JP6484781B1 - Ultrasonic image display device - Google Patents

Abstract

Ultrasound that enables accurate puncture because it can capture the entire image of the target site and puncture needle in the subject and display it as an ultrasound image without complicated operations and reduced image responsiveness. Provision of image display devices. In this apparatus (1), a line-shaped mapping region (81) is designated on an imaginary straight line (L2) that passes through a substantially central portion of the first tomographic image (8). Only the designated line-shaped mapping region (81) is subjected to signal processing based on the color flow mapping method to generate color flow mapping data for generating a color flow mapping image (84, 85). A color flow mapping image (84, 85) is generated based on the generated color flow mapping data, and is superimposed on the linear mapping region (81) in the first tomographic image (8) and displayed.

Description

The present invention relates to an ultrasound image display equipment for performing puncture while acquiring an ultrasonic tomographic image of the subject, to determine the location of the puncture needle with the ultrasound probe.

  In medical practice, puncture of living tissue (subject) such as general injection, nerve block injection, blood sampling, and catheter insertion is widely performed. When performing treatments such as nerve block injection and catheter insertion, the body tissue may be damaged unless the target site in the subject is punctured accurately. In such a background, in recent years, an ultrasonic guide technique has been proposed in which an ultrasonic probe is used to capture the state of a target site and a puncture needle, and puncture is performed while observing them with an ultrasonic tomographic image. .

  Conventionally, in an apparatus using an ultrasonic guide technique, a normal ultrasonic probe (a so-called single plane probe) is used to capture one tomographic image, and puncture is performed by displaying this tomographic image. However, in the conventional apparatus, only one of the short-axis image (transverse section) and the long-axis image (longitudinal section) can be confirmed, and the entire portion of the target site and the puncture needle in the subject can be captured simultaneously. could not. Therefore, even when the puncture needle is not accurately punctured, there is a problem that the operator is difficult to notice it. Therefore, in order to perform accurate puncturing, the puncture needle must be advanced little by little while repeating fine probe operations, and the operation is complicated.

  Therefore, the inventors of the present application are ultrasonic probes (so-called biplane probes) that can simultaneously observe in two orthogonal cross sections (cross section and vertical section) in order to simultaneously capture the entire part of the target site and the puncture needle. Have been proposed in the past (see, for example, Patent Document 1). If this type of ultrasonic probe is used, an ultrasonic image (short axis image and long axis image) of each cross-section can be displayed, and the operator can observe the two ultrasonic images to obtain a target. It is possible to simultaneously capture the entire part and the entire surface of the puncture needle.

Japanese Patent No. 5292581 Japanese Patent No. 4653454

  However, according to the conventional technique described in Patent Document 1, for example, discrimination between an artery and a vein and discrimination between a blood vessel and a nerve may be difficult on an ultrasonic image. Here, if color flow mapping (CFM), which is an additional function of the ultrasonic diagnostic apparatus, is used, a color flow mapping image generated by extracting a Doppler shift (frequency shift) generated from the blood flow is displayed on the ultrasonic image. Is superimposed on. As a result, it is possible to easily determine these by observing the presence or type and color of the color flow mapping image. In addition, although it is an apparatus of the type which displays one tomographic image, for example, Patent Document 2 discloses a technique for superimposing a color flow mapping image in a mapping region designated on an ultrasonic image.

  On the other hand, the operation of color flow mapping (designation of a mapping area, etc.) is complicated, and the frame rate of the ultrasonic image is extremely reduced due to the load of signal processing itself based on the color flow mapping method. As a result, there is a problem that the responsiveness of the ultrasonic tomographic image is deteriorated.

  Further, when puncturing, it is necessary to advance the puncture needle while simultaneously capturing the target site and the state of the puncture needle (especially the tip). For example, a mapping region having a size as disclosed in Patent Document 2 is designated. If so, the image of the blood vessel wall or the tip is buried by the color flow mapping image. For this reason, the state of the tip after penetrating the blood vessel wall becomes difficult to understand, and there is a problem that a problem occurs when performing accurate puncture.

The present invention has been made in view of the above problems, and its purpose is to reliably capture the entire image of the target site and the puncture needle in the subject without complicated operations and a decrease in image responsiveness. because displayable as an ultrasonic image, is to provide an ultrasound image display equipment which can perform an accurate puncture.

In order to solve the above problem, the invention according to claim 1 acquires a first tomographic image showing a transverse section of a subject and a second tomographic image showing a longitudinal section in a direction intersecting the transverse section. Accordingly, by performing ultrasonic transmission / reception using an ultrasonic probe having a probe body in which a plurality of ultrasonic transducers for linearly scanning ultrasonic waves are orthogonally arranged, the object along the longitudinal section is transmitted to the subject. An apparatus for simultaneously displaying the first tomographic image and the second tomographic image on the same screen when performing a puncture for inserting a puncture needle, wherein a mapping region is not designated at all in the second tomographic image. Thus, a mapping area designating means for designating a linear mapping area on a vertical line displayed at a position corresponding to a straight line extending in the vertical direction which is the ultrasonic wave incident direction through a substantially central portion of the first tomographic image. When, Mapping data generating means for generating color flow mapping data for generating a color flow mapping image by performing signal processing based on a color flow mapping method only in the defined line-shaped mapping region, and the generated color generating the color flow mapping image on the basis of the flow mapping data, and the color flow mapping image generating display means for displaying which was superimposed on the linear mapping region within the first tomographic image, the first tomographic A depth position at which the tip of the puncture needle begins to appear in the image is indicated in advance, and a guide mark larger than the diameter of the image corresponding to the tip of the puncture needle is placed on the vertical line of the first tomographic image. And a guide marker displayed in a region between the substantially center portion and the upper end portion of the first tomographic image. Display means, and the mapping area designating means has a shape that is smaller than a maximum width of an image corresponding to the guide mark at a position excluding the guide mark on the vertical line. The gist of the ultrasonic image display device is characterized by designating a mapping region .

  Therefore, according to the first aspect of the present invention, the color flow mapping data is generated by the mapping data generating means performing predetermined signal processing only in the line-shaped mapping area specified by the mapping area specifying means. The color flow mapping image generation / display unit superimposes and displays the color flow mapping image generated based on the data on the line-shaped mapping region. In this case, since the displayed color flow mapping image is narrow and sufficiently smaller than the image of the target portion in the subject, it is difficult to bury the image of the target portion in the subject. Therefore, it is possible to reliably capture the entire appearance of the target site and the puncture needle in the subject and display it as an ultrasound image, and the operator can perform accurate puncture by observing the ultrasound image. . Also, since the mapping area is designated by the mapping area designation means rather than by the operator, complicated operations can be avoided. Furthermore, according to the designation of the mapping region in a very narrow range as described above and the limited signal processing in that range, the load of signal processing based on the color flow mapping method is reduced. As a result, a decrease in the frame rate of the ultrasonic image is suppressed, and a decrease in the responsiveness of the ultrasonic tomographic image is avoided.

Further , according to the present invention , by visually recognizing the guide mark displayed on the vertical line of the first tomographic image, it is possible to easily and accurately foresee the position where the tip of the puncture needle starts to be seen. Further, since the line-shaped mapping area is designated at a position excluding the guide mark on the vertical line , the guide mark is not buried even if the color flow mapping image is superimposed. Therefore, the visibility of the guide mark and the tip of the puncture needle can be maintained.

According to a second aspect of the present invention, in the first aspect , the mapping area designating unit has the line shape so as to have a width smaller than the inner diameter of the image of the tubular structure displayed on the vertical line. The gist is to specify the mapping area.

Therefore, according to the second aspect of the present invention, since the line-shaped mapping region is specified to have a width smaller than the inner diameter of the image of the tubular structure such as a blood vessel, the color flow mapping image is the tubular structure. Is superimposed on a part of the image instead of the entire image. Therefore, the image of the tubular structure is not buried by the color flow mapping image, and the state of the tube wall of the tubular structure is easily understood.

The invention according to claim 3 is the invention according to claim 1 or 2 , wherein the mapping area designating unit has a width of 0.5 to 2 times the diameter of the image corresponding to the tip of the puncture needle. The gist is to designate the line-shaped mapping area.

Therefore, according to the third aspect of the present invention, it is possible to prevent the image corresponding to the tip of the puncture needle or the image of the tubular structure from being buried while maintaining the visibility of the color flow mapping image. Therefore, it becomes easy to understand the state of the tip of the puncture needle and the tube wall of the tubular structure. Here, when the width is less than 0.5 times the diameter, the width of the color flow mapping image becomes too narrow, and the visibility of the color flow mapping image is deteriorated. Further, when the width is more than twice the diameter, there is a possibility that an image corresponding to the tip of the puncture needle is buried by the color flow mapping image, or an image of the tubular structure is buried.

Further, in the invention according to claim 1 or the like, normally, the guide mark is set smaller than the inner diameter of the tubular structure as a reference, a smaller width than the maximum width of the image corresponding to the guide mark Thus, a line-shaped mapping area is designated. For this reason, the color flow mapping image is superimposed not on the entire image of the tubular structure but on a part thereof. Therefore, the image of the tubular structure is not buried by the color flow mapping image, and the state of the tube wall of the tubular structure is easily understood.

According to a fourth aspect of the present invention, in any one of the first to third aspects, the vertical line is displayed using a chromatic color other than blue and red used in the color flow mapping image. The gist.

Therefore, according to the fourth aspect of the present invention, by actually visualizing and displaying the virtual curve on the first tomographic image, it is possible to more accurately grasp the line through which the puncture needle will pass. Since the visualized virtual straight line (that is, vertical line) is displayed using chromatic colors other than blue and red used in the color flow mapping image, it can be visually recognized without being confused with the color flow mapping image.

As described above in detail, according to the inventions described in claims 1 to 4 , the entire image of the target site and the puncture needle in the subject can be reliably captured without complicated operations and a decrease in image responsiveness. Since it can be displayed as an ultrasonic image, accurate puncture can be performed.

1 is an overall schematic diagram illustrating an angiography apparatus according to a first embodiment that embodies the present invention; 1 is a block diagram showing an electrical configuration of an angiography apparatus according to a first embodiment. The perspective view which shows the probe main body of the ultrasonic probe in 1st Embodiment. In 1st Embodiment, explanatory drawing which shows the 1st tomographic image and 2nd tomographic image of the state before insertion of a puncture needle and before a color flow mapping image superimposition. In 1st Embodiment, explanatory drawing which shows the 1st tomographic image and 2nd tomographic image of the state after insertion of a puncture needle and after a color flow mapping image superimposition. Explanatory drawing which shows the 1st tomographic image and 2nd tomographic image of the state after insertion of a puncture needle, and after a color flow mapping image superimposition in 1st Embodiment. Explanatory drawing which shows the usage method of the said ultrasonic probe. In 2nd Embodiment, explanatory drawing which shows the 1st tomographic image and 2nd tomographic image of the state before insertion of a puncture needle and before a color flow mapping image superimposition. In 2nd Embodiment, explanatory drawing which shows the 1st tomographic image and 2nd tomographic image of the state after insertion of a puncture needle and after a color flow mapping image superimposition. Explanatory drawing which shows the 1st tomographic image and the 2nd tomographic image of the state after insertion of a puncture needle and a color flow mapping image superimposition in 2nd Embodiment. In another embodiment, (a) is a first tomographic image in a state before insertion of the puncture needle and before the color flow mapping image is superimposed, and (b) is a first tomographic image in a state before insertion of the puncture needle and after the color flow mapping image is superimposed. Explanatory drawing which shows 1 tomographic image. In another embodiment, (a) is a first tomographic image in a state before insertion of the puncture needle and before the color flow mapping image is superimposed, and (b) is a first tomographic image in a state before insertion of the puncture needle and after the color flow mapping image is superimposed. Explanatory drawing which shows 1 tomographic image.

[First Embodiment]
Hereinafter, an embodiment in which the present invention is embodied in an angiography apparatus as an ultrasonic image display apparatus will be described in detail with reference to the drawings. FIG. 1 is an overall schematic diagram showing an angiographic apparatus 1 according to the present embodiment, and FIG. 2 is a block diagram showing an electrical configuration of the angiographic apparatus 1.

  As shown in FIGS. 1 and 2, the angiography apparatus 1 of this embodiment includes an apparatus main body 2 and an ultrasonic probe 3 connected to the apparatus main body 2. This angiography apparatus 1 is used, for example, when a puncture needle 6 such as a catheter is inserted into a vein 82 in a living tissue 4 (subject). The angiography apparatus 1 includes a first tomographic image 8 (short axis image) showing a transverse section of a vein 82 and a second tomographic image 9 (long axis image) showing a longitudinal section of the vein 82 on the same screen 10. They are displayed simultaneously (see FIGS. 4 to 6).

  As shown in FIGS. 1 to 3, the ultrasonic probe 3 includes a signal cable 11, a probe main body 12 connected to the tip of the signal cable 11, and a puncture guide that is detachably fixed to the probe main body 12. Attachment 14 (puncture guide mechanism) and a probe-side connector 15 provided at the proximal end of the signal cable 11. A connector 16 is provided in the apparatus main body 2, and a probe-side connector 15 of the ultrasonic probe 3 is connected to the connector 16.

  The ultrasonic probe 3 is a linear probe for performing linear electronic scanning, and, for example, linearly scans ultrasonic waves of 5 MHz. A plurality of ultrasonic transducers 23 and 24 (probes) are arranged on the transducer installation surface 20 serving as the bottom surface of the probe main body 12 so that the arrangement directions are orthogonal to each other and are substantially T-shaped. Yes.

  More specifically, the probe body 12 includes a first element unit 25 that houses a plurality of first ultrasonic transducers 23 for acquiring the first tomographic image 8 and a plurality of elements for acquiring the second tomographic image 9. And a second element unit 26 that houses the second ultrasonic transducer 24. The plurality of first ultrasonic transducers 23 in the first element unit 25 are linearly arranged along the minor axis direction X corresponding to the cross section. The plurality of second ultrasonic transducers 24 in the second element unit 26 are linearly arranged along the major axis direction Y corresponding to the longitudinal section. In the present embodiment, the number of elements of the first ultrasonic transducer 23 accommodated in the first element unit 25 is, for example, 48, and the second ultrasonic transducer 24 accommodated in the second element unit 26. The number of elements is larger than that (for example, 80). Therefore, the length of the ultrasonic transducers 23 and 24 in the arrangement direction is longer in the second element unit 26 than in the first element unit 25.

  In the second element unit 26, the ultrasonic transducer array 27 extending in the major axis direction Y is located on the center line L 0 of the probe body 12 on the transducer installation surface 20. Furthermore, the ultrasonic transducer array 27 is located at the approximate center of the ultrasonic transducer array 28 whose starting end is in the minor axis direction X.

  In the ultrasonic probe 3 of the present embodiment, the scanning of the ultrasonic waves in the substantially T-shaped ultrasonic transducer arrays 27 and 28 is performed by, for example, one end of the ultrasonic transducer array 28 in the short axis direction X (for example, FIG. It starts from the ultrasonic transducer 23 at the right end (start end). Then, the elements are sequentially performed one by one toward the ultrasonic transducer 23 at the other end of the ultrasonic transducer array 28 in the short axis direction X (for example, the terminal end at the left end in FIG. 2). Thereafter, the other end from the ultrasonic transducer 24 at one end of the ultrasonic transducer row 27 in the major axis direction Y located at the approximate center of the ultrasonic transducer row 28 in the minor axis direction X (the start end which is the lower end in FIG. 2). Ultrasonic scanning is performed in order for each element toward the ultrasonic transducer 24 at the upper end (the upper end in FIG. 2).

  In the ultrasonic probe 3 of the present embodiment, the transducer installation surface 20 located on the bottom surface of the probe main body 12 is a contact surface with the biological tissue 4 and serves as a transmission / reception surface for transmitting and receiving ultrasonic waves. In the transducer installation surface 20, a substantially T-shaped acoustic lens 29 is disposed via a not-shown acoustic matching layer at a portion where the ultrasonic transducer arrays 27 and 28 are disposed in a substantially T-shape. Yes. The acoustic lens 29 is made of, for example, a silicone resin, and is provided on the ultrasonic radiation surface 30 side of the ultrasonic transducers 23 and 24 in the first element unit 25 and the second element unit 26. The acoustic lens 29 is formed in a convex shape with a curved outer surface in contact with the living tissue 4, and an ultrasonic beam output in the normal direction from the ultrasonic radiation surfaces 30 of the ultrasonic transducers 23 and 24. The aperture is narrowed down and converged at a predetermined focal position. In addition, a backing material (not shown) for preventing propagation of ultrasonic waves to the rear is disposed on the opposite side of the ultrasonic radiation surface 30 in the ultrasonic transducers 23 and 24.

  In the probe main body 12, the extension line of the ultrasonic transducer array 27 in the major axis direction Y (the center line L0 of the probe main body 12 on the transducer installation surface 20) and the edge of the transducer installation surface 20 (lower in FIG. 2). A positioning portion 31 is provided on the side (on the left edge in FIG. 3). The positioning portion 31 is a recess for abutting and guiding the distal end 71 side of the puncture needle 6 when determining the insertion position of the puncture needle 6 with respect to the living tissue 4. Furthermore, on the transducer installation surface 20 of the probe body 12 that the living tissue 4 contacts, at both ends in the minor axis direction X, convex strips 32 for avoiding compression of the observation site of the living tissue 4 are arranged in the major axis direction. It is provided along Y (see FIG. 3). By providing the pair of ridges 32 apart from each other on the transducer installation surface 20 of the probe body 12, the region between the pair of ridges 32 on the transducer installation surface 20 side is not pressed too strongly. Therefore, the vein 82 at the observation site is prevented from being crushed, and the vein 82 can be punctured with certainty.

  As shown in FIGS. 1 and 2, the puncture guide attachment 14 has a multi-stage insertion angle of the puncture needle 6 and the puncture needle guide portion 34 in which a guide groove 33 for guiding the puncture needle 6 is formed. And an angle adjusting mechanism 35 that can be adjusted to each other, and a fixing portion 36 that is fitted into and fixed to the lower part of the side surface of the probe main body 12. The puncture guide attachment 14 has the puncture needle 6 positioned at a predetermined angle along the longitudinal section indicated by the second tomographic image 9 with the puncture needle 6 positioned at the center of the transverse section indicated by the first tomographic image 8. The puncture needle 6 is guided so as to be inserted into the tissue 4. The puncture guide attachment 14 of the present embodiment is a resin molded part formed using a flexible resin material.

  The lower portion of the probe main body 12 has a hammerhead type outer shape (substantially T-shaped) in which the first element unit 25 disposed on the distal end side protrudes in the lateral direction (see FIGS. 2 and 3). In the puncture guide attachment 14, the fixing portion 36 is formed in an annular shape along the hammerhead type outer shape. For example, an engagement recess (not shown) is formed on the inner peripheral side of the fixed portion 36, and the engagement recess engages with an engagement protrusion (not shown) formed on the probe main body 12. A puncture guide attachment 14 is fixed to the probe body 12.

  In the puncture guide attachment 14, an angle adjustment mechanism 35 is provided at one end of the fixing portion 36, and a puncture needle guide portion 34 is detachably attached to the angle adjustment mechanism 35. The puncture needle guide part 34 protrudes at a position spaced upward from the transducer installation surface 20. The angle adjustment mechanism 35 is an adjustment mechanism that is provided so as to move the puncture needle guide portion 34 in multiple steps in the circumferential direction around the positioning portion 31 of the probe main body 12 and to be fixed at each position. The angle adjustment mechanism 35 is provided with, for example, three stages of switching positions.

  The guide groove 33 of the puncture needle guide portion 34 is formed on the center line L0 of the probe main body 12 in a projection view from the transducer installation surface 20 and extends along the center line L0. . The puncture needle guide portion 34 is constituted by two rod-like members 40 extending in a direction parallel to the arrangement direction of the ultrasonic transducer arrays 27 in the major axis direction Y and having base end portions connected to each other. The shape seen is substantially U-shaped. A gap provided between the two bar-shaped members 40 in the puncture needle guide portion 34 is a guide groove 33. In a state where the puncture guide attachment 14 is attached to the probe body 12, the guide groove 33 is disposed on the center line L 0 of the probe body 12. The guide groove 33 is provided with an opening 41 for introducing the puncture needle 6 and a bottom portion 42 for contacting the introduced puncture needle 6. Further, the guide groove 33 of the puncture needle guide portion 34 is provided with a puncture needle introduction portion 43 formed so that the groove width gradually increases toward the opening 41 side.

  The insertion angle of the puncture needle 6 is determined by the combination of the bottom portion 42 of the guide groove 33 and the positioning portion 31 of the probe main body 12. That is, the tip 71 of the puncture needle 6 is brought into contact with the positioning portion 31 of the probe main body 12 and the side surface of the puncture needle 6 is brought into contact with the bottom 42 of the guide groove 33, thereby inserting the puncture needle 6 into the living tissue 4. The angle is determined. Further, in the puncture guide attachment 14, the angle adjustment mechanism 35 is operated to move the puncture needle guide portion 34 to change the position of the bottom portion 42 of the guide groove 33, thereby determining the bottom portion 42 and the positioning portion 31. The insertion angle of the puncture needle 6 is adjusted in multiple steps.

  Next, the electrical configuration of the angiography apparatus 1 will be described in detail with reference to FIG.

  As shown in FIG. 2, the apparatus main body 2 of the angiography apparatus 1 includes a controller 50, a pulse generation circuit 51, a transmission circuit 52, a reception circuit 53, a signal processing unit 54, an image processing unit 55, a memory 56, and a storage device 57. , An input device 58, a display device 59, and the like. The controller 50 is a computer configured to include a known central processing unit (CPU), and executes a control program using the memory 56 to control the entire apparatus in an integrated manner.

  The pulse generation circuit 51 operates in response to a control signal from the controller 50, and generates and outputs a pulse signal having a predetermined period. The transmission circuit 52 includes a plurality of delay circuits (not shown) corresponding to the number of elements of the ultrasonic transducers 23 and 24 in the ultrasonic probe 3, and based on the pulse signal output from the pulse generation circuit 51, The drive pulse delayed according to the sound wave vibrators 23 and 24 is output. The delay time of each drive pulse is set so that the ultrasonic wave output from the ultrasonic probe 3 is focused at a predetermined irradiation point.

  The reception circuit 53 includes a signal amplification circuit, a delay circuit, and a phasing addition circuit (not shown). In this receiving circuit 53, each reflected wave signal (echo signal) received by each ultrasonic transducer 23, 24 in the ultrasonic probe 3 is amplified, and the delay time considering the reception directivity is each reflected wave signal. Is added to, and then phased and added. By this addition, the phase difference between the reception signals of the ultrasonic transducers 23 and 24 is adjusted.

  The signal processing unit 54 includes a first signal processing block 54a and a second signal processing block 54b.

  The first signal processing block 54a includes a logarithmic conversion circuit, an envelope detection circuit, an A / D conversion circuit, and the like (not shown). The data expressed in the above (B mode data) is generated. The logarithmic conversion circuit logarithmically converts the reflected wave signal, and the envelope detection circuit detects the envelope of the output signal of the logarithmic conversion circuit. The A / D conversion circuit converts the analog signal output from the envelope detection circuit into a digital signal.

  Based on the reflected wave signal data from the receiving circuit 53, the second signal processing block 54b performs frequency analysis on velocity information in a specified area, extracts a blood flow echo component due to the Doppler effect, and averages the blood flow Data (color flow mapping data) in which information such as speed, dispersion, power, etc. is extracted for multiple points is generated.

  More specifically, the second signal processing block 54b functions as a mapping area designating unit that performs a process of designating a line-shaped mapping area 81 on a virtual straight line L2 passing through a substantially central portion of the first tomographic image 8. (See FIGS. 4 to 6). In addition, the second signal processing block 54b performs signal processing based on the color flow mapping method only on the specified line-shaped mapping region 81, and generates color flow mapping images 84 and 85 showing the blood flow dynamics. It functions as mapping data generation means for generating color flow mapping data for this purpose.

  The image processing unit 55 includes a first image processing block 55a and a second image processing block 55b.

  The first image processing block 55a performs predetermined image processing based on the B-mode data generated by the first signal processing block 54a, and generates a B-mode ultrasound image (tomographic image). Specifically, the first image processing block 55a generates image data with luminance corresponding to the amplitude (signal intensity) of the reflected wave signal. The image data generated by the first image processing block 55 a is sequentially stored in the memory 56. Here, image data of the first tomographic image 8 showing the transverse section of the living tissue 4 and the second tomographic image 9 showing the longitudinal section of the living tissue 4 are generated and stored in the memory 56. Based on the image data for one frame stored in the memory 56, the first tomographic image 8 and the second tomographic image 9 of the living tissue 4 are displayed on the display device 59 in black and white shades (FIGS. 4 to 4). 6).

  The second image processing block 55b performs predetermined image processing based on the color flow mapping data generated by the second signal processing block 54b, and generates color flow mapping images 84 and 85. The data of the color flow mapping images 84 and 85 generated by the second image processing block 55 b are sequentially stored in the memory 56. That is, the second image processing block 55b of this embodiment functions as part of the color flow mapping image generation / display unit.

  The input device 58 includes a keyboard 61, a trackball 62, and the like, and is used for inputting requests and instructions from the user. The display device 59 is, for example, a display such as an LCD or a CRT, and is used to display a first tomographic image 8 and a second tomographic image 9 of the living tissue 4 and an input screen for various settings.

  As shown in FIGS. 4 to 6, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the screen 10 of the display device 59 of the present embodiment at the same time. When a virtual straight line L2 extending linearly along the vertical direction of the screen exists at the center of the first tomographic image 8, the position corresponding to the virtual straight line L2 indicates the direction in which the puncture needle 6 advances. The first guideline 65 (vertical line) is actually displayed. Further, on the second tomographic image 9, a second guideline 66 indicating the course at the insertion angle of the puncture needle 6 is displayed so as to extend linearly from the upper left of the screen toward the lower right. In the present embodiment, the guide lines 65 and 66 on the first tomographic image 8 and the second tomographic image 9 are displayed with the same line type (for example, broken line) and line color (for example, yellow). That is, the first guideline 65 as a vertical line is displayed using chromatic colors other than blue and red used in the color flow mapping images 84 and 85.

  Further, on the first tomographic image 8 and the second tomographic image 9, a position display unit is displayed that indicates in advance to the operator the depth position at which the tip 71 of the puncture needle 6 starts to be seen. In the present embodiment, a horizontal line 67 and a guide mark 68 are displayed as the position display unit. The guide mark 68 of the present embodiment is a quadrangular frame-like mark displaying a tomographic image in a frame at the intersection of the guide line 65 and the horizontal line 67 on the first tomographic image 8. The guide mark 68 has a size larger than the diameter of the image corresponding to the tip 71 of the puncture needle 6 (for example, a size about 1.5 to 3 times larger). In the present embodiment, the controller 50 functions as guide mark display means for displaying the guide mark 68 on the display device 59.

  The horizontal line 67 is a line horizontal to the transducer installation surface 20 in the probe main body 12. The horizontal line 67 is displayed with a different line type (for example, one-dot chain line) and a different line color (for example, green) from the guidelines 65 and 66. On the other hand, the guide mark 68 is displayed with the same line type (for example, dotted line) and line color (for example, yellow) as the guide lines 65 and 66. That is, the horizontal line 67 is also displayed using chromatic colors other than blue and red used in the color flow mapping images 84 and 85. Note that the image data of the guide lines 65 and 66, the horizontal line 67, and the guide mark 68 is stored in the memory 56, and the controller 50 reads out the image data and displays it on the display device 59. .

  The storage device 57 is a magnetic disk device, an optical disk device, or the like, and stores a control program and various data in a recording medium. The controller 50 transfers programs and data from the storage device 57 to the memory 56 in accordance with instructions from the input device 58, and sequentially executes them. The program executed by the controller 50 may be a program stored in a storage medium such as a memory card, a flexible disk (FD), a CD-ROM, a DVD, an optical disk, or a program downloaded via a communication medium. At the time of execution, it is installed in the storage device 57 and used.

  Here, the second signal processing block 54b functioning as the mapping area designating means is a tubular structure (that is, the vein 82) displayed on the virtual straight line L2 (actually on the first guideline 65 as a vertical line). The line-shaped mapping area 81 is designated so as to have a width (for example, a width of about 1/20 to 1/3) smaller than the inner diameter of the image of the artery 83). Further, the second signal processing block 54b has a line width of 0.5 to 2 times, preferably 1 to 2 times the diameter of the image corresponding to the tip 71 of the puncture needle 6. Is set so as to designate a mapping area 81 of a shape. Further, the second signal processing block 54b designates the line-shaped mapping area 81 so that the width is smaller than the maximum width of the image corresponding to the guide mark 68 (for example, about 1/10 to 1/2). It is set to be.

  Next, an operation example when the puncture needle 6 of the catheter is inserted into the vein 82 of the living tissue 4 using the angiographic apparatus 1 of the present embodiment will be described.

  Here, an operator such as a doctor first determines the insertion angle of the puncture needle 6 suitable for the treatment section of the patient. Then, the operator attaches the puncture guide attachment 14 in which the position of the puncture needle guide portion 34 is set by operating the angle adjustment mechanism 35 so as to be the insertion angle to the probe body 12. Thereafter, the operator operates the keyboard 61 of the input device 58 as position information input means, and inputs position information corresponding to the set position of the insertion angle of the puncture needle 6 set by the angle adjustment mechanism 35. At this time, the controller 50 temporarily stores the position information in the memory 56.

  Further, the operator applies an acoustic medium (sterile gel or sterilized gel) to the surface of the biological tissue 4 serving as a treatment portion (for example, the surface of the forearm 4a having the vein 82 as shown in FIG. 7), The transducer installation surface 20 of the probe main body 12 is brought into contact via an acoustic medium. Thereafter, the operator operates a scan start button (not shown) provided on the input device 58. Then, the controller 50 determines the button operation, and starts processing for displaying the tomographic images 8 and 9 of the living tissue 4.

  In this process, the controller 50 operates the pulse generation circuit 51 to start transmission / reception of ultrasonic waves by the ultrasonic probe 3. Specifically, the pulse generation circuit 51 operates in response to a control signal output from the controller 50, and a pulse signal having a predetermined cycle is supplied to the transmission circuit 52. In the transmission circuit 52, a drive pulse having a delay time corresponding to each of the ultrasonic transducers 23 and 24 is generated based on the pulse signal and supplied to the ultrasonic probe 3. Thereby, each ultrasonic transducer | vibrator 23 and 24 of the ultrasonic probe 3 vibrates, and an ultrasonic wave is irradiated toward the biological tissue 4. FIG. A part of the ultrasonic wave propagating in the living tissue 4 is reflected by a tissue boundary surface (for example, blood vessel wall) in the living tissue 4 and received by the ultrasonic probe 3. At this time, the reflected waves are converted into electric signals (reflected wave signals) by the ultrasonic transducers 23 and 24 of the ultrasonic probe 3. The reflected wave signal is amplified by the receiving circuit 53 and then input to the signal processing unit 54.

  In the first signal processing block 54 a in the signal processing unit 54, signal processing such as logarithmic conversion, envelope detection, and A / D conversion is performed, and the reflected wave signal converted into a digital signal is supplied to the image processing unit 55. In the first image processing block 55a in the image processing unit 55, image processing for generating image data of the tomographic images 8 and 9 is performed based on the reflected wave signal. In the second signal processing block 54b in the signal processing unit 54, a process for designating the line-shaped mapping area 81 on the virtual straight line L2 is performed (mapping area designating step), and the process is limited to the line-shaped mapping area 81. Then, signal processing based on the color flow mapping method is performed, and color flow mapping data is generated (mapping data generation step). In the second image processing block 55b in the image processing unit 55, processing for generating the color flow mapping images 84 and 85 based on the color flow mapping data is performed. Then, the controller 50 temporarily stores each image data generated by the image processing unit 55 in the memory 56.

  The controller 50 reads out each image data stored in the memory 56 and displays display data for displaying the first tomographic image 8 and the second tomographic image 9 on the display device 59 and the color flow mapping images 84 and 85. Display data to be displayed on 59 is generated. Further, the controller 50 as the insertion angle determination means reads the position information stored in the memory 56 and determines the insertion angle of the puncture needle 6 based on the position information. And the controller 50 as a guideline display means produces | generates the display data of the guidelines 65 and 66 according to the insertion angle of the puncture needle 6. FIG. Further, the controller 50 as the position display means predicts the depth position at which the tip 71 of the puncture needle 6 starts to appear in the first tomographic image 8 and the second tomographic image 9 based on the insertion angle of the puncture needle 6. At the same time, display data of a position display section (horizontal line 67 and guide mark 68) indicating the depth position to the worker in advance is generated.

  Thereafter, the controller 50 outputs the generated display data of the tomographic images 8 and 9, the display data of the color flow mapping images 84 and 85, the display data of the guide lines 65 and 66, the horizontal line 67, and the guide mark 68 to the display device 59, respectively. To do. As a result, as shown in FIG. 3, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the screen 10 of the display device 59 at the same time. The guide lines 65 and 66, the horizontal line 67, and the guide mark 68 are superimposed and displayed on these tomographic images 8 and 9 (guide mark display step). At the same time, color flow mapping images 84 and 85 are superimposed and displayed on the line-shaped mapping region 81 designated in the first tomographic image 8 (color flow mapping image generation display step). In the present embodiment, the tomographic images 8 and 9 are displayed on the farthest side. The color flow mapping images 84 and 85 are superimposed on the front side of the first tomographic image 8, and the guideline 65, the horizontal line 67, and the guide mark 68 are further superimposed on the front side thereof. The guide line 66 and the horizontal line 67 are superimposed on the front side of the second tomographic image 9.

  Next, the operator adjusts the position of the ultrasonic probe 3 while visually recognizing the first tomographic image 8 and the second tomographic image 9 displayed on the display device 59. Specifically, first, a cross section of the vein 82 is photographed on the first tomographic image 8 (short axis image), and the first guideline 65 on the first tomographic image 8 is positioned at the center of the vein 82. Then, the first element unit 25 side of the ultrasonic probe 3 is moved. Further, the second element unit 26 side of the ultrasonic probe 3 is moved so that the longitudinal section of the vein 82 is photographed along the second tomographic image 9 (long axis image), and the direction in which the vein 82 extends ( (Axial direction) and the major axis direction Y of the probe main body 12 are matched. At this time, in a state where the position of the ultrasonic probe 3 on the first element unit 25 side (short axis side) is kept, the second element unit 26 side (long axis side) which is the rear side is swung left and right. Try to align.

  Here, the operator inserts the insertion angle of the puncture needle 6 based on the horizontal line 67 and the guide mark 68 on the first tomographic image 8 and the second tomographic image 9 and the second guideline 66 on the second tomographic image 9. Is determined to be at an angle suitable for puncturing the vein 82. 4 and 5 show a state before the puncture needle 6 is inserted, and the first tomographic image 8 and the second tomographic image 9 are compared to the treatment unit for puncturing the vein 82. The horizontal line 67 and the guide mark 68 are located above. When it is determined that the insertion angle of the puncture needle 6 is an angle suitable for puncture of the vein 82, the operator punctures the catheter from the opening 41 of the guide groove 33 in the puncture needle guide portion 34 of the puncture guide attachment 14. The needle 6 is introduced. Then, the operator brings the tip 71 of the puncture needle 6 into contact with the position of the positioning portion 31 of the probe main body 12 and makes the side surface of the puncture needle 6 contact with the bottom 42 of the guide groove 33, and then the biological tissue 4. The puncture needle 6 is inserted into the (forearm 4a).

  Then, the puncture needle 6 is displayed in the first tomographic image 8 and the second tomographic image 9 as can be seen from FIG. 6 showing the state after the puncture needle 6 is inserted. Here, the puncture needle 6 is first displayed within the frame of the guide mark 68 in the first tomographic image 8 and then displayed on the second guideline 66 in the second tomographic image 9. The operator inserts the puncture needle 6 while confirming the insertion position of the puncture needle 6 along the second guideline 66 in the second tomographic image 9.

  At this time, the operator can easily and accurately foresee the position where the tip 71 of the puncture needle 6 starts to be seen by visually recognizing the guide mark 68 displayed on the virtual straight line L2 of the first tomographic image 8. . The line-shaped mapping area 81 is designated at a position excluding the guide mark 68 on the virtual straight line L2. Therefore, even if the color flow mapping images 84 and 85 are superimposed, the guide mark 68 and the area surrounded by the guide mark 68 are not buried. Therefore, the visibility of the guide mark 68 and the tip 71 of the puncture needle 6 can be maintained. Further, since the frame-shaped guide mark 68 is displayed in a size larger than the diameter of the image corresponding to the tip 71 of the puncture needle 6, the guide mark 68 itself and the image of the puncture needle 6 do not overlap, and the puncture is performed. The moment when the needle 6 starts to be visible can be confirmed more reliably.

  As shown in FIG. 6 and the like, a vein 82 as a tubular structure is located at a relatively shallow position in the living tissue 4 (forearm 4a) as a subject, and the tubular structure is also located at a relatively deep position. The artery 83 is located. A narrow line-shaped mapping area 81 is designated on the virtual straight line L2 of the first tomographic image 8, and the color-flow mapping images 84 and 85 are superimposed on the line-shaped mapping area 81. Is displayed. Here, the color flow mapping image 84 displayed in the vein 82 and the color flow mapping image 85 displayed in the artery 83 have different colors. That is, since the blood flow from the near side direction of the first tomographic image 8 to the far side direction (blood flow from the right side direction of the second tomographic image 9 to the left side) exists in the vein 82, the former. The color flow mapping image 84 is blue. On the other hand, blood flow from the back side direction to the near side direction of the first tomographic image 8 (blood flow from the left side direction to the right side of the second tomographic image 9) exists in the artery 83. Therefore, the latter color flow mapping image 85 is red. Therefore, before inserting the tip 71 of the puncture needle 6 into the blood vessel wall, the operator can easily and accurately discriminate the vein 82 and the artery 83 based on the color difference between the color flow mapping images 84 and 85. Can do.

  These color flow mapping images 84 and 85 are both narrow and sufficiently smaller than the image of the target site in the subject, that is, the tomographic image of the vein 82 and artery 83. Specifically, the width of the color flow mapping images 84 and 85 is about 1/20 to 1/3 of the tomographic image of the vein 82 and the artery 83, and is 1 time the diameter of the image corresponding to the tip 71 of the puncture needle 6. It is about 1 to 10 times the maximum width of the image corresponding to the guide mark 68. Therefore, the color flow mapping images 84 and 85 are not superimposed on the whole tomographic image of the vein 82 and the artery 83 but on a part thereof. Therefore, even when the color flow mapping images 84 and 85 are superimposed and displayed, the tomographic images of the vein 82 and the artery 83 are not buried by the color flow mapping images 84 and 85, and the state of the blood vessel wall is easily understood. Further, if the color flow mapping images 84 and 85 have such a width, it is possible to maintain suitable visibility without being too small to make it difficult to distinguish red and blue.

  When the operator determines that the tip 71 of the puncture needle 6 has reached the blood vessel wall of the vein 82 as described above, the worker then penetrates the blood vessel wall with the tip 71 of the puncture needle 6 and enters the vein 82 into the puncture needle 6. The tip 71 is inserted. After confirming that the tip 71 of the puncture needle 6 has reached the vein 82 based on the second tomographic image 9, the operator stops the puncture operation of the puncture needle 6.

  Thereafter, the operator operates a scan end button (not shown) provided on the input device 58. The controller 50 determines the button operation, and ends the process for displaying the tomographic images 8 and 9 of the living tissue 4. Further, the operator moves the probe main body 12 along the guide groove 33 while maintaining the puncture state of the puncture needle 6 (while leaving the puncture route). Then, the operator removes the ultrasonic probe 3 (the puncture guide attachment 14 and the probe main body 12) from the puncture needle 6 through the opening 41 of the guide groove 33. Thereafter, the operator operates the catheter, inserts the catheter into the vein 82, and performs a predetermined treatment.

  Therefore, according to the present embodiment, the following effects can be obtained.

  (1) According to the angiography apparatus 1 of the present embodiment, as described above, the narrow line-shaped mapping area 81 is designated in advance, and the color flow mapping images 84 and 85 are displayed in a superimposed state. . In this case, since the displayed color flow mapping images 84 and 85 are narrow and sufficiently smaller than the tomographic images of the vein 82 and the artery 83, it is difficult to embed these images. Therefore, it is possible to reliably capture the whole picture of the vein 82, the artery 83, and the puncture needle 6 and display it as an ultrasonic image, and the operator can perform accurate puncture by observing the ultrasonic image. it can.

  (2) In this angiography apparatus 1, the designation of the line-shaped mapping area 81 is not performed by the operator, but is performed by the mapping area designating unit based on a predetermined program, so that complicated operations can be avoided. it can.

  (3) In this angiography apparatus 1, designation of the mapping region 81 in the very narrow range as described above (specifically, an area of about 1/20 to 1/100 of the screen 10) and limitation in that range It is characterized by performing a simple signal processing. For this reason, the load of signal processing based on the color flow mapping method is larger than that of the conventional apparatus in which the mapping region 81 is designated with a relatively large area (for example, an area of about 1/2 to 1/5 of the screen 10). Get smaller. As a result, a decrease in the frame rate of the ultrasonic image is suppressed, and a decrease in the responsiveness of the ultrasonic tomographic image can be avoided.

[Second Embodiment]
Next, a second embodiment in which the present invention is embodied in an angiography apparatus 1 as an ultrasonic image display apparatus will be described in detail with reference to FIGS. FIG. 8 shows the first tomographic image 8 and the second tomographic image 9 before the puncture needle 6 is inserted and before the color flow mapping images 84 and 85 are superimposed. FIG. 9 shows the first tomographic image 8 and the second tomographic image 9 before insertion of the puncture needle 6 and after the color flow mapping images 84 and 85 are superimposed. FIG. 10 shows the first tomographic image 8 and the second tomographic image 9 in a state after the insertion of the puncture needle 6 and after the color flow mapping images 84 and 85 are superimposed. Here, detailed description of parts common to the first embodiment will be omitted, and different parts will be mainly described.

  The angiography apparatus 1 of the present embodiment includes the apparatus main body 2 and the ultrasonic probe 3 as in the first embodiment. The ultrasonic probe 3 used here includes a signal cable 11 and a probe. While the main body 12 and the probe-side connector 15 are provided, the puncture guide attachment 14 is not provided. Similarly to the first embodiment, the ultrasonic probe 3 includes a controller 50, a pulse generation circuit 51, a transmission circuit 52, a reception circuit 53, a signal processing unit 54, an image processing unit 55, a memory 56, a storage device 57, and an input. It is electrically connected to the apparatus body 2 including the apparatus 58, the display apparatus 59, and the like. The configuration related to the puncture guide mechanism is omitted from the apparatus main body 2.

  As shown in FIGS. 8 to 10, the first tomographic image 8 and the second tomographic image 9 are displayed side by side on the screen 10 of the display device 59 of the present embodiment at the same time. A first guide line 65 (vertical line) is superimposed and displayed at a position corresponding to the virtual straight line L2 in the center of the first tomographic image 8. On the other hand, in the present embodiment, the second guideline 66, the horizontal line 67, and the guide mark 68 are not particularly displayed. In addition, color flow mapping images 84 and 85 are superimposed and displayed on a line-shaped mapping area 81 designated in the first tomographic image 8. Therefore, before inserting the tip 71 of the puncture needle 6 into the blood vessel wall, the operator can easily and accurately discriminate the vein 82 and the artery 83 based on the color difference between the color flow mapping images 84 and 85. Can do. Therefore, according to the present embodiment, an angiography apparatus capable of reliably capturing the whole picture of the vein 82, the artery 83, and the puncture needle 6 and displaying it as an ultrasound image without complicated operations and a decrease in image responsiveness. 1 can be provided.

  In addition, you may change embodiment of this invention as follows.

  In the first and second embodiments, the line-shaped mapping area 81 is designated on one virtual straight line L2 passing through the central portion of the first tomographic image 8, but the number of virtual straight lines L2 is not necessarily limited. The number is not limited to one and may be plural. For example, in another embodiment shown in FIGS. 11A and 11B, three parallel virtual lines L2 exist so as to pass through a substantially central portion of the first tomographic image 8, and these virtual lines L2 are present. A line-shaped mapping area 81 is designated above.

  In the first and second embodiments, the line-shaped mapping region 81 has a strip shape that is continuously formed along the virtual straight line L2, but may be formed intermittently. For example, in another embodiment shown in FIGS. 12A and 12B, the small-area and rectangular regions 86 are arranged in a line at equal intervals along the virtual straight line L2. This is a line-shaped mapping area 81 ".

  In each of the above embodiments, the size, shape, position, etc. of the line-shaped mapping area 81 are basically set to one type and cannot be changed. You may comprise so that it can select arbitrarily from.

  In each of the above embodiments, the color flow mapping images 84 and 85 are always superimposed and displayed on the line-shaped mapping area 81. However, the present invention is not limited to this. For example, a selection function for switching the color flow mapping images 84 and 85 to the display state or the non-display state may be provided. Specifically, the controller 50 may display a selection button for switching between display and non-display of the color flow mapping images 84 and 85 on the setting screen of the display device 59.

  In the angiography apparatus 1 of the first embodiment, the horizontal line 67 and the guide mark 68 may be provided with a selection function for setting display or non-display. Specifically, the controller 50 may display a selection button for setting the horizontal line 67 and the guide mark 68 to display or non-display on the setting screen of the display device 59. Then, the controller 50 displays or deletes the horizontal line 67 and the guide mark 68 on the first tomographic image 8 and the second tomographic image 9 based on the operator's button operation. For example, a skilled worker accustomed to the operation of the angiography apparatus 1 predicts the position where the tip 71 of the puncture needle 6 starts to appear based on the positions of the guide lines 65 and 66 displayed in the tomographic images 8 and 9. can do. For this reason, when a skilled worker uses the angiography apparatus 1, the puncture needle 6 may be punctured without displaying the horizontal line 67 and the guide mark 68. Further, when used by an operator who is not familiar with the operation of the angiography apparatus 1, the puncture needle 6 can be punctured reliably and securely by displaying the horizontal line 67 and the guide mark 68. .

  In the first embodiment, the guide mark 68 as the position display unit has a quadrangular frame shape, but may have a triangular or circular frame shape. Further, the guide mark 68 is not limited to the frame-shaped mark, and may be a cross-shaped mark, a dot-shaped mark, or the like as long as the position can be recognized. Of course, the guide mark 68 may not be displayed as in the second embodiment.

  In the angiographic apparatus 1 of each of the above embodiments, the tomographic images 8 and 9 such as the veins 82 are displayed and the treatment using the catheter is performed. However, angiography is performed when other treatment such as blood collection is performed. The apparatus 1 may be used. Further, the present invention is not limited to the angiography apparatus 1, and the present invention may be embodied in an ultrasonic image display apparatus that displays a tomographic image of a nerve other than a blood vessel and performs other treatment such as nerve block injection. .

DESCRIPTION OF SYMBOLS 1 ... Angiography apparatus as an ultrasonic image display apparatus 3 ... Ultrasonic probe 4 ... Living tissue as a subject 6 ... Puncture needle 8 ... First tomographic image 9 ... Second tomographic image 10 ... Screen 12 ... Probe body 14 ... Attachment for puncture guide as puncture guide mechanism 23... (First) ultrasonic transducer 24... (Second) ultrasonic transducer 50... Controller 54 b constituting color flow mapping image generation display means and guide mark display means ... Second signal processing block 55b as mapping area designating means and mapping data generating means ... Second image processing block constituting color flow mapping image generating / displaying means 57 ... Storage device with recording medium 65 ... First as vertical line 68 ... Guide mark 71 ... Puncture needle tip 81 ... Linear mapping area 8 2 ... Veins as tubular structures 83 ... Arteries as tubular structures 84 ... Color flow mapping image (shown in red) 85 ... Color flow mapping image (shown in blue) L2 ... Virtual straight line

Claims (4)

A plurality of ultrasonic transducers for linearly scanning ultrasonic waves are orthogonal to obtain a first tomographic image showing a cross section of a subject and a second tomographic image showing a vertical cross section in a direction crossing the cross section. The first tomographic image at the time of performing puncture for inserting a puncture needle into the subject along the longitudinal section by performing transmission and reception of ultrasonic waves using an ultrasonic probe having an arrayed probe main body and the first tomographic image An apparatus for simultaneously displaying the second tomographic image on the same screen,
While the mapping area is not specified at all in the second tomographic image, a vertical line displayed at a position corresponding to a straight line extending in the vertical direction that is the ultrasonic wave incident direction through a substantially central portion of the first tomographic image. Above, mapping area specifying means for specifying a line-shaped mapping area,
Mapping data generation means for generating color flow mapping data for generating a color flow mapping image by performing signal processing based on a color flow mapping method only in the specified linear mapping region;
Color flow mapping image generation and display means for generating the color flow mapping image based on the generated color flow mapping data and displaying the color flow mapping image superimposed on the line-shaped mapping region in the first tomographic image; ,
A depth position at which the tip of the puncture needle begins to be visible in the first tomographic image is indicated in advance, and a guide mark larger than the diameter of the image corresponding to the tip of the puncture needle is displayed on the first tomographic image. Guide mark display means for displaying in a region on the vertical line and between a substantially center portion and an upper end portion of the first tomographic image;
With
The mapping area designating means designates the line-shaped mapping area so that the width is smaller than the maximum width of the image corresponding to the guide mark at a position excluding the guide mark on the vertical line. An ultrasonic image display device characterized by the above. Wherein the mapping area designating means, so that the smaller width than the inner diameter of the image of the tubular structure that is displayed on the vertical line on claim 1, wherein the designating the linear mapping area The ultrasonic image display device described in 1. The said mapping area designation | designated means designates the said linear mapping area | region so that it may become 0.5 to 2 times the diameter of the image corresponding to the front-end | tip of the said puncture needle. 3. The ultrasonic image display device according to 1 or 2 . The vertical line, the ultrasound image display apparatus according to any one of claims 1 to 3, characterized in that is displayed using the chromatic color other than blue and red used for the color flow mapping image.