JP6243769B2 - Tomographic apparatus and method for operating the same - Google Patents

Description

  The present invention relates to a tomographic imaging apparatus that performs tomographic imaging using a catheter and a control method thereof.

  A tomographic imaging apparatus that performs tomographic imaging in a blood vessel using optical coherence tomography (OCT), optical frequency domain imaging (OFDI), and intravascular ultrasound imaging (IVUS) has been put into practical use. In this type of tomography apparatus, a drive shaft (imaging core) in which a signal transmitting / receiving unit for transmitting / receiving light or ultrasound is arranged at the distal end is disposed in the lumen of the catheter. Then, in the lumen of the catheter disposed along the blood vessel, imaging is performed by moving the signal transmitting / receiving unit along the axial direction of the catheter while rotating the signal transmission / reception unit at high speed via the drive shaft. A plurality of cross-sectional images are obtained.

  In order to insert the catheter into the blood vessel up to the imaging target position, a guide wire is first inserted to the imaging target position in the blood vessel, and the catheter is fed along the guide wire. Generally, a short monorail type catheter is used so that a lumen for passing a guide wire does not interfere with image acquisition. However, in the case of a short monorail type catheter, since the length of the lumen through which the guide wire is passed is short enough to push the catheter into the blood vessel, the push may not work. Therefore, in a site of chronic total occlusion (CTO), it may be difficult to feed the catheter into the blood vessel.

  Therefore, double lumen type or long monorail type catheters are used in parts where strength is required for feeding, such as CTO. As shown in FIG. 7A, a double-lumen type catheter as described in Patent Document 1 has a single-lumen region 701 and a double-lumen region 702, and a drive shaft 703 in the single-lumen region. The image can be acquired by subtracting.

Japanese Patent No. 3367666

  In a double lumen type catheter as described in Patent Document 1, if a guide wire 704 and a drive shaft 703 exist simultaneously in a single-men region 701, they physically interfere with each other. For example, as shown in FIG. 7B, when the drive shaft 703 exists in the single lumen region 701, when the guide wire 704 is pushed into the single lumen region 701, both interfere with each other. In particular, when such interference occurs when the drive shaft 703 is rotating, the catheter 710 or the drive shaft 703 may be damaged. Therefore, two radiopaque markers (hereinafter referred to as a distal marker 711 and a proximal marker 712) are provided, and a tomographic imaging technique is performed while confirming the positional relationship between the guide wire 704 and the drive shaft 703 by performing X-ray fluoroscopy. Will do.

More specifically,
(1) The operator passes the guide wire 704 through the catheter 710 with the drive shaft 703 pulled back to the position of the proximal marker, and sends the catheter to the target site.
(2) The operator pulls the guide wire 704 to the position of the proximal marker 712 while confirming the target site by X-ray fluoroscopy.
(3) After the drive shaft 703 is advanced to the imaging region through the single lumen region 701, the drive shaft 703 is pulled back while rotating to obtain a tomographic image.
(4) The guide wire 704 is again passed through the single lumen region 701 and the catheter 710 is removed.

  In the procedure as described above, when the guide wire 704 is pulled to the position of the proximal marker 712 and then to be fed forward again, if the drive shaft 703 has not returned to the position of the proximal marker 712, both Interference occurs. This is because the drive shaft 703 and the guide wire 704 exist in the single lumen region 701 at the same time. Therefore, it is necessary for the surgeon to carefully perform the procedure while confirming the fluoroscopic image, which places a heavy burden on the surgeon.

  Further, in a catheter corresponding to a site having a long imaging region such as a lower limb, the single lumen region 701 (or the distance between the distal marker 711 and the proximal marker 712) becomes long. Therefore, when the X-ray fluoroscopic region for observing the region to be imaged is at a position including the distal marker 711, the proximal marker 712 may be out of the X-ray fluoroscopic region. In such a case, the operator will not be able to see the position of the proximal marker 712 and will not know how far to pull them to avoid interference between the guide wire 704 and the drive shaft 703. In addition, the X-ray fluoroscopic region may be changed frequently so that the proximal marker 712 enters the X-ray fluoroscopic region, but it is obvious that the operability is significantly deteriorated.

  The present invention has been made in view of the above problems, and reduces the burden on the operator when taking a tomographic image by inserting and removing the guide wire and drive shaft in the single lumen region of the catheter, and improves operability. The purpose is to do.

In order to achieve the above object, a tomographic imaging apparatus according to one aspect of the present invention comprises the following arrangement. That is,
A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens,
Obtaining means for obtaining a tomographic image using the signal transmitting and receiving unit;
First determination means for determining whether or not the medical elongated body is reflected in the tomographic image acquired by the acquisition means;
By the first judging means, wherein allow the movement of the imaging core when the medical long body is determined not reflected, said medical long body is reflected in the tomographic image in the tomographic image Second determination means for determining that the movement of the imaging core is not permitted when it is determined that
A slide mechanism connected to the proximal end side of the imaging core and moving the imaging core;
Control means for placing the slide mechanism in a movable state when it is determined to be permitted by the second determination means, and for locking the slide mechanism when it is determined to be disapproved by the second determination means; , comprising a.

  According to the present invention, when taking a tomographic image by inserting and removing a medical long body (for example, a guide wire) and an imaging core in a single lumen region of a catheter, the burden on an operator is reduced and operability is improved. improves.

The figure which shows the external appearance of the intravascular ultrasonic imaging apparatus by embodiment. The block diagram which shows the example of a control term structure of the intravascular ultrasonic imaging apparatus by embodiment. The figure explaining the structure of a catheter part. The figure explaining the structure of a catheter part. The figure which shows the example of the tomogram acquired according to the positional relationship of a guide wire and an imaging core. The flowchart explaining operation | movement of the intravascular ultrasonic imaging apparatus by embodiment. The figure explaining insertion of the guide wire and drive shaft in a double lumen type catheter, and retraction.

  Hereinafter, an intravascular ultrasonic imaging apparatus will be exemplified as a tomographic imaging apparatus to which the present invention is applied. The application of the present invention is not limited to the imaging method of intravascular ultrasound imaging (IVUS), and the present invention is applicable to imaging methods such as optical coherence tomography (OCT) and optical frequency domain imaging (OFDI). Obviously it is applicable.

  FIG. 1 is a diagram showing an external configuration of an intravascular ultrasonic imaging apparatus 100 according to the present embodiment. As shown in FIG. 1, the intravascular ultrasound imaging apparatus 100 includes a catheter 101, a motor drive unit (hereinafter referred to as MDU 102) including a slide mechanism that pulls back a drive shaft inserted into the catheter 101, and an operation control apparatus 103. With. The MDU 102 and the operation control device 103 are connected by a signal line 104.

  A part of the catheter 101 is directly inserted into the blood vessel of the subject, and a drive shaft having a signal transmission / reception unit including an ultrasonic transducer (hereinafter referred to as transducer) provided at the tip is inserted into the lumen. The The MDU 102 is a drive unit that drives a drive shaft in the catheter 101, and regulates rotation and movement of the signal transmission / reception unit. The operation control apparatus 103 has a function for inputting various setting values and a function for processing data obtained by measurement and displaying it as a cross-sectional image when performing intravascular ultrasound imaging.

  In the operation control device 103, reference numeral 111 denotes a main body control unit that processes data obtained by measurement and outputs a processing result. Reference numeral 114 denotes a printer / DVD drive, which prints the processing result in the main body control unit 111 or stores it as data. Reference numeral 112 denotes an operation panel, and the user inputs various setting values via the operation panel 112. Reference numeral 113 denotes an LCD monitor that displays a processing result in the main body control unit 111.

  Next, the functional configuration of the intravascular ultrasound imaging apparatus 100 of the present embodiment will be described with reference to FIG. FIG. 2 is a diagram illustrating a functional configuration of the intravascular ultrasound imaging apparatus 100 illustrated in FIG. 1, and is a diagram illustrating an internal configuration of the catheter 101, the MDU 102, and the operation control apparatus 103 included in the intravascular ultrasound imaging apparatus 100. It is.

  The catheter 101 includes a signal transmission / reception unit 201 having a transducer for transmitting / receiving ultrasonic waves inside the distal end. The signal transmission / reception unit 201 is connected to the ultrasonic signal transmitter / receiver 221 via the connector unit 202 and the rotary joint 211. The transducer of the signal transmission / reception unit 201 transmits an ultrasonic wave in the cross-sectional direction of the blood vessel based on the pulse wave transmitted from the signal transmission / reception unit 201 with the distal end of the catheter 101 inserted into the blood vessel, and the reflection thereof. Receive a wave (echo). The received reflected wave signal is transmitted to the signal transmitting / receiving unit 201 as an ultrasonic echo through the connector unit 202 and the rotary joint 211.

  The MDU 102 includes a rotary joint 211, a rotation drive device 212, and a linear drive device 215. The signal transmission / reception unit 201 in the catheter 101 is rotatably mounted by a rotary joint 211 that couples between the non-rotating unit and the rotating unit, and is rotationally driven by a radial scanning motor 213. The signal transmission / reception unit 201 rotates in the blood vessel in the circumferential direction, so that an ultrasonic echo necessary for generating a cross-sectional image at a predetermined position in the blood vessel can be detected.

  The operation of the radial scanning motor 213 is controlled based on a control signal transmitted from the control unit 225 via the video tuning circuit 226. The rotation angle of the radial scanning motor is detected by the encoder unit 214. An output pulse output from the encoder unit 214 is input to the control unit 225 and used for transmission / reception timing in the signal transmission / reception unit 201. In addition, the MDU 102 includes a linear drive device 215 and regulates the operation in the insertion direction (front-rear direction) of the catheter 101 based on an instruction from the control unit 225.

  The ultrasonic signal transmitter / receiver 221 includes a transmission wave circuit and a reception wave circuit (not shown). The transmission wave circuit transmits a pulse wave to the ultrasonic transducer in the catheter 101 based on the control signal transmitted from the control unit 225. The reception wave circuit receives an ultrasonic signal from the transducer in the catheter 101. The received ultrasonic signal is amplified by the amplifier 222 and then input to the detector 223 for detection.

  The A / D converter 224 samples the ultrasonic signal output from the detector 223 for 200 points at 30.6 MHz, and generates one line of digital data (ultrasound echo data). Here, 30.6 MHz is assumed, but this is calculated on the assumption that 200 points are sampled at a depth of 5 mm when the sound speed is 1530 m / sec. Therefore, the sampling frequency is not particularly limited to this.

  The line-unit ultrasonic echo data generated by the A / D converter 224 is input to the control unit 225. The control unit 225 converts the ultrasound echo data to gray scale, thereby forming a cross-sectional image at each position in the blood vessel and outputs it to the LCD monitor 113 at a predetermined frame rate. Note that the control unit 225 includes a computer (CPU), a ROM, a RAM, and the like (not shown), and the CPU executes a program stored in the ROM or RAM, thereby performing processing as shown in the flowchart of FIG. Various controls of the intravascular ultrasound imaging apparatus 100 are realized.

  Next, the structure of the catheter 101 of this embodiment is demonstrated with reference to FIG. 3, FIG. As shown in FIG. 3, the catheter 101 is a long catheter sheath 301 that is inserted into the blood vessel, and is not inserted into the blood vessel to be operated by the user, but is disposed on the user's proximal side (base end side). The connector 302 is configured. As shown in FIG. 4, the distal end side of the catheter sheath 301 is a single lumen region 321, and the other region is a double lumen region 322. As shown by the BB cross section, the double lumen region 322 includes a first lumen 451 through which a guide wire 401 as a medical long body passes and an imaging core for tomographic imaging (a signal transmitting / receiving unit at the distal end). And a second lumen 452 through which the drive shaft 402) having 201 passes. The single lumen region 321 is connected to the distal end side of the double lumen region 322 and has a third lumen 453 that communicates with the first lumen 451 and the second lumen 452 of the double lumen region 322. is there. The structure of the catheter sheath 301 of this embodiment is similar to the structure shown in FIG. 7, but there is no proximal marker for determining whether the guide wire 401 or the signal transmitting / receiving unit 201 is in the interference area. May be.

  The connector 302 includes a sheath connector 302 a configured integrally with the proximal end of the catheter sheath 301 and a drive shaft connector 302 b configured integrally with the proximal end of the drive shaft 402. A kink protector 311 is provided at the boundary between the sheath connector 302a and the catheter sheath 301, so that a predetermined rigidity is maintained, and bending (kinking) of the catheter sheath 301 due to a sudden change can be prevented. . Further, the drive shaft connector 302b is provided with an injection port 312 to which a syringe (not shown) or the like can be attached in order to fill the entire lumen of the catheter sheath 301 with the ultrasonic transmission liquid. The base end of the drive shaft connector 302b is configured to be connectable to the MDU 102.

  Inside the lumen of the catheter sheath 301, an imaging core 403 including a signal transmission / reception unit 201 including a transducer for transmitting / receiving ultrasonic waves and a drive shaft 402 for transmitting a driving force for rotating the signal transmission / reception unit 201 is substantially the same as the catheter sheath 301. It is inserted through the entire length. In the present embodiment, ultrasonic waves are transmitted from the transducer toward the tissue in the body cavity, and the reflected waves from the tissue in the body cavity are received by the transducer. The transducer has, for example, a rectangular shape or a circular shape, and is formed by vapor-depositing electrodes on both surfaces of a piezoelectric material made of PZT or the like. The transducer is installed so as to be positioned near the center in the direction of the rotation axis so that the drive shaft 402 does not cause uneven rotation. Further, the drive shaft 402 is formed in a coil shape, and a signal line is arranged inside thereof, and extends from the signal transmission / reception unit 201 (from the transducer to the connector 302).

  The drive shaft 402 is capable of rotating and sliding in the lumen of the catheter sheath 301, is flexible, and has a characteristic capable of transmitting rotation well, for example, a multi-layered close contact coil made of a metal wire such as stainless steel. Etc. Although observation over 360 degrees is possible by rotation of the drive shaft 402, in order to further observe the range along the axial direction, the drive shaft 402 may be slid in the axial direction.

  FIG. 4 shows a state in which the drive shaft 402 is 491 slid relative to the catheter sheath 301 from the state shown in FIG. As shown in FIG. 4, when the drive shaft connector 302b is slid toward the proximal end (in the direction of the arrow 491) while the sheath connector 302a is fixed, the signal transmission / reception fixed to the internal drive shaft 402 or the distal end thereof is performed. The part 201 slides in the axial direction. The sliding in the axial direction may be performed by the user manually moving the rotary driving device 212 of the MDU 102 in the axial direction, or may be performed by driving the linear driving device 215. Further, the driving of the linear drive device 215 may be automatically performed by the control unit 225 according to a programmed pattern, or may be performed by turning on and off the linear drive device 125 by a user's switch operation.

  Next, the operation of the intravascular ultrasound imaging apparatus 100 of the present embodiment having the above-described configuration will be described with reference to FIGS. FIG. 5 is a diagram showing an example of a tomographic image acquired in accordance with the positional relationship between the imaging core 403 (the signal transmitting / receiving unit 201 and the drive shaft 402) in the single lumen region of the catheter sheath 301 and in the vicinity thereof. FIG. 6 is a flowchart for explaining a tomographic imaging operation by the intravascular ultrasound imaging apparatus 100 of the present embodiment. In the following operation procedure, it is assumed that at least the imaging core 403 is retracted to the double lumen region 322 at the start of tomographic imaging.

  First, in step S601, the control unit 225 locks the slide mechanism of the MDU 102. As described above, the slide mechanism is connected to the proximal end side of the drive shaft 402 and moves the drive shaft 402 (imaging core) in the front-rear direction. The state where the slide mechanism of the MDU 102 is locked is a state where the hold function related to the slide mechanism of the MDU 102 is turned on and the drive shaft 402 is not easily moved by an external force or the like. Further, in a state where the slide mechanism is locked, movement in the front-rear direction by the linear drive device 215 is not permitted, and for example, an input signal corresponding to a slide instruction operation on the operation panel 112 by the operator is not accepted, It will be ignored.

  In step S602, the control unit 225 rotates the imaging core and acquires at least one tomographic image using the signal transmission / reception unit 201. The rotational speed of the imaging core at this time may be lower than the rotational speed for acquiring a diagnostic image. This is because it is not safe whether the positional relationship between the guide wire 401 and the imaging core is in an interference state, and therefore it is safer to rotate at a low speed. For example, when the imaging core and the guide wire 401 are positioned as shown in FIG. 5A, a tomographic image 501 is obtained. It should be noted that the tomographic images 501 to 503 shown in FIG. 5 are schematically drawn for easy understanding of the explanation, and do not accurately show the tomographic images actually obtained. . When a guide wire is included in the tomographic image acquisition position, as shown in the tomographic image 501, a shadow of the guide wire extending in the direction of the deep portion in the fan shape (missing of the rear image by the guide wire) is observed. In addition, since the tube wall of the catheter sheath 301, the first lumen 451, and the second lumen 452 are generally masked so as not to be observed as an image inside the blood vessel wall 511, they are indicated by dotted lines in FIG. Has been. The image 513 is the external shape of the signal transmission / reception unit 201 itself. In step S603, the control unit 225 analyzes such a tomographic image, and determines whether or not a shadow 512 (missing image) corresponding to the guide wire 401 exists in the tomographic image (whether or not the guide wire 401 is reflected). Determine.

  When the shadow 512 of the guide wire 401 is shown as in the tomographic image 501, it is determined that the guide wire 401 is inserted into the single lumen region 321 and the process proceeds from step S604 to step S605. As shown in FIG. 5A, when the imaging core is fed into the single lumen region 321 when the guide wire 401 exists in the single lumen region 321, mechanical interference occurs between the guide wire 401 and the imaging core. Possible damage to the catheter. Therefore, the control unit 225 maintains the slide mechanism provided by the linear drive device 215 of the MDU 102 in a locked state. For example, the brake of the linear drive device 215 is turned on. Further, in step S606, the control unit 225 instructs the guide wire 401 to be pulled back further by notifying the LCD monitor 113 that the guide wire 401 is not sufficiently retracted from the single lumen region. Thereafter, the process returns to step S602, and the processes of steps S602 to S606 are repeated until no image of the guide wire 401 is detected.

  When the surgeon pulls back the guide wire 401 and the positions of the guide wire 401 and the imaging core are in the state as shown in FIG. 5B, the shadow corresponding to the guide wire 401 does not exist as shown in the tomographic image 502, Processing proceeds from step S604 to step S610. In step S610, the control unit 225 releases the locked state of the slide mechanism to make it movable. In this state, the surgeon can manually slide the rotational drive device 212 to feed the imaging core into the single lumen region 321. Alternatively, the advance operation by the linear drive device 215 is permitted, and the surgeon can advance the imaging core 403 by a switch operation or the like. In addition, the process of step S626 may be inserted between step S610 and step S611 (not shown). In this case, the process immediately proceeds from step S610 to step S626, the guide wire 401 is not allowed to be sent, and the guide wire 401 is not allowed to be sent, and then the procedure goes to step S611. . In step S611, the control unit 225 displays on the LCD monitor 113 that the imaging core 403 can be sent. After this display, the surgeon can send the signal transmitting / receiving unit 201 of the imaging core to the position to be imaged manually or by a switch operation.

  The surgeon instructs execution of imaging via the operation panel 112. Upon receiving this instruction, the control unit 225 controls the MDU 102 to execute diagnostic imaging. That is, the control unit 225 captures a tomographic image of a blood vessel over a predetermined range by rotating the imaging core 403 at a high speed by the rotation driving device 212 and pulling back the imaging core 403 by the linear driving device 215. When the diagnostic imaging is completed, the process proceeds from step S613 to step S620.

The determination of the end of shooting in step S613 will be described. Examples of the method for determining the end of shooting include the following (1) to (5). Note that in step S613, if it is determined that shooting is ended by any one of (1) to (5), the process is branched to step S620. The following determination methods (1) to (5) can be applied to either the case of automatically pulling back by the MDU 102 or the case of manually pulling back.
(1) A tomographic image capturing range (distance in the axial direction) is set, and when the set distance from the start of diagnosis image capturing is pulled back, it is determined that the capturing has ended. For example, if the imaging range is 10 cm in the axial direction, it is determined that the imaging is finished when the linear drive device 215 pulls back the imaging core 403 by 10 cm.
(2) When it is detected that a predetermined time has elapsed from the start of imaging of the diagnostic image, it is determined that imaging has been completed. For example, a timer is started from the start of imaging of a diagnostic image, and imaging of a diagnostic tomographic image is terminated when a time preset in the timer has elapsed.
(3) When the guide wire 401 is detected by analysis of the diagnostic image, it is determined that the imaging has been completed.
(4) When it is detected that the pull back has been reached to the limit of the MDU 102, it is determined that the photographing has been completed.
(5) When the switch for instructing the end of shooting is operated by the user, it is determined that the shooting has ended.

  In step S620, the control unit 225 determines whether or not the imaging core 403 has been pulled to the limit of the pull back of the MDU 102. If the imaging core 403 is pulled, it is determined that the tip of the imaging core 403 has passed through the interference area (single lumen area 321), and the process proceeds to step S624. If the imaging core 403 has not reached the pullback limit, the process advances to step S621. In step S621, tomographic imaging for determining the possibility of interference between the guide wire 401 and the imaging core 403 is performed. That is, similarly to step S602, the control unit 225 acquires a tomographic image for confirming the presence of the guide wire 401. As described in step S602, the rotation speed at this time may be slower than the rotation speed in capturing a tomographic image for diagnosis. In step S622, the control unit 225 analyzes the tomographic image acquired in step S620 and determines whether an image corresponding to the guide wire 401 exists in the tomographic image. For example, after imaging tomographic imaging is completed, if the imaging core 403 is at a position (in the single lumen region 321) as shown in FIG. 5C, the tomographic image is displayed as shown in the tomographic image 503. There is no shadow corresponding to the guide wire 401. In other words, when the guide wire image does not exist in the tomographic image obtained by the imaging in step S621, the imaging core may exist in the single lumen region 321. In this case, when the guide wire 401 is fed into the single lumen region 321, the imaging core 403 and the guide wire 401 may interfere with each other.

  Therefore, if it is determined as a result of the analysis in step S622 that the image of the guide wire 401 does not exist, the process proceeds from step S623 to step S626, and the control unit 225 prohibits the guide wire 401 from being fed. And / or an instruction to further draw the imaging core 403 is given to the LCD monitor 113. And a process returns to step S620 and the process mentioned above is repeated.

  Thereafter, when the operator pulls back the imaging core 403 to a position where the image of the guide wire 401 appears in the tomographic image, and it is determined that the image of the guide wire 401 exists in the tomographic image as a result of the analysis in step S621, Control proceeds from step S623 to step S624. In step S624, the control unit 225 terminates tomographic image capturing and locks the slide mechanism of the MDU 102 as in step S601. In step S625, the control unit 225 uses the LCD monitor 113 to notify that the guide wire 401 is allowed to be fed to the distal end side. In the determination of the end of shooting in step S613, if the end of shooting is determined in (3) or (4) described above, the process may proceed immediately from step S613 to step S626. In addition, when it is determined in (5) that shooting is to be ended, shooting after the switch for instructing shooting to be operated (processing after step S620) may not be performed. In this case, if the guide wire 401 is not detected in the analysis result of the tomographic image at the time when the switch is operated and is not pulled to the pull back limit of the MDU 102, the imaging core 403 is pulled to the pull back limit of the MDU 102. Such an instruction may be given by the LCD monitor 113 or the like.

  In the above embodiment, the presence of an image corresponding to the guide wire 401 is determined in steps S622 and S623, but the present invention is not limited to this. The guide wire 401 may be sent in as long as it can be confirmed that the signal transmission / reception unit 201 of the imaging core has returned to the double lumen region 322. Therefore, for example, an image of a lumen (first lumen 451) for allowing the guide wire 401 to pass through the tomographic image is reflected, and when the presence can be detected, the guide wire 401 is allowed to be fed, The slide mechanism of the MDU 102 may be locked. Alternatively, a marker such as the proximal marker 712 in FIG. 7 (which may be X-ray transmissive or X-ray transmissive) is provided in the double lumen region 322, and the guide wire 401 is allowed to be fed when this is reflected in a tomographic image. However, the slide mechanism of the MDU 102 may be locked.

  In the above embodiment, the rotational speed of the imaging core in tomographic imaging (steps S602 and S621) for confirming the reflection of the guide wire is set lower than the rotational speed in diagnostic tomographic imaging (step S612). did. However, it is not essential to switch the rotational speed of the imaging core, and all tomographic imaging shown in the flowchart of FIG. 6 may be performed at the same rotational speed (rotational speed for diagnostic imaging in step S612).

  Further, in the above-described embodiment, the permission or non-permission of the feeding of the imaging core or the guide wire is displayed on the LCD monitor 113. However, the display unit may be provided on the MDU 102 for display. In this case, the MDU 102 may be notified by a plurality of LED lamps. It is also clear that the permission or non-permission of the feeding of the imaging core or guide wire may be notified by sound. Further, the tomographic images (tomographic images 501 to 503) taken in step S602 and step S620 may be displayed on the LCD monitor 113.

  In the above-described embodiment, the pull-in of the drive shaft 402 by the MDU 102 is stopped at the end of imaging of the diagnostic tomographic image, but the present invention is not limited to this. For example, the drive shaft 402 may be continuously retracted even after the imaging for diagnosis is completed, and the processes in steps S620 to S623 may be repeated until the reflection of the guide wire 401 is detected in step S622. That is, the control unit 225 drives the slide mechanism of the MDU 102 after taking the diagnostic tomographic image, and pulls back the drive shaft 402 until it is determined that the guide wire 401 is reflected in the tomographic image. May be. According to such control, the operability is improved because the drive shaft 402 is automatically retracted to a safe position after taking a diagnostic tomographic image.

  As described above, according to the present embodiment, it is determined whether or not the guide wire 401 is reflected in the tomographic image acquired in step S602, and the front and rear of the drive shaft 402 in the catheter are determined based on the determination result. Permitted or not permitted to move in the direction. Therefore, it is not necessary to confirm the position of the drive shaft 402 using the proximal marker as shown in FIG. That is, even if the proximal marker is not present in the range of fluoroscopy, the drive shaft 402 can be safely fed. In the present embodiment, the case where a guide wire is reflected on a diagnostic tomographic image in imaging of a diagnostic tomographic image has been described, but the present invention is not limited to a guide wire. For example, a medical catheter different from the catheter 101, an endoscope, and the like can be used, and any medical long body used in combination with the image diagnostic catheter 101 used in the present invention can be used. It doesn't matter.

  DESCRIPTION OF SYMBOLS 100: Intravascular ultrasonic imaging apparatus, 101: Catheter, 102: MDU, 103: Scanning control apparatus, 201: Signal transmission / reception part, 301: Catheter sheath, 302: Connector, 401: Guide wire, 402: Drive shaft, 451: First lumen, 452: Second lumen, 453: Third lumen

Claims (14)

A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens,
A slide mechanism connected to the proximal end side of the imaging core and moving the imaging core;
Obtaining means for obtaining a tomographic image using the signal transmitting and receiving unit;
First determination means for determining whether or not the medical elongated body is reflected in the tomographic image acquired by the acquisition means;
By the first judging means, wherein allow the movement of the imaging core when the medical long body is determined not reflected, said medical long body is reflected in the tomographic image in the tomographic image Second determination means for determining that the movement of the imaging core is not permitted when it is determined that
Control means for placing the slide mechanism in a movable state when it is determined to be permitted by the second determination means, and for locking the slide mechanism when it is determined to be disapproved by the second determination means; , tomography apparatus, characterized in that it comprises a. The control means includes
In response to an input signal by an operator's operation, the slide mechanism is driven to move the imaging core,
While it is determined that the prohibition by the second judging means, tomography apparatus according to claim 1, characterized in that ignoring the input signal. Upon completion of tomographic imaging, the control unit drives the slide mechanism to pull back the imaging core until the first determination unit determines that the medical long body is reflected in the tomographic image. The tomographic imaging apparatus according to claim 2 . The tomography according to any one of claims 1 to 3 , further comprising first notification means for notifying a result of determination of permission or non-permission of movement of the imaging core by the second determination means. Image taking device. The apparatus further comprises third determination means for determining permission or non-permission of movement of the medical elongated body in the catheter based on whether or not the medical elongated body is reflected in the tomographic image. The tomographic imaging apparatus according to any one of claims 1 to 4 . A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens,
Obtaining means for obtaining a tomographic image using the signal transmitting and receiving unit;
First determination means for determining whether or not the medical elongated body is reflected in the tomographic image acquired by the acquisition means;
Second determination means for determining permission or non-permission of movement of the imaging core in the catheter based on a result of determination by the first determination means;
Third determination for determining permission or non-permission of movement of the medical elongated body in the catheter based on whether or not the first lumen and the second lumen are reflected in the tomographic image sectional Sozo imaging device characterized by obtaining Bei and means. A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens,
Obtaining means for obtaining a tomographic image using the signal transmitting and receiving unit;
First determination means for determining whether or not the medical elongated body is reflected in the tomographic image acquired by the acquisition means;
Second determination means for determining permission or non-permission of movement of the imaging core in the catheter based on a result of determination by the first determination means;
Based on whether or not the marker arranged at the position where the first lumen and the second lumen are present in the tomographic image, the movement of the medical elongated body in the catheter is determined. allow the sectional Sozo imaging device you wherein the third determining means for determining disablement, that obtain Bei a. By the third judging means, permission of movement of the medical long body, in any one of claims 5 to 7, further comprising a second informing means for informing a result of determination of prohibition The tomographic imaging apparatus described. A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens,
Obtaining means for obtaining a tomographic image using the signal transmitting and receiving unit;
First determination means for determining whether or not the first lumen and the second lumen are reflected based on the tomographic image acquired by the acquisition means;
A tomography apparatus comprising: a second determination unit that determines permission or non-permission of movement of the medical elongated body in the catheter based on a determination result of the first determination unit. . A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens ,
Operation of the tomographic imaging apparatus, which is connected to the proximal end side of the imaging core and includes a slide mechanism that moves the imaging core, an acquisition unit, a first determination unit, a second determination unit, and a control unit A method,
The acquisition unit acquires a tomogram using the signal transmitting and receiving unit;
A first determination step in which the first determination means determines whether or not the medical elongated body is reflected in the tomographic image acquired in the acquisition step;
Said second judging means, wherein the first determination step, the permits the movement of the imaging core when the medical long body is determined not reflected in the tomographic image, the medical to the tomographic image A second determination step of determining that the movement of the imaging core is not permitted when it is determined that the long body for use is reflected ;
When the control means is determined to be permitted by the second determination means, the slide mechanism is moved, and when the second determination means is determined not to be permitted, the slide mechanism is locked. A method of operating the tomographic imaging apparatus, comprising:   A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens,
  The tomographic imaging apparatus comprising a slide mechanism that is connected to a proximal end side of the imaging core and moves the imaging core, an acquisition unit, a first determination unit, a second determination unit, and a third determination unit The operation method of
  The acquisition unit acquires a tomogram using the signal transmitting and receiving unit;
  A first determination step in which the first determination means determines whether or not the medical elongated body is reflected in the tomographic image acquired in the acquisition step;
  A second determination step in which the second determination means determines permission or non-permission of movement of the imaging core in the catheter based on a result of determination in the first determination step;
  Based on whether the first lumen and the second lumen are reflected in the tomographic image, the third determination means permits or disallows movement of the medical elongated body in the catheter. And a third determination step of determining permission. An operation method of the tomographic imaging apparatus characterized by comprising:   A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region A tomographic imaging apparatus for imaging a tomographic image using a catheter comprising a second region having a third lumen connected to the first lumen and communicating with the first and second lumens,
  The tomographic imaging apparatus comprising a slide mechanism that is connected to a proximal end side of the imaging core and moves the imaging core, an acquisition unit, a first determination unit, a second determination unit, and a third determination unit The operation method of
  The acquisition unit acquires a tomogram using the signal transmitting and receiving unit;
  A first determination step in which the first determination means determines whether or not the medical elongated body is reflected in the tomographic image acquired in the acquisition step;
  A second determination step in which the second determination means determines permission or non-permission of movement of the imaging core in the catheter based on a result of determination in the first determination step;
  Based on whether or not the marker arranged at a position where the first lumen and the second lumen are present in the tomographic image, the third determination unit is configured to perform the medical treatment in the catheter. And a third determination step of determining permission or non-permission of movement of the long body for operation. A first region having a first lumen through which a medical elongated body passes and a second lumen through which an imaging core having a signal transmission / reception unit for tomographic imaging passes, and a distal end side of the first region And a second region having a third lumen that communicates with the first and second lumens, and obtains a tomogram using a catheter. An operation method of the tomographic imaging apparatus comprising means, first determination means, and second determination means ,
The acquisition unit acquires a tomogram using the signal transmitting and receiving unit;
A first determination step in which the first determination means determines whether the first lumen and the second lumen are reflected in the tomographic image acquired in the acquisition step;
Said second determination means, based on the result of the determination in the first determination step, that having a, a second determination step of determining permission of movement of the medical long body, a prohibition of the catheter A method of operating a tomographic imaging apparatus characterized by the above. The program for making a computer perform each process of the operating method of any one of Claims 10 thru | or 13 .

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