JP5609690B2 - Ultrasonic diagnostic apparatus and program - Google Patents

Description

  The present invention relates to an ultrasonic diagnostic apparatus and a program.

  Conventionally, breast examination using an ultrasonic diagnostic apparatus has been performed as one of breast cancer examinations. As a technique for supporting an examination using an ultrasonic diagnostic apparatus, for example, Patent Document 1 discloses that a high-luminance is obtained by extracting a minute structure such as a microcalcification portion from a target image captured by an ultrasonic diagnostic apparatus in real time. The technology to display with is described.

  Further, in Patent Document 2, a time lag between the moment when the operator wants to freeze and the time when the freeze operation is actually performed is registered in advance, and an ultrasonic image is taken into consideration when freezing. The technology to display is described.

JP 2010-143 A JP 2000-126187 A

  By the way, in mammary gland inspection using ultrasonic waves, it takes about 10 minutes per person, so it is difficult for a diagnostician to perform an examination in the current examination environment. Therefore, if a photographer such as a radiographer observes the breast in real time using an ultrasonic diagnostic apparatus and finds a part that seems to be necessary for diagnosis, such as an area suspected of being abnormal, it uses the freeze operation to detect the ultrasound at that part. The image is taken in as a diagnostic image and provided to the diagnostician. The diagnostician makes a final diagnosis with reference to diagnostic images and reports provided by the photographer.

  In this way, since the photographer and the diagnostician are different in mammary gland examination, the image provided to the diagnostician is objective such as an abnormal shadow candidate or a portion that is similar to an abnormal shadow but is normal (called a normal candidate). In particular, it is necessary to provide an image suitable for diagnosis, including a portion necessary for diagnosis. However, since the diagnostic image is acquired by subjectivity of the photographer and by the imaging technique, it is not necessarily an image that is objectively suitable for diagnosis.

  Here, since the technique described in Patent Document 1 is to extract and display a microstructure in real time from the acquired ultrasonic image, the position and state of the microstructure in real time to the photographer. Can be presented. However, such useful information cannot be provided to a diagnostician who cannot observe an ultrasound image in real time. Further, in the technique described in Patent Document 1, a micro structure extraction process is performed on all the images acquired regardless of the freeze operation of the photographer, and any result obtained by the photographer interpreting is processed. It is not reflected in.

  On the other hand, the technique described in Patent Document 2 aims to eliminate the time lag of the freeze operation, but an image at a timing shifted in advance from the freeze operation is not necessarily an image suitable for diagnosis. There is a problem. In addition, it is conceivable that the ultrasonic probe moves between the time when the freeze operation is performed and the actual freeze operation, but in this case, the diagnostician cannot capture a desired image.

  SUMMARY OF THE INVENTION An object of the present invention is to provide a diagnostician with an image suitable for diagnosis, including a portion necessary for diagnosis, when a photographer and a diagnostician using an ultrasonic diagnostic apparatus are different.

In order to solve the above-mentioned problem, the invention described in claim 1
An ultrasonic probe that outputs a transmission ultrasonic wave toward the subject and receives a reflected ultrasonic wave from the subject, and an ultrasonic probe that obtains a reception signal, and based on the reception signal acquired by the ultrasonic probe An ultrasonic diagnostic apparatus comprising: an image processing unit that generates an ultrasonic image; and a display unit that sequentially displays the generated ultrasonic image on a screen,
Temporary storage means for temporarily storing a plurality of temporally continuous ultrasonic images generated by the image processing means;
Operation means for inputting an instruction to hold the display of the ultrasonic image displayed on the display means on the screen;
An ultrasonic image acquired within a predetermined time range before and / or after the timing at which the operation means is operated is read out from the temporary storage means, and the read-out ultrasonic image Among them, search means for searching as a search target an ultrasonic image including an abnormal shadow candidate, an ultrasonic image including a normal candidate, an ultrasonic image including at least one of an abnormal shadow candidate or a normal candidate,
Output means for outputting the ultrasound image searched by the search means as a diagnostic image;
A selection means for a user to select an image type to be searched by the search means from an image including an abnormal shadow candidate, an image including a normal candidate, an image including at least one of an abnormal shadow candidate and a normal candidate;
Is provided.

The invention according to claim 2 is the invention according to claim 1,
Setting means for the user to set the time range to be searched by the search means is provided.

The program of the invention described in claim 3 is:
Based on an ultrasonic probe that outputs a transmission ultrasonic wave toward the subject and receives a reception ultrasonic wave by receiving a reflected ultrasonic wave from the subject, and a reception signal acquired by the ultrasonic probe An image processing means for generating an ultrasonic image and a display means for sequentially displaying the generated ultrasonic image on a screen;
Temporary storage means for temporarily storing a plurality of temporally continuous ultrasonic images generated by the image processing means;
Operation means for inputting an instruction to hold the display of the ultrasonic image displayed on the display means on the screen;
An ultrasonic image acquired within a predetermined time range before and / or after the timing at which the operation means is operated is read out from the temporary storage means, and the read-out ultrasonic image Among them, a search means for searching as a search target an ultrasonic image including an abnormal shadow candidate, an ultrasonic image including a normal candidate, an ultrasonic image including at least one of an abnormal shadow candidate or a normal candidate,
Output means for outputting the ultrasonic image searched by the search means as a diagnostic image;
A selection means for the user to select an image type to be searched by the search means from an image including an abnormal shadow candidate, an image including a normal candidate, an image including at least one of an abnormal shadow candidate and a normal candidate;
To function as .

The invention according to claim 4 is the invention according to claim 3,
The computer is further caused to function as a setting unit for a user to set the time range to be searched by the search unit .

  ADVANTAGE OF THE INVENTION According to this invention, when the photographer and diagnostician by an ultrasonic diagnostic apparatus differ, it becomes possible to provide the diagnostician with the image suitable for a diagnosis including the location required for a diagnosis.

It is a figure which shows the example of whole structure of the ultrasonic diagnosing system in this Embodiment. It is a flowchart which shows the diagnostic image search process performed by the control part of an ultrasonic diagnosing device. It is a figure which shows an example of an image classification selection screen. It is a figure for demonstrating the calculation method of the shape of an edge.

(Configuration of ultrasonic diagnostic system 100)
First, the configuration of the embodiment of the present invention will be described.
FIG. 1 shows a system configuration of an ultrasonic diagnostic system 100 in the present embodiment.

  As shown in FIG. 1, an ultrasonic diagnostic system 100 is configured by connecting an ultrasonic diagnostic apparatus 1 and a terminal apparatus 2 so as to be able to transmit and receive data via a communication network N such as a LAN (Local Area Network). ing.

As shown in FIG. 1, the ultrasonic diagnostic apparatus 1 includes an ultrasonic diagnostic apparatus main body 10 and an ultrasonic probe P.
The ultrasonic probe P transmits ultrasonic waves (transmission ultrasonic waves) to a subject such as a living body (not shown) and receives reflected waves (reflected ultrasonic waves: echoes) reflected by the subject. To do. Then, the ultrasound probe P acquires a received signal that is an electrical signal from the received reflected ultrasound and outputs it to the ultrasound diagnostic apparatus body 10.
The ultrasonic diagnostic apparatus main body 10 is connected to the ultrasonic probe P via a cable or the like, and transmits a transmission signal of an electrical signal to the ultrasonic probe P to the subject to the ultrasonic probe P. Or transmitting and displaying the internal state of the subject as an ultrasonic image based on the received signal received from the ultrasonic probe P.

  As shown in FIG. 1, the ultrasonic diagnostic apparatus main body 10 includes a control unit 11, a transmission unit 12, a reception unit 13, an image processing unit 14, a memory unit 15, a display unit 16, a storage unit 17, an operation unit 18, and communication control. The unit 19 and the like are provided, and each unit is connected via the bus 101.

  The control unit 11 includes a CPU (Central Processing Unit), a RAM (Random Access Memory), and the like, and executes various processes in cooperation with various programs stored in the storage unit 17. The operation of 1 is comprehensively controlled.

  The transmission unit 12 supplies a transmission signal to the ultrasonic probe P via a cable or the like, and causes the ultrasonic probe P to generate ultrasonic waves. The transmission unit 12 includes, for example, a high-voltage pulse generator that generates a high-voltage pulse, and supplies a pulse as a transmission signal to the ultrasonic probe P.

  The reception unit 13 includes an amplifier, a logarithmic converter, an envelope detection circuit, an A / D converter, and the like, receives a reception signal from the ultrasonic probe P via a cable or the like, and receives the converted reception signal. The electric signal is electrically amplified, subjected to signal processing such as digital conversion, and output to the image processing unit 14.

  The image processing unit 14 generates a B-mode image based on the digital reception signal output from the reception unit 13. A B-mode image represents the intensity of a received signal by luminance. The B-mode image generated in this way is output to the memory unit 15 as an ultrasonic image.

The memory unit 15 includes a frame memory 151, a cine memory 152, a temporary storage unit 153, and the like.
The frame memory 151 stores the ultrasonic image output from the image processing unit 14 in units of frame images. When the ultrasonic image is output from the image processing unit 14, the control unit 11 overwrites the frame memory 151 with the output ultrasonic image and causes the display unit 16 to display the frame memory 151.
For example, the cine memory 152 temporarily stores a plurality of ultrasonic images (a plurality of frame images) acquired in the last few minutes so that a moving image can be reproduced.
The temporary storage unit 153 stores a plurality of ultrasonic images (a plurality of frame images) acquired within a time range set as a search target time in a diagnostic image search process described later. If a time that can be recorded in the cine memory 152 is set as the search target time, the cine memory 152 may function as the temporary storage unit 153 and the ultrasound image stored in the cine memory 152 may be used for the search of the diagnostic image. good.

  The display unit 16 includes an LCD (Liquid Crystal Display), a CRT (Cathode-Ray Tube) display, an organic EL (Electronic Luminescence) display, a plasma display, or the like, and is stored in the frame memory 151 according to control from the control unit 11. The ultrasonic images being displayed are sequentially displayed sequentially, and various operation screens are displayed on the screen.

  The storage unit 17 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. The storage unit 17 stores various programs and data necessary for executing the programs.

  The operation unit 18 includes various switches, function buttons, a trackball, a mouse, a keyboard, and the like, and outputs an operation signal to the control unit 11. For example, the operation unit 18 includes a freeze button 181. The freeze button 181 is a button for performing a freeze operation. That is, the button is used to stop overwriting the image in the frame memory 151 and to input an instruction to hold the display of the ultrasonic image currently displayed on the display unit 16 on the screen. For example, when a photographer who is a user finds a shadow that is suspected to be a lesion, the photographer can operate the freeze button 181 to observe the shadow in detail as a still image.

  The communication control unit 19 is configured by a LAN card or the like, and transmits and receives data to and from an external device such as the terminal device 2 connected to the communication network N via a switching hub.

The terminal device 2 is a device that receives an ultrasonic image from the ultrasonic diagnostic apparatus 1 and displays it for a doctor's diagnosis.
As shown in FIG. 1, the terminal device 2 includes a control unit 21, an operation unit 22, a display unit 23, a communication control unit 24, a storage unit 25, and the like, and each unit is connected via a bus 26. .

  The control unit 21 includes a CPU (Central Processing Unit), a RAM (Random Access Memory), and the like, and executes various processes in cooperation with various programs stored in the storage unit 25. Control the overall operation.

  The operation unit 22 includes a keyboard having character input keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key pressing signal pressed by the keyboard and an operation signal by the mouse. Are output to the control unit 21 as an input signal.

  The display unit 23 includes a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), for example, and displays various screens according to instructions of a display signal input from the control unit 21.

  The communication control unit 24 is configured by a LAN card or the like, and transmits / receives data to / from an external device such as the ultrasonic diagnostic apparatus 1 connected to the communication network N via a switching hub.

  The storage unit 25 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. The storage unit 25 stores various programs as described above.

(Operation of the ultrasonic diagnostic system 100)
Next, the operation in the ultrasonic diagnostic system 100 will be described.
FIG. 2 is a flowchart showing a diagnostic image search process executed by the control unit 11 of the ultrasonic diagnostic apparatus 1. The diagnostic image search process is executed in cooperation with the program stored in the control unit 11 and the storage unit 17 in response to an instruction from the operation unit 18.

  Here, in general, in the ultrasound diagnosis of the breast, a photographer such as a radiographer applies the ultrasound probe P to the breast and performs observation in real time while capturing the ultrasound image of the breast, which is necessary for the diagnosis. When a region (specifically, an abnormal shadow candidate or a normal candidate) appears, a freeze operation is performed, and an ultrasound image at that timing is captured as a still image and provided to a diagnostician. However, an image intended by the photographer may not be obtained due to movement of the ultrasound probe P during the freeze operation or a time lag between the freeze operation and image capture. Further, the image displayed at the timing when the photographer performs the freeze operation is not necessarily an image that is objectively suitable for diagnosis. However, since it is considered that the photographer performs a freeze operation when a certain shadow is found, an image suitable for diagnosis, that is, an abnormal shadow candidate or a normal candidate is drawn immediately before or after the freeze operation timing. Images are considered to exist.

  Therefore, in the ultrasonic diagnostic apparatus 1, a diagnostic image search process described below is performed, and the image is captured within a predetermined search target time based on the timing at which the freeze operation (pressing the freeze button 181) is performed. The type of ultrasonic image selected from the selected ultrasonic images (for example, a frame image in which an abnormal shadow candidate exists) is automatically searched, and the searched ultrasonic image is transmitted to the terminal device 2 as a diagnostic image. By doing so, the diagnosis result that the photographer who is the user determines to be important for the diagnosis is reflected, and an image that is objectively suitable for the diagnosis is provided to the diagnostician.

  First, a setting screen (not shown) for the user to set the search target time for the diagnostic image is displayed on the display unit 16, and the search target time is set according to the input of the operation unit 18 from the setting screen. (Step S1). The search target time is, for example, (1) the time from the start of image acquisition to the timing at which the freeze operation is performed (the time from the timing at which the freeze operation is performed to the image acquisition start time), and (2) the cine memory 152 The recordable time (the time when an image can be recorded in the cine memory 152 retroactively from the timing when the freeze operation is performed, (3) the time range specified by the user based on the timing when the freeze operation is performed, etc. can be set. In (3), not only before the freeze operation is performed, but also after the freeze operation and / or the time range including before and after the freeze operation can be set. If a time range that includes images is set, the ultrasound image acquired within the time range set after the freeze operation Storage in the storage unit 153 is continued.

  Next, an ultrasonic image is acquired. That is, an ultrasonic wave is supplied from the ultrasonic probe P to the subject, an ultrasonic image is generated by the image processing unit 14 based on the received signal received from the subject, and the generated ultrasonic image is stored in the memory. It is stored in each memory of the unit 15 (step S2). Until the freeze button 181 is pressed (until the freeze operation is performed), acquisition of ultrasonic images is repeated.

When pressing of the freeze button 181 is detected (step S3; YES), an image type selection screen 161 for the user to select an image type to be presented to the diagnostician is displayed on the display unit 16 (step S4).
FIG. 3 shows an example of the image type selection screen 161. As shown in FIG. 3, the image type selection screen 161 includes a patient information display field 161a, an abnormality button 161b, a normal button 161c, a normal / abnormal button 161d, a search execution button 161e, a freeze result display field 161f, and a presentation candidate display field. 161g, an image transmission button 161h, and the like are provided.
The patient information display column 161a is a column for displaying information on a patient to be diagnosed. The abnormal button 161b is a button for selecting an image including an abnormal shadow candidate as an image type to be presented to a diagnostician. The normal button 161c is a button for selecting an image including normal candidates as an image type to be presented to the diagnostician. The normal / abnormal button 161d is a button for selecting an image including at least one of an abnormal shadow candidate and a normal candidate as an image type to be presented to a diagnostician. The search execution button 161e is a button for instructing execution of a search for an image of a type selected from the abnormal button 161b, the normal button 161c, and the normal / abnormal button 161d. The freeze result display column 161f is a column for displaying the ultrasonic image that was displayed when the freeze operation was performed. The presentation candidate display field 161g is a field for displaying the searched image. The image transmission button 161 h is a button for instructing to transmit the image displayed in the presentation candidate display field 161 to the terminal device 2.

When the operation unit 18 instructs to search for an image including an abnormal shadow candidate by pressing the abnormal button 161b and the search execution button 161e (step S5; YES), the search stored in the temporary storage unit 153 is performed. An ultrasonic image acquired within the target time is read, and an ultrasonic image including an abnormal shadow candidate is searched from the read ultrasonic image (step S6).
When the operation unit 18 presses the normal button 161c and the search execution button 161e to instruct the search for an image including normal candidates (step S5; NO, step S7; YES), the temporary storage unit 153 stores the image. The ultrasonic image acquired within the search target time is read, and an ultrasonic image including a normal candidate is searched from the read ultrasonic image (step S8).
When the normal / abnormal button 161d and the search execution button 161e are pressed by the operation unit 18, an instruction to search for an image including at least one of a normal candidate and an abnormal shadow candidate is given (step S7; NO, step S9; YES), an ultrasonic image acquired within the search target time stored in the temporary storage unit 153 is read, and at least one of an abnormal shadow candidate and a normal candidate is included from the read ultrasonic image The ultrasonic image to be searched is searched (step S10).

Search for an image including an abnormal shadow candidate and a normal candidate can be performed using a technique such as a CAD (Computer-Aided Diagnosis) technique or a similar image search technique.
Search using CAD technology can be performed as follows, for example.
(1) First, an area suspected of being abnormal is identified. For an area suspected of being abnormal, for example, the area detected by edge detection by the canny method and then divided by the wartershed method, the area, the average density, the position of the center of gravity, and the density difference from the surrounding area. It can be specified by calculating feature values such as aspect ratio and comparing the calculated feature values with a predetermined threshold (Daisuke Fukuoka, “CAD System in Breast Ultrasound Images” The Japanese Society of Radiological Technology) Magazine, December 2007).
(2) Next, for an area identified as suspected of being abnormal (referred to as a primary candidate), feature amounts such as edge shape, internal non-uniformity, aspect ratio, and shape of the lesion edge are calculated. .
For example, as shown in FIG. 4, the shape of the edge can be obtained by dividing the shortest distance dmin from the center of gravity of the primary candidate region to the edge by the longest distance dmax.
The aspect ratio can be obtained by calculating the ratio of 1/2 of the vertical axis of the ellipse circumscribing the primary candidate region to 1/2 of the horizontal axis.
The internal non-uniformity can be obtained by calculating entropy represented by the following equation.
The shape of the lesion edge can be obtained by calculating the fractal dimension shown in the following equation.
(3) Next, the four feature amounts calculated in (2) are applied to different four-dimensional axes, and a vector x composed of these quaternary elements is set.
(4) Next, a vector composed of the elements of the above four feature values for each of a large number of previously collected abnormal shadow patterns (known abnormal shadow patterns) and normal shadow patterns (known normal shadow patterns). And an average vector u for each of the abnormal shadow pattern and the normal shadow pattern is calculated. Then, by applying x and u to the formula [Equation 3] below, the Mahalanobis distance D _M 1 (x) from the primary candidate to the abnormal shadow pattern, and the Mahalanobis distance D _M 2 from the primary candidate to the normal shadow pattern (X) is calculated.
(5) The primary candidate of Mahalanobis distance D _M 1 (x)> D _M 2 (x) is extracted as an abnormal shadow candidate, and the primary candidate of Mahalanobis distance D _M 2 (x) ≧ D _M 1 (x) is a normal candidate. Extracted as
In addition, by assigning numbers (or sorting) in ascending order of Mahalanobis distance, images can be displayed in descending order of importance during diagnosis.

  The search using the similar image search technique can use, for example, a technique disclosed in Japanese Patent Application Laid-Open No. 2004-5364. For example, an image showing a known abnormal shadow, an image showing a normal shadow, stored in a database, and an image showing an abnormal shadow stored in the database from each ultrasonic image taken at the search target time An ultrasound image having a similarity degree of similarity determination items (for example, the shape of the shadow, the size of the shadow, the direction of the shadow, and the characteristics of the shading pattern) can be acquired as an image including an abnormal shadow candidate. Similarly, an ultrasonic image in which the similarity between the image indicating the normal shadow and the similarity determination item is equal to or higher than a predetermined value can be acquired as an image including normal candidates.

  When the image search is completed, the searched image is displayed in the presentation candidate display field 161g of the image type selection screen 161 displayed on the display unit 16 (step S11). Then, in response to a transmission instruction from the operation unit 18, the searched image is transmitted to the terminal device 2 by the communication control unit 19 (step S12). The ultrasonic image may be transmitted in a still image format or a moving image format.

  In the terminal device 2, when the ultrasound image transmitted from the ultrasound diagnostic apparatus 1 is received by the communication control unit 24, the received ultrasound image is stored in the storage unit 25. And it is displayed according to the display instruction | indication from the operation part 22 by a diagnostician.

  As described above, according to the ultrasonic diagnostic apparatus 1, when the control unit 11 generates an ultrasonic image by the image processing unit 14 based on the ultrasonic reception signal from the ultrasonic probe P, The generated ultrasonic images are sequentially stored in the temporary storage unit 153. When the freeze button 181 is operated, an ultrasonic image acquired within a predetermined time range before and / or after the timing at which the freeze button 181 is operated is read from the temporary storage unit 181, From the read ultrasound image, a search is performed using any one of an ultrasound image including an abnormal shadow candidate, an ultrasound image including a normal candidate, and an ultrasound image including at least one of an abnormal shadow candidate and a normal candidate as a search target. Then, the searched ultrasonic image is output to the terminal device 2 by the communication control unit 19 as a diagnostic image.

Therefore, it is an objective that an abnormal shadow candidate or a normal candidate is included in the ultrasonic image acquired in the vicinity of the timing when the photographer determines that the part necessary for diagnosis is included and the freeze operation is performed. Since an ultrasonic image suitable for diagnosis is output in the case where the photographer and the diagnostician using the ultrasonic diagnostic apparatus are different, the photographer includes an ultrasonic wave that is objectively suitable for diagnosis, including the portions necessary for diagnosis. Images can be provided to the diagnostician.
In addition, because the search for abnormal shadow candidates and normal candidates is performed on an ultrasound image acquired within a predetermined search target time based on the timing of the freeze operation, the search processing time is minimized. It becomes possible to suppress to.
In addition, since the timing of the freeze operation is the base point of the search process, the photographer observes the entire inside of the breast, and as a result, it can be a target to be provided to the diagnostician only for locations that are determined to be important for diagnosis. This makes it possible to improve the efficiency of medical diagnosis.

  In addition, since the photographer who is the user can set the range of the ultrasonic image acquired from the timing when the freeze operation is performed, it is possible to set the interpretation level of the photographer. A user-friendly device can be provided.

  Further, the type of image to be searched for providing to the diagnostician may be selected by the user from an image including an abnormal shadow candidate, an image including a normal candidate, and an image including at least one of an abnormal shadow candidate and a normal candidate. Therefore, it is possible to provide a doctor with an image according to the purpose of the examination.

  In addition, the description content in the said embodiment is a suitable example of this invention, and is not limited to this.

  For example, in the above-described embodiment, the ultrasonic image is provided to the diagnostician by transmitting the ultrasonic image to the terminal device 2, but the ultrasonic image may be printed out by a printer. .

  In the above description, an example in which a hard disk, a semiconductor nonvolatile memory, or the like is used as a computer-readable medium of the program according to the present invention is disclosed, but the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. A carrier wave is also applied as a medium for providing program data according to the present invention via a communication line.

  In addition, the detailed configuration and detailed operation of each device constituting the ultrasonic diagnostic system can be changed as appropriate without departing from the spirit of the present invention.

DESCRIPTION OF SYMBOLS 100 Ultrasonic diagnostic system 1 Ultrasonic diagnostic apparatus 10 Ultrasonic diagnostic apparatus main body 11 Control part 12 Transmission part 13 Reception part 14 Image processing part 15 Memory part 151 Frame memory 152 Cine memory 153 Temporary storage part 16 Display part 17 Storage part 18 Operation part 181 Freeze button 19 Communication control unit 101 Bus P Ultrasonic probe 2 Terminal device 21 Control unit 22 Operation unit 23 Display unit 24 Communication control unit 25 Storage unit 26 Bus

Claims (4)

An ultrasonic probe that outputs a transmission ultrasonic wave toward the subject and receives a reflected ultrasonic wave from the subject, and an ultrasonic probe that obtains a reception signal, and based on the reception signal acquired by the ultrasonic probe An ultrasonic diagnostic apparatus comprising: an image processing unit that generates an ultrasonic image; and a display unit that sequentially displays the generated ultrasonic image on a screen,
Temporary storage means for temporarily storing a plurality of temporally continuous ultrasonic images generated by the image processing means;
Operation means for inputting an instruction to hold the display of the ultrasonic image displayed on the display means on the screen;
An ultrasonic image acquired within a predetermined time range before and / or after the timing at which the operation means is operated is read out from the temporary storage means, and the read-out ultrasonic image Among them, search means for searching as a search target an ultrasonic image including an abnormal shadow candidate, an ultrasonic image including a normal candidate, an ultrasonic image including at least one of an abnormal shadow candidate or a normal candidate,
Output means for outputting the ultrasound image searched by the search means as a diagnostic image;
A selection means for a user to select an image type to be searched by the search means from an image including an abnormal shadow candidate, an image including a normal candidate, an image including at least one of an abnormal shadow candidate and a normal candidate;
An ultrasonic diagnostic apparatus comprising:   The ultrasonic diagnostic apparatus according to claim 1, further comprising setting means for a user to set the time range to be searched by the searching means. Based on an ultrasonic probe that outputs a transmission ultrasonic wave toward the subject and receives a reception ultrasonic wave by receiving a reflected ultrasonic wave from the subject, and a reception signal acquired by the ultrasonic probe An image processing means for generating an ultrasonic image and a display means for sequentially displaying the generated ultrasonic image on a screen;
Temporary storage means for temporarily storing a plurality of temporally continuous ultrasonic images generated by the image processing means;
Operation means for inputting an instruction to hold the display of the ultrasonic image displayed on the display means on the screen;
An ultrasonic image acquired within a predetermined time range before and / or after the timing at which the operation means is operated is read out from the temporary storage means, and the read-out ultrasonic image of ultrasound image including the abnormal shadow candidate, ultrasound image including a normal candidate, ultrasound image including at least one of the abnormal shadow candidate or normal candidate search means to search for either a searched,
Output means for outputting the ultrasonic image searched by the search means as a diagnostic image;
A selection means for the user to select an image type to be searched by the search means from an image including an abnormal shadow candidate, an image including a normal candidate, an image including at least one of an abnormal shadow candidate and a normal candidate;
Program to function as. The program according to claim 3, further causing the computer to function as a setting unit for a user to set the time range to be searched by the search unit .