to be treated in step S16 and step S17 and can be compared and referred to for the treatment status of the site is displayed on the display screen 12a of the monitor 12 as shown in FIG. 9C. And display on the display screen 12b, respectively, and the puncture treatment under the ultrasound image guide is started. A typical ultrasonic diagnostic apparatus for performing a puncture treatment under an ultrasonic image guide is equipped with puncture mode setting specifications such as an ultrasonic image enhancement display 65a, 75b of a puncture needle and a display 66a, 76b of puncture route prediction. Therefore, by operating the instruction switch “treatment” for selecting the puncture mode, these are activated and displayed.

  In step S19, the luminance information of the real-time ultrasonic image data is displayed by superimposing the displayed treatment target part images 73b / 43b on the screen display B12b based on the image processing of the transparent superimposed display by the image processing unit 27. The practitioner observes and confirms the progress and progress of treatment.

  In step S20, which is the final stage of the treatment, for example, the practitioner displays the treatment effect image 73b and the background image by this treatment displayed in a semitransparent manner on the screen display B12b on the display screen of the monitor 12 shown in FIG. The target part image 43b before the treatment is compared with the treatment tumor image 63a in which the treatment effect by treatment is displayed on the screen display A12a as a real-time ultrasonic image, and whether a predetermined treatment margin is ensured. I can confirm. In particular, the difference between the treatment effect image 73b superimposed on the screen display B12b and the target part image 43b can be directly compared and observed.

  When the confirmation of step S20 is completed, inversion of the “treatment” switch for ending the puncture treatment is instructed in step S21 (operation of the switch button again).

  In subsequent step S22, the display screen 12 of the ultrasonic diagnostic apparatus 10 is displayed in a general two-screen display state, that is, in steps S11 and S12, and the “superimposed display” switch operation is performed. It returns to the state waiting for it.

  According to the ultrasonic diagnostic apparatus 10 of the present embodiment, after the predetermined alignment operation performed in step S15, following the operation of the ultrasonic probe, a real-time ultrasonic image and a medical image that is a past reference image before treatment. Each of them can display the same part, and the reference operation of the reference image, which is the background image in the superimposed display, is automatically moved to the operation position of the ultrasonic probe and displayed. Can be done easily, over details.

  In addition, at least two screen images are displayed by this ultrasonic diagnostic apparatus, and for example, in a puncture treatment performed under the guidance of an ultrasonic image, a real-time ultrasonic image for a treatment target region is observed on one display screen. However, on the other display screen, the ultrasonic image acquired in real time is superimposed and displayed on the past reference image before treatment, for example, a CT image that moves following the operation of the ultrasonic probe. By comparing two image data such as the above, it is possible to easily compare the difference in treatment spread.

  In addition, since past images are displayed following the operation of the ultrasound probe, it is easy to confirm the treatment margin by comparing the real-time ultrasound image with transparency and the medical image referenced as the past image. It is possible to easily increase the level of treatment that enhances the therapeutic effect.

(Second display processing example)
In the second display processing example in the second embodiment of the ultrasonic diagnostic apparatus of the present application shown below, in order to make the contrast with the past reference image data clear, real-time ultrasonic image data is displayed in the superimposed display. As a base image, past reference image data is displayed on top of transparency. The operation and operation of the second display processing example will be described with reference to the flowchart of the operation processing shown in FIG.

  In step S41 performed in the second display processing example, dual display is performed in which the same real-time ultrasonic image is displayed on both the display screen A12a and the display screen B12b of the monitor.

  In step S42, the past 3D (three-dimensional) CT image data of the subject stored and stored in the medical image center 101 via the network 100 is read out under the control of the control CPU unit 25 shown in FIG. The image is recorded and stored in the image recording device 29a. As the past image data, MRI image data, PET image data, and ultrasonic image data acquired by the own device or another device may be read and displayed.

  In step S43, the display of the real-time ultrasonic image on the display screen A12a is continued, and the same real-time ultrasonic image data displayed on the display screen B12b is used as the background image, for example the past CT read and stored in step S42. Display image data superimposed on transparency.

  For example, in the CT image data, hue information is generally assigned and displayed for each CT value of the living tissue, but in step S43, processing is performed on the CT image data superimposed on the display screen B12b. For example, in this process, the hue information of the CT image data to be superimposed and displayed is monochromatic, and predetermined luminance information is assigned to each hue, and the original luminance information is also integrated, and the pixel data is configured by the luminance information. Convert to reference image data. The conversion process for converting the past image data into the transparent reference image is performed by the control CPU unit 25 controlling and operating the image processing unit 27 according to a protocol preset in the database unit 26. Similar processing is performed on medical image data including other hue information. For past ultrasonic image data without hue information, monochromatic color assignment is performed to assign light hue information to distinguish it from real-time ultrasonic image data. This conversion information is preset in the database unit 26 as the protocol, and is executed by the control CPU unit 25 controlling and operating the image processing unit 27.

  In the next step S44, the subject of the ultrasonic probe 11 is displayed on the display screen B12b in which the past CT image data, for example, is superimposed on the real-time ultrasonic image data by the processing of step S43. The operator searches for a position and direction in which the superimposition of both 3D (2D in the case of 2D images) coincides with each other by performing an operation of changing the position and direction of contact with the body surface.

  In this step S44, for example, enlargement / reduction, rotation / translation pixel data processing is performed on the image data to be superimposed, that is, CT image data in this example, by the image processing unit 27 and further combined. Image processing is performed.

  In step S44, the operator operating the ultrasonic probe 11 stops the operation of the ultrasonic probe 11 at the overlapping operation position and direction in which the living body part images of both image data match, and instructs “match”. The switch of the operation panel 13 to be operated is operated.

  The process proceeds to step S45 by operating the “match” switch. In this step S45, the position sensor 15 provided in the ultrasonic probe 11 uses the position data of the 3D (three-dimensional) spatial position of the ultrasonic probe 11 and the orientation of the ultrasonic image tomographic plane (slice scanning direction) to A reference position / orientation definition is set as a probe origin coordinate position in a reference coordinate space (not shown) defined by the ultrasonic diagnostic apparatus 10 that is transmitted to the position sensor receiver 15a and includes the position sensor receiver 15a. Do. In step S45, the image position processing unit 24 calculates, compares, and records the origin coordinates, the moving distance of the ultrasonic probe, the moving position, and the like under the control of the control CPU unit 25.

  By setting the probe origin coordinate position in step S45, the position sensor 15 detects changes in the probe movement position, scan direction, and direction due to the operation of the ultrasonic probe. Further, this detection data is sequentially input to the control CPU unit 25 via the receiving unit 15a of the position sensor, and the spatial position and scanning direction of the ultrasonic probe 11 in the reference coordinate space defined by the ultrasonic diagnostic apparatus 10 are determined. Be recognized.

  In step S46, the operator obtains an ultrasound image that can be optimally observed and diagnosed for the treatment purpose while observing the display screen A12a that displays a real-time ultrasound image for the site to be treated. Then, an operation for changing the contact position of the ultrasonic probe 11 and the scanning direction is performed, and the best position for dealing with the treatment is searched for under the guidance of the real-time ultrasonic image. The detection data of the moving position of the position sensor 15 and the scanning direction / azimuth in the search operation by the ultrasonic probe 11 is sequentially detected by the image position processing unit 24 as a change amount from the reference position / azimuth, that is, the probe origin coordinate position. Calculated and calculated.

  In step S47, the movement position and slice plane orientation change of the calculation result are applied to the display space coordinates of the past CT image data displayed semi-transparently on the display screen B12b, and the coordinates of the volume image data are applied. Move space, change direction and direction (rotation). That is, the display state of the ultrasound image data that is the base of the transparent superimposed display is “match” on the display screen B12b that performs the same display as a general ultrasound image that is displayed while maintaining a predetermined direction. In the operation of the ultrasonic probe 11 after the instruction, the display of the CT image data with respect to the past target portion that is placed on the superimposed display is moved and rotated.

  In the processing of the superimposed display position of the image placed on the display screen B12b in step S47, the change amount from the probe origin coordinate position by the image position processing unit 24 is sequentially input to the control CPU unit 25, and the image processing unit 27 The rotation / translation pixel data processing is performed by image processing performed on, for example, past CT image data displayed on the display screen B12b.

  In step S48, image data that is the best for the region to be treated in step S46 and step S47 and can compare and refer to the treatment status of the region are displayed on the display screen 12a and the display screen 12b of the monitor 12, respectively. Then, for example, puncture treatment under the ultrasound image guide is started. A typical ultrasound diagnostic apparatus that performs puncture treatment under an ultrasound image guide is equipped with puncture mode specification settings such as highlighting the ultrasound image of the puncture needle and displaying the predicted puncture path. The instruction switch “treatment” for selecting is operated, and these settings are activated.

  In step S49, the treatment practitioner confirms the progress and progress of the treatment based on the screen display B12b in which the luminance information of the real-time ultrasound image data is displayed by the image processing unit 27 by the image processing of the transparent superimposed display.

  In step S50, which is the final stage of the treatment, the practitioner compares the treatment effect image obtained by this treatment, which is displayed in a translucent manner on the screen display B12b, with the target portion of the base image before the treatment treatment, and performs a predetermined treatment. It can be confirmed whether a margin is secured.

  When the confirmation of step S50 is completed, inversion of the “treatment” switch for ending the puncture treatment is instructed in step S41 (operation of the switch button again).

  In subsequent step S42, the display screen 12 of the ultrasonic diagnostic apparatus 10 is displayed in a general two-screen display state, that is, displayed in steps S41 and S42, and waits for the “superimposed display” switch operation. doing.

  In the processing procedure of the present embodiment, steps S44 to S46, step S48, and steps S50 to S51 are respectively steps S14 to S16, step S18, and step S20 of the processing procedure (FIG. 8) in the first display processing example. Is exactly the same.

  According to the ultrasonic diagnostic apparatus of the present embodiment, at least two screen images are displayed by the ultrasonic diagnostic apparatus, and in the puncture treatment performed under the guide of the ultrasonic image, real-time ultrasonic waves for the treatment target site are performed. Both images are displayed on the respective display screens. On one display screen, a reference image of a past treatment target region, for example, CT image data is aligned with real-time ultrasonic image data acquired during treatment. In addition, the image can be displayed superimposed on the transparency. In addition, according to the display by superimposing in the present embodiment, the treatment area based on the ultrasound image data of the background, that is, the treatment margin, is compared with the reference medical image to be placed, for example, the past treatment target part image data of the CT image. It is possible to easily confirm the state of treatment, observe the status of the treatment being performed, and easily determine the spread of the treatment effect.

(Third display processing example)
In the third display processing example in the second embodiment of the ultrasonic diagnostic apparatus of the present application, medical image data, for example, CT is displayed in the superimposed display in order to emphasize and contrast a changed portion with medical image data that is past image data. A superimposed display is performed on the image data by performing a difference process using real-time ultrasonic image data.

  This difference processing is generally performed on medical image data with a large visual field. However, the result of the differential processing based on medical image data specifying the region of interest ROI is displayed for real-time ultrasound image data with a small visual field. You may make it do.

  Regarding the acquisition and processing of the ultrasonic image performed by the ultrasonic diagnostic apparatus 10 of the present invention, steps S11 to S18 shown in FIG. 2 are performed in the same manner as in the first display processing example.

  In step S19 of the flowchart of the operation process in the third display processing example, the image processing unit 27 of the main body unit 20 replaces “transparent superimposed display processing” with “real-time processing for medical image data”. The process of performing the difference processing on the ultrasonic image data and displaying the result ”is performed as step S19, and the result is displayed on the screen B.

  Thereafter, the processes of steps S20 to S22 shown in FIG. 8 are performed again.

  In the ultrasonic diagnostic apparatus according to the present embodiment, the real-time ultrasonic image data for displaying the status of the treatment during the puncture treatment is a monochrome grayscale image, and the treatment area with the puncture needle is generally strongly whitened. In other words, in the differential processing image, the treatment area display of the real-time ultrasound image data is the unmasked image data, and the range of the treatment treatment is displayed on the display screen B12b without medical masking for the medical image data as the past image data. be able to.

  According to the ultrasonic diagnostic apparatus of the present embodiment, a screen display of real-time ultrasonic image data that is undergoing a therapeutic treatment, and a treatment area in which the therapeutic treatment is performed on medical image data including past treatment targets are masked. Since the cut-out screen display can be displayed in conjunction with the operation of the ultrasonic probe, it is possible to perform an observation for easily and appropriately performing a therapeutic treatment under the guidance of the ultrasonic diagnostic apparatus.

<Third Embodiment>
The third embodiment of the ultrasonic diagnostic apparatus of the present application is based on the reference position and the medical image data, which is past image data, and the real-time ultrasonic image data that is observing and diagnosing the treatment, with the display spaces set to coincide with each other. This makes it easy to return to the reference position / azimuth in the operation of the ultrasonic probe 11 and to reset it.

  In the image position processing unit 24 of the ultrasonic diagnostic apparatus 10 of the present embodiment, the medical position that is referred to together with the reference position / orientation data set as the probe origin coordinates in step S15 of FIG. 8 or step S45 of FIG. The image position processing unit 24 includes a reference position recording unit 24a that records and stores file identification information of image data.

  The image position processing unit 24 includes real-time position data acquired from the position sensor 15 in the operation of the ultrasonic probe 11 for acquiring real-time ultrasonic image data for observing and diagnosing the treatment status, and A probe position display unit 24b for displaying a deviation value of the set reference position / orientation with respect to the reference position data is provided.

  As shown in FIG. 9D, the reference position recording unit 24a and the probe position display unit 24b display a first display of the reference positions X, Y, Z and azimuth α on the display screen A12a that displays an ultrasonic image. 81 and a second display 82 of the deviation values x, y, z, α of the position of the ultrasonic probe being operated is displayed.

  When the display of the medical image data on the display screen B12b following the operation of the ultrasonic probe 11 becomes larger than the superimposed ultrasonic image data, or the subject shifts his / her posture during treatment or observation. When it moves, it is necessary to carry out the initial “match” setting again. In this case, it is complicated to repeat Steps S11 to S15 or Steps S41 to S45, and it is not easy to search for a matching position by operating the ultrasonic probe 11.

  As shown in FIG. 9D, in the ultrasonic diagnostic apparatus of the present embodiment that displays the first display 81 and the second display 82 on the display screen A12a, each numerical value of the second display 82 is “0 (zero)”. By operating and returning the ultrasonic probe 11 to the position, it is possible to easily return to the initially set reference position and orientation. Further, in the vicinity of the returned position, steps S14 and S15 or steps S44 and S45 can be performed to reset the reference position / orientation in the reference position recording unit 24a. By this resetting, the reference positions X, Y, Z and the direction α of the first display 81 are updated, and thereafter various processes are performed based on the updated values.

  According to the ultrasonic diagnostic apparatus of the third embodiment of the present invention, when the display of the medical image data that the display screen B12b follows is large with respect to the superimposed ultrasonic image data, or the subject is in a posture. When changed, it is possible to easily return to the reference position / orientation where the initial “match” setting is performed again. Since the reference position / orientation can be easily reset in the vicinity of the return position, it is easy to reproduce and maintain the level of treatment that enhances the therapeutic effect.

  The processing steps described in the first to third embodiments are programmed to be operated by the computer of the ultrasonic diagnostic apparatus of the present application, that is, the control CPU 25 or the control CPU 317.

As described above, according to the ultrasonic diagnostic equipment of the present invention, treatment is performed guided ultrasound image, for example in the puncture treatment, and reference medical image pre-treatment to the treatment target site, real-time desired site to be treated The ultrasonic image is displayed in parallel or superimposed on the monitor so that the comparison can be easily performed. Furthermore, it is possible to easily confirm whether or not a procedure including a treatment margin has been performed by comparing the two images, and a therapeutic effect can be determined.

  Further, according to the present invention, the display position of the reference medical image data can be changed at the same time following the change in the operation position of the ultrasonic probe, so even if the observation position changes due to the body movement of the subject. The reference medical image and the real-time ultrasonic diagnostic image can be displayed in parallel or superimposed to display the observation site.

  The present invention is not limited to the above-described embodiment, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, the constituent elements over different embodiments may be appropriately combined. These are also included in the present invention as long as the technical idea of the present invention is used.

10, 300 ... ultrasonic diagnostic apparatus,
11, 101, 302 ... ultrasonic probe,
12,305 ... monitor,
13, 304 ... operation panel,
14, 303 ... input device,
15 ... position sensor,
15a ... Position sensor receiver,
17 ... Network I / F (interface),
20, 301 ... main body,
21, 311 ... ultrasonic signal transmitter,
22, 312 ... ultrasonic wave signal receiver,
23a, 313 ... B-mode processing unit,
23b, 314 ... color mode processing unit,
24: Image position processing unit,
24a: Image position recording unit,
24b ... probe position part,
25, 317 ... control CPU section,
26 ... Database section
27. Image processing unit,
28 ... display part,
29a ... Image recording device,
29b, 319 ... Cine memory unit,
81 ... 1st display part,
82 ... the second display unit,
29a ... Image recording device,
100, 322 ... Network,
102 ... Volume data,
103 ... MPR display example,
315 ... 3D processing unit,
320 ... 3D image processing unit for reference image,
321... 3D alignment processing unit.

Claims (12)

Medical image acquisition means for acquiring three-dimensional medical image data for a target region of a subject in advance by another medical image device;
Ultrasonic image data acquisition means for acquiring real-time ultrasonic image data obtained by real-time imaging of a target site for ablation treatment by puncturing the target site from an ultrasonic probe;
Alignment means for aligning substantially corresponding regions of the medical image data and the real-time ultrasound image data;
A position storage means for storing position information between the medical image data and the real-time ultrasonic image data, which are aligned,
Image display means for displaying an image of a processing result obtained by subtracting the real-time ultrasound image data from the medical image data aligned by the alignment means;
An ultrasonic diagnostic apparatus comprising interlocking operation means capable of interlockingly changing the cross section or region of the image according to the operation content of the user.   2. The ultrasonic wave according to claim 1, wherein the medical image data acquired in advance by the other medical image device includes any of ultrasonic image data, CT image data, MRI image data, and PET data. Diagnostic equipment   The real-time ultrasonic image data and the medical image data updated each time the ultrasonic probe is scanned are sequentially aligned using the alignment means, and the medical image data and the real-time ultrasonic image data are Alignment image update means for sequentially calculating relative spatial positions, calculating corresponding cross sections and regions of the medical image data and the real-time ultrasonic image data from the relative spatial positions, and displaying the positions together The ultrasonic diagnostic apparatus according to claim 1, further comprising:   The ultrasonic diagnostic apparatus according to claim 1, wherein the alignment unit is an image calculation unit that searches for a positional relationship that maximizes similarity between two three-dimensional image data.   The position storage means stores position information between the two aligned three-dimensional image data, and the interlock operation means performs an operation using the position information to link the corresponding cross section or region. The ultrasonic diagnostic apparatus according to claim 4, wherein the ultrasonic diagnostic apparatus can be changed.   The alignment means operates the ultrasonic probe so that the selected tomographic plane between the two three-dimensional image data becomes a substantially equivalent tomographic plane, and the spatial position of the ultrasonic probe and the ultrasonic wave The apparatus further comprises reference position setting means for acquiring position data related to a scanning direction by a position sensor included in the ultrasonic probe and storing position information between the aligned data as reference position data. Item 2. The ultrasonic diagnostic apparatus according to Item 1.   The alignment means operates the display tomographic plane of the real-time ultrasonic image data so that the selected tomographic plane between the two three-dimensional image data becomes a substantially equivalent tomographic plane, and the ultrasonic probe And a reference position setting means for acquiring position data related to the spatial position and display tomographic plane by a position sensor included in the ultrasonic probe and storing position information between the aligned data as reference position data. The ultrasonic diagnostic apparatus according to any one of claims 1 to 6, wherein The image display means includes image processing means for performing image enlargement / reduction / rotation / translation and pixel brightness / hue conversion on the medical image data and the real-time ultrasonic image data, and the medical image data. And image position processing means for defining an image space for the ultrasonic image data, moving these image data, and changing the orientation;
First display screen means for displaying the ultrasonic image data, second display screen means for displaying the medical image data, and the ultrasonic image data, which are processed by the image processing means and the image position processing means, respectively. 2. The ultrasonic diagnostic apparatus according to claim 1, further comprising monitor display means including at least two display screen means for displaying both the first and second medical image data.   When the real-time ultrasonic image data is acquired, the interlock operation means acquires the position data during operation of the ultrasonic probe by a position sensor included in the ultrasonic probe, compares it with the reference position data, and moves A moving position calculating means for calculating position data, and a display position correction for changing and correcting the relative spatial position in the display of the medical image data on the display screen means by the image position processing means based on the calculated moving position data. The display position correcting means is used for the alignment, and the corresponding cross section or region is displayed on the monitor in conjunction with the operation of the ultrasonic probe and can be observed. The ultrasonic diagnostic apparatus according to claim 6 or 7.   The reference position setting means includes a reference position recording means for storing file identification information of the read medical image data together with the reference position data, and a deviation of real-time position data by the ultrasonic image data acquisition means with respect to the reference position data. 8. A probe position display means for displaying a value, and the reference position data and the deviation value are displayed on any display screen means of the image display means. An ultrasonic diagnostic apparatus according to 1.   The process for subtracting the real-time ultrasound image data from the medical image data is performed in a region of interest set for the medical image data or the real-time ultrasound image data. Ultrasound diagnostic equipment. Image processing means for performing at least one of enlargement, reduction, and rotation of the image on the medical image data and the real-time ultrasonic image data after being aligned by the alignment means;
Input means for instructing the enlargement / reduction / rotation,
2. The image processing unit according to claim 1, wherein the image processing unit performs at least one of image enlargement / reduction and rotation on both the medical image data and the real-time ultrasonic image data based on the instruction. Ultrasonic diagnostic equipment.