JPH07204184A - Method for medical diagnosis and device therefor - Google Patents

Abstract

PURPOSE:To provide a method and device for medical diagnosis capable of surely detecting the motion of a patient during the medical diagnosis and corresponding to the generation of an accident. CONSTITUTION:An examinee 20 is arranged on a diagnosis means 21. The medical diagnosis device which performs the diagnosis on the examinee 20 is arranged in the 1st direction X. It is provided with a 1st optical detecting means 70 detecting the location of the examinee 20, a 2nd optical detecting means 80 arranged on the 2nd direction Y and detecting the location of the examinee 20, and a monitoring means 6 monitoring the location of the examinee based on the signal from the 1st and 2nd optical detecting means 70 and 80.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical diagnostic apparatus such as an X-ray CT apparatus and a medical diagnostic method.

[0002]

2. Description of the Related Art FIG. 6 shows an outline of an X-ray CT apparatus. Since X-rays are harmful to the human body, as shown in FIG.
The operator 120 operates the apparatus from the operation room 104 separated by the scanner gantry 100 and the X-ray protection wall 102.

Normally, the lead glass 1 is provided on the X-ray protective wall 102.
No. 06 is fitted, and the operator 120 directly contacts the patient P.
Can be monitored. Operator 12
A TV camera 114 is installed in the X-ray CT room 116 in order to monitor the back side of the main body 110 of the scanner gantry 100 having a blind spot of 0 or read the facial expression of the patient P lying on his back. An operator 120 monitors using the monitor 118.

The reason why such a monitor is required is that the operator 120 needs to accurately grasp the operation of the patient P. At the time of capturing an X-ray CT image, all types of patients such as anesthetized patients and persons with impaired motor function are captured. While taking an image of such a patient, (1) When the anesthesia is cut off, it suddenly becomes violent. (2) When the motor function is impaired, the body cannot be controlled,
It works greatly during shooting. (3) Seizures and convulsions occur during shooting. It is considered that there is a possibility of causing an accident such as.

In the case of (2), measures such as fixing the patient to the patient table with a belt or the like are taken in advance.
In the case of (1) as well, similar treatment may be taken, but it is considered that the treatment is often not taken because of being anesthetized.

When the above-mentioned accident occurs, (1) reduce unnecessary X-ray exposure (patient, operator, or nurse, etc ...). (2) To prevent the risk of the patient table moving because the X-ray exposure position is shifted during imaging (for example, sandwiching the patient table and the scanner gantry). For the purpose of (1) X-ray exposure stop, (2) Patient table operation stop operation is required.

In the current X-ray CT apparatus, when the above-mentioned accident occurs, it is considered that the operator operates according to the operation flow shown in FIG. As shown in FIG. 7, X-ray irradiation is started (step S1), and the operator visually monitors the patient through the lead glass (step S).
2). If the patient has an abnormality (step S
3), X-ray exposure is stopped (step S6), and the patient table is stopped (step S7). This patient table stop command is issued even when the patient table is not moving.

On the other hand, when there is no abnormality in the patient (step S3), the operator monitors the patient on the monitor (step S4). Then, if there is an abnormality during the monitoring by the monitor (step S5), the X-ray exposure is stopped and the patient table is stopped (steps S6, S).
7). If there is no abnormality (step S5), and if the X-ray irradiation is completed (step S8), the patient table is moved by the amount moved (step S9). When the movement is completed (step S10), the diagnosis work is finished.

[0009]

However, it is considered that the human visual diagnosis method has the following inconveniences. (1) The operator may take his eyes off during shooting. (2) There is a lack of operator concentration (due to fatigue, etc.). (3) There is an unexpected interference (telephone etc.) with the operator. Therefore, when the above-mentioned accident occurs, the process for the medical diagnostic apparatus may not be immediately executed.

Therefore, the present invention has been made in order to solve the above-mentioned problems, and it is possible to reliably detect the movement of a patient during a medical diagnosis, and to surely deal with the occurrence of an accident. An object of the present invention is to provide a medical diagnostic device and a medical diagnostic method.

[0011]

According to the present invention, the above object is arranged in a first direction in a medical diagnostic apparatus for arranging an object to be diagnosed and diagnosing the object. A first optical detecting means for detecting the position of the subject, a second optical detecting means arranged for the second direction for detecting the position of the subject, and the first optical detecting means. And a monitoring unit that monitors the position of the subject based on the signal from the second optical detection unit. In the present invention, preferably, the diagnostic means is an X-ray CT apparatus. Further, in the present invention, preferably the first
The optical detecting means and the second optical detecting means each include a light projecting portion and a light receiving portion, and the first direction is a vertical direction and the second direction is a horizontal direction.

Further, the above object of the present invention is to provide a medical diagnostic method for diagnosing a subject, comprising:
With respect to the second direction, the subject is arranged in the diagnosis means, and the position of the subject with respect to the diagnosis means is arranged with respect to the first direction, and the first optical detection means is arranged to detect the position of the subject. And a second optical detecting means which is arranged to detect the position of the subject, and the medical diagnosis method of monitoring the position of the subject. According to the present invention, preferably, as a result of monitoring the position of the subject, if the movement or movement of the subject changes, the diagnostic operation given to the subject is stopped. Further, in the present invention, preferably, stopping the diagnostic operation includes at least one of stopping X-ray exposure and stopping movement of means on which the subject is placed.

[0013]

According to the above structure, the first optical detecting means detects the position of the subject with respect to the subject, and the second optical detecting means with respect to the subject is different from the position of the subject. The position of the subject is detected from the direction. Then, the position of the subject is monitored based on the signals from the first optical detection means and the second optical detection means, and if necessary, for example, stop of X-ray exposure or the subject is detected. Stop the movement of the means carrying.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT A preferred embodiment of the present invention will be described in detail below with reference to the accompanying drawings. It should be noted that the examples described below are suitable specific examples of the present invention, and therefore, various technically preferable limitations are given, but the scope of the present invention particularly limits the present invention in the following description. Unless otherwise stated, the present invention is not limited to these modes.

FIG. 1 shows a system configuration diagram of an X-ray CT apparatus which is a preferred embodiment of the medical diagnostic apparatus of the present invention. In FIG. 1, the system of the X-ray CT apparatus is roughly configured by a scanner gantry 1, a patient table 2, an X-ray controller 3, an operation console 4, an image processing apparatus 5, a central control computer 6, and other units. .

The scanner gantry 1, the X-ray controller 3, and the operation console 4 have control computers 11, 12, and 14 for controlling them. The scanner gantry control computer 11 controls the mechanism inside the scanner gantry 1 and controls the horizontal movement and the upward movement of the patient table 2. Further, the scanner gantry control computer 11 monitors the input of an operation panel (not shown) installed on the surface of the scanner gantry 1 or the side surface of the patient table 2, and detects position information and height information of the top plate 16 of the patient table 2. Display. The X-ray generator control computer 12
It controls the output of generated X-rays and monitors abnormalities.

Further, the operation console control computer 1
4 is a switch input monitor on the operation console 4, LE
Display by a display device composed of D, for example, display on a 7-segment type output device is performed. In the scanner gantry 1, an X-ray tube 7 and an X-ray detector 8 are arranged so as to face each other, and each is installed on the same rotary plate (not shown).

Before taking the X-ray CT image, the patient table 2
An operator previously moves the subject (patient, living body) placed on the top plate 16 into the opening diameter 1a, which is also called the opening of the scanner gantry 1, and uses the positioning means such as a localizer to fix the subject. Position. Then, the rotating plate on which the X-ray tube 7 and the X-ray detector 8 are mounted rotates around the subject to irradiate X-rays to collect data.

The data from the X-ray detector 8 is sequentially sent to the measurement data buffer 13, the analog signal is converted into a digital signal, pre-processing such as image data compression is performed, and the data is stored. The storage here is performed temporarily, and when the data collection is completed, the stored data (RAW d
data) is transferred to the image processing apparatus 5 through image processing, and an X-ray CT image is formed by reconstruction calculation processing.
At the same time, the image is stored in the external storage device 15.

The operation monitor 9 is for displaying the operating status of the system to the diagnostician or the operator while the central control computer 6 guides and supports the operation to the operator.

Next, a CT image photographing method of this X-ray CT apparatus will be described. In FIG. 1, a diagnostician or an operator previously moves a top plate 16 on which a patient is placed inside the opening diameter 1a of the scanner gantry 1. This time,
The operator finely adjusts the X-ray irradiation area with a line of light marked on the surface of the patient's body. When the positioning is completed, the operator uses the operation console 4 and the operation monitor 9 to select and set X-ray CT image capturing conditions. The imaging conditions differ depending on the imaging region of the patient, and are displayed in advance on the operation console 4 or the operation monitor 9 as preset information. The operator can also change a part of the preset information.

Imaging conditions mainly consist of a plurality of parameters such as X-ray generation conditions (tube voltage, tube current, scan time, etc.) and image reconstruction conditions (number of display matrices, filter shape, magnification, reconstruction calculation area, etc.). It is configured. As soon as the imaging conditions are determined, the central control computer 6 reads out the imaging conditions from the operation console control computer 14, edits the imaging conditions into a predetermined format, and scans the scanner gantry control computer 11 and the X-ray generator control computer. A message is issued to 12 together with the command of “shooting preparation”.

In an X-ray generating apparatus, it takes time for the rotor (target rotating anode) in the X-ray tube to start and rotate at a constant speed. When the rotor rotates at a constant speed, the X-ray generator control computer 12 gives a command "ready for X-ray generator" to the central control computer 6. When the scanner gantry 1 receives the command of “imaging preparation” while the X-ray generator 3 is preparing, the positions of the X-ray tube 7 and the X-ray detector 8 are confirmed. Both have initial positions (X-ray tube at the top, X-ray tube
If the line detectors are not at the bottom, rotate each to its initial position.

When all the units are in the "ready state" and each control computer recognizes this, the central control computer 6 causes the control computers 11, 1 to operate.
An instruction of "X-ray exposure, start of X-ray data acquisition" is given to the Nos. 2 and 14. In addition, the central control computer 6
Gives the image processing apparatus 5 a command of “data acquisition, image preprocessing standby”.

The CT image is captured by the X-ray tube 7 and the X-ray detector 8.
Is performed by rotating around the subject placed inside the opening diameter 1a of the scanner gantry 1. The X-ray irradiation is performed while the X-ray tube 7 and the X-ray detector 8 are rotating 360 °. Therefore, the X-ray tube 7 and the X-ray detector 8 are 360
Rotating at least ° (including rotation during acceleration / deceleration).

The X-ray generation method includes a pulse generation method and a continuous generation method. The former is 1 view (pr) with 1 pulse.
data) and the latter is 1 sa
The data of 1 view is obtained by plumping. The more this view is, the more the amount of information increases,
Although the image quality is improved, an image processing device capable of processing a large amount of data at high speed is required.

Since the data output by the X-ray detector 8 is an analog signal, the measurement data buffer 13
Analog-to-digital conversion is performed at the stage of being transferred to. At the same time, the image data is compressed, image pre-processed, and stored. When the X-ray irradiation is completed and all the data is transferred to the measurement data buffer, the image processing device 5 receives a command of “image reconstruction calculation” from the central control computer 6,
An X-ray CT image is created on the basis of the image reconstruction conditions described above, and at the same time as being displayed on the image monitor 10, the CT image and the Raw data are stored in the external storage device 15 as data.

In the patient table 16, if the message sent from the central control computer 6 in advance contains the patient table feed amount for each measurement for each X-ray CT image. For example, the scanner gantry control computer 11 horizontally moves the patient table every time one measurement is completed.

Referring now to FIG. A subject (patient) 20 is placed on the top plate 16 of the patient table 2. The body of the scanner gantry 1 is shown at 21.
FIG. 2 illustrates that the patient is placed on the top plate 16 and is about to be inserted into the scanner gantry opening diameter 1a. 23 is a main body of the patient table 16.

In FIG. 2, the first optical detecting means 70
And the second optical detection means 80 is connected to the scanner gantry 1
The body of is arranged at 21. That is, the first optical detecting means 70 and the second optical detecting means 80 are arranged around the opening diameter 1a. First optical detection means 7
0 is arranged in the arrow X direction. The second optical detection means 80 is arranged in the arrow Y direction.

The first optical detecting means 70 and the second optical detecting means 80 are preferably optical line sensors. The first optical detecting means 70 has a light emitting section 25 and a light receiving section 26. In addition, the second optical detection means 80
Has a light emitting portion 27 and a light receiving portion 28. Light emitting part 25
The light receiving unit 26 and the light receiving unit 26 are respectively arranged at positions in the vertical direction (X direction) with respect to the patient 20, and the movement of the patient P (arrow Y
It is possible to recognize movement in the direction). Further, the light emitting unit 27 and the light receiving unit 28 are respectively arranged at positions in the left-right direction (Y direction) with respect to the patient 20, and can recognize the movement of the patient P (movement in the arrow X direction).

Reference numeral 29 is an input device for inputting detection information from the light receiving portions 26 and 28. The input device 29 is connected to the scanner gantry control computer 11. The scanner gantry control computer 11 can always read the detection information of the light receiving units 26 and 28.
The central control computer 6 can receive the input information of the line sensor from the scanner gantry control computer 11 by using the communication means 40. The central control computer 6 monitors the position of the subject based on the detection information of the light receiving sections 26 and 28.

The line sensor type first optical detecting means 70 and the second optical detecting means 80 are generally transmission type. This is detected by blocking the optical axes of the light emitting units 25 and 27 and the light receiving units 26 and 28 that face each other as shown in FIG. The features of such a sensor are: (1) The detection distance can be increased. (2) As long as it blocks light, it does not depend on the material, color, or shape of the object to be detected. (3) The detection position accuracy is good. Etc.

Usually, the patient 20 on the patient table 16 is photographed in various forms, such as with or without clothes, and covered with sheets or the like. In the embodiment of the present invention, from such a point, it is possible to accurately monitor the patient in two directions, that is, the vertical direction and the horizontal direction.

3 and 4 show a method of discriminating a patient's motion according to the present invention. In the example of monitoring the movement of the patient shown in FIG. 3 and FIG. 4, the monitoring of the movement of the patient 20 by the first optical detection means 70 is shown as a representative. However, the monitoring of the movement of the patient 20 by the second optical detection means 80 can be performed in the same manner except that the direction is different.

FIG. 3 shows the operating state of the patient obtained at a certain time. The judgment can be determined by the length of the arrow shown on the lower side of FIGS. 3 and 4. That is, FIG.
In this state, the shadow of the patient 20 is the portion indicated by the arrow B. If the patient 20 remains stationary, the length of arrow B is approximately constant. However, if the patient performs an unexpected operation as shown in FIG. 4, the length of the arrow B1 in FIG. 4, for example, becomes B> B1 as compared with the length B in FIG. The central control computer 16 constantly monitors the length of the arrow B and the length of the arrow B1 so that the movement of the patient 20 can be accurately monitored. Also, depending on the software, the amount of deviation in the following equation

[0037]

[Equation 1]

On the other hand, a certain width is provided, which is used as the detection sensitivity.

For example, in FIG. 3, the length of the arrow B in the shaded area is 3.5 when the unit length on the paper surface is 1. Similarly, in FIG. 4, it is 2.5. That is,
3.5-2.5 = 1, and this difference 1 is the amount of deviation caused by the operation. For example, if the deviation amount is 2 or more, the central control computer 6 is made to recognize that an unexpected operation has occurred in the patient 20. This is because it may not be possible for the patient 20 to be completely stationary.

FIG. 5 is a flow chart for executing the medical diagnosis method in the embodiment of the present invention. In FIG. 5, first, preparation for imaging an X-ray CT image is performed (step ST
1).

Next, photographing is started (step ST2), and X
Radiation exposure (step ST3) is started. Data regarding the position of the patient 20 is fetched from the first optical detection means 70 and the second optical detection means 80 shown in FIG. 2 (step ST
4). Then, these data are stored (step ST
5). The central control computer 6 takes in the initial data (step ST6), compares the sensor data (step ST7), and replaces the old and new sensor data as necessary (step ST8) to judge whether or not the patient has operated. (Step ST9).

For example, when the central control computer 6 determines that the patient has operated (step ST9), the diagnostic operation is stopped, for example, the X-ray exposure is stopped (step ST10) according to a command from the central control computer 6, and The operation of the patient table is also stopped (step ST11).
Then, the medical diagnosis operation is ended thereby. On the other hand, when there is no patient motion (step ST9),
When the exposure is completed (step ST12), the patient table is moved (step ST13). When the patient table is moved (step ST14), the medical diagnosis operation is ended.

In this way, when the X-ray exposure is completed and the patient table is completely moved, this data is taken in, and when an unexpected operation occurs in the patient, the X-ray exposure is immediately stopped or the patient table is stopped. Both of them, or at least one of them can be urgently stopped as required. X
Since the loop has a high execution speed from the line exposure to the completion of movement of the patient table, software-like sensor data acquisition is performed in a certain cycle. The reason for this is that the operation speed of the patient is considered to be slower than the speed of the central control computer 6.

As described above, in the embodiment of the present invention, the X-ray CT apparatus is used as an example of the medical diagnostic apparatus. In this X-ray CT apparatus, the X-ray tube and X
A scanner that rotates the line detector, a unit called a scanner gantry including its peripheral mechanism, a patient table for transferring the patient to be imaged inside the opening diameter of the scanner gantry, and an operator instructing the device And a console for giving device information.

During imaging, X-rays are generated from the medical diagnostic apparatus, and X-rays are emitted in all directions due to scattering and diffraction. Since this X-ray is harmful to the human body,
An X-ray CT room where a scanner gantry is usually installed,
The operation room where the operator operates using the console is separated by a protective wall.

In contrast to the conventional patient monitoring method, in the embodiment of the present invention, (1) optical line sensors are installed above and below and to the left and right of the entrance of the opening diameter of the scanner gantry. (2) The input state of the vertical sensor and the horizontal sensor is constantly monitored by the computer of the medical diagnostic apparatus. (3) By detecting changes in the patient's movements during imaging,
Diagnosis operations such as X-ray irradiation stop and patient table movement stop are stopped.

Thus, the X-ray C which is an embodiment of the present invention
The T device has various functions. Further, in the embodiment of the present invention, the movement of the patient can be monitored regardless of the human sense (visual sense, auditory sense, etc.). Further, when an abnormal operation of the patient occurs during imaging, the medical diagnostic device can be immediately stopped (improvement of safety).

The present invention can be applied to an existing X-ray CT apparatus or a new type X-ray CT apparatus in the future. The present invention can be applied to not only the X-ray CT apparatus but also medical diagnostic apparatuses other than the X-ray CT apparatus such as an MRI apparatus and a gamma camera. Since the medical diagnostic apparatus can be stopped immediately, unnecessary X-ray exposure to the patient, operator, etc. can be reduced.

[0049]

As described above, according to the present invention, it is possible to reliably detect the motion of the patient during the medical diagnosis and to surely handle the occurrence of the accident.

[Brief description of drawings]

FIG. 1 is a perspective view showing an X-ray CT apparatus as a preferred embodiment of a medical diagnostic apparatus of the present invention.

FIG. 2 is a diagram showing a scanner gantry, a subject, a first optical detection unit, a second optical detection unit, and the like in the X-ray CT apparatus in FIG.

FIG. 3 is a diagram showing an example of monitoring the movement of a subject by using a first optical detection unit as an example.

FIG. 4 is a diagram showing a state in which the subject moves compared to the state in FIG.

FIG. 5 is a diagram showing an example of an execution flow chart of a medical diagnosis operation in the embodiment of the present invention.

FIG. 6 is a perspective view showing the outline of a conventional X-ray CT apparatus.

FIG. 7 is a diagram showing an execution flowchart of medical diagnosis in a conventional X-ray CT apparatus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Scanner gantry 2 Patient table 3 X-ray control device 6 Central control computer (monitoring means) 7 X-ray tube 8 X-ray detector 16 Top plate of patient table 20 Patient (subject, living body) 21 Main body of scanner gantry (diagnosing means) ) 25,27 Light projecting section 26,28 Light receiving section 70 First optical detecting means 80 Second optical detecting means

Claims (6)

[Claims] 1. A medical diagnostic apparatus for arranging a subject on a diagnostic means to diagnose the subject, wherein the first optical detection is arranged in a first direction and detects the position of the subject. Means, second optical detection means arranged in the second direction for detecting the position of the subject, and based on signals from the first optical detection means and the second optical detection means. And a monitoring unit that monitors the position of the subject. 2. The medical diagnostic apparatus according to claim 1, wherein the diagnostic means is an X-ray CT apparatus. 3. The first optical detection means and the second optical detection means each include a light projecting portion and a light receiving portion, the first direction being a vertical direction, and the second direction. Is the left-right direction, and the medical diagnostic apparatus according to claim 1 or 2. 4. A medical diagnostic method for diagnosing a subject, wherein the subject is arranged in a diagnostic means, and the position of the subject with respect to the diagnostic means is arranged in a first direction. The position of the subject is detected by the first optical detecting means for detecting the position of the subject and the second optical detecting means arranged for the second direction to detect the position of the subject. A medical diagnostic method characterized by monitoring. 5. The diagnostic operation applied to the subject is stopped when the movement or movement of the subject changes as a result of monitoring the position of the subject. The medical diagnostic method described. 6. The medical diagnostic method according to claim 5, wherein the stopping of the diagnostic operation includes at least one of stopping the X-ray exposure and stopping the movement of the means carrying the subject.