JP6611104B1 - Portable ultrasound imaging system - Google Patents

Abstract

A puncture needle is securely punctured into a blood vessel at a target site while confirming an ultrasonic image. A portable ultrasonic diagnostic imaging apparatus includes a first probe that acquires a first ultrasonic image showing a cross section orthogonal to a blood vessel direction, and a position that is parallel to the first probe and different from a position where the cross section is obtained. A second probe for acquiring a second ultrasonic image showing a cross section orthogonal to the blood vessel direction and a third ultrasonic image showing a cross section along the blood vessel direction provided between the first probe and the second probe are acquired. An outer portion located at least in the vicinity of the first probe on the outer surface of the housing portion. A device body that supports a puncture needle that punctures a blood vessel at a lower end portion of the side surface and a center in the longitudinal direction of the first probe, and that is provided with a recess that restricts the puncture direction of the puncture needle, and is provided in the device body First, second, and Comprising a display means for displaying the third ultrasound image. [Selection] Figure 3

Description

  The present invention relates to a portable ultrasonic diagnostic imaging apparatus that positions an ultrasonic probe with respect to a blood vessel of a living body, for example, when puncturing with a puncture needle.

  In a medical institution, treatments for puncturing a patient such as general injection, nerve block injection, blood sampling, and catheter insertion are performed. Among these procedures, for example, in the insertion of a central venous catheter, cases of death due to complications after the procedure have been reported. Causes of complications after the treatment include, for example, infection during placement and pulmonary thromboembolism at the time of removal, as well as puncture.

  As a method for suppressing complications resulting from puncture, for example, an ultrasonic guide method in which puncture is performed while observing the state of a target region with an ultrasonic image can be cited. The ultrasonic guide method is a method of puncturing while observing a living tissue at a target site from an ultrasonic image obtained by using, for example, an ultrasonic probe. The ultrasonic probe used in the ultrasonic guide method shows, for example, a cross section of a blood vessel cross section (hereinafter referred to as a longitudinal cross section) in a direction in which the blood vessel extends or a blood vessel cross section (hereinafter referred to as a cross section) orthogonal to the direction in which the blood vessel extends. Only ultrasound images can be obtained. As a result, the practitioner may mistakenly recognize the puncture needle reflected in the ultrasonic image as the tip of the puncture needle even though it is not the tip when observing the ultrasound image in which the puncture needle is reflected. As a result, an event occurs in which the puncture needle breaks through a blood vessel or injures other tissues in the body, such as nerves.

  In order to solve the occurrence of such an event, it is possible to perform the act of puncturing a puncture needle while simultaneously acquiring the above-described longitudinal and transverse ultrasonic images and observing the acquired ultrasonic images. Various apparatuses have been proposed (see Patent Document 1 and Patent Document 2).

Japanese Patent No. 5292581 Japanese Patent No. 5778066

  However, in the case of Patent Document 1 and Patent Document 2, the operation of adjusting the position of the blood vessel while confirming the two ultrasonic images of the longitudinal section and the transverse section is an action with skill, and confirming these two ultrasound images. However, it is difficult to say that the puncture needle can be punctured reliably with respect to the blood vessel at the target site.

  The present invention has been made in order to meet such a problem, and the present invention provides a technique capable of reliably puncturing a puncture needle into a blood vessel at a target site while confirming an ultrasonic image. There is.

The ultrasonic diagnostic imaging apparatus of the present invention is arranged in parallel with a first probe unit that acquires a first ultrasonic image showing a first cross section perpendicular to the extending direction of a blood vessel, and the first probe unit, A second probe unit that acquires a second ultrasonic image showing a second cross section perpendicular to the extending direction of the blood vessel at a position different from a position at which the first cross section is obtained; A third probe unit that is provided between the two probe units and acquires a third ultrasonic image showing a third cross section along the extending direction of the blood vessel, and the third probe unit An ultrasonic probe disposed from the center in the longitudinal direction of the first probe part to the center in the longitudinal direction of the second probe part, a storage part in which the ultrasonic probe is stored, and a user There a device body which have a a gripping portion for gripping said first It has a ridge that inclined downward toward the first probe portion at a predetermined angle to the longitudinal direction and the horizontal plane in a direction perpendicular to the probe portion, of the outer surface of the housing part, at least the first It provided the longitudinal centerline a position of 且 one first probe portion to the lower portion of the outer surface located in the vicinity of the probe portion of the puncture needle while supporting the puncture needle for puncturing the blood vessel A concave portion that regulates the puncture direction in a direction along the ridgeline and a side surface that is continuous with a side surface of the storage portion in which the first probe portion is disposed, among the side surfaces of the grip portion included in the apparatus main body. The first ultrasonic image acquired by the first probe unit included in the ultrasonic probe, the second ultrasonic image acquired by the second probe unit, and the third probe unit. Display means for displaying the serial third ultrasound images simultaneously, the first using the ultrasonic image and the second ultrasound image, a position detecting means for determining the center position of the blood vessel at each ultrasonic image for each image The determination as to whether the center position in the ultrasound image matches the center position of the blood vessel in the ultrasound image is performed for each of the first ultrasound image and the second ultrasound image. Based on the determination result by the first determination means and the first determination means, the center position of the blood vessel obtained from each ultrasound image is the center position in each of the first ultrasound image and the second ultrasound image. First notifying means for notifying that they match each other.

  And a pressure detecting means for detecting a pressure acting on the ultrasonic probe, wherein the display means displays the first ultrasonic image, the second ultrasonic image, and the third ultrasonic image. The pressure is displayed.

  In this case, the second detection means for determining whether or not the pressure detected by the pressure detection means becomes a preset pressure, and the pressure detection means detects the pressure based on the determination result by the second determination means. It is preferable to have a 2nd alerting | reporting means which alert | reports that the set pressure corresponded with the preset pressure.

  Further, the apparatus main body has a magnetic body that adsorbs the puncture needle and regulates the puncture direction of the puncture needle inside the storage portion and in the vicinity of the concave portion.

  In addition, the ultrasonic probe is arranged outside the second probe part so that the longitudinal direction is the same as the longitudinal direction of the third probe part, and at a position different from the third cross section, It further has a 4th probe part which acquires the 4th ultrasonic picture which shows the 4th section along the extension direction of the above-mentioned blood vessel.

  According to the present invention, it is possible to reliably puncture a puncture needle with respect to a blood vessel at a target site while confirming an ultrasonic image.

(A) The perspective view which shows an example of the external appearance of the front side of the portable ultrasonic image diagnostic apparatus of this embodiment, (b) is a perspective view which shows an example of the external appearance of the back side. 2A is a top view of the portable ultrasonic diagnostic apparatus shown in FIG. 1, and FIG. 2B is a bottom view of the portable ultrasonic diagnostic apparatus. It is a right view of the portable ultrasonic image diagnostic apparatus shown in FIG. (A) is a perspective view which shows an example of the recessed part provided in the lower end part of an apparatus main body, (b) is a perspective view which shows the adsorption | suction state of a puncture needle. It is a schematic diagram which shows the display screen in a display apparatus. It is a functional block diagram which shows an example of the electrical structure of a portable ultrasonic image diagnostic apparatus. It is a flowchart which shows an example of a process when positioning a portable ultrasonic diagnostic imaging apparatus with respect to the blood vessel. (A) is a figure which shows the positional relationship of an ultrasonic probe part and a blood vessel when a portable ultrasonic diagnostic imaging apparatus is arrange | positioned diagonally with respect to the blood vessel, (b) is the superposition displayed on the display screen of a display apparatus. It is a figure which shows an example of a sound wave image. (A) is a figure which shows the positional relationship of an ultrasonic probe part and a blood vessel when arrange | positioning a portable ultrasonic imaging diagnostic apparatus in parallel with respect to the blood vessel, (b) is the superposition displayed on the display screen of a display apparatus. It is a figure which shows an example of a sound wave image. (A) is a figure which shows the positional relationship of an ultrasonic probe part and a blood vessel when a portable ultrasonic diagnostic imaging device is correctly positioned with respect to the blood vessel, and (b) is an ultrasound displayed on the display screen of the display device. It is a figure which shows an example of a sound wave image. (A) is a figure which shows the state at the time of puncturing a living body with a puncture needle in the state which positioned the portable ultrasonic diagnostic apparatus correctly with respect to the blood vessel, (b)-(d) punctures a living body with a puncture needle. It is a figure which shows an example of the ultrasonic image displayed on the display screen of a display apparatus in the process to perform. It is a flowchart which shows an example of the process which concerns on determination whether the pressing force when pressing a portable ultrasonic image diagnostic apparatus on a biological body is appropriate. It is a figure which shows an example of the 1st-3rd ultrasonic image displayed on a display apparatus, when a portable ultrasonic image diagnostic apparatus is pressed with the pressing force more than appropriate pressing force with respect to the biological body. (A) is a perspective view which shows an example of the external appearance of the front side in another embodiment of a portable ultrasonic diagnostic imaging apparatus, (b) is a perspective view which shows an example of the external appearance of a back side.

  Hereinafter, the portable ultrasonic diagnostic imaging apparatus of the present embodiment will be described with reference to the drawings.

  As shown in FIGS. 1 to 3, the portable ultrasonic diagnostic imaging apparatus 10 includes an apparatus main body 15 and a display device 16. Note that the external shape of the apparatus main body 15 in the portable ultrasonic diagnostic imaging apparatus 10 shown in FIGS. 1 to 3 is merely an example, and other shapes may be adopted as long as the present invention can be implemented. Is possible. Although not shown, the portable ultrasonic diagnostic imaging apparatus 10 is housed in, for example, a probe cover made of latex or polyurethane, and prevents contamination from body fluids or blood during use.

  The apparatus main body 15 includes a gripping portion 15a that a user grips and a storage portion 15b in which the ultrasonic probe 20 is stored. The ultrasonic probe 20 includes two probe parts 21 and 22 arranged in parallel with each other and a probe part 23 arranged between the probe parts 21 and 22 so as to be orthogonal to the probe parts 21 and 22. Have. The probe portion 23 is arranged so that both end portions in the longitudinal direction are located in the center portion in the longitudinal direction of the probe portions 21 and 22. Therefore, these probe parts 21, 22, and 23 are arranged so as to be H-shaped. In accordance with the arrangement of the probe portions, the storage portion 15b described above has an H shape in the xy plane.

  Hereinafter, the two probe parts 21 and 22 arranged in parallel to each other are referred to as a first short axis probe part 21 and a second short axis probe part 22, and each probe part is connected between the probe parts 21 and 22. The probe part 23 arranged so as to be orthogonal to the lines 21 and 22 is referred to as a long axis probe part 23. Although not shown in the drawings, the probe units 21, 22, and 23 include a transducer array having a plurality of ultrasonic transducers (piezoelectric elements) arranged on a straight line, an acoustic matching layer, and an acoustic lens. These have a structure in which an acoustic lens, an acoustic matching layer, and a transducer array are arranged in this order from the bottom side of the apparatus main body 15. In addition, the surface of the acoustic lens which each probe part 21,22,23 has becomes a probe surface.

  The first short axis probe unit 21 is provided to acquire an ultrasonic image of a cross section (first cross section) orthogonal to the direction in which the blood vessel extends (the blood vessel extending direction). The second short axis probe unit 22 is provided to acquire an ultrasonic image of a cross section (second cross section) orthogonal to the blood vessel extending direction at a position different from the first short axis probe unit. . Further, the long axis probe unit 23 acquires an ultrasonic image of a cross section along the blood vessel extending direction between the position where the first cross section is acquired and the position where the second cross section is acquired. Provided.

  Pressure sensors 26, 27, and 28 are disposed above the probe portions 21, 22, and 23, respectively. The pressure sensors 26, 27, and 28 are pressing forces applied to the probe portions 21, 22, and 23 of the ultrasonic probe 20 when the probe surface of the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the surface of the living body. Is detected. Hereinafter, the pressure sensor 26 disposed above the first short axis probe unit 21 is referred to as the first pressure sensor 26, and the pressure sensor 27 disposed above the second short axis probe unit 22 is referred to as the second pressure sensor 27. The pressure sensor 28 disposed on the upper part of the long axis probe unit 23 is referred to as a third pressure sensor 28.

  Note that pressure sensors 26, 27, and 28 are provided in each of the probe parts 21, 22, and 23 to detect the pressing force applied to the probe parts 21, 22, and 23 of the ultrasonic probe 20, It is not necessary to limit to this, For example, the pressing force applied to each probe part 21,22,23 of the ultrasonic probe 20 is detected using the some ultrasonic transducer | vibrator which each probe part 21,22,23 has. It is also possible.

  Further, pressure sensors 26, 27, and 28 are provided in each of the probe parts 21, 22, and 23 to detect the pressing force applied to the probe parts 21, 22, and 23 of the ultrasonic probe 20, It is not necessary to limit to this, and it is sufficient that at least a pressure sensor is provided corresponding to the first short-axis probe portion 21 and the second short-axis probe portion 22, so that it corresponds to the long-axis probe portion 23. It is also possible to omit the pressure sensor.

The apparatus main body 15 has a concave portion 32 at the lower end edge of the side surface 31 constituting the storage portion 15b, and a concave portion 34 at the lower end edge of the side surface 33 constituting the storage portion 15b. The position where the concave portion 32 is provided is a position that matches the midpoint of the first short axis probe portion 21 in the longitudinal direction. Similarly, the position where the recess 34 is provided is a position that matches the midpoint in the longitudinal direction of the second short axis probe section 22.
That is, the concave portions 32 and 34 are provided at the midpoints in the width direction of the side surfaces 31 and 33. Since the concave portions 32 and 34 have the same shape, the concave portion 32 will be described below, and the description of the concave portion 34 will be omitted.

  As shown in FIGS. 4A and 4B, the recess 32 has a shape that is cut out, for example, in a triangular pyramid shape from the side surface 31 to the bottom surface side. In the recess 32, the inner wall surfaces 32 a and 32 b are in line contact with the distal end portion of the puncture needle 36 to define the inclination of the puncture needle 36. Here, the ridgeline 32c of the recess 32 is inclined at a predetermined angle θ with respect to the horizontal plane (xy plane). The predetermined angle θ is not particularly limited, but it is desirable to set θ to be 30 ° or less in consideration of puncturing the puncture needle 36 along the blood vessel. Note that the shape of the recess 32 is not limited to the above. For example, the recess 32 has a shape that can define the puncture direction of the puncture needle 36, such as a recess notched in a tapered shape so as to be reduced in diameter from the side 31 side. I just need it.

  Here, by providing the concave portion 32 described above, the distance between the concave portion and the first short-axis probe portion 21 on the bottom surface of the apparatus main body 15 is reduced as compared with other portions. In other words, the provision of the recess 32 has an effect of making it easy to visually recognize the position of the distal end portion of the puncture needle 36 from the ultrasonic image acquired when the puncture needle 36 is punctured while being guided by the recess 32.

  A permanent magnet 35 is disposed in the vicinity of the recess 32 in the side surface 31 described above. The permanent magnet 35 adsorbs the puncture needle 36 to define the direction in which the puncture needle 36 punctures. Then, the puncture needle 36 is punctured into the blood vessel while keeping the puncture needle 36 in line contact with the inner wall surfaces 32a and 32b. That is, the recess 32 has a function of guiding the puncture direction when the puncture needle is punctured. A permanent magnet is also provided in the vicinity of the recess 34 in the side surface 33.

  Here, although the permanent magnet is arrange | positioned in the recessed parts 32 and 34 vicinity, if it is a magnetic body, it is not necessary to limit to a permanent magnet and it is also possible to arrange an electromagnet.

  In the present embodiment, the case where the concave portions 32 and 34 having a guide function when the puncture needle 36 is punctured is provided in each of the lower end portion of the side surface 31 and the lower end portion of the side surface 33 is described. It is only necessary to provide the recess 32 only on the side surface 31 on the side where the surface is disposed, and the recess 34 on the side surface 33 side is not necessarily provided.

  Returning to FIG. 1 to FIG. 3, the display device 16 displays the ultrasonic images obtained by the probe units 21, 22, and 23 of the ultrasonic probe 20 described above. The display device 16 displays the pressing force when the device body 15 described above is pressed against the surface of the living body. Here, the display device 16 can transmit and receive data and signals to and from the device body 15 by wire or wireless. In the present embodiment, the display device 16 represents a case where data and signals are transmitted / received to / from the device main body 15 by wireless communication.

  The display device 16 is directly or indirectly attached to the grip portion 15a of the device main body 15 via a connecting means 40 having a spherical bearing. As a method of attaching the display device 16 indirectly to the grip portion 15a of the apparatus main body 15 via the connecting means 40, for example, a holding mechanism for holding the display device 16 may be provided in the connecting means 40. The display device 16 shown in the present embodiment may be detachable from the connecting member 40 of the device main body 15 or may be fixed to the connecting means 40.

  The display device 16 attached via the connecting means 40 can be rotated around at least one of the x-axis, y-axis, and z-axis with respect to the grip portion 15a of the device body 15. Become. In view of the display content on the display device 16 and the usage status of the portable ultrasonic diagnostic imaging apparatus 10, it is preferable to rotate the display device 16 about only the x-axis direction.

  As shown in FIG. 5, when the portable ultrasonic diagnostic imaging apparatus 10 is used, the following display image is displayed in the display area 16 a of the display device 16. The display image includes areas 41, 42, and 43 for displaying ultrasonic images acquired by the first and second short axis probe units 21 and 22 and the long axis probe unit 23 of the ultrasonic probe 20. . Note that these regions 41, 42, and 43 are provided along the longitudinal direction of the display device 16. For example, the area 41 is an area in which an ultrasonic image (hereinafter referred to as a first ultrasonic image) obtained by the first short axis probe unit 21 is displayed. The region 42 is a region (hereinafter referred to as a third ultrasonic image) where an ultrasonic image obtained by the long axis probe unit 23 is displayed. Further, the region 43 is a region where an ultrasonic image (hereinafter referred to as a second ultrasonic image) obtained by the second short axis probe unit 22 is displayed. Further, an area 44 shown in FIG. 5 is an area for displaying a pressing force when the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the surface of the living body. Although not shown, the display area 16a is also provided with an area for displaying various buttons such as a switch button for switching an image to be displayed and a power button for switching the display device 16 on and off.

  FIG. 6 is a functional block diagram showing an example of an electrical configuration of the portable ultrasonic diagnostic imaging apparatus 10 of the present embodiment. As described above, the portable ultrasonic diagnostic imaging apparatus 10 includes the apparatus main body 15 and the display device 16. In addition to the ultrasonic probe 20, the first pressure sensor 26, the second pressure sensor 27, and the third pressure sensor 28, the apparatus main body 15 includes a transmission / reception circuit 51, a buffer memory 52, a B-mode processing circuit 53, and a Doppler processing circuit. 54, an image generation circuit 55, an image memory 56, a control circuit 57, and a communication circuit 58.

  The transmission / reception circuit 51 supplies drive signals to the probe units 21, 22, and 23 of the ultrasonic probe 20, and applies A / A to signals received by the probe units 21, 22, and 23 of the ultrasonic probe 20. D conversion processing, addition processing, and the like are performed to obtain an echo signal.

  The buffer memory 52 temporarily stores an echo signal generated for each probe unit 21, 22, 23 of the ultrasonic probe 20 in the transmission / reception circuit 51.

  The B-mode processing circuit 53 reads the echo signals of the probe units 21, 22, and 23 stored in the buffer memory 52, and performs logarithmic amplification and envelope on the read echo signals of the probe units 21, 22, and 23. Detection processing, logarithmic compression, and the like are performed to generate data (hereinafter referred to as B-mode data) in which the signal intensity is expressed by brightness.

  The Doppler processing circuit 54 reads out the echo signal of each probe unit stored in the buffer memory 52, extracts the Doppler shift (Doppler shift frequency) by performing frequency analysis on the read echo signal of each probe unit, and extracts it Using Doppler shift, blood flow and tissue due to Doppler effect, contrast agent echo components are extracted, and moving body information such as average velocity, dispersion, power, etc. is extracted from multiple points or one point (Doppler data) Generate.

  The image generation circuit 55 generates display image data (ultrasound image data) using the data generated by the B-mode processing circuit 53 and the Doppler processing circuit 54. In addition, as an image for display, a B-mode image that represents the intensity of an echo signal generated from B-mode data in luminance, a velocity image that represents blood flow information created from Doppler data, a dispersion image, a power image, or A color Doppler image as a combined image of these can be mentioned.

  The image memory 56 is a memory for storing each image data generated by the image generation circuit 55.

  The control circuit 57 includes a CPU 61, a ROM 62, and a RAM 63. The CPU 61 executes a control program 64 stored in the ROM 62 to drive and control each unit of the apparatus main body 15 and transmit / receive data and signals to / from the CPU 81 included in the display device 16. The ROM 62 stores a control program 64 for driving and controlling the portable ultrasonic diagnostic imaging apparatus 10. The RAM 63 expands the control program 64 when the CPU 61 executes the control program 64 stored in the ROM 62, and temporarily stores operators and data used when the control program 64 is executed.

  The CPU 61 described above executes the functions of the position determination unit (first determination unit) 71 and the pressure determination unit (second determination unit) 72 by executing the control program 64 described above.

  The position determination unit 71 uses the two B-mode image data generated based on the echo signals obtained from the first short-axis probe unit 21 and the second short-axis probe unit 22, in each B-mode image. Find the center of the blood vessel. First, the position determination unit 71 performs template matching on the obtained B-mode image using the reference image indicating the cross section of the blood vessel, and specifies the blood vessel in the B-mode image. Note that the image data that is the basis of the reference image may be stored in the ROM 62 in advance. The position determination unit 71 calculates the coordinates of the specified center position of the blood vessel, and obtains the distance from the center position of the blood vessel to the center of the B-mode image in the x-axis direction. Finally, the position determination unit 71 determines whether or not the obtained distance in the x-axis direction is zero. In each B-mode image, the position determination unit 71 outputs a signal indicating that they match to the display device 16 when the distance from the center position of the blood vessel to the center of the B-mode image is zero. Although template matching is performed as an example of specifying a blood vessel, the present invention is not limited to this, and the position of a blood vessel can be specified using data obtained by the Doppler processing circuit 54.

  The pressure determination unit 72 calculates the pressing force applied to each probe unit 21, 22, 23 from the signals output from the first pressure sensor 26, the second pressure sensor 27, and the third pressure sensor 28. After calculating the pressing force in each of the probe units 21, 22, and 23, the pressure determination unit 72 obtains the average value of the calculated pressing force. The pressure determination unit 72 determines whether or not the reference pressing force value read from the database 88 included in the management terminal 86 matches the calculated average pressing force value. When the read reference pressing force value and the calculated average pressing force value match, the pressure determination unit 72 outputs a signal indicating the matching to the display device 16.

  Here, in the management terminal 86, the reference pressing force indicates a pressing force that does not collapse a blood vessel existing in the target site when the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the target site. Note that the value of the reference pressing force varies depending on, for example, sex, body type, age, measurement site, and the like. Therefore, it is preferable that the value of the reference pressing force is a statistical value of only the subject. In addition, the range of the pressing force that is appropriate as the reference pressing force is obtained in advance by statistics, etc., and it is determined whether or not the average value of the measured pressing force is included in the range of the reference pressing force value. It is also possible to do.

  The communication circuit 58 is a circuit that transmits and receives data and signals between the apparatus main body 15 and the display device 16. In addition, the communication circuit 58 transmits and receives data to and from the management terminal 86 via the network 87.

  The display device 16 includes a display unit 75, a control circuit 76, and a communication circuit 77. The display unit 75 includes, for example, an LCD panel 78 and a touch panel 79. In addition to the LCD panel 78, an organic EL display can be used. The touch panel 79 is disposed on the front surface of the LCD panel 78 and accepts user input operations.

  The control circuit 76 includes a CPU 81, a ROM 82, and a RAM 83. The CPU 81 controls each unit of the display device 16 by executing a display control program 84 stored in the ROM 82. Specifically, the CPU 81 displays a B-mode image obtained from each probe unit 21, 22, 23 of the ultrasonic probe 20 and displays a pressing force. At that time, the CPU 81 superimposes a display of a necessary coordinate system and a display of numerical values and units on each image. Further, notification based on the determination results of the position determination unit 71 and the pressure determination unit 72 is executed using the LCD panel 78 and the speaker 85. In the portable ultrasonic diagnostic imaging apparatus 10, when the display device 16 can be detached from the apparatus main body 15, the display apparatus 15 is connected to the management terminal 86 via the network 87 and has a data ambition. May be transmitted / received.

  The management terminal 86 transmits and receives data and signals to and from the apparatus main body 15 via the network 87. The management terminal 86 has a database 88 in which medical record data and the like are stored, stores the data output from the apparatus main body 15 in the database 88, and manages these data. In addition to storing and managing medical record data in the database 88, the management terminal 86 updates the above-described statistical value of the pressing force based on the medical management data.

  Next, an example of processing when positioning the portable ultrasonic diagnostic imaging apparatus 10 with respect to the blood vessel will be described.

  Step S101 is processing for starting scanning with the ultrasonic probe. The CPU 61 outputs a signal indicating the start of scanning toward the transmission / reception circuit 51. In response to this signal, the transmission / reception circuit 51 supplies a drive signal to each of the probe units 21, 22, and 23 of the ultrasonic probe 20. Thereby, the echo signal of the target location is acquired by each probe part 21,22,23.

  Step S102 is processing for generating B-mode data. The B-mode processing circuit 53 performs logarithmic amplification, envelope detection processing, logarithmic compression, and the like on the echo signal of each probe unit stored in the buffer memory 52 to generate B-mode data.

  Step S103 is processing for generating Doppler data. The Doppler processing circuit 54 performs frequency analysis on the echo signal of each probe unit stored in the buffer memory 52, thereby using the Doppler shift (Doppler shift frequency) and blood flow and tissue due to the Doppler effect using the Doppler shift. Then, Doppler data is generated by extracting the contrast agent echo component.

  Step S104 is processing to generate first to third ultrasonic image data. The image generation circuit 55 uses the B-mode data generated in step S103 and the Doppler data generated in step S104, so that the first to third supercorresponding to the probe units 21, 22, and 23 of the ultrasonic probe 20 are obtained. Sound image data is generated. When the image size of the first to third ultrasonic image data is large, the image generation circuit 55 performs a reduction process so that the image size can be displayed on the display device 16, and the first image size of the original image size. Along with the first to third ultrasonic image data, it is stored in the image memory 56.

  Step S105 is processing to transmit the first to third ultrasonic image data. The CPU 61 reads the first to third ultrasonic image data from the image memory 56 and outputs it to the communication circuit 58 together with the display start signal. In response to this, the communication circuit 58 transmits the display start signal and the first to third ultrasonic image data to the display device 16. When the image size of the first to third ultrasonic image data is large, the CPU 61 reads the first to third ultrasonic image data subjected to the reduction process from the image memory 56 and transmits it to the display device 16. Thereby, in the display device 16, an image (first to third ultrasonic images) based on the received image data is displayed on the display unit 75. Here, the image data transmitted to the display device 16 via the control circuit 57 may be stored in the RAM 82 or may be stored in an image memory (not shown) of the display device 16.

Step S106 is processing for calculating coordinates of the center position of the blood vessel using each of the first and second ultrasonic image data. The CPU 61 performs template matching on the first and second ultrasonic image data to specify the position of the blood vessel, and then calculates the coordinates of the specified center position of the blood vessel.

Step S107 is a process of calculating the deviation amount of the center position of the blood vessel. The CPU 61 calculates the shift amount of the center position of the blood vessel in the x-axis direction from the coordinates of the center position of the blood vessel obtained in step S106 and the coordinates of the center position in the ultrasonic image. The CPU 61 calculates the shift amount using each of the first and second ultrasonic image data.

  Step S108 is processing for determining whether or not the shift amount is 0 in each of the first and second ultrasonic image data. For example, in any one of the first and second ultrasonic image data, when the deviation amount of the center position of the blood vessel does not become zero, the CPU 61 sets the determination process in step S108 to No. In this case, the process returns to step S101.

  On the other hand, in both the image data of the first and second ultrasonic image data, when the deviation amount of the center position of the blood vessel becomes 0, in other words, both the images of the first and second ultrasonic image data, When the center positions of the included blood vessels match, the CPU 61 determines Yes in step S108. In this case, the process proceeds to step S109.

  Step S109 is a process of transmitting a signal indicating that they match. When the determination result in step S108 is Yes, the CPU 61 transmits a signal indicating that they match to the display device 16 via the communication circuit 58. Thereby, the display device 16 notifies that both the images of the first and second ultrasonic image data match the center position of the blood vessel included in both images. This notification includes lighting or blinking a predetermined area on the display unit 75 or reproducing a notification sound from the speaker 85.

  For example, as shown in FIGS. 8A and 8B, when the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the surface of the living body at the target location, the blood vessel 100 present at the target location extends. When the direction and the longitudinal direction of the long-axis probe unit 23 do not match (intersect), the first ultrasonic wave in which the blood vessel 100 is imaged at a position where the cross-sectional shape is elliptical and deviates from the center of the image An image 101 and a second ultrasonic image 102 are displayed on the display screen 110. In FIG. 8B, the alternate long and short dash lines indicated by reference numerals 111 and 112 are lines indicating the centers in the x-axis direction of the first ultrasonic image 101 and the second ultrasonic image 102, respectively. When the second ultrasonic image 102 is displayed on the display screen 110, it is superimposed on these images. In this case, since the direction in which the blood vessel 100 extends intersects with the longitudinal direction of the long-axis probe unit 23, the third ultrasonic image 103 in which the blood vessel 100 whose cross section is a tube ellipse is captured is displayed. It is displayed on the screen 110.

  Further, as shown in FIGS. 9A and 9B, the long-axis probe unit 23 in the portable ultrasonic diagnostic imaging apparatus 10 extends in the longitudinal direction and the direction in which the blood vessel 100 existing at the target location extends. And the center position of the blood vessel 100 may be displaced from the longitudinal center of the first short-axis probe unit 21 and the longitudinal center of the second short-axis probe unit 22. In this case, for example, the first ultrasonic image 101 and the second ultrasonic image 102 obtained by imaging the cross section of the blood vessel 100 are displayed on the display screen 110. The center of the cross section of the blood vessel 100 is shifted from the center in the x-axis direction in each ultrasonic image, but the direction in which the blood vessel 100 extends and the longitudinal direction of the long-axis probe unit 23 are parallel to each other. Accordingly, the third ultrasonic image 103 where the cross section of the blood vessel 100 deviates from the center or the cross section of the blood vessel 100 is not displayed is displayed on the display screen 110. FIG. 9B shows a case where the third ultrasound image 103 in which the cross section of the blood vessel 100 is not displayed is displayed on the display screen 110.

  On the other hand, as shown in FIGS. 10A and 10B, when the portable ultrasonic diagnostic imaging apparatus 10 can be accurately positioned with respect to the blood vessel 100, the blood vessel 100 has a substantially circular shape and its center. Are displayed on the display screen 110. The first ultrasonic image 101 and the second ultrasonic image 102 captured at a position coincident with the center of each ultrasonic image are displayed. In this case, since the direction in which the blood vessel 100 extends and the longitudinal direction of the long axis probe unit 23 are parallel, the third ultrasonic image 103 in which a cross section passing through the center of the blood vessel 100 is reflected is displayed on the display screen 110. The In this state, a notification indicating that the user matches is executed. This notification includes lighting or blinking a predetermined area on the display screen 110 of the display device 16 or reproducing a notification sound from a speaker.

  Then, as shown in FIG. 11A, the puncture needle 36 is punctured into the target blood vessel 100 with the puncture needle 36 adsorbed to the recess 32 and the puncture direction of the puncture needle 36 is regulated. The recess 32 is cut out from the side surface 31 to the bottom surface. Therefore, as shown in FIG. 11B, as soon as the puncture needle 36 is punctured on the surface of the living body, the puncture needle 36 is imaged by the first short axis probe unit 21. Therefore, the first ultrasonic image 101 in which the puncture needle 36 is reflected is displayed on the display screen 110.

  When the puncture needle 36 whose puncture direction is regulated is further punctured, the puncture needle 36 is imaged not only by the first short axis probe unit 21 but also by the long axis probe unit 23. Therefore, as shown in FIG. 11C and FIG. 11D, not only the first ultrasonic image 101. A third ultrasonic image 103 showing how the puncture needle 36 punctures the blood vessel 100 is displayed on the display screen 110.

  Note that the position of the concave portion 32 that guides the puncture needle 36 is a position that is the center in the longitudinal direction of the first short-axis probe section 21, so that the portable ultrasonic diagnostic imaging apparatus 10 can be accurately Therefore, the puncture needle 36 can accurately puncture the blood vessel 100.

  In the case of FIG. 11, the case where the puncture needle 36 is punctured into the living body while the puncture needle 36 is guided in the recess 32 is described. However, the puncture needle 36 is inserted into the living body while the puncture needle 36 is guided in the recess 34. The same applies to puncture.

  When the above-described portable ultrasonic diagnostic imaging apparatus is accurately positioned with respect to the blood vessel 100, the pressing force of the portable ultrasonic diagnostic imaging apparatus 10 is measured and it is determined whether or not the pressing force is appropriate. Is done. Hereinafter, a process related to determination of whether or not the pressing force when the portable ultrasonic diagnostic imaging apparatus 10 is pressed against a living body will be described using the flowchart shown in FIG.

  Note that the processing related to the determination of whether or not the pressing force when the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the living body is appropriate is performed by applying the portable ultrasonic diagnostic apparatus 10 shown in FIG. It is carried out after the processing when positioning with respect to.

  Step S201 is processing for detecting a pressing force. By pressing the portable ultrasonic diagnostic imaging apparatus 10 against the living body, the pressure (pressing force) is measured by the first pressure sensor 26, the second pressure sensor 27, and the third pressure sensor 28, and the measurement signal is output to the CPU 61. The

  Step S202 is processing for calculating an average value of the pressing force. The CPU 61 calculates the first short axis probe unit 21, the second short axis probe unit 22, and the long axis probe unit from the measurement signals output from the first pressure sensor 26, the second pressure sensor 27, and the third pressure sensor 28. The pressing force acting on each of 23 is calculated. And CPU61 calculates | requires the average value of the calculated pressing force.

  Step S203 is processing for reading the reference pressing force. The CPU 61 reads the reference pressing force data from the database 88 of the management terminal 86 via the communication circuit 58.

  Step S204 is processing to determine whether or not the average value of the pressing force matches the value of the reference pressing force. The CPU 61 compares the average value of the pressing force obtained in step S202 with the value of the reference pressing force acquired in step S203. For example, when the average value of the pressing force matches the value of the reference pressing force, the CPU 61 sets the determination result in step S204 to Yes. In this case, the process proceeds to step S205. On the other hand, when the average value of the pressing force does not match the value of the reference pressing force, the CPU 61 sets the determination result in step S204 to No. In this case, the process proceeds to step S206.

  Step S205 is a process of transmitting a signal indicating that the average value of the pressing force and the appropriate pressing force are present. The CPU 61 transmits a signal indicating the average value of the pressing force and the appropriate pressing force to the display device 16 via the communication circuit 58. In response to this, the CPU 81 of the display device 16 displays the value of the pressing force in the area 44 of the display screen 110 in the LCD panel 78. At the same time, the CPU 81 of the display device 16 notifies that the appropriate pressing force is indicated. This notification may include turning on or blinking a predetermined area on the display screen 110 of the LCD panel 78 or reproducing a notification sound from the speaker 85.

  As shown in FIGS. 10A and 10B, when the portable ultrasonic diagnostic imaging apparatus 10 can be accurately positioned with respect to the blood vessel 100, the cross section of the blood vessel 100 is such that the center of the blood vessel 100 is super A first ultrasonic image 101 and a second ultrasonic image 102 appearing at a position that coincides with the center of the sound wave image are displayed on the display screen 110. At the same time, a third ultrasonic image 103 in which a cross section passing through the center of the blood vessel 100 is reflected is displayed.

  As shown in FIG. 10 (b), for example, when the portable ultrasonic diagnostic imaging apparatus 10 is accurately positioned and pressed against the living body with an appropriate pressing force, the first The cross section of the blood vessel 100 in the ultrasonic image 101 and the second ultrasonic image 102 is shown in a substantially circular shape. On the other hand, as shown in FIG. 13, for example, the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the living body with a pressing force equal to or higher than an appropriate pressing force even though the portable ultrasonic diagnostic imaging apparatus is accurately positioned. In this case, the cross section of the blood vessel 100 in the first ultrasonic image 101 and the second ultrasonic image 102 has a substantially elliptical shape or a shape in which the upper part is crushed. In the present invention, when the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the living body with an appropriate pressing force, it is notified that the pressing force is appropriate, so the notification and the display of the pressing force are confirmed. However, the portable ultrasonic diagnostic imaging apparatus 10 can be pressed against the living body, and the portable ultrasonic diagnostic imaging apparatus 10 can be positioned on the blood vessel 100. Therefore, positioning can be performed accurately while pressing the portable ultrasonic diagnostic imaging apparatus 10 against a living body with an appropriate pressing force without the user's skill or experience.

  In the present embodiment, the portable ultrasonic diagnostic imaging apparatus 10 is positioned with respect to the blood vessel 100 in the determination process of whether or not the pressing force when the portable ultrasonic diagnostic imaging apparatus 10 is pressed against the living body is appropriate. However, the process of determining whether or not the pressing force when the portable ultrasonic diagnostic apparatus 10 is pressed against the living body is appropriate is determined by the portable ultrasonic diagnostic apparatus 10. It may be performed simultaneously with the processing for positioning with respect to the blood vessel 100 or may be omitted.

  In the present embodiment, the case where the first short axis probe unit 21, the second short axis probe unit 22, and the long axis probe unit 23 have the ultrasonic probe 20 arranged in an H shape is taken as an example. For example, it is also possible to employ an ultrasonic probe to which a long axis probe unit is further added. In the following, portions having the same configuration as in FIG. As shown in FIG. 14A, the apparatus body 15 'constituting the portable ultrasonic diagnostic imaging apparatus 10' is defined as a gripping part 15a and a storage part 15b '. In addition to the first short axis probe section 21, the second short axis probe section 22, and the first long axis probe section 23 ', the ultrasonic probe 20' stored in the storage section 15b 'is replaced with the second long axis. The probe unit 120 is used. Among these probe parts, the first short axis probe part 21, the second short axis probe part 22, and the first long axis probe part 23 'are arranged in an H shape, and the second long axis probe part 120 is The longitudinal direction of the first long axis probe portion 23 ′ is aligned with the longitudinal direction of the first long axis probe portion 23 ′. Although not shown, when an ultrasonic probe 20 ′ having a single probe portion is provided in the apparatus main body 15 ′, the ultrasonic image obtained by each probe portion is in the insertion direction of the puncture needle. Arrange them in a row. As a result, as in this embodiment, it is possible to confirm over a wide range whether or not the catheter or the like is moving normally within the blood vessel 100.

DESCRIPTION OF SYMBOLS 10, 10 '... Portable ultrasonic diagnostic imaging device, 15, 15' ... Apparatus main body, 15a ... Holding part, 15b, 15b '... Storage part, 16 ... Display apparatus, 20 ... Ultrasonic probe, 21 ... 1st short Axis probe part (first probe part), 22 ... second short axis probe part (second probe part), 23 ... long axis probe part (third probe part), 23 '... first length Axis probe unit, 26 ... first pressure sensor, 27 ... second pressure sensor, 28 ... third pressure sensor, 32, 34 ... recess, 35 ... permanent magnet, 36 ... puncture needle, 71 ... position determination unit (first Determination means), 72 ... Pressure determination section (second determination means), 78 ... LCD panel (first and second notification means), 85 ... Speakers (first and second notification means), 120 ... For the second long axis Probe part

Claims (5)

A first probe unit that acquires a first ultrasonic image showing a first cross section orthogonal to the extending direction of the blood vessel, and a position that is arranged in parallel with the first probe unit and from which the first cross section is obtained Provided between a second probe unit that acquires a second ultrasonic image showing a second cross section orthogonal to the extending direction of the blood vessel at different positions, and between the first probe unit and the second probe unit. And a third probe unit that acquires a third ultrasonic image showing a third cross section along the extending direction of the blood vessel, and the third probe unit is a longitudinal portion of the first probe unit. An ultrasonic probe disposed from the center in the direction to the center in the longitudinal direction of the second probe portion;
A storage unit for the ultrasonic probe is housed, the device body to have a a gripping portion for the user to grip,
A ridge line that slopes downward toward the first probe part at a predetermined angle with respect to a horizontal plane in a direction perpendicular to the longitudinal direction of the first probe part, and at least of the outer surface of the storage part provided at a position the longitudinal center of 且 one first probe portion to the lower portion of the outer surface located in the vicinity of the first probe portion, wherein while supporting the puncture needle for puncturing the blood vessel A recess that regulates the puncture direction of the puncture needle in a direction along the ridgeline;
Of the side surfaces of the gripping portion of the apparatus main body , the ultrasonic probe is attached to a side surface that is continuous with the side surface of the storage portion where the first probe portion is disposed, and is acquired by the first probe portion of the ultrasonic probe. Display means for simultaneously displaying the first ultrasonic image, the second ultrasonic image acquired by the second probe unit, and the third ultrasonic image acquired by the third probe unit ;
Position detecting means for obtaining the central position of the blood vessel in each ultrasonic image for each image using the first ultrasonic image and the second ultrasonic image;
A determination is made as to whether or not the center position in the ultrasound image matches the center position of the blood vessel in the ultrasound image for each of the first ultrasound image and the second ultrasound image. 1 determination means;
Based on the determination result by the first determination means, it is notified that the center position of the blood vessel obtained from each ultrasound image matches the center position in each of the first ultrasound image and the second ultrasound image. First notification means;
A portable ultrasonic diagnostic imaging apparatus comprising: The portable ultrasonic diagnostic imaging apparatus according to claim 1,
Pressure detecting means for detecting pressure acting on the ultrasonic probe,
The portable ultrasonic diagnostic imaging apparatus , wherein the display means displays the pressure when displaying the first ultrasonic image, the second ultrasonic image, and the third ultrasonic image . The portable ultrasonic diagnostic imaging apparatus according to claim 2 ,
Second determination means for determining whether or not the pressure detected by the pressure detection means is a preset pressure;
Second notification means for notifying that the pressure detected by the pressure detection means matches a preset pressure based on the determination result by the second determination means;
Mobile ultrasonic diagnostic imaging apparatus characterized by having a. The portable ultrasonic diagnostic imaging apparatus according to any one of claims 1 to 3,
The apparatus main body has a magnetic body that adsorbs the puncture needle and regulates the puncture direction of the puncture needle in the storage portion and in the vicinity of the concave portion. Diagnostic device. The portable ultrasonic diagnostic imaging apparatus according to any one of claims 1 to 4,
The ultrasonic probe is arranged outside the second probe portion so that the longitudinal direction is the same as the longitudinal direction of the third probe portion, and the blood vessel is located at a position different from the third cross section. A portable ultrasonic diagnostic imaging apparatus further comprising a fourth probe unit that acquires a fourth ultrasonic image showing a fourth cross section along the extending direction of the first ultrasonic wave.

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